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KMID : 0378019770200080111
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New Medical Journal
1977 Volume.20 No. 8 p.111 ~ p.129
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A Study on Improvement of Comprehensive Medical Care in Urban Slum and Island Areas in Korea
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黃仁澹/Hwang, In Dam
奇老錫/朴榮洙/Ki, No Suk/Park, Young Soo
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Abstract
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This study was carried out from January to October, 1976 for the attainment of the following purposes:
1. To obtain for the establishment a model program of comprehensive medical care
(integrated preventive and curative medical care) of the selected areas.
2. To train the doctors of tomorrow to meet the community needs adequately through the
field practice of community medicine.
The sites of the study are the urban slum area in Jeonju city and the Island area in Ocku-gun, Jeonbug province, the former of which suffered from socio-economic difficulties including the shortage of medical care and the latter from the lack of medical care services .due to its location.
The research procedures were planned into three stages. First, we carried out a house-hold survey of the health and socio-economic status of the residents; secondly, we planned a .comprehensive medical care for research areas. Finally, we executed a comprehensive medical .care service for the residents.
Summarized results were as follows:
I. Results of the Community Diagnosis
1. Socio-demographic background:
1) Location: Sooksa village is an urban slum located north-east of Jeonju city in Jeonbug province and Sinsi-do which belongs to Ocku-gun administratively is one of the Old-Kunsan Islands and is largely dependent on Kunsan harbor (Refer to Fig. 1 and 2).
2) Demographic characteristics:
(1) The average family size was 5.6 persons in Sooksa village and 6.3 persons in Sinsi-do.
(2) The population composition by age and sex of the urban slum area was much different
from the Island area. The age group 0-4 years of Sinsi-do comprised 6. 8 per cent and that of Sooksa village was 15. 2 percent.
(3) Occupation: Sooksa village: 50.6 percent of the occupational- population were daily-waged laborers lacking special skills thereby suggesting the unstability of their lives.
Sinsi-do: 60.0 per cent of the- occupational population was engaged in fishing and the other were regular-waged laborers, officials, and farmers.
(4) Education: 25-30 per cent of the household heads were illiterate in the urban slum and island areas, but the population of educated persons (received education from middle school and above) was higher in Sinsi-do than in Sooksa village.
(5) Religion: Housewives were found to have more religious beliefs than their husbands in both areas and 24.4 per cent of the housewives of Sinsi-do were protestant, indicating that the church can play a significant role for the attainment of medical care in Island area.
(6) Marital status: Sooksa village showed the tendency of early marriage; judging from: that 9.4 per cent of the women married below 25 years old in Sooksa village while 1.3 percent in Sinsi-do.
(7) Residential duration: The urban slum areas consist of immigrants from rural area and unemployed population in cities.
2. Environmental Health
1) Housing:
Sooksa village: Inadequate housing status and malpractice of house maintenance including overcrowding and poor facilities for kitchen and bed room,(Refer to photo. ).
Sinsi-do: With the exception of the reconstruction of rooves and fences by the new-village movement, the internal structure of the houses are-the same as those of other fishing and farming villages in Korea.
2) Night-soil and Waste disposal:
Sooksa village: The use of unsanitary public toilets, improper treatment of feces and waste disposal contribute to parasitic and communicable diseases.
Sinsi-do: Although in Sinsi-do, each house has its own toilet, the unsanitary conditions.
lead to parasitic and communicable diseases also.
3) Drinking Water:
Sooksa village: Public wells were. so contaminated with feces that it seemed dangerous to be supplied drinking water from them. These unsanitary wells might typhoid or other epidemics caused from unsatisfactory conditions such as these.
Sinsi-do: All the house-holds of the Island utilized the rural type of piped water but they suffered from the shortage of water in the drought season and in summer.
3. Fertility and Family planning:
1) The proportion of married women was 12. 1 percent in Sooksa village and 12. 0 percent in Sinsi-do, however, the age composition by area was quite different, showing younger. women more prevalent in Sooksa village.
2) Most of cases of delivery were carried out at home under the help of mother-in-law,. mother, or neighbors, with only 5. 6 per cent hospital delivery in Sooksa village and 3.3: per cent in Sinsi-do.
3) Acceptability of family planning showed 26.6 per cent in Sooksa village while that of Sinsi-do showed 33.3 percent. Methods of contraception were intrauterine device and oral pill in Sooksa village and I. U. D., condom, and oral pill in Sinsi-do.
4) The main reason of not practicing family planning was firstly the parents desired more:
children and secondly they were too busy making a living, especially in Sooksa village. 4. Morbidity and Medical , Care:
1) The monthly prevalence rate by area was 209.4 (male; 199.6, female; 219.8) per 1, 000 persons in Sooksa village and 127.0 (male; 130.3, female; 123.5) in Sinsi-do.
2) The monthly incidence rate by area was 72.7 (male; 70.0, female; 75.2) ; per 1, 000 persons in Sooksa village and 61.5 (male; 61.3, female; 61.7) in Sinsi-do.
3) In Sooksa village, the diseases most prevalent were disease of the disgestive and respiratory system and diseases of the nerves and sense organs. By the contrast, in Sinsi-do, the most prevalent diseases were respiratory and digestive; also diseases of the bone and organs of movement.
4) The ratio of the demand for medical care to the requirement for medical care was 53.9 percent in Sooksa village while 70.4 per cent in Sinsi-do.
5) The way how to satisfy the requirement of medical care was divided into several types, among which the main way was carried out by drug therapy without doctor´s prescription in both areas.
Only 3. 2 per cent Sooksa village and 7.8 per cent of Sinsi-do visited clinics or hospitals.
6) In Sinsi-do, the expenditures of medical care was increasing trend, indicating that the percentage of medical care out of total expenditures was from. 7.4 per cent to 11. 1 percent yearly, from-the middle of 1974 to that of 1976.
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