Plague, SARS and the Story of Medicine in Hong Kong (review)

One of the most interesting consequences of the SARS epidemic of 2003 has been a renewed focus on the history of medicine in the East Asian region and in world history. Some bookstores in Taiwan, Hong Kong, Singapore, and mainland China now even feature popularized books on the world history of plagues, disease, medicine, and public health. The epidemic not only caused medical professionals, public-health scientists, and governments to review how they handled (or mishandled) SARS and how to make future improvements, it also made the history of infectious diseases, Western medicine, and Chinese medicine in the East Asian region suddenly current and relevant. The Hong Kong Museum of Medical Sciences Society published Plague, SARS and the Story of Medicine in Hong Kong to mark both its tenth anniversary and the centenary of the opening of Hong Kong's first Bacteriological Institute in 1906. Nevertheless, this book also participates in the current conversation throughout East Asia to align regional medical histories with contemporary concerns about medicine, the health care system, and public health.

The five-person editorial committee chose six lenses through which to structure their historical narrative of medicine in Hong Kong: infectious diseases, hospitals, the Bacteriological Institute, tuberculosis, healthcare issues, and medical education. They utilized the publications, archives, and other materials of all the major medical-related institutions, societies, colleges, and government organizations in Hong Kong to provide a comprehensive and useful overview on the subject. Each chapter contains contributions from multiple authors, which allows for impressive coverage of a wide range of diseases, from plague and malaria to tuberculosis and SARS, and an equally broad spectrum of institutions, people, chronologies, and issues. This story of Hong Kong medicine is well organized, comprehensive, informative, amply illustrated, and clearly written. The elegantly produced hard copy of the book provides a much-needed and readable introduction in English to the subject.

The coverage-by-committee approach, however, has reproduced the available archives—e.g., summary of policy statements, chronologies of institutions and infrastructure development, lists of services and activities, numbers of hospital beds over time, short biographies of key people—and provided an ultimately teleological narrative of medical triumph and enlightened governance in Hong Kong. Although it is comprehensive, it is not an exhaustive synthesis on the subject either. Scholarship that is more politically critical, analytically sharp, and written by scholars outside of the tightly knit Hong Kong community of physicians, scientists, and historians who contributed to this volume, for instance, was not integrated into the narrative or cited in the bibliography.¹

Furthermore, it has a more favorable slant toward the current SARS system in Hong Kong after its 1997 return to mainland China than At the Epicentre: Hong Kong and the SARS Outbreak, which it does not cite and whose authors were strongly critical of government ineptitude, increasingly centralized control, and initial lack of transparency during the SARS epidemic.2 On the other hand, none of the contributors to At the Epicentre seriously engaged the use of traditional Chinese medicine (TCM) among the people during the SARS epidemic in Hong Kong.

The Story of Medicine in Hong Kong, in contrast, mentions the need to define the role of TCM for future outbreaks (p. 71), devotes several subsections to a description of TCM's central place in Hong Kong history and society (pp. 91–98) and expresses support for both further integration into the Hong Kong hospital system and further research on its clinical value (pp. 245–51). Political alignments appear to match the way in which each book deals with the TCM "elephant" on the island and Kowloon. At the Epicentre's skepticism toward the new political system may have influenced its near elision of the role Chinese medicine played in the 2003 SARS epidemic in Hong Kong. By contrast, the relative optimism of The Story...