• 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.96
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• pp.54-88
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• 2019

The Album of Complete Views of Seas and Mountains comprises sixty real scenery landscape paintings depicting Geumgangsan Mountain, the Haegeumgang River, and the eight scenic views of Gwandong regions, as well as fifty-one pieces of writing. It is a rare example in terms of its size and painting style. The paintings in this album, which are densely packed with natural features, follow the painting style of the Southern School yet employ crude and unconventional elements. In them, stones on the mountains are depicted both geometrically and three-dimensionally. Since 1973, parts of this album have been published in some exhibition catalogues. The entire album was opened to the public at the special exhibition "Through the Eyes of Joseon Painters: Real Scenery Landscapes of Korea" held at the National Museum of Korea in 2019. The Album of Complete Views of Seas and Mountains was attributed to Kim Eung-hwan (1742-1789) due to the signature on the final leaf of the album and the seal reading "Bokheon(painter's penname)" on the currently missing album leaf of Chilbodae Peaks. However, there is a strong possibility that this signature and seal may have been added later. This paper intends to reexamine the creator of this album based on a variety of related factors. In order to understand the production background of Album of Complete Views of Seas and Mountains, I investigated the eighteenth-century tradition of drawing scenic spots while travelling in which scenery of was depicted during private travels or official excursions. Jeong Seon(1676-1759), Sim Sa-jeong(1707-1769), Kim Yun-gyeom(1711-1775), Choe Buk(1712-after 1786), and Kang Se-hwang(1713-1791) all went on a journey to Geumgangsan Mountain, the most famous travel destination in the late Joseon period, and created paintings of the mountain, including Album of Pungak Mountain in the Sinmyo Year(1711) by Jeong Seon. These painters presented their versions of the traditional scenic spots of Inner Geumgangsan and newly depicted vistas they discovered for themselves. To commemorate their private visits, they produced paintings for their fellow travelers or sponsors in an album format that could include several scenes. While the production of paintings of private travels to Geumgangsan Mountain increased, King Jeongjo(r. 1776-1800) ordered Kim Eung-hwan and Kim Hong-do, court painters at the Dohwaseo(Royal Bureau of Painting), to paint scenic spots in the nine counties of the Yeongdong region and around Geumgangsan Mountain. King Jeongjo selected these two as the painters for the official excursion taking into account their relationship, their administrative experience as regional officials, and their distinct painting styles. Starting in the reign of King Yeongjo(r. 1724-1776), Kim Eung-hwan and Kim Hong-do served as court painters at the Dohwaseo, maintained a close relationship as a senior and a junior and as colleagues, and served as chalbang(chief in large of post stations) in the Yeongnam region. While Kim Hong-do was proficient at applying soft and delicate brushstrokes, Kim Eung-hwan was skilled at depicting the beauty of robust and luxuriant landscapes. Both painters produced about 100 scenes of original drawings over fifty days of the official excursion. Based on these original drawings, they created around seventy album leaves or handscrolls. Their paintings enriched the tradition of depicting scenic spots, particularly Outer Inner Geumgang and the eight scenic views of Gwandong around Geumgangsan Mountain during private journeys in the eighteenth century. Moreover, they newly discovered places of scenic beauty in the Outer Geungang and Yeongdong regions, establishing them as new painting themes. The Album of Complete Views of Seas and Mountains consists of four volumes. The volumes I, II include twenty-nine paintings of Inner Geumgangsan; the volume III, seventeen scenes of Outer Geumgangsan; and the volume IV, fourteen images of Maritime Geumgangsan and the eight scenic views of Gwandong. These paintings produced on silk show crowded compositions, geometrical depictions of the stones and the mountains, and distinct presentation of the rocky peaks of Geumgangsan Mountain using white and grayish-blue pigments. This album reflects the Joseon painting style of the mid- and late eighteenth century, integrating influences from Jeong Seon, Kang Se-hwang, Sim Sa-jeong, Jeong Chung-yeop(1725-after 1800), and Kim Hong-do. In particular, some paintings in the album show similarities to Kim Hong-do's Album of Famous Mountains in Korea in terms of its compositions and painterly motifs. However, "Yeongrangho Lake," "Haesanjeong Pavilion," and "Wolsongjeong Pavilion" in Kim Eung-hwan's album differ from in the version by Kim Hong-do. Thus, Kim Eung-hwan was influenced by Kim Hong-do, but produced his own distinctive album. The Album of Complete Views of Seas and Mountains includes scenery of "Jaundam Pool," "Baegundae Peak," "Viewing Birobong Peak at Anmunjeom groove," and "Baekjeongbong Peak," all of which are not depicted in other albums. In his version, Kim Eung-hwan portrayed the characteristics of the natural features in each scenic spot in a detailed and refreshing manner. Moreover, he illustrated stones on the mountains using geometric shapes and added a sense of three-dimensionality using lines and planes. Based on the painting traditions of the Southern School, he established his own characteristics. He also turned natural features into triangular or rectangular chunks. All sixty paintings in this album appear rough and unconventional, but maintain their internal consistency. Each of the fifty-one writings included in the Album of Complete Views of Seas and Mountains is followed by a painting of a scenic spot. It explains the depicted landscape, thus helping viewers to understand and appreciate the painting. Intimately linked to each painting, the related text notes information on traveling from one scenic spot to the next, the origins of the place names, geographic features, and other related information. Such encyclopedic documentation began in the early nineteenth century and was common in painting albums of Geumgangsan Mountain in the mid- nineteenth century. The text following the painting of Baekhwaam Hermitage in the Album of Complete Views of Seas and Mountains documents the reconstruction of the Baekhwaam Hermitage in 1845, which provides crucial evidence for dating the text. Therefore, the owner of the Album of Complete Views of Seas and Mountains might have written the texts or asked someone else to transcribe them in the mid- or late nineteenth century. In this paper, I have inferred the producer of the Album of Complete Views of Seas and Mountains to be Kim Eung-hwan based on the painting style and the tradition of drawing scenic spots during official trips. Moreover, its affinity with the Handscroll of Pungak Mountain created by Kim Ha-jong(1793-after 1878) after 1865 is another decisive factor in attributing the album to Kim Eung-hwan. In contrast to the Album of Famous Mountains in Korea by Kim Hong-do, the Album of Complete Views of Seas and Mountains exerted only a minor influence on other painters. The Handscroll of Pungak Mountain by Kim Ha-jong is the sole example that employs the subject matter from the Album of Complete Views of Seas and Mountains and follows its painting style. In the Handscroll of Pungak Mountain, Kim Ha-jong demonstrated a painting style completely different from that in the Album of Seas and Mountains that he produced fifty years prior in 1816 for Yi Gwang-mun, the magistrate of Chuncheon. He emphasized the idea of "scholar thoughts" by following the compositions, painterly elements, and depictions of figures in the painting manual style from Kim Eung-hwan's Album of Complete Views of Seas and Mountains. Kim Ha-jong, a member of the Gaeseong Kim clan and the eldest grandson of Kim Eung-hwan, is presumed to have appreciated the paintings depicted in the nature of Album of Complete Views of Seas and Mountains, which had been passed down within the family, and newly transformed them. Furthermore, the contents and narrative styles of Yi Yu-won's writings attached to the paintings in the Handscroll of Pungak Mountain are similar to those of the fifty-one writings in Kim Eunghwan's album. This suggests a possible influence of the inscriptions in Kim Eung-hwan's album or the original texts from which these inscriptions were quoted upon the writings in Kim Ha-jong's handscroll. However, a closer examination will be needed to determine the order of the transcription of the writings. The Album of Complete View of Seas and Mountains differs from Kim Hong-do's paintings of his official trips and other painting albums he influenced. This album is a siginificant artwork in that it broadens the understanding of the art world of Kim Eung-hwan and illustrates another layer of real scenery landscape paintings in the late eighteenth century.