East Asia history of science

Remembering MERS in South Korea: Mobilizing Experience of Epidemic Disease

By John DiMoia
Figure One: Poster at Incheon Airport requesting passengers with MERS symptoms to report themselves to public health authorities (author’s photo: June 2015, Incheon, ROK).

With South Korean elections held in mid-April (April 15th), one of the major issues became the Moon Jae-in government’s handling of the COVID-19 crisis. Though briefly one of the world’s leading countries in terms of the number of cases as of mid-February, the nation has since earned international praise for its ability to “flatten the curve,” quickly reducing the number of cases through an intensive testing and tracing program. Indeed, the government has been quick to claim credit for the collective response of its public health workers, earning public trust, and aiming for electoral success. Still, the question remains: which experiences in the Korean past contributed to this impressive output? Could it be, as some have suggested, that the experience of SARS played a role?

Following the SARS (Severe Acute Respiratory Syndrome) outbreak of 2003, governments throughout the greater East and Southeast Asian region mobilized the lessons they claim to have “learned from SARS.” This was certainly the case with H1N1 (2009) in Singapore; and later, with the MERS (Middle East Respiratory Syndrome) outbreak which took place in South Korea (2015). Although the analogy to SARS is understandable, an easily available comparison, I suggest here that there are much richer possibilities in the Korean past for understanding the present circumstances of COVID-19. Although SARS is clearly an important precedent, the disease carries with it a great deal of ideological baggage, seeking to blame China specifically for a failure to ensure reliable reporting of cases, and for a corresponding failure to be transparent and maintain communication with international institutions. It was MERS, rather than SARS, which helped to reshape the South Korean experience, especially as it surprised a large number of people, including those in charge of the public health system.

Public Health: Origins in Successive Crises
Before touching on MERS, we should first recall the spread of epidemic disease in the late 1940s as the formative context for public health in Northeast Asia, especially following the closing weeks of World War Two. Japan neglected the peninsula’s infrastructure in the later war years, given the need to fight on multiple fronts. In 1945 and following, with the Korean War (1950-1953) soon to come, the migration of refugees between China, Japan, and South Korea led to frequent outbreaks of cholera and typhus. The joint occupations of Japan (1945-1952) and South Korea (1945-1948), along with the resumption of China’s civil conflict (1945-1949), heightened concerns for American military authorities. During the Korean War, the hanta virus, manifesting itself in the form of hemorrhagic fever, led to kidney ailments for combatants regardless of their ideology, and some historians have speculated about linking this development to Chinese and North Korean allegations of biological warfare. As a coda to this story, Dr Ho Wang Lee, a Korean physician, isolated the virus in 1976, bringing a successful result to a quest beginning with the war.

If the rapid spread of epidemic disease in the region lingers powerfully in Korean memory, a related point concerns the South Korean public health system as an ongoing set of bureaucratic institutions, a significant number of which derive their origins in part from late Japanese colonial rule (1910-1945) and the subsequent period of Korean military rule (1961-1987). The period spanning the late 1940s through the 1970s witnessed the gradual introduction of national health insurance (1963, 1977), with major reforms coinciding with the arrival of democratization (1989). At about the same time (1954-1960) as the earliest forms of health insurance, many South Korean hospitals received international aid in the aftermath of the Korean War, and began transforming their approach to clinical practice with new resources and medical pedagogy from Europe (Norway, Sweden, and Denmark) and the United States (University of Minnesota). If South Korea now possesses biomedical facilities more than capable of handling any crisis, the practices and institutional norms at these sites were nonetheless acquired under very different conditions at mid-20th century. This was medical care directed at an emergency situation, one filled with refugees, bodies, and the exigencies associated with wartime conditions and its immediate aftermath.

With these difficult circumstances, beginning in the late 1950s, South Korea pursued a series of ambitious national health campaigns, first targeting chronic disease, such as leprosy, tuberculosis, and malaria, often working in conjunction with the WHO (World Health Organization). These campaigns were followed by additional schemes, associated with a heavy dose of social engineering, here including Family Planning (1964-mid 1980s), and Anti-Parasite Campaigns (1968-early 1990s). Once again, efforts were carefully coordinated with international partners and institutions, including the Population Council and Japanese technical cooperation (JICA, Japan International Cooperation Agency). Moreover, the second of these campaign, targeting parasites, focused on school-age children, requiring them to submit stool samples on a bi-annual basis, with teachers collecting the “data” before it was analyzed. The stories from these campaigns indicate that there was a good deal of unfamiliarity with the Korean state’s goals, and sometimes, embarrassed students avoided school, or submitted a pet’s sample in place of their own. Only through concerted efforts, including posters, print ads, and public outreach could the government make its public health intentions clear. The generations of Koreans raised in the post-Korean War era through the early 1980s soon learned to become familiar with frequent health interventions (inspections, vaccinations, samples), whether at school, the office, or comparable public institutions.

