Tung Wah hospitals history reveals a good dose of East and West

Tung Wah hospital group's archive keeper tells of the days when Chinese and Western medicine co-existed - and yet were at odds

PUBLISHED : Saturday, 12 October, 2013, 12:00am
UPDATED : Saturday, 12 October, 2013, 2:56am

Flipping the delicate pages of Kwong Wah Hospital's century-old registry, the archive keeper's gloved fingers scan the detailed records harbouring the essence of the city's medical history.

On one day in the spring of 1917, eight patients were admitted. One was homeless, two came on their own, and six had introducers, the carefully calligraphed Chinese characters show.

One of them was a 65-year-old man from Hung Hom who suffered a cough. He died in 20 days. The archive keeper, Stella See Sau-ying, noticed two small characters in his row - "changed Western" - meaning he was transferred from Chinese to Western medical care.

"Integration of Chinese and Western medicine is something recent, but the two have co-existed all along in Tung Wah," said See, head of the Tung Wah Group of Hospitals' records and heritage office.

The group's historical records show informal interaction between these two classes of medicine in a Chinese city governed by Westerners. The two groups of doctors were practising alongside each other as early as 1896.

It was two years after the plague outbreak and Western medicine was introduced into Tung Wah Hospital in Sheung Wan, Hong Kong's first Chinese medical hospital.

The hospital had opened in 1872 to serve a Chinese community that was suspicious of Western medicine, especially surgery, and could not afford hospital treatment. Many sick people died without being treated.

A group of Chinese leaders, mostly businessmen, founded the Chinese medical hospital under a Western legal framework - the Tung Wah Hospital Incorporation Ordinance - even though Westerners in the government did not believe in the benefits of Chinese medicine.

The hospital's first annual report included rules that allowed certain Chinese practices but also imposed constraints.

The rules were detailed, forbidding such practices as drinking games and drunkenness. Another rule said the hospital was "not a place for worshipping gods", but permitted small-scale rituals on certain days.

See explained that many patients sought gods' protection and hospital staff also derived peace from worship because many patients died.

After the plague, in which many Hongkongers died, a government medical official's report criticised the effectiveness of Chinese medicine provided by Tung Wah. The government asked the hospital to improve its management and appointed a Chinese doctor practising Western medicine to be stationed there.

In 1911, to meet the increasing demand for treatment, Kwong Wah Hospital opened in Yau Ma Tei. In the early days, it served all who lived in Kowloon and the New Territories, as well as those who lived on boats, since Yau Ma Tei used to be a fishing village.

The two hospitals, together with Tung Wah Eastern Hospital in Causeway Bay that opened in 1929, were put together under the same management by the Tung Wah board of directors in 1931.

The first-floor plan of Kwong Wah's main building, now the Tung Wah Museum, already showed the co-existence of Chinese and Western medicine. The Chinese herbal department was next to the Western pharmacy.

The building's architecture was like that of a Chinese temple, as people were resistant to Western culture at a time of foreign invasions, See said. Patients had a choice of Chinese or Western medical treatment at the hospital, but the government subsidised only Western medication and patients had to pay for Chinese herbal treatment.

Free provision of herbal medicine started in 1922 because of an anonymous donor, who identified herself only as a "little woman". She brought HK$580 to Kwong Wah in spring that year and suggested that the hospital offer free Chinese medicine.

She said she saw many poor people dying because they could not afford medication, and that the hospital's free consultation was meaningless without free medicine as well.

Tung Wah's director thanked her, but said the hospital could not afford the extra expenditure even with her donation. She came again with HK$10,000, but the board remained worried that it could not sustain its supply of medicine.

So the "little woman" donated another HK$40,000 - at a time when a new building cost only several thousand dollars. She wrote a letter to the board in June that year, saying the donation came from all her savings and that she hoped it would raise awareness of the problem.

"I am just a woman doing what I should to help people in agony," she wrote. "I hope you generous gentlemen can help."

