Sino-NK

The sharp-suited Dr. Frank Schofield teaching in the lab circa 1919. | Image: Yonsei Medical Journal vol. 60, no. 4 (April 2019)

The public health crisis presented by COVID-19 has shone a light on the politics and societies of the two Koreas. Determined to test and trace its way around the need for wholesale economic lockdowns following a big initial outbreak in Daegu, South Korea has to date seen a relatively modest 350,000 cases of the disease and fewer than 3,000 deaths. North Korea sealed its borders completely in January 2020, even to goods, and has reported zero cases and zero deaths. Pyongyang’s self-reporting is implausible; Daily NK has reported on outbreaks of disease in North Korea that are are indistinguishable from COVID-19, and it is not likely that all such reports would be inaccurate. Nevertheless, it does seem that North Korea, leveraging a long-standing and extremely harsh authoritarian instinct, has also managed to limit the impact of the disease at home (so far). 

It is peculiar (at least in the South) that amidst these successes in both Koreas, there has been almost no desire to look back to experiences of the great pandemic of the 1900s, the Spanish Flu of 1918-1921. It is a history worthy of reconsideration. Returning to Sino-NK in order to do exactly that is Christopher Richardson, one of our most popular authors. In the first part of a brand new series, Christopher recalls the arrival of the new influenza in Korea. — Christopher Green, Senior Editor

Plagues & Peoples in Korea, I: The Visitation

by Christopher Richardson

It is a curious fact that Spanish Flu rarely features in histories of Korea. Many seminal works – in English at least – make no mention of it at all. Yet only two events killed more Koreans in the Twentieth Century than the pandemic of 1918-1921: the Korean War of 1950-1953 and the North Korean famine of the 1990s. In the first of a three-part series for Sino-NK, I look back at the arrival of the Spanish Flu in Korea. We will trace the lives of three physicians whose lives reflect the political, social, and cultural dynamics of a country already groaning beneath the yoke of Japanese imperialism when the pandemic struck. During the first wave of the Spanish Flu a new Korean nationalism would rise on a wave of anger at the colonial administration’s mishandling of the new disease. Many on the frontlines of the March 1^st Movement of 1919 were also on the frontlines of the war against the invisible foe then ravaging the land, including the father of the man who would one day rule in North Korea. This is a tale of modernity and medicine, revivalists and revolutionaries, a history of plagues and peoples and the birth pangs of a new Korea.

Dr. Frank Schofield in Korea. | Image: Yonsei University

A Doctor Calls | In 1970, Dr. Frank William Schofield was buried in the National Cemetery of the Republic of Korea (South Korea), the first foreigner to receive the honour. His Korean name was Seok Ho-pil. Born in England, Schofield had migrated to Canada, trained as a veterinarian, then moved to Seoul to teach microbiology, hygiene, and vaccine development. Schofield came to Korea in 1916 at the behest of Dr. Oliver R. Avison, one of the founders of Severance Hospital and Medical College, the first Western-style hospital in Korea, today affiliated with Yonsei University.¹⁾Kyu-hwan Sihn, “‘The 34th National Representative,’ Dr. Frank W. Schofield (石虎弼, 1889–1970),” Yonsei Medical Journal 60, no. 4 (2019): 315-318. The hospital was co-founded by the Korean government and North American church organisations, although financing would fall to the responsibility of the North American Presbyterian Mission from 1894. As Yeo In-sok of the Department of Medical History at Yonsei University College of Medicine writes, “the hospital became host to anyone seeking treatment for their illnesses, both commoner and royal family alike.”²⁾In-Sok Yeo, “Severance Hospital: Bringing Modern Medicine to Korea,” Yonsei Medical Journal 56, no. 3 (2015): 593. This revolutionary new hospital would cure disease, whilst cultivating new ideas about medicine and hygiene in Korea. It would also spread the Word of God.