The MERS Mishap (May-June 2015)
Give this successful legacy of national campaigns, and a developmental trajectory often assumed to be “progressive,” the MERS scenario began modestly, with health authorities assuming that it would not represent a major problem. The disease was framed as a “foreign” problem, with MERS manifesting itself in 2012, and only three years later appearing in Korea. Posters placed at Incheon airport, and also at rail and bus stations, typically depicted a camel and a palm tree (see Figure One) to underscore the external nature of the virus, which would require a Korean to travel through the region to be exposed. One famous poster illustrated the disease with a bactrian, or two-humped camel (see Figure Two), which is not the species associated with the spread of MERS. A relaxed attitude, and the freedom of movement permitted to possible cases, caught the system by surprise, leading to a genuine health problem, and a related political problem for the government of President Park Geun-hye. This series of events soon became the largest outbreak of MERS to occur outside its original setting.

Figure Two: South Korean poster illustrated with a two-hump Bactrian camel (author’s photo).

The diverse stories emerging during the spread of MERS illustrate a strong continuity with earlier historical developments, as the first patient traveled to four hospitals over a nine-day period, seeking a diagnosis, with uncertain symptoms. In the course of this movement, this individual, along with others to follow, some of whom broke quarantine, infected surrounding individuals, and also the surrounding space of health care facilities. In turn, after the outbreak became public knowledge, Korean patients sought to gain access to major health facilities in Seoul, often with crowded, inhospitable conditions in the wards. The structural inequities of the nation’s health care system—the rural / urban divide, geographical isolation, access to public health care in a system strongly favoring its more lucrative, private side—are certainly not new, and very likely exacerbated conditions as MERS made its way rapidly through hospitals, ultimately killing thirty-eight individuals, out of one hundred eighty-five confirmed cases. The largest MERS outbreak to take place outside of the Middle East, this incident served as a critical wake-up call.

Figure Three: Sign posted in a Korean church, southern Seoul, asking church-goers to understand that the facilities are temporarily unavailable due to COVID-19 (author’s photo, March 2020).

As South Korea grapples with COVID-19, receiving a great deal of praise for its series of rapid testing, drive-in checkpoints, contact tracing, and the distribution of masks, we should remember that these developments cannot be attributed to culture, a set of attitudes, or be credited to a narrow set of political interests. If it is reasonable to screen for elevated temperature and related symptoms, we also need to be careful about assuming ready consent upon the part of all Koreans, and to recognize that much of the domestic criticism of the Moon Jae-in government does not make the international press. In fact, the link of the virus to the Shincheonji church has been controversial, with some elderly Koreans complaining about their treatment, and the disruption of church services (see Figure Three).

Ultimately, the MERS outbreak in the region, tied to a longstanding legacy of institutional and structural inequities, brought much-needed attention to these kinds of issues within the Korean health system. A bureaucracy with a lengthy history, health care in South Korea derives from the period of transition following colonialism and two wars—Korean participation in Vietnam (1964-1973) was also extensive, and featured the nation’s first overseas medical outreach—and it holds onto a deeply ingrained set of practices, many of which require periodic updating. MERS became the critical factor calling attention to this need, and the renewed practices of 2020 started only in the intervening period, especially the use of rapid and effective testing.

When it became apparent that Korea would be affected by China’s circumstances in mid to late January 2020, there was a rapid turnaround in terms of implementing many of these newer measures. In particular, the use of credit card data, allowing for tracking of purchases, and by extension, an individual’s movements, became a core part of the new approach, a measure first adopted following the MERS quarantine breaks. If there has been controversy, and continues to be, over this concession and the use of phone / credit data, many Koreans treat it as a worthwhile trade-off under emergency conditions. In fact, the Korean government has been extremely careful to avoid claims of targeting, especially with the church, given that former President Park Geun-hye continues to maintains strong support among groups such as the elderly and evangelical Christians.

