• Journal of Preventive Medicine and Public Health
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• 제7권1호
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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.

• 복식
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• 제4권
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• pp.87-114
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• 1981

A costume reveals the social characteristics of the era in which it is worn, thus we can say that the history of change of the costume is the history of change of the living culture of the era. Since the Three States era, the costume structure of this country had been affected by the costume system of the China's historical dynasties in the form of the grant therefrom because of geographical conditions, which affection was conspicuous for the bureaucrat class, particularly including but not limited to the Kings' familities. Such a grant of the costume for the bureaucrat class (i.e., official uniform) was first given by the Dang-dynasty at the age of Queen Jinduck, the 28th of the Shilla-dynasty. Since then, the costume for the bureaucrats had consecutively been affected as the ages had gone from the unified Shilla, to the Koryo and to the Yi-dynasty. As the full costumes officially used by government officials (generally called "Baek Gwan") in the Yidynasty, there existed Jo-bok, Gong-bok and Sang-bok. Of such official costumes, Gong-bok was worn at the time of conducting official affairs of the dynasty, making a respectful visit for the expression of thanks or meeting diplomatic missions of foreign countries. It appears no study was made yet with regard to the Gong-bok while the studies on the Jo-bok and the Sangbok were made. Therefore, this article is, by rendering a study and research on the styles of costumes of civil servants' stone images erected at the Kings' tombs of the Yi-dynasty, to help the persons concerned understand the Gong-bok, one of the official costume for Baek Kwan of that age and further purports to specifically identify the styles and changes of the Gong-bok, worn by Baek Gwan during the Yi-dynasty, consisting of the Bok-doo (a hat, four angled and two storied with flat top), Po (gown), Dae (belt), and Hol (small and thin plate which was officially held by the government officials in hand, showing the courtesy to and writing brief memorandums before the King) and Hwa (shoes). For that purpose, I investigated by actually visiting the tombs of the Kings of the Yi-dynasty including the Geonwon-neung, the tomb of the first King Tae-jo and the You-neung, the tomb of the 27th King Soon-jong as well as the tombs of the lawful wives and concubines of various Kings, totalling 29 tombs and made reference to relevant books and records. Pursuant. to this study, of the 29 Kings' tombs the costume styles of civil servants' stone images erected at the 26 Kings' tombs are those of Gong-bok for Baek-gwan of the Yi-dynasty wearing Bok-doo as a hat and Ban-ryeong or Dan-ryenog Po as a gown with Dae, holding Hol in hand and wearing shoes. Other than those of the 26 tombs, the costume styles of the Ryu-neung, the tomb of the Moon-jo who was the first son of 23rd King Soon-jo and given the King's title after he died and of the You-neung, the tomb of the 27th King Soon-jong are those of Jobok with Yang-gwan (a sort of hat having stripes erected, which is different from the Bok-doo), and that of the Hong-neung, the tomb of the 26th King Go-jong shows an exceptional one wearing Yang-gwan and Ban-ryeong Po ; these costume styles other than Gongbok remain as the subject for further study. Gong-bok which is the costume style of civil servants' stone images of most of the Kings' tombs had not been changed in its basic structure for about 500 years of the Yi-dynasty and Koryo categorized by the class of officials pursuant to the color of Po and materials of Dae and Hol. Summary of this costume style follows: (1) Gwan-mo (hat). The Gwan-mo style of civil servants' stone images of the 26 Kings' tombs, other than Ryu-neung, Hong-neung and You-neung which have Yang-gwan, out of the 29 Kings' tombs of the Yi-dynasty reveals the Bok-doo with four angled top, having fore-part and back-part divided. Back part of the Bok-doo is double the fore-part in height. The expression of the Gak (wings of the Bokdoo) varies: the Gyo-gak Bok-doo in that the Gaks, roundly arisen to the direction of the top, are clossed each other (tombs of the Kings Tae-jong), the downward style Jeon-gak Bok-doo in that soft Gaks are hanged on the shoulders (tombs of the Kings Joong-jong and Seong-jong) and another types of Jeon-gak Bok-doo having Gaks which arearisen steeply or roundly to the direction of top and the end of which are treated in a rounded or straight line form. At the lower edge one protrusive line distinctly reveals. Exceptionally, there reveals 11 Yang-gwan (gwan having 11 stripes erected) at the Ryu-neung of the King Moon-jo, 9 Yang-gwan at the Hong-neung of the King Go-jong and 11 Yang-gwan at the You-neung of the King Soon-jong; noting that the Yang-gwan of Baek Kwan, granted by the Myeong-dynasty of the China during the Yi-dynasty, was in the shape of 5 Yang-gwan for the first Poom (class) based on the principle of "Yideung Chaegang" (gradual degrading for secondary level), the