A prayer meeting during the Pyongyang Revival. | Image: Wikicommons

Christianity already had a three-hundred-year history on the Korean Peninsula and had weathered waves of persecution under the Choson Kings, yet the Holy Spirit spread like wildfire in the first years of the Twentieth Century. The Wonsan Revival of 1903 – in what would one day be North Korea – was led by a Canadian missionary named Dr. Robert Alexander Hardie.³⁾Sun-wook Kim, “Evaluating the Revival Experience of Korean Missionary Robert A. Hardie (1865-1949) in View of Jonathan Edwards’ Religious Affections,” Expository Times128, no. 9 (2017): 434-439. This event would, in turn, inspire the Pyongyang Revival of 1907, one of the most significant revivals of the Twentieth Century, earning the future capital of North Korea its reputation as the “Jerusalem of the East”.⁴⁾Arun Jones, “The Great Revival of 1907 as a Phenomenon in Korean Religions,” Journal of World Christianity 2, no. 1 (2009): 82-110. Arriving in Korea in 1890, Dr. Hardie had also worked at Severance Hospital in Seoul with Dr. Horace Allen. Christ had healed the sick and the apostles had worked miracles. In God’s name, hospitals proved a site of transformation in Korea, both physical and spiritual. For a pioneering and ambitious medical researcher like Schofield, Korea must have seemed a thrilling and challenging frontier. Yet just as Jerusalem had fallen under the yoke of the Roman Empire, so did the Jerusalem of the East soon fall beneath the yoke of the Empire of Japan. Japan annexed the Korean Peninsula in 1910, ending almost half a millennium of Choson rule. Koreans would be ruled by the Governor-General of Korea on behalf of the Emperor in Tokyo. In the first volume of his eight-volume memoir, Kim Il Sung lamented how, “our country, with its long history, rich natural resources and beautiful mountains and rivers, found itself trampled underfoot by the Japanese military … Korea in those days was a living hell.”⁵⁾Kim Il-sung, Reminiscences: With The Century, Volume One (Pyongyang: Foreign Languages Publishing House, 1994), 3-4.

Kim Hyong-jik and family, including the young Kim Il-sung. | Image: KCNA

From Revival to Rebellion | Born in 1912, Kim Il Sung came from a devout Christian family.⁶⁾Yong-ho Choe, “Christian Background in the Early Life of Kim Il-Song,” Asian Survey 26, no. 10 (1986): 1082-1091. His mother Kang Pan-sok was a Presbyterian deaconess, whilst his father Kim Hyong-jik attended Sungsil Middle School in Pyongyang, founded by missionaries from the United States of America. Along with history, mathematics, physics, and music, hygiene, physiology, and physical training were features of the missionary curriculum. According to Kim Il Sung, his father was a keen student who developed a schoolboy interest in the medical sciences.⁷⁾Kim Il-sung, Reminiscences, 20. Kim Hyong-jik was also a budding revolutionary. In the autumn of 1917, he would be arrested for anti-Japanese activism and imprisoned. At the time, Kim Hyong-jik was working as a teacher, perhaps inspired by the missionaries at Sungsil Middle School. This was a formative experience for Kim Il Sung. Kimist hagiography makes much of these early years, seeking to bind Kim Il Sung to the anti-Japanese struggle from an early age. Visiting his father in prison at the tender age of five, Kim recalled how “the physical wounds to my father made me feel to the marrow of my bones how fiendish was Japanese imperialism.”⁸⁾Ibid., 34. Released after a year confined in wretched conditions, Kim Hyong-jik convalesced in the home of an uncle named Kim Sung-hyon during the autumn of 1918. According to Kim Il Sung, this uncle was an ophthalmologist and man of great learning. As Kim recalled:

“My father read books even in his sickbed … [at the home of Kim Sung-hyon] he continued with his medical studies which he had started in prison. From Kim Sung-hyon my father obtained many books on medicine. Earlier in his Sungsil Middle School days my father had learned medicine from the doctor and read medical books enthusiastically. It was in prison that my father made his mind to change from a teacher to a doctor.”⁹⁾Ibid., 36.

During the Autumn of 1918, whilst Kim Hyong-jik was poring over his uncle’s textbooks on his sickbed, Korea was spiraling into its gravest medical crisis of the century.

Plague | The most important contemporary account of the arrival of the Spanish Flu in Korea comes from the pen of Dr. Frank Schofield and his student Dr. Cynn Hyun-chang at Severance Hospital in Seoul. Their testimony resonates with the anguished urgency of eyewitnesses yet provisions us with the meticulous detail of clinical researchers. Schofield and Cynn’s article appeared in the prestigious JAMA: The Journal of the American Medical Association on the 5^th of April 1919, six months into the pandemic in Korea. It is worth quoting at length:

“The great influenza pandemic made its appearance in Korea during the month of September, 1918. There seems to be no doubt that the infection came from Europe, via Siberia. The disease spread from north to south along the line of the Southern Manchurian Railway. The first cases seen by us in Seoul, the capital, were during the latter part of September. Before the middle of October the epidemic was at its height. The unsanitary conditions of oriental life greatly enhanced the spread of the infection. At present it is impossible to estimate either the number of cases or deaths, as accurate information has not been received from the Japanese authorities. From one quarter to one half of the population must have been affected. Most of the schools were closed, owing to the high incidence among the scholars and teachers. As elsewhere the serious nature of the outbreak was due to the frequent sequelae, bronchitis, bronchopneumonia, and heart failure. The symptoms were those of ordinary influenza, but of a more exaggerated type.”¹⁰⁾Frank W. Schofield & H.C. Cynn, “Pandemic Influenza in Korea: With Special Reference to its Etiology,” Journal of the American Medical Association 72, no. 14 (1919): 981-983.

