• Journal of Preventive Medicine and Public Health
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• v.7 no.1
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• pp.29-94
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• 1974

Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

• MISULJARYO - National Museum of Korea Art Journal
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• v.98
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• pp.226-241
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• 2020

Located on the right side of the third floor of the State Hermitage Museum in St. Petersburg, the "Art of Central Asia" exhibition boasts the world's finest collection of artworks and artifacts from the Silk Road. Every item in the collection has been classified by region, and many of them were collected in the early twentieth century through archaeological surveys led by Russia's Pyotr Kozlov, Mikhail Berezovsky, and Sergey Oldenburg. Some of these artifacts have been presented around the world through special exhibitions held in Germany, France, the United Kingdom, the Netherlands, Korea, Japan, and elsewhere. The fruits of Russia's Silk Road expeditions were also on full display in the 2008 exhibition The Caves of One Thousand Buddhas - Russian Expeditions on the Silk Route on the Occasion of 190 Years of the Asiatic Museum, held at the Hermitage Museum. Published in 2018 by the Shanghai Chinese Classics Publishing House in collaboration with the Hermitage Museum, Kuche Art Relics Collected in Russia introduces the Hermitage's collection of artifacts from the Kuche (or Kucha) region. While the book focuses exclusively on artifacts excavated from the Kuche area, it also includes valuable on-site photos and sketches from the Russian expeditions, thus helping to enhance readers' overall understanding of the characteristics of Kuche art within the Buddhist art of Central Asia. The book was compiled by Dr. Kira Samosyuk, senior curator of the Oriental Department of the Hermitage Museum, who also wrote the main article and the artifact descriptions. Dr. Samosyuk is an internationally renowned scholar of Central Asian Buddhist art, with a particular expertise in the art of Khara-Khoto and Xi-yu. In her article "The Art of the Kuche Buddhist Temples," Dr. Samosyuk provides an overview of Russia's Silk Road expeditions, before introducing the historical development of Kuche in the Buddhist era and the aspects of Buddhism transmitted to Kuche. She describes the murals and clay sculptures in the Buddhist grottoes, giving important details on their themes and issues with estimating their dates, and also explains how the temples operated as places of worship. In conclusion, Dr. Samosyuk argues that the Kuche region, while continuously engaging with various peoples in China and the nomadic world, developed its own independent Buddhist culture incorporating elements of Gandara, Hellenistic, Persian, and Chinese art and culture. Finally, she states that the culture of the Kuche region had a profound influence not only on the Tarim Basin, but also on the Buddhist grottoes of Dunhuang and the central region of China. A considerable portion of Dr. Samosyuk's article addresses efforts to estimate the date of the grottoes in the Kuche region. After citing various scholars' views on the dates of the murals, she argues that the Kizil grottoes likely began prior to the fifth century, which is at least 100 years earlier than most current estimates. This conclusion is reached by comparing the iconography of the armor depicted in the murals with related materials excavated from the surrounding area (such as items of Sogdian art). However, efforts to date the Buddhist grottoes of Kuche must take many factors into consideration, such as the geological characteristics of the caves, the themes and styles of the Buddhist paintings, the types of pigments used, and the clothing, hairstyles, and ornamentation of the depicted figures. Moreover, such interdisciplinary data must be studied within the context of Kuche's relations with nearby cultures. Scientific methods such as radiocarbon dating could also be applied for supplementary materials. The preface of Kuche Art Relics Collected in Russia reveals that the catalog is the first volume covering the Hermitage Museum's collection of Kuche art, and that the next volume in the series will cover a large collection of mural fragments that were taken from Berlin during World War II. For many years, the whereabouts of these mural fragments were unknown to both the public and academia, but after restoration, the fragments were recently re-introduced to the public as part of the museum's permanent exhibition. We look forward to the next publication that focuses on these mural fragments, and also to future catalogs introducing the artifacts of Turpan and Khotan. Currently, fragments of the murals from the Kuche grottoes are scattered among various countries, including Russia, Germany, and Korea. With the publication of this catalog, it seems like an opportune time to publish a comprehensive catalog on the murals of the Kuche region, which represent a compelling mixture of East-West culture that reflects the overall characteristics of the region. A catalog that includes both the remaining murals of the Kizil grottoes and the fragments from different parts of the world could greatly enhance our understanding of the murals' original state. Such a book would hopefully include a more detailed and interdisciplinary discussion of the artifacts and murals, including scientific analyses of the pigments and other materials from the perspective of conservation science. With the ongoing rapid development in western China, the grotto murals are facing a serious crisis related to climate change and overcrowding in the oasis city of Xinjiang. To overcome this challenge, the cultural communities of China and other countries that possess advanced technology for conservation and restoration must begin working together to protect and restore the murals of the Silk Road grottoes. Moreover, centers for conservation science should be established to foster human resources and collect information. Compiling the data of Russian expeditions related to the grottoes of Kuche (among the results of Western archaeological surveys of the Silk Road in the early twentieth century), Kuche Art Relics Collected in Russia represents an important contribution to research on Kuche's Buddhist art and the Silk Road, which will only be enhanced by a future volume introducing the mural fragments from Germany. As the new authoritative source for academic research on the artworks and artifacts of the Kuche region, the book also lays the groundwork for new directions for future studies on the Silk Road. Finally, the book is also quite significant for employing a new editing system that improves its academic clarity and convenience. In conclusion, Dr. Kira Samosyuk, who planned the publication, deserves tremendous praise for taking the research of Silk Road art to new heights.