[Historical origins between National Medical Association of China and Boji Hospital in Guangzhou]

In 2015, National Medical Association of China, now being called the Chinese Medical Association, celebrates its centennial and Boji Hospital in Guangzhou ( also known as Canton Hospital, or the Canton Pok Tsai Hospital, and now Sun Yat-sen Memorial Hospital of Sun Yat-sen University ) marks its 180th anniversary. Three major historical events establish the role of Boji Hospital in the founding and development of the National Medical Association of China during the last 100 years, viz.: ①hosting and participating in the establishment of the Medical Missionary Association of China and its official journal: the China Medical Missionary Journal; ②holding the 11th scientific sessions of the National Medical Association of China; ③nominating Dr. Wu Lien-teh as a candidate for the Nobel Prize in Physiology or Medicine in 1935 by William Warder Cadbury, the president of Boji Hospital.

German wine in an American bottle: the spread of modern psychiatry in China, 1898-1949

Modern psychiatry was first introduced to mainland China around 1900 by Western missionaries. By 1949 the field had developed gradually as a result of contact with Western psychiatry and especially its American practitioners. This paper analyses the role played by key individuals and events in this process in the years prior to 1949. It argues that modern psychiatry was introduced to China through a process of cultural adaptation in which the USA served as a bridge for German thought.

Breakdown + Breakdown runners-up

Slow international response and missed opportunities to contain the outbreak make this year's Ebola epidemic Science 's breakdown of the year. Also, Breakthrough staff chose a few of this year's notable flaps, stumbles, and reverses as runners-up.

Cost-effectiveness of the "helping babies breathe" program in a missionary hospital in rural Tanzania

OBJECTIVE

The Helping Babies Breathe" (HBB) program is an evidence-based curriculum in basic neonatal care and resuscitation, utilizing simulation-based training to educate large numbers of birth attendants in low-resource countries. We analyzed its cost-effectiveness at a faith-based Haydom Lutheran Hospital (HLH) in rural Tanzania.

METHODS

Data about early neonatal mortality and fresh stillbirth rates were drawn from a linked observational study during one year before and one year after full implementation of the HBB program. Cost data were provided by the Tanzanian Ministry of Health and Social Welfare (MOHSW), the research department at HLH, and the manufacturer of the training material Lærdal Global Health.

FINDINGS

Costs per life saved were USD 233, while they were USD 4.21 per life year gained. Costs for maintaining the program were USD 80 per life saved and USD 1.44 per life year gained. Costs per disease adjusted life year (DALY) averted ranged from International Dollars (ID; a virtual valuta corrected for purchasing power world-wide) 12 to 23, according to how DALYs were calculated.

CONCLUSION

The HBB program is a low-cost intervention. Implementation in a very rural faith-based hospital like HLH has been highly cost-effective. To facilitate further global implementation of HBB a cost-effectiveness analysis including government owned institutions, urban hospitals and district facilities is desirable for a more diverse analysis to explore cost-driving factors and predictors of enhanced cost-effectiveness.

Healthcare and warfare. Medical space, mission and apartheid in twentieth century northern Namibia

In the year 1966, the first government hospital, Oshakati hospital, was inaugurated in northern South-West Africa. It was constructed by the apartheid regime of South Africa which was occupying the territory. Prior to this inauguration, Finnish missionaries had, for 65 years, provided healthcare to the indigenous people in a number of healthcare facilities of which Onandjokwe hospital was the most important. This article discusses these two agents' ideological standpoints. The same year, the war between the South-West African guerrillas and the South African state started, and continued up to 1988. The two hospitals became involved in the war; Oshakati hospital as a part of the South African war machinery, and Onandjokwe hospital as a 'terrorist hospital' in the eyes of the South Africans. The missionary Onandjokwe hospital was linked to the Lutheran church in South-West Africa, which became one of the main critics of the apartheid system early in the liberation war. Warfare and healthcare became intertwined with apartheid policies and aggression, materialised by healthcare provision based on strategic rationales rather than the people's healthcare needs. When the Namibian state took over a ruined healthcare system in 1990, the two hospitals were hubs in a healthcare landscape shaped by missionary ambitions, war and apartheid logic.

