어느 시골 농부의 ‘반의사’(半醫師) 되기: 『대곡일기』로 본 1960-80년대 농촌 의료

This article attempts to review the reality of rural health care in Korea from the 1960s to the 1980s by analyzing the Daegok Diary. There has been two myths about rural healthcare. One is that the absence of institutional medicine was replaced by folk medicine, which could be identified with folk remedies or shamanic healing distinguished from Western medicine. This is a frame that understands institutional and Western medicine as a pair and folk medicine and traditional medicine as another. Another popular belief is that rural healthcare had remained almost nonexistent, and only dramatically improved after the Regional Health Insurance was implemented. Of course, some claim that the Regional Health Insurance was disadvantageous to farmers, but it is generally understood that there was an absence of government policy regarding medical care. The Daegok Diary, telling many aspects of rural life, is a good source to reflect on these common notions. Unlike other farmers’ diaries, the diary of Shin Kwonsik contains a wealth of medical culture records because he chose unique ways to cure his and neighbors’ illnesses by himself. It can be summarized as the life of “quasi-doctor”. Shin was distinguished from quacks in that he practiced as an intellectual in the village rather than as a profession, and that he learned official medical knowledge and recognized the difference between a licensed physician and himself. Also, he was different from doctors because of the lack of a medical license and the limited range of diseases that he could treat. The life of quasi-doctor shows the social structure of rural areas in Korea from the 1960s to the 1980s. The reality of rural healthcare can be summarized in two ways. First, the medical vacuum was filled by civilian efforts. There was virtually no institutional healthcare in rural areas, but the government did little to improve the situation . The policy of sending doctors to the countryside proved to be ineffective, and the community doctor system did not work properly. Health Insurance was also a system for city workers rather than farmers. In the late 1970s, the situation only slightly improved due to reasons unrelated to the government policy regarding rural healthcare. These were improvements in traffic conditions and the increasing popularity of private insurance, which improved the physical and economic accessibility to medical institutions. Second, Western medicine had become a part of folk medicine. Those who could not go to a hospital utilized Western medicine, which had penetrated the folk medical culture. When people were sick, they bought Western drugs from pharmacies, drug dealers, and sometimes quacks. The knowledge of Western medicine also spread widely, with family medical books such as Million People’s Medicine as the medium. These two characteristics show that the existing myths that regard the absence of government policy as that of medical care and interpret the medical vacuum as the prevalence of folk remedies and shamanic healing are far from the truth. From the 1960s to the 1980s, gaps in institutional medicine was filled by Western medicine which had become part of the folk medicine already, and the accessibility of institutional medicine was improved through civilian efforts. Of course, the Daegok Diary shows more than the social structure of rural areas. It also reveals a lot about the man who wrote it, Shin Kwonsik. Unlike the others, Shin chose to become a quasi-doctor because of his separation from the tradition and his desire to learn. He grew up alone without parental care and later moved to Seoul by himself. This meant a break with the tradition. He joined the army in the wake of the Korean War and learned how to give injections there. After he was discharged, he devoured many books and newspapers including Million People’s Medicine. In short, the existence of a quasi-doctor like Shin was the result of the combination of the absence of institutional medicine, the predominance of Western medicine, and the characteristic of Shin as a ‘learning modern.’