Coda: This analysis was written prior to the ROK elections held on April 15,,2020. The ruling party of President Moon went on to win an electoral majority. The ROK government has since issued its version of the COVID-19 story as a pamphlet, and it can be found here:

How Korea responded to a pandemic using ICT: Flattening the curve on COVID-19

Suggested Readings:

John DiMoia is Associate Professor in the Department of Korean History at Seoul National University. He is the author of Reconstructing Bodies: Biomedicine, Health, and Nation-Building in South Korea since 1945 (Stanford University Press / WEAI 2013), and with Hiromi Mizuno and Aaron S Moore, one of the co-editors of Engineering Asia: Technology, Colonial Development and the Cold War Order (Bloomsbury / WEAI 2018).

Asian History East Asia Intellectual history Interview Podcast

In Theory: Brendan Mackie interviews Joshua Fogel on Friendship and the Intellectual World of Shanghai in the 1930s

Brendan Mackie, a contributing editor for the JHI Blog and the host of “The Making of a Historian” podcast, speaks with Professor Joshua Fogel of York University about his book A Friend in Deed: Lu Xun, Uchiyama Kanzō, and the Intellectual World of Shanghai on the Eve of War (Association for Asian Studies, 2019).

East Asia Japan Literature

Lu Xun (1881–1936) and Uchiyama Kanzō (1885–1959)

By guest contributor Joshua Fogel

Several years ago, I was invited to give a paper at a workshop organized by graduate students at University of California, Berkeley. The topic was friendship in East Asia—with no specified time period or country or discipline. I have worked in the field of the cultural relations between Chinese and Japanese for several decades now, and I have long been intrigued by the friendship between the two men given in my title—the former China’s best-known writer of the twentieth century and the latter the Japanese owner of a bookstore in Shanghai, who lived in China for thirty years. I knew something of their ties, but this invitation gave me an opportunity to plunge into it head-first. The workshop did not produce a volume of proceedings, but I continued with my paper and came up with a short book published earlier this year (2019) by the Association for Asian Studies in Ann Arbor, Michigan.

Lu Xun

Lu Xun was one of the best-educated men of his era, a thoroughgoing iconoclast in many realms and, at the same time, a man deeply attached to many of his own cultural traditions. He managed to alienate almost all of the political types who came into contact with him—Communist or Nationalist—because he simply couldn’t abide empty slogans and did not suffer fools, and he was a virtual magnet for young writers and artists, and of course journalists. He was an open Japanophile (culturally, not politically) at a time when that was anything but politically correct, and mercilessly critical of countless aspects of Chinese behavior. The Communists have adopted him (posthumously, of course), although in the 1930s they attacked him pitilessly; since his death (when he no longer had the capacity to affect his image), he has become an icon in China and the center of a publishing cottage industry, with journals, and schools, and parks, and museums named after him. In fact, for the longest time, he was for Western Sinology the only twentieth-century Chinese writer worthy of more than one book. I never dreamed that I might add to that section of the library.

Uchiyama Kanzō

Meanwhile, across the Yellow Sea, Uchiyama dropped out of school at age twelve, held a number of menial dead-end jobs, and then found God, converted to Christianity, and became a traveling salesman in the Lower Yangzi region on the Chinese Mainland. Somehow, he acquired sufficient Chinese to do this and then with his wife opened a bookstore in Shanghai in the late 1910s. The store grew and grew until it held the largest collection of Japanese books in the city. This was a time when thousands of Chinese who had earlier studied in Japan and returned home were now trying to keep abreast of the world, and doing so via Japanese publications and translations was the means of choice. They flocked to Uchiyama’s bookstore and made it a success.

Lu Xun showed up several days after moving to Shanghai in 1927, and the two men—despite their entirely different backgrounds—hit it off immediately and became the closest of friends. As the political world of Shanghai was closing in on Lu Xun—there were several attempts on his life—Uchiyama repeatedly found safe houses for him and his family to relocate to, including the second story of his own store. He also handled all of Lu Xun’s mail and royalties through the bookstore—which also meant that Lu Xun’s address would not be public knowledge. When Lu Xun tried to popularize Chinese woodcuts, a project which became extremely important to him, on several occasions Uchiyama found space in the city for exhibitions and even imported his brother from Tokyo to teach the craft to Chinese students. Woodcuts were an ancient Chinese art (or craft), but the technique had largely been forgotten in the country.

