I’ve been thinking again about the broader issue of beginning to approach the South Korean post-colonial state and post-1945 medicine, recognizing the immense problems that this presents.

Even leaving aside lengthy traditons of shamans and religious healers of varying persuasions, if we restrict medicine to two loose clusters–한의학 and biomedicine–then minimally this leaves us with the need to consider at least some of the following:

a) W. Medicine as brought / conveyed by misssionaries;

b) German academic medicine / biosciences of the mid to late 19th century (esp. maybe Virchow?);

c) German academic tradition as conveyed through colonial Japanese medicine, public health, and parasitology (Meiji, Taisho, and Showa);

d) USAMGIK / 미군정 (especially the CATS lectures prepared by Winslow); also here–pre-Korean War visits by Rockefeller in the form of prominent American demographers / social scientists–among them Taeuber, Notestein, Balfour;

e) military medicine and psychiatry (here meaning the ROKA and its own internal public health practice, starts even prior to independence, allegedly);

f) Korean War era aid / efforts–UNKRA, WHO report, NORMASH, MASH, Jutlandia, etc.;

g) post Korean-War medical relief / aid projects / technical assistance: e.g., Minnesota Project, Scandinavian Teaching Hospital, CMB, AKF, KAVA, etc.;

h) Public health efforts tailored to specific endemic diseases;

i) Public health mobilizations of the Park period (FP, KAHP), including assistance from Japan’s OTCA, SIDA, and various university demography centers;

j) Vietnam War and once again ROKA military medicine (esp. 열대의학);

k) The incremental growth / provision of national health insurance (1963-1989).

This is only a partial list, but and within this diversity I have two basic generalizations:

1) Lots of continuity / overlap with previous forms of Japanese practice, especially in public health terms, that is, the large-scale mobilizations of 1960′s and 1970′s (FP, Anti-Parasite eradication).

2) Immense effort to link personal health to national welfare as related themes, especially with international aid in post-Korean War period, but even into the 70′s and 80′s.

More on this later, and for now, just recognizing the immense complexity of one little slice of time on these issues. I don’t work on the colonial period, but I suspect it’s equally complicated on issues of medicine / health, far more complicated than some would have it.

Just a quick note, even as the Japan situation continues to unfold, to recall that (1) the current ROK government wants to prioritize nuclear exports in the coming years; and that (2) the domestic industry provides a significant portion of the nation’s energy (28 plants either in operation or under construction).

At this point, it would be unfair to make any sweeping generalizations or loose analogies with the Fukushima site, but it is not unfair to recognize similar types of actors (General Electric) and contractors dating to the late 1970′s, in roughly the same part of the world, and to ask some hard questions about those plants and their lifespans.

More on this later, but I have been surprised (although I suppose I should not be) about the press coverage from Japan, much of which has focused on TEPCO, and very little of it looking at the reactor origins and hardware.

Thanks to Adam at Mutantfrog for pointing me to these North Korean Propoganda posters. I think this is my favorite but the whole group is worth a look.

Seungsook Moon at Japan Focus has an interesting historiographical essay about the contested life and legacy of Park Chung Hee, who led Korea through the 60s and 70s. The debate is particularly interesting because it parallels discourses which are ongoing in other post-dictatorial societies, including the debates about Stalin in Russia, Mao and Deng in China, Chiang Kaishek in Taiwan, etc. The history itself is fascinating, though I do wish Moon had spent a little more effort mediating some of the factual basis for the competing narratives.

I remember the shocked look on my students’ faces fifteen years ago when I told them that we actually had no idea how decisions were made or leaders picked in North Korea, that it was more or less still a “black box.” I find it fascinating that we’re starting to get a better public picture of the internal processes of North Korea.

One of the reasons is the steady stream of refugees. In the Financial Times, Matthew Engel reports on a Korean enclave in the SW London suburb of New Malden. The relatively closed and self-reliant society is mostly middle-class, “bourgeois,” but among “the beginnings of an underclass” are North Koreans. I get the impression from the article that many of them are illegal immigrants, and their “underclass” status comes both from their lack of professional skills and their desire to remain outside of official notice.

Mitchell Lerner, at Ohio State University, believes that he’s found the key to understanding the Kim dynasty of North Korea: juche. And when “self-reliance” is slipping, domestically, they bluster internationally to bolster their credentials as strong and independent leaders. It’s counterintuitive: when they need help the most, they can’t get it. But their legitimacy as rulers is based on juche. He writes

In the political realm, it called for chaju (independence), in which North Korean leaders governed without constraint from outside pressure or internal challenge. Economically, juche called for charip (self-sustenance), which required a largely self-contained economy based on domestic workers using domestic resources to satisfy domestic needs. In international relations, juche advocated chawi (self-defense), a foreign policy based on complete equality and mutual respect between nations as well as the right of self-determination and independent policymaking.

Juche, simply, demanded the people subordinate themselves to the state, and the state in turn would advance their collective interests in accordance with the uniqueness and majesty of Korea, and always in pursuit of greater economic, political, and international independence.

By justifying the position of the suryong (single leader) and uniting the people behind him, juche successfully advanced Kim’s interests.

I’d call that a fairly textbook kind of fascism: emphasizing the independence of the nation, the subordination of the people to the nation, and the fuhrerprincip — the leader who embodies sovereignty. Even the reliance on the US as a hobgoblin echoes the “we have been denied our rightful place in the world” rhetoric of the early 20c fascist regimes. The only thing that distinguishes North Korea from them, really, is the longevity of the Kim dynasty. The Kim refered to in the above excerpt is Kim Il Sung, the founder of the DPRK; his son, Kim Jong Il, is one of the only examples I can think of of a successful fascist succession.

However, by closely associating the government’s legitimacy with its successful pursuit of juche, Kim had opened the door to potential disaster. When he triumphantly achieved juche, North Koreans would perpetuate and even embrace his rule. But if the pursuit was unsuccessful, the most fundamental justification for the regime would appear violated.

Legitimation of a government is always a double-edged sword. Some forms of legitimation have a sharper back edge than others: the Confucian Mandate of Heaven is like this, as well.

When considered within this framework, Kim’s tendency to behave more aggressively when he seemed to be at his weakest makes sense. Unable to deny economic and political instability that suggested his government was not acting in accordance with juche principles, Kim redoubled his efforts to demonstrate his strength and independence in the third juche realm, foreign policy.

He does a nice job fitting the periods of economic trouble with the eras of international tension. He also does a good job illustrating the claustrophobic environment — the limited, controlled media, the cradle-to-grave indoctrination, the purges, etc — which makes North Korea such a surreal place.

Update: Speaking of Surreal, Curzon has a post on Reverend Billy Graham’s relationship with North Korea, starting with his missionary ancestors. [via