above-mentioned Yang-gwans are very contrary to the principle and I do not touch such issue in this study, leaving for further study. (2) Po (gown). (a) Git (collar). Collar style of Po was the Ban-ryeong (round collar) having small neck-line in the early stage and was changed to the Dan-ryeong (round collar having deep neck-line) in the middle of the: dynasty. In the Dan-ryeong style of the middle era (shown at the tomb of the King Young-jo); a, thin line such as bias is shown around the internal side edge and the width of collar became wide a little. It is particularly noted that the Ryu-neung established in the middle stage and the You-neung in the later stage show civil servants in Jo-bok with the the Jikryeong (straight collar) Po and in case of the Hong-neung, the Hong-neung, the tomb of the King Go-jong, civil servants, although they wear Yang-gwan, are in the Ban-ryeong Po with Hoo-soo (back embroidery) and Dae and wear shoes as used in the Jo-bok style. As I could not make clear the theoretical basis of why the civil servants' costume styles revealed, at these tombs of the Kings are different from those of other tombs, I left this issue for further study. It is also noted that all the civil servants' stone images show the shape of triangled collar which is revealed over the Godae-git of Po. This triangled collar, I believe, would be the collar of the Cheomri which was worn in the middle of the Po and the underwear, (b) Sleeve. The sleeve was in the Gwan-soo (wide sleeve) style. having the width of over 100 centimeter from the early stage to the later stage arid in the Doo-ri sleeve style having the edge slightly rounded and we can recognize that it was the long sleeve in view of block fold shaped protrusive line, expressed on the arms. At the age of the King Young-jo, the sleeve-end became slightly narrow and as a result, the lower line of the sleeve were shaped curved. We can see another shape of narrow sleeve inside the wide sleeve-end, which should be the sleeve of the Cheom-ri worn under the Gong-bok. (c) Moo. The Moo revealed on the Po of civil servants' stone images at the age of the King Sook-jong' coming to the middle era. Initially the top of the Moo was expressed flat but the Moo was gradually changed to the triangled shape with the acute top. In certain cases, top or lower part of the Moo are not reveald because of wear and tear. (d) Yeomim. Yeomim (folding) of the Po was first expressed on civil servants' stone images of the Won-neung, the tomb of the King Young-jo and we can seemore delicate expression of the Yeomim and Goreum (stripe folding and fixing the lapel of the Po) at the tomb of the Jeongseong-wanghoo, the wife of the King Young-jo, At the age of the King Soon-jo, we can see the shape of Goreum similar to a string rather than the Goreum and the upper part of the Goreum which fixes Yeomim was expressed on the right sleeve. (3) Dae. Dae fixed on the Po was placed half of the length of Po from the shoulders in the early stage. Thereafter, at the age of the King Hyeon-jong it was shown on the slightly upper part. placed around one third of the length of Po. With regard to the design of Dae, all the civil servants' stone images of the Kings' tombs other than those of the Geonwon-neung of the King Tae-jo show single or double protrusive line expressed at the edge of Dae and in the middle of such lines, cloud pattern, dangcho (a grass) pattern, chrysanthemum pattern or other various types of flowery patterns were designed. Remaining portion of the waist Dae was hanged up on the back, which was initially expressed as directed from the left to the right but thereafter expressed. without orderly fashion,. to the direction of the left from the right and vice versa, Dae was in the shape of Yaja Dae. In this regard, an issue of when or where such a disorderly fashion of the direction of the remaining portion of waist Dae was originated is also presented to be clarified. In case of the Ryuneung, Hong-neung and You-neung which have civil servants' stone images wearing exceptional costume (Jo-bok), waist Dae of the Ryu-neung and Hong-neung are designed in the mixture of dual cranes pattern, cosecutive beaded pattern and chrvsenthemum pattern and that of You-neung is designed in cloud pattern. (4) Hol. Although materials of the Hol held in hand of civil servants' stone images are not identifiable, those should be the ivory Hol as all the Baek Gwan's erected as stone images should be high class officials. In the styles, no significant changes were found, however the Hol's expressed on civil servants' stone images of the Yi-dynasty were shaped in round top and angled bottom or round top and bottom. Parcicularly, at the age of the King Young-jo the Hol was expressed in the peculiar type with four angles all cut off. (5) Hwa (shoes). As the shoes expressed on civil servants' stone images are covered with the lower edges of the Po, the styles thereof are not exactly identifiable. However, reading the statement "black leather shoes for the first class (1 Poom) to ninth class (9 Poom)," recorded in the Gyeongkook Daejon, we can believe that the shoes were worn. As the age went on, the front tips of the shoes were soared and particularly, at the Hong-neung of the King Go-jong the shoes were obviously expressed with modern sense as the country were civilized.