Under normal circumstances, Lu Xun would appear every day at the Uchiyama Bookstore and spend hours “holding court” with younger writers and journalists, smoking non-stop—in fact, there was a special rattan chair that Uchiyama placed in the bookstore which everyone knew was reserved for Lu Xun. Tea and sweets were always in served by the Uchiyamas, especially in wintertime.

Lu Xun (left) and his acolytes

His daily presence rendered the bookstore a kind of latter-day salon, and his followers constituted a who’s who of Chinese culture.

My book follows the friendship between these two men, how they helped each other, and what each may have gained from the other’s friendship. Friendship is a difficult concept about which to generalize—being culturally, temporally, and personally bound in so many ways. Nonetheless, Uchiyama provided Lu Xun with a safe space in his bookstore where he could meet and converse with dozens and dozens of Chinese and Japanese poets, novelists, screenwriters, publishers, artists of all stripes, and many others, a space relatively free of fractious political world outside. And, he could smoke (in the bookstore!) to his heart’s content.  It was Lu Xun’s happiest place, other than his home, to spend time over the last decade of his life. Uchiyama, of course, looked up to Lu Xun, as did almost everyone in the cultural world of Shanghai. He also arranged an assortment of meetings between Lu Xun and Japanese publishing houses—and even with visiting dignitaries, such as George Bernard Shaw.

Lu Xun’s chain-smoking caught up with him in 1936, while Uchiyama lived another twenty-plus years before suddenly succumbing to a heart attack while on a visit to China. He is buried in the international cemetery in Beijing. Writing this book over the past few years has thrown into relief just how hard it can be for people with totally different backgrounds, nationalities, religions, and politics to remain friends. If anything, it was probably harder in Shanghai in the late 1920s and 1930s, as total war was soon to engulf the region; one year after Lu Xun’s death, the Japanese military launched an attack on Shanghai. That same year, on the anniversary of his death, Mao Zedong (then hiding in the caves of far-off Yan’an) wrote a eulogy for the man he dubbed a “sage” (shengren). I’m sure Lu Xun is still turning in his grave.

Joshua Fogel holds a Canada Research Chair in history at York University, and is the author of numerous books, most recently A Friend in Deed: Lu Xun, Uchiyama Kanzō, and the Intellectual World of Shanghai on the Eve of War (Ann Arbor: Association for Asian Studies, 2019).

East Asia Japan nationalism Political history

Towards a New Era: “Reiwa” and the Politics of the Classics in Japan

By Guest Contributor John D’Amico

On April 1, 2019, the government of Japan announced the name of the new era. With the abdication of Emperor Akihito and the accession of Crown Prince Naruhito, the curtain  falls on the Heisei period (1989 – 2019), and on May 1st, the new era, dubbed Reiwa (literally: “Ordering Harmony,” but the government suggested “Beautiful Harmony” as the official translation), begins.

The practice of changing era names upon the succession of a new emperor — one only established with the post-1868 emergence of a modern Japanese nation-state — might seem like an empty ritual. But the two character phrases that make up the era names are meant to “bear a meaning appropriate to serve as an ideal for the [Japanese] people,” and so serve an important ideological function (1979 Cabinet Report).

In contrast to earlier reign names, all based on phrases from Chinese classics, Reiwa comes from the Man’yoshū, the earliest extant vernacular poetry collection in Japan. It is the first reign name sourced from a Japanese work.

Critics quickly latched onto the authoritarian ring of “Ordering Harmony.” The right-wing bona fides of current Prime Minister Abe Shinzo are well known. He has called for the return of Japan to the status of a “normal” country through remilitarization and the rewriting of the postwar constitution. But what does his evocation of the Man’yoshū mean politically?

To help answer this question, it is worth quoting the prime minister’s remarks at the announcement of the new era at length.

Today, we have decided as a cabinet on the change in era name. The new era name is Reiwa. This is from the Man’yoshū passage, “An auspicious month (reigetsu), the beginning of spring. In the fine weather a fair breeze blows gently (kaze yawaragi[wa]). Plum blossoms bloom, scattering like powder before a mirror, and orchids give off the fragrance of perfume.”

Thus, “Reiwa” means that when people beautifully bring their hearts together, culture is born.

The Man’yoshū, though compiled over 1,200 years ago as Japan’s oldest poetry collection, featured poems from a broad spectrum of society: not only from the emperor, the imperial family, and nobility, but also from people like border guards and farmers. It’s a national work that represents the rich national culture and long tradition of our nation.

An eternal history and an elegant [literally: “aromatic”] culture, beautiful nature changing with the seasons. This Japanese national character should firmly be passed on to the next generations. Like the proudly blooming plum blossoms that herald the coming of spring after a long winter, each and every Japanese person, along with their hopes for tomorrow, can make their flowers bloom. That’s the kind of Japan I want to see. With that hope, we decided on the name “Reiwa.” Bearing heartfelt thanks for peaceful days where we can cultivate culture and appreciate the beauty of nature, I want to open up a path to a new era full of hope along with the people of Japan.

In spite of their classical trappings, the links drawn by Abe between poetry, social harmony, and cultural unity are of a more recent vintage. They hearken back to a pre-World War II discourse that idealized Japanese antiquity and the idea of a classless polity united under the divine authority of the emperor.

Readings of the Man’yoshū played an important role in the construction of this discourse, one that Abe drew on in his speech. The text was seen to represent an overcoming of the barriers of class and status and a repository of the raw, unfiltered emotions of the Japanese people. Abe’s appeals to culture, similarly, mirror the turn of many thinkers in the politically charged 1930s and 40s to see aesthetics as a solution to the mounting contradictions and conflicts inherent in modern life.

Writing in 1942, literary critic and leader of the Japanese Romantic school Yasuda Yojūrō argued in his The Spirit of the Man’yoshū (Man’yoshū no seishin) that, “In the Man’yoshū is the faith to establish the nation, expressed in a confidence in the nation itself…I felt deeply, painfully the idea behind the Man’yoshū: to protect the spirit of the nation’s history in an era of incommensurable darkness, shining forth an unextinguishable light” (426).

Screenshot 2019-04-19 at 12.13.07
Yasuda Yojūrō, leader of the Japanese Romantics (日本浪曼派), writer, and literary critic. Image: Sankei News.

Yasuda saw in this ideal a transcendent spirit passed down from the Man’yoshū poet Ōtomo no Yakamochi (718 – 785) via the “national learning” scholars of the Tokugawa period. Yakamochi is an important figure in his own right. But in the 1930s and 40s, he was most well known among the general public for his verse Umi yukaba [If we go on the sea], set to music in a popular military song emblematic of the war years:

If we go on the sea, our dead are sodden in the water

If we go on the mountains, our dead are grown over with grass

We shall die, by the side of our lord [i.e. the emperor]

We shall never look back (trans. Cranston, The Gem-Glistening Cup, 458)

Ōtomo no Yakamochi, statesman, member of the “Thirty-six Immortal Poets,” and a compiler of the Man’yōshū. Image: Chūnagon Yakamochi by Kanō Tan’yū, 1648.

In 1942, the associations between the Man’yoshū, emperor worship, and militarism were impossible to ignore. That same year a conference on “overcoming modernity” was held by the Bungakkai (The Organization for Literary Studies), with members of the Japanese Romantics and the Kyoto School of philosophers also in attendance. Many of the participants saw their enemy as the relentless process of history itself. The Man’yoshū’s status as a repository of tradition and source of authenticity made it a potent tool in the hands of those searching to turn away from the contradictions of contemporary life and embrace a transhistorical “Japanese spirit.”

Yasuda did not participate in the conference, however. Philosopher Karatani Kojin contends that Yasuda sought instead to “overcome” the modern through an active rejection of “interest” through aesthetics, cultivating a detached “romantic irony” that spurned explicit ideological motivations. (Senzen no shikō 110-1) To participate in any kind of coherent, practical project would stink too much of “interest” for Yasuda. In Karatani’s words, Yasuda saw the war as “nothing more than an occasion for poetry” (111). This reading makes Yasuda, a former Marxist, more an amoral aesthete than a full-throated militarist.

What he shared with the conference participants, in the historian Harry Harootunian’s words, was “…a dangerous kinship with fascism in its desire to bracket history and hence the development that had propelled the country to its present in order to represent Japan as fixed and eternal. In all of those discussions about an ineluctable ‘spirit,’ the symposium shared with the prevailing discourse on cultural authenticity the fantasy that neither history nor techno-economic development had managed to change what was essentially and eternally Japanese” (Overcome by Modernity, 40).

Abe also wants to share in this fantasy. Cloaked in the language of valuing a rich “cultural life,” his remarks seem almost innocuous. But they speak to the enduring desire to transcend the modern through a retreat into the classical past, an impulse that should give us pause in light of its dark history.

John D’Amico is a second-year PhD student in history at Yale University. His research focuses on merchants and commercial networks in early modern Japan.