Resistance and religion: health care in Uganda, 1971-1979

This article situates women's roles in community health care during violence in Uganda in the 1970s. It examines the lived reality of Catholic missionary sister nurses, midwives, and physicians on the ground where sisters administered health care to local communities. The goal is to examine how religious women worked with local individuals and families in community health during periods of violence and war. Catholic sisters claimed to be apolitical, yet their mission work widened to include political issues. As they saw local Ugandans threatened, sisters engaged in political activities by their identification with and protection of "their people."

Pre-travel preparation of US travelers going abroad to provide humanitarian service, Global TravEpiNet 2009-2011

We analyzed characteristics of humanitarian service workers (HSWs) seen pre-travel at Global TravEpiNet (GTEN) practices during 2009-2011. Of 23,264 travelers, 3,663 (16%) travelers were classified as HSWs. Among HSWs, 1,269 (35%) travelers were medical workers, 1,298 (35%) travelers were non-medical service workers, and 990 (27%) travelers were missionaries. Median age was 29 years, and 63% of travelers were female. Almost one-half (49%) traveled to 1 of 10 countries; the most frequent destinations were Haiti (14%), Honduras (8%), and Kenya (6%). Over 90% of travelers were vaccinated for or considered immune to hepatitis A, typhoid, and yellow fever. However, for hepatitis B, 292 (29%) of 990 missionaries, 228 (18%) of 1,298 non-medical service workers, and 76 (6%) of 1,269 medical workers were not vaccinated or considered immune. Of HSWs traveling to Haiti during 2010, 5% of travelers did not receive malaria chemoprophylaxis. Coordinated efforts from HSWs, HSW agencies, and clinicians could reduce vaccine coverage gaps and improve use of malaria chemoprophylaxis.

The protestant medical missions to China: Dr Thomas Richardson Colledge (1796-1879) and the founding of the Macao Ophthalmic Hospital

A surgeon of the British East India Company, Dr Thomas Richardson Colledge, founded the Macao Ophthalmic Hospital in 1827. This was not only the first Western hospital ever opened in China for the purpose of bringing modern medicine to the Chinese but also the precursor of similar efforts of later medical missions in China. The gratifying results of this institute proved that employing Western medicine was an effective way to introduce Christianity to China and to open her door to the outside world. Though not a missionary himself, Colledge is rightfully regarded as the originator of medical missionaries to China.

The Protestant medical missions to China: the introduction of Western medicine with vaccination

Modern medicine in China began with the arrival of Anglo-American Protestant missionaries in the early 19th century. Conditions were vastly different from the times of the Jesuits in Peking during the 17th and 18th centuries, when the priests enjoyed the endorsement of the Court and high officials. Faced with hostile and xenophobic officialdom and populace, surgeons of the British East India Company in collaboration with missionaries took the initiative. In 1805 Dr Alexander Pearson (1780-1874) introduced smallpox vaccination in Macao and Canton. Reverend Dr Robert Morrison (1782-1834) of the London Missionary Society with another East India Company Surgeon, Dr John Livingstone (1829) opened a dispensary for the poor in Macao in 1820. These pioneers paved the way for later Anglo-American medical missionaries who revolutionized medical practice in China.

Indian hospitals and government in the colonial Andes

This article examines the reception of the early modern hospital among the indigenous people of the Andes under Spanish colonial rule. During the period covered by this study (sixteenth to mid-eighteenth centuries), the hospital was conceived primarily as a manifestation of the sovereign’s paternalistic concern for his subjects’ spiritual well being. Hospitals in the Spanish American colonies were organised along racial lines, and those catering to Indians were meant to complement the missionary endeavour. Besides establishing hospitals in the main urban centres, Spanish colonial legislation instituted hospitals for Indians in provincial towns and in small rural jurisdictions throughout the Peruvian viceroyalty. Indian hospitals often met with the suspicion and even hostility of their supposed beneficiaries, especially indigenous rulers. By conceptualising the Indian hospital as a tool of colonial government, this article investigates the reasons behind its negative reception, the work of adaptation that allowed a few of them to thrive, and the eventual failure of most of these institutions.

