Saving Lives in Wartime China China Studies
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Saving Lives in Wartime China China Studies Edited by Glen Dudbridge Frank Pieke VOLUME 26 The titles published in this series are listed at brill.com/chs Saving Lives in Wartime China How Medical Reformers Built Modern Healthcare Systems Amid War and Epidemics, 1928–1945 By John R. Watt LEIDEn • BOSTON 2014 Cover illustration: The ABMAC Blood Bank saved combat soldiers in west China in 1944. Source: ABMAC Archive. Library of Congress Cataloging-in-Publication Data Watt, John R. (John Robertson), 1934– Saving lives in wartime China : how medical reformers built modern healthcare systems amid war and epidemics, 1928–1945 / by John R. Watt. pages cm. — (China studies ; volume 26) Includes bibliographical references and index. ISBN 978-90-04-25645-3 (hardback : alk. paper) — ISBN 978-90-04-25646-0 (e-book) 1. Public health—China—History—20th century. 2. Medical care—China—History— 20th century. 3. China—History—20th century. 4. Health care reform—China—History. I. Title. RA527.W38 2013 362.10951—dc23 2013027832 This publication has been typeset in the multilingual “Brill” typeface. With over 5,100 characters covering Latin, IPA, Greek, and Cyrillic, this typeface is especially suitable for use in the humanities. For more information, please see www.brill.com/brill-typeface. ISSN 1570-1344 ISBN 978-90-04-25645-3 (hardback) ISBN 978-90-04-25646-0 (e-book) Copyright 2014 by Koninklijke Brill NV, Leiden, The Netherlands. Koninklijke Brill NV incorporates the imprints Brill, Global Oriental, Hotei Publishing, IDC Publishers and Martinus Nijhoff Publishers. All rights reserved. No part of this publication may be reproduced, translated, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior written permission from the publisher. 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For Anne CONTENTS List of Photographs, Graphs, Maps, and Tables ................................... xi Foreword .......................................................................................................... xv Preface ............................................................................................................... xvii Acknowledgements ....................................................................................... xix List of Abbreviations ..................................................................................... xxi Introduction: Saving Lives in the Context of Disease, Poverty and War ............................................................................................................ 1 Communicable Disease .......................................................................... 4 Superstition ................................................................................................ 6 Patriarchal Oppression ........................................................................... 8 Conduct of Warfare ................................................................................. 9 Disregard for the Peasantry ................................................................... 10 The Argument ........................................................................................... 13 1. Epidemics, Wars and Public Healthcare Advocacy in Republican China, 1911–1928 ...................................................................... 17 Epidemic Disease and Public Healthcare up to 1928 ............... 21 Lack of Scientific Rigor ...................................................................... 26 Government Indifference .................................................................. 27 Injecting Science-based Thinking into Chinese Education and Public Policy ............................................................................ 28 Ill Health and National Weakness ................................................. 30 State Medicine and Gongyi Zhidu .................................................. 31 2. Advances and Setbacks in Nationalist China’s Public Health Management, 1928–1937 .............................................................................. 35 Rise and Fall of the Ministry of Health, 1928–1931 ................... 35 Progress under the National Health Administration, 1931–1937 45 Getting Preventive Health into Rural and Urban Health Agencies ............................................................................................ 50 Nationalist Rural Health Initiatives in Jiangxi Province ......... 57 Nursing, Midwifery and Public Health ......................................... 63 The National Health Administration’s Summary of Public Health Results during the Nanjing Era 1928–1937 ............... 68 Conclusion: How the National Health Administration Made a Difference during the Nanjing Era, 1928–1937 .................. 70 viii contents 3. Red Army Health Services in Jiangxi and on the Long March, 1927–1936 .................................................................................................... 73 Creating Healthcare under the Stress of Civil War, 1927–1930 74 Healthcare during the First Two Encirclement and Suppression Campaigns, 1930–1931 .......................................... 82 Advancement of Healthcare during the Third Encirclement and Suppression Campaign, July to September 1931 .......... 86 Expanding the Scope of Healthcare: Red Army Healthcare School and Medical Supply Workshops .................................. 89 Campaign against Epidemic Disease ............................................. 94 The Fourth and Fifth Encirclement and Suppression Campaigns, June 1932 to October 1934 ................................... 98 Health Care during the Long March from Jiangxi to Northwest China ............................................................................. 104 Arrival of Red Army Forces in Northern Shaanxi and Revival of the United Front ........................................................................ 110 Summary ................................................................................................ 113 4. Japanese Invasion, Army Medicine, and the Chinese Red Cross Medical Relief Corps (CRCMRC), 1937–1942 ....................... 115 Part I: Constructing a Modern Military Healthcare System ... 116 Army Medical Services up to 1937 ............................................ 116 Army Healthcare Units in Wartime: The Early Phase ........ 117 The Chinese Red Cross and War Relief ................................... 121 Lin Kesheng and the Chinese Red Cross Medical Relief Corps ............................................................................................. 123 Organization of Emergency Medical Service Training School (EMSTS) .......................................................................... 127 Growth of Medical Relief Corps Work, 1938–1940 .............. 129 Part II: Politics Prevail over Healthcare ....................................... 137 Reorganization of Chinese Red Cross Headquarters and Downgrading of Lin Kesheng ................................................ 137 Lin’s Ambitions for the EMSTS and the MRC ....................... 140 Problems in Army Medical Management ............................... 144 Lin’s Move to Convert EMSTS and MRC into Centers of Modern Medicine ...................................................................... 146 Political Troubles Assail Dr. Lin ................................................ 147 Fights over Control of Assets, Lin in Burma and India, and Lin’s Resignation from the MRC .................................. 151 Conclusion: Outcomes in the Balance ..................................... 157 contents ix 5. How Rigidity, Disease and Hunger Undermined Nationalist China’s Military Medical Reformers ................................................... 159 Eclipse of Lin Kesheng and the MRC ............................................ 160 EMSTS, X Force and US Medical Services of Supply: How Lin’s Organizations Continued His Work ..................... 168 EMSTS, Y Force, and the ABMAC Blood Bank ........................... 170 EMSTS Work in Central China ........................................................ 173 Campaign Ichigo, Refugee Crisis, and Disease ........................... 177 Z Force and American Medical Aid .............................................. 181 The Alpha Plan Triggers Changes in Military Medical Policy, and Lin Kesheng Returns to Office ........................................... 182 Effects of the Alpha Plan on Nationalist Army Medical Field Commands ........................................................................................ 188 Food, the Key to Military Health and Performance ................. 189 Lin Aids in Upgrading China’s Medical Services of Supply (SOS) .................................................................................... 193 Unsolved Problems of Army Conscription .................................. 194 1945: