Authors
Changhoon Shin
Published in
Ui sahak. Volume 35. Issue 2. Pages 539-574.
Abstract
The term muui (doctorless) refers to a state of absolute deprivation of medical care. In modern Korean history, chronic shortages and regional disparities of medical resources resulted in the widespread existence of muuichon (doctorless village). In response, the Ministry of Health and Social Affairs implemented a series of policies and initiatives, including the establishment of a public health center system and the mobilization of public doctors. Yet the very term muuichon also suggested that the problem of public health was inseparable from that of space. Above all, there was a distinct spatial hierarchy of medical accessibility, extending from the capital, Seoul, to major cities, smaller cities, rural villages, and, finally, to remote mountainous and island regions. Among these areas, the islands along the western and southern coast faced significant geographical obstacles, making even minimal access to medical services exceedingly difficult. Hospital ships emerged as a historical product of this intertwined medical-spatial context. By the mid-1960s, as the public doctor mobilization program came to an end, local health authorities and private medical institutions in island regions devised a plan to construct specialized ships equipped with medical facilities and dispatch them to circulate among muuido (doctorless island). Consequently, Korea's first hospital ships, Gyeonggi and Badaui Byeol, began operations and helped fill the gap left by the absence of medical institutions in island regions. In doing so, they moved beyond conventional approaches tied to fixed administrative boundaries and pioneered a healthcare delivery system adaptable to the region's distinctive spatial characteristics. Moreover, this system demonstrated its effectiveness by requiring relatively modest expenditures while extending medical services to islands throughout the region. During the 1970s, the central government also came to recognize the advantages of this system and sought to institutionalize mobile medical services aboard hospital ships. In the mid-to-late 1970s, in particular, President Park Chung Hee spearheaded the construction of numerous hospital ships, thereby establishing the material foundation for the system. In 1978, the island regions along the western and southern coasts were reorganized into nine medical service districts, each assigned one or two hospital ships under the newly established Hospital Ship Medical Service District System. As a result, the system followed a reversed trajectory in which an initiative first pioneered at the local level was subsequently integrated into and institutionalized at the national level. This process exemplifies a dimension of dynamism in South Korean medical administration that cannot be fully captured through a state-centered perspective or adequately explained by structural accounts based solely on budgets or fiscal considerations. Yet, in the final phase of institutionalization, President Park Chung Hee intervened directly to bring the matter to a definitive conclusion, thereby also reinforcing the image of his rule as benevolent.
PMID:
42823808
Bibliographic data and abstract were imported from PubMed on 02 Oct 2026.
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