Dr Walter Henry Anderson (1870-1937) and the mission hospital at Safed, Palestine

Walter Henry Anderson, a brewer's clerk in Burton-upon-Trent, became a missionary doctor, supported by a society promoting welfare and evangelism in Jewish communities abroad. His family background was rich in pastoral ministry at home and adventure abroad. Arguably, this background played a part in his decision to serve the Jews of Safed. His life in Palestine entailed much enterprise and hardship as he raised a family, fought disease and set up a mission hospital serving not only the Jewish community but persons of all faiths. His years in Palestine, from 1894 to 1915, were times of peace in the Middle East before the turmoil unleashed by the Great War. Jews from the Diaspora were gaining an increasing foothold in Palestine, their 'Promised Land'. Themes of that era - the rise of Zionism, confrontation between Judaism and evangelical Christianity, conflict between immigrant Jew and Palestinian Arab and the remarkable travels of Lawrence of Arabia were interwoven with the lives of Dr Anderson and his family.

The 'Mandarin-missionary' strategy: Robert Kennicott, Spencer Fullerton Baird and specimen collection in the Hudson's Bay Territory

In 1859, Robert Kennicott, one of the most promising specimen collectors and young naturalists in the United States, was dispatched to Hudson's Bay Territory by Spencer Fullerton Baird, the Assistant Secretary of the Smithsonian. Kennicott was chosen because of previous experience in Canada, the familiarity with biota of the American Midwest, and because he had a boundless, infectious, enthusiasm for natural history that was typical among Baird's closest protégées. Kennicott was a natural scientific envoy--or missionary--to the officers of the Hudson's Bay Company, and many officers were enthusiastically 'converted' to the cause of collecting and/or overseeing the collection of natural history specimens. Due to this collaboration between Baird, Kennicott and the officers of the Hudson's Bay Company, the Smithsonian became a leading center of Canadian natural history in the Western hemisphere.

[Research on the hospital construction and structure in Daehan empire and colonial modern period]

It was the late Chosun Dynasty and Daehan Empire era that Western Medicine has firstly been introduced to Korea, previously operating on a basis of Korean traditional medicine. Western Medicine has been introduced by American missionary and Japanese Imperialism. An introduction of Western Medicine made it feasible to proceed new type medical care including operation, leading to require a new form of medical facilities. In the beginning, new facilities were constructed by Japanese Imperialism. Other hand many of facilities including Severance Hospital were established by missionaries. First of all, Daehan Empire established and managed a modern type of medical facility named "Jejoongwon" in 1885 as a government institution hospital. The Red Cross Hospital built in 1889. Afterwards, Jejoongwon and the Red Cross Hospital were taken over to missionary hospital and Japanese Imperialism, respectively. Japanese Imperialists firstly have protected their nationals residing in Chosun but have proceeded care a few Chosun people to exploit medical treatment as a mean to advertise superiority of the Empire of Japan. The facility that has firstly been established and managed was Jeseang Hospital in Busan in 1877, leading to establish in Wonju, Wonsan, and Mokpo. Afterwards, Japan has organized "Donginhoi" as a civil invasion organization, leading for "Donginhoi" to established "Dongin Hospital" in Pyeongyang, Daegu, and Seoul. Since 1909, governmental leading medical facility named Jahye Hospital was established according to an imperial order, leading to establish 32 hospitals all over the nation. American missionaries have established and managed 28 hospitals started from Severance Hospital built in 1904. However, Chosun doctors started to having educated and opening up their own hospital since 1920, leading for many of medical facilities to be established, but most of them have taken different roles followed by 6.25 War and economic development period. However, some of them are currently under protection as cultural assets, and some of them are now preserved. Buildings have originally been structured of wood as a single story in the beginning, but bricks started to be steadily used, leading to build two story building. Each of clinic department started to be separated since 1920, establishing operation room and treatment room. Now, a change of perception as to buildings that need to be preserved and an attention from government and doctors are required since modern medical facilities keep disappearing.

Special people? An exploratory study into re-entering missionaries' identity and resilience

Home country re-entry from cross-cultural missionary work abroad may be associated with psychological distress. Re-entrants experience multiple losses including loss of identity which may be associated with personal/relational identity gaps and depersonalization/dehumanization. However, research suggests that some re-entrants are resilient with good mental health, while others are fragile with poor mental health. The aims of this paper are to explore the nature and frequency of re-entering missionaries' identity gaps and their depersonalization/dehumanization in resilient and fragile re-entrants. Fifteen re-entering adult Australian cross-cultural missionary workers from four interdenominational Australian mission organizations completed semi-structured interviews. Results were analysed using modified Consensual Qualitative Research methods. Links were established between personal/relational identity gaps, depersonalization/dehumanization and resilience on re-entry. Implications for re-entrants' care are discussed with suggestions for further research.

