행정부 이전이란 비상카드를 꺼낼 정도로 국토불균형이 심각하다고 보는 참여정부의 인식에는 절대 공감한다. 하지만 수도 이전은 단지 균형개발 이유만으로 추진하기에는 구실이 약하다. 경제 사회적 상황 못지 않게. 아니 훨씬 더 중요하게 국내외 정치상황과 직결된 것이 수도의 입지요 이전이기 때문이다. 1970년대 중반, 3공이 수립했던 '임시' 행정수도안은 안보가 절대 이유였다. 그때 김대중 야당지도자는 휴전선에서 멀리 안전거리를 확보하려함은 군사적 고려일 뿐, 백성들의 호국의지를 더 무게 있게 감안한다면 대치 현장에 바싹 붙여 수도를 유지함이 옳다 했다. 실제로 독립 파키스탄은 수도를 카라치에서 인도와 영토분쟁중인 카슈미르 인근 이슬라마바드로 옮겼다. 이번 행정수도발상에서 핵구름이 짙게 드리워진 급박한 한반도 정세에 대한 고려가 일체 없음은 유감이다. 개인도 건강이 있고 나서야 꿈을 들을 수 있듯이. 나라 또한 안보가 확실해야만 비로소 국토균형개발도 추진할 수 있다. 현대도시이론에 따르면 국가운명은 대도시가 변수라 했다. 방위가 소홀한 수도는 나라를 결딴내는 인질이 될 염려가 있다는 말이다. 이 말대로 북한이 아직 버리지 않은 무력 적화통일전략의 주 공격대상은 단연 서울이다. 때문에 우리 국체를 지키자면 서울을 북한의 인질이 되는 상황을 막는 방패로 삼아야 마땅하다. 주한미군 주력이 서울 북방에 자리잡은 것도 대한민국 안보를 위해서는 서울 사수가 절대적이란 판단에 근거한다. 그 사이. 입장은 다를지언정 같은 민족이 두 국가로 나눠져 있음이 '비정상'임을 남북한이 다함께 인정한다. 예측 불가사항인 통일은 뜻밖에 빠를 수도 있다는 말이다. 통일의 그 날이 수도이전의 적기일 것이다. 제대로 만들자면 최소한 20년은 걸릴 일인데 졸속으로 수도를 이곳저곳으로 끌고 다닐 수 없지 않은가. 자유민주가 확보되는 통일의 그 날이면 브라질이나 호주처럼 새 국운의 장소 상징을 만들자는 국민적 합의는 자연스럽게 생겨날 것이다. 안보가 문제될 게 없다해도 정부발상은 국토균형발전에 별로 기여할 것 같지 않다. 새 입지로 점찍은 충청권은 수도권 인접효과를 가장 많이 누려온 선택된 곳이지 격차해소 대상인 푸대접 또는 무대접 지역이 아니다. 이 시점에서 안보와 균형개발을 동시에 지향하면서 멀리 통일이후도 고려한 후보지를 굳이 찾는다면 한반도의 중심성도 있는 휴전선 근접 철원 일대가 그럴싸하다. 남북대치의 현 상황을 깊이 유념한 끝에 통일의 그 날까지 천도를 미룬다해도 균형발전 실현의 지름길은 분명 있다. 그건 중앙부처의 지리적 분산이 아니라 중앙권력의 지방분권이다. 아니할 말로 수도란 상징 장소를 새로 만들 여유 돈이 있다면, 이를테면 그냥 마시기를 기피하는 전국 수돗물 수질을 높이고. 적자에 허덕인 끝에 대형 참사도 낳았던 지방 대도시 지하철을 돕는 것이 옳다. 그리고 천도는 통일의 천기(天機)에 맞추는 것이 옳다.
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.