Immediately after Korea was liberated from Japan and established a government in 1948, the Korean War occurred from 1951 through 1953. As a result, the public health system was not able to meet its demand because the structure of the public health system, along with the broader socioeconomic system, was completely destroyed by the war. From this starting point, South Korea has developed its public health system over the past 60 years, culminating in the modern system of today. The specific reasons for the success of the early immunization program despite an insufficient public health infrastructure are as follows:
First of all, technical support from developed countries including the WHO was applied efficiently. The Saemaeul (“New Community”) Movement (a pan-national campaign for local community development beginning in the 1970s), environmental hygiene projects initiated at the recommendation of WHO advisors, and family planning services including children’s health care were important opportunities to enlighten residents at the village level. These opportunities for public health education became stepping stones toward a comprehensive immunization program as these projects were implemented based on the growth of the national economy.
Secondly, public health branches and health workers were systematically distributed throughout towns. Even though the national socioeconomic condition was terrible several decades ago, strongly driven by a policy named “the solution for a doctorless town,” the Korean government built public health branches in every town, which was a fundamental administrative unit. In addition, health care providers in charge of family planning services, maternal and child health care, and the tuberculosis control program were assigned to control acute and chronic infectious diseases and provide family planning services, which were the most urgent needs. Providing visiting public training and services with a village as a unit, collective education and practice were made available. In other words, the village was the unit in which community-based setting participatory health programs were carried out.
Thirdly, mobile mass immunization was conducted by mobilizing resources on a grand scale. Various infectious diseases such as dysentery, typhoid, cholera, Japanese encephalitis, polio, and measles occurred year after year and the deaths caused by these diseases were difficult to control given the insufficient infrastructure. In particular, people could rarely access the public health clinics due to the shortage of clinics and limited transportation. In these circumstances, having a legal imperative for a mobile mass immunization program, for the distribution of access to physicians, and for the mobilization of health care workers was an important and effective strategy.
Lastly, the government actively implemented the policy of “the solution for a doctorless town” by distributing physicians among towns. To place physicians and nurses in public health institutions, the government provided a scholarship covering tuition fees and additional expenses for students in the health care professions. After graduating, they were expected to work in areas assigned by the government. Afterward, the government continued to try to distribute physicians in each town (the primary unit by law) and also used incentive systems. Physicians had finally been placed in every town by 1983, and infectious diseases were successfully controlled by public health worker education and infectious disease controls in the 1960s and 70s.