Dengue virus infections among travelers returning from Haiti--Georgia and Nebraska, October 2010

In October 2010, a Nebraska clinician notified the state's Central District Health Department (CDHD) of a cluster of dengue-like illnesses in six of 28 missionary workers from Nebraska and Georgia who recently had returned after 7-11 days in Haiti. Infection with the mosquito-transmitted dengue virus (DENV) later was confirmed by laboratory testing in seven persons, five of whom were hospitalized. CDHD, the Nebraska Department of Health and Human Services (NDHHS), the Georgia Department of Public Health (GDPH), and CDC conducted a retrospective cohort study to assess the pretravel dengue knowledge and mosquito-avoidance practices of those with and without laboratory-confirmed infection. This report describes the results of that study, which indicated that 90% of those in the study had a pretravel health-care appointment, 57% sought travel advice on the Internet, and 24% used mosquito repellent several times a day; neither pretravel knowledge nor mosquito-avoidance practices were significantly associated with absence of DENV infection. Clinicians should be vigilant for dengue among travelers returning from Haiti and other areas where DENV is endemic or likely to be endemic and should report suspected cases of dengue to public health authorities.

Discovering the African freshwater "torpedo": legendary Ethiopia, religious controversies, and a catfish capable of reanimating dead fish

The electric catfishes of African rivers and lakes, once depicted on Egyptian tomb art, have been largely overlooked in histories and reviews of electric fish biology and animal electricity. This article examines how Westerners, especially Dominican and Jesuit missionaries, discovered them in Ethiopia and other parts of Africa at the beginning of the seventeenth century. What transpired took place against the backdrop of tales involving the Bible, Prester John's mythical empire, and imaginary animals with fabulous powers. In effect, how they were found is related to attempts to convert Ethiopian Christians to true Catholicism, hopes of discovering great riches, and opportunities to trade, and not with the efforts of skilled natural philosophers to document and conduct experiments on the wildlife of this continent. Nevertheless, the early descriptions by Europeans circulated, and during the next century these catfishes began to be used in experiments that helped to make animal electricity a reality.

Medical missionaries to China: the Jesuits

The 15th and 16th centuries saw a religious revival in Europe and an increased interest in church missions. With geographical discoveries supported by strong monarchies in Spain, Portugal and later France, Catholic missions and in particular the Society of Jesus resumed the spread of Christianity to China. Convinced that it was wise policy to address themselves to the most influential upper classes, the Jesuits under the leadership of Father Matteo Ricci became friendly with the aristocrats and the intelligentsia. The Jesuits introduced Western scientific ideas into China and even practised medicine. Between periods of adversity and persecutions, Chinese emperors who valued them for their scientific expertise generally tolerated their missionary activities. Any lasting influence on Chinese culture was limited.

Surgical relief work in Haiti: a practical resident learning experience

INTRODUCTION

A once-a-year, week-long surgical missionary trip to Haiti has become incorporated into our residency experience on a voluntary basis since 2007. The purpose of this article is to describe our experience with this mission effort during the last 4 years.

METHODS

Since 2007, at least one PGY 3-5 surgical resident from our program has traveled to the Hôpital Sacré Coeur in Milot, Haiti for a voluntary, week-long surgical mission working with the local health care providers. Their personal and clinical experiences in Haiti, in the surgical clinics, and in the operating room, were recorded.

RESULTS

Since 2007, 6 surgical residents and members of the surgical staff have traveled to Haiti for this surgical mission. During that time, a total of 247 patients were observed in the clinic and 184 surgical cases were performed. The case distribution covered a wide range of defined categories, including head and neck, breast, hernia, abdominal, biliary, stomach, small and large bowel, colorectal, skin and soft tissue, and urology. The personal aspect of this experience could not be quantitated but was profound.

CONCLUSIONS

We feel that the surgical missionary trip to Haiti is an asset to our program. It provides humanitarian surgical care to patients in need, teaching and infrastructure support to the local health care providers, a clinical and operative experience to our residents, and an invaluable personal experience.