The article goes on to detail at length the challenges Dr. Schofield and Dr. Cynn faced in grappling with this terrifying new disease. This was not seasonal influenza.

Pandemic | The Spanish Flu ravaged Korea in waves from 1918-1921. As Dr. Lim Chaisung writes, over the course of the pandemic, “half of the population [of Korea] was infected by the disease, with over more than 200,000 losing their lives.”¹¹⁾Chaisung Lim, “The Pandemic of the Spanish Influenza in Colonial Korea,” Korea Journal 51, no. 4 (2011): 84. The population of Korea in 1918 was approximately 17 million.¹²⁾17 million is roughly the population of the Netherlands today. The Netherlands has lost fewer than 20,000 people to COVID-19 at time of writing. The first wave struck during the harvest of 1918, impacting food supply at a time when Japan was already exploiting Korean agriculture to satisfy its needs at home. The cost of fuel, charcoal, and firewood soared, even as a biting Winter loomed. A panicked colonial authority introduced mask mandates and banned public assemblies. Koreans were ordered to avoid weddings, funerals, and ancestral rites. At a time when the imperial occupation was seen as ruthlessly suppressing Korean culture, such public health measures would have seemed to many like mere pretext for further social and cultural control, however necessary to protect the population from disease. The shuttering of factories and other workplaces to stop the spread of the disease left many Koreans without work. Even with radical measures in place, during the Second Wave, Lim writes that, “the influenza spread so swiftly that over a third of total deaths [in Seoul] from December 1919 to January 1920 were caused by the influenza.”¹³⁾Lim, “The Pandemic of the Spanish Influenza in Colonial Korea,” 78.

The pandemic exacerbated social and economic divisions in colonial Korea. Except for the missionary hospitals, healthcare infrastructure for Koreans was scarce in 1918. As Lim writes, “rather than quarantining patients, the general treatment was to make patients lie on a floor equipped with traditional Korean underfloor heating, thus raising their body temperature so as to sweat out the fever. The desired effect was not achieved but instead gave rise to diseases such as bronchitis, pneumonia, and meningitis.”¹⁴⁾Ibid., 74. Others relied on traditional medicines or shamanism, exacerbating the disease in many cases. Without widespread medical infrastructure, the police were tasked with managing outbreaks. Although some interventions were well intentioned, others veered between shambolic incompetence and outright discrimination. Koreans were already deemed “unclean” in the eyes of the colonial government, manifest in its policies concerning the treatment of Venereal Disease and rabies. As Lim notes, “the mortality rate for ethnic Koreans was more than double the rate of the deaths of ethnic Japanese [in Korea]. Mortality rates for known infected patients were 8.1% for the Japanese and 18.8% for ethnic Koreans.”¹⁵⁾Ibid., 68.

The new railways – which had promised the fruits of empire and modernity – instead brought death. As Schofield and Cynn noted in JAMA in early 1919, the pandemic spread north to south along the Southern Manchurian Railway. Lim notes that rail hubs remained key epicenters for the disease throughout the course of the pandemic. The principal obstacle faced by Dr. Schofield and Dr. Cynn in studying this new disease was the institutional mendacity of a tyrannical state. As they wrote, “at present it is impossible to estimate either the number of cases or deaths [from Spanish Flu in Korea], as accurate information has not been received from the Japanese authorities.”¹⁶⁾Schofield & Cynn, “Pandemic Influenza in Korea,” 981. Indeed, later research suggests that Spanish Flu had already started spreading in Korea during the Spring of 1918.¹⁷⁾Lim, “The Pandemic of the Spanish Influenza in Colonial Korea,” 65. The confluence of plague and the cruelty of Japanese occupation exacted a terrible toll on the Korean people and soon the streets would fill with rage.

In the next instalment of this series for Sino-NK I will explore the social and political consequences of the pandemic for Korea as the March 1st Movement erupts and track the journey of two doctors as they take their place in Korean history and revolutionary mythology.