I am just a woman doing what I should to help people in agony

Touched by the donor's perseverance, the hospitals' directors raised another HK$70,000 and bought 10 shops on Reclamation Street in Yau Ma Tei, using the rental income generated to provide free Chinese medicine for patients.

From then, the number of patients who received free Chinese medical treatment at the hospital rose sharply.

The figures increased from 18,000 in 1922 to almost 44,000 the following year, while those seeking free Western treatment remained around 25,000 in those two years. Chinese-medicine patients continued to rise, reaching almost 163,000 in 1935, compared with 48,000 who had Western treatment that year.

However, the Great Depression in the 1930s and subsequently the Japanese invasion brought into the city a large number of refugees from the mainland, putting heavy pressure on the hospital's services.

It suffered a HK$150,000 deficit and asked for government funding. The government agreed, but issued seven criteria, including eliminating the hospital's Chinese medical services.

Tung Wah's directors accepted the other six criteria, but insisted on keeping the service as it was the hospital's founding mission. After several rounds of negotiations, the government finally relented.

But the controversy over abolishing the hospital's Chinese medical services did not end there. Historian Joseph Ting Sun-pao wrote of conflicts between the two groups of doctors in the book, The Tung Wah Group of Hospitals and the Chinese Community in Hong Kong (1870-1997).

The hospital's admissions department would turn down patients who requested Chinese medical treatment. Some of those admitted by the Chinese medical department were driven out of the hospital by Western doctors. Others were forced to receive Western medical treatment and left because of that.

There were also arguments within the management over whether Chinese medicine should be banned from treating infectious diseases.

It was not until during the second world war that Chinese medical services at both Tung Wah and Kwong Wah hospitals were stopped, due to a lack of resources. People then became more accepting of Western medicine, and the government continued to promote its development.

Tung Wah Hospital later resumed limited Chinese medicine outpatient services. In the 1990s, it started expanding to meet public demand.

Further development in Chinese medicine came with the return of Hong Kong to China. In 2001, Tung Wah's hospitals began collaborating with universities to train Chinese medical practitioners.

Kwong Wah's upcoming redevelopment will see an increase in Chinese medicine facilities. It now has Western and Chinese combined inpatient services and has applied to the government for 20 beds for Chinese medical services.

"After more than a century, we are now heading back to the beginning of providing Chinese inpatient services," See said, adding that experiences from the past might bring insight for future development.

A lot of the hospital records have yet to be analysed, and the archive keeper hopes that more people will take part in reviving Hong Kong's medical history.


Charity is at the heart of hospital group

In the 1800s, when the mainland was still under the Qing reign, the Tung Wah Group of Hospitals was already a beacon of light for Chinese workers toiling away far from their hometowns.

The living were given passage to return to their loved ones, while those who died had their remains taken home and laid to rest, mostly in Guangdong.

"Dead or alive, they all returned home through Tung Wah," said Stella See Sau-ying, head of the group's Records and Heritage Office.

The charitable spirit of the Hong Kong-based Tung Wah was integral to the lives of the Chinese community in the early days of colonial rule.

In its 1873 annual report, the hospital listed patients who had died. Most of their families could not afford a burial ground and the hospital arranged one for them.

The burial service was one of its biggest areas of expenditure. "Seeking medical treatment was already not easy, and dying was even harder," See said.

The report also named 32 male refugees who received help to return home that year, and 17 female refugees whom the hospital arranged marriage for.

Another large-scale service it provided was transporting the bones and ashes of Chinese workers from overseas to Hong Kong, and then back to their hometowns in Guangdong.

An 1874 article in the Chinese-language newspaper Universal Circulating Herald reported that about 30 coffins bearing Guangdong natives were sent from Japan to Tung Wah. The hospital published advertisements to inform the deceased's relatives and arranged transport for the bodies to be sent home.

The service was largely stopped in the second world war and scrapped after 1949.