Natural Disaster and Disease Week

Taipei and Disease

By Nora Ma


What diseases afflicted Taipei? How does disease affect the dynamics between groups in heterogeneous populations? Does it redefine roles?


There are numerous sources within the literature that discuss disease and Taiwan. However, few sources specifically discuss Taipei City. The literature in English does, however, at times reference Taipei in relation to Japanese policies toward handling disease. The first two sources specifically address the history of diseases in Taipei, including both pre-colonial and colonial analyses. The third and fourth sources draw theoretical conclusions from the high incidence of malaria, specifically focusing on colonial dynamics. The fifth source provides a background on the Taiwan Education Society, which promoted hygiene in Taiwan through film. Most of these sources specifically focus on malaria due to its widespread influence during and prior to Japanese colonization, though some also briefly mention cholera as another major disease in Taiwanese history.

The conference paper “Disease and Mortality in the History of Taiwan”by Liu and Liu is important to the literature because it provides both a qualitative and quantitative assessment of the pre-colonial landscape of disease, distinguishing it from most other literature on disease in Taiwan. The authors surveyed population records, diary entries, and detailed descriptions of experiences of disease. The paper begins with a qualitative assessment of Dutch missionaries in the 1660s, the influence of zhang (malaria) on Koxinga, who lost nearly 70% of his army to disease in 1661, and later the Qing army leader Shi Lang’s loss of men to the same disease (2-3). Their qualitative evaluation concludes with examples of Japanese soldiers falling ill throughout the late-1800s (4). They then use written population records spanning from the mid-1600s to the late-1880’s to tabulate “events of epidemic” through this time period. The table is rough and undetailed because it relied on local gazetteers, which failed to provide annual information (p.8). Another quantitative table shows the relationship between age and morbidity, with Taibeizhou, which includes present-day Taipei, having the third lowest morbidity rate of 7.1% on the island from 1921 to 1929; this was calculated from health examinations conducted between these years (13). They later note that the lower rate of morbidity was surprising, given that the North Danshui area of Taibeizhou used to be “notorious malaria country (13). They propose that this decrease could have been the result of malaria control programs introduced by the Japanese administration.

Barclay’s book chapter discusses the techniques used by the Japanese in Taiwan to promote healthier cities and living conditions, explaining how they eradicated cholera, through the careful reordering of irrigation and water systems, and the plague, through inspection of ocean cargo for infected rats (136). The case of malaria was more difficult; the Japanese had to implement strict systems of medical oversight and establish compulsory treatment (137). Barclay focuses on the decreasing mortality rate in Taiwan during Japanese occupation, noting that the mortality rate pre-occupation could not be determined; he highlights that the notable accuracy of Taiwanese deaths and births was due to the mandatory paochia system registration, enforcing conformity as a matter of “collective interest” considering civil status was only granted through registration (p. 140). Summarizing his chapter, Barclay then goes on to connect the decline in mortality to the Japanese’s “administrative efficiency,” “slight reorganization on a mass scale,” and “constant vigilance” (171). He notes that Taipei Prefecture was one of the safest parts of the island because it was a “favorite residence” of many Japanese; it was rich in medical resources because it was the center of training and research for tropical medicine and less affected by malaria than other areas of Taiwan (166). Barclay’s book is important to the literature because of its detail and ability to establish a tighter quantitative relationship between Japanese occupation and decreases in Taiwanese mortality.

Liu’s journal article, “Overview of Public Health Development in Japan-Ruled Taiwan,” focuses on the European roots of Japanese medicine applied in Taiwan and the transition from malaria eradication for Japanese colonizers to a focus on the Taiwanese as well. Liu argues that the surveillance-based public health system afforded both the Japanese and Taiwanese more protection against disease, but it reshaped how Taiwanese and Japanese interacted because of the universal protection. Liu begins with Goto Shinpei’s adoption of Staatsmedizin, the German concept that public health should be protected by the government, focusing on establishing “public hygiene” and “social hygiene” through public works (p. 169). Liu identifies heavily Japanese-populated Taipei as the first part of Taiwan to build a comprehensive water system in 1896 (173). Later, he notes that cities had more pipes laid because of higher Japanese populations in urban areas; by 1942, 65% of all water pipes in Taiwan were in Taipei (173). This demonstrates how the quality of water supply, and therefore sanitation, diverged based on the level of Japanese population in an area. Liu later notes that in 1930-1939 the rate of “summer diarrhea in Taipei” was only 3.7% of the population for Japanese residents but 16.4% for Taiwanese (173). However, social changes were also underway. The colonial police outlawed traditional Taiwanese medicinal practices, provided an “omnipresent surveillance system,” and promoted accountability and standardization of medical training (171). Furthering the public health system, the Japanese established a Household Registration System, which allowed them to track vaccinations of each person. In Liu’s concluding remarks, he notes that this robust public health system was far larger and included more people than Goto had anticipated; Taiwanese were protected by the system as well after Tagaki Tomoe, who designed the comprehensive public health system, had implemented his plans. The system“blurred” the “line” that separated “the colonized and the colonizer,” forcing Taiwanese to give up political liberties for medical security (182). Wen Ku Ya’s article, “Anti-Malaria Policy and Its Consequences in Colonial Taiwan,” elaborates on the relationship: She argues that the policies implemented by the Japanese were tainted with assimilationist aims, “othering” traditional Taiwanese practices toward preventing and treating malaria (32). In connection with Liu, she highlights how official policy of Taiwanese developed into an assimilationist policy through surveillance and public works, further teaching Taiwanese to “understand their role… as Japanese subjects,” similarly blurring the line through health policy (42).

Daw-Ming Lee’s article on films by the Taiwan Education Society is included because of its important discussion of Japanese film propaganda promoting “healthy” habits that would prevent disease. The Taiwan Education Society’s goal was to promote Japanese assimilation, which included encouraging the use of Japanese language through film (115). In August 1917, Hagiya Kenzo was hired by the TES as a technician, and began creating films for events like the Hygiene Exhibition. The Hygiene Exhibition was filmed by Hagiya. It educated people by recreating scenes of infection and prevention (115). When cholera flared up throughout the island, this film was screened in places where the disease was severe, including areas near Taihoku, which includes Taipei, and Kiryu. Over 125,000 schoolchildren attended a film showing in 1919 over the span of 67 screenings (116). By 1924, the TES had produced over 84 films, five of which were specifically focused on educating the Taiwanese about public health. While this article did not focus on disease, but rather film as Japanese propaganda, it showed how media and disease intersected, with both serving as tools of Japanese assimilationist goals.

Much of the scholarly literature regarding disease, and malaria specifically, has focused on the Japanese colonial period, and the literature in English lacks substantial information on Taipei specifically. It is notable that the public health system established by the Japanese initially differentiated between colonizer and colonized; however, after implementation of surveillance policies, housing registration systems, and a comprehensive health system that included both Japanese and Taiwanese, both groups benefited from the policies implemented. The problem of disease demonstrates the tensions inherent in understanding Japanese colonialism of Taiwan: despite improvements to the health of the Taiwanese, the aims of Japanese administrators and policymakers nonetheless reflect a power dynamic of colonizer and colonized.


Liu, Ts’ui-Jung, and Liu Shi-yung. Disease and Mortality in the History of Taiwan. 1996, p. 1-21,

Barclay, George W. “Chapter 6: Public Health and the Risks of Death.” Colonial Development and Population in Taiwan, Princeton University Press, 1954, pp. 133–72. JSTOR, JSTOR, doi:10.2307/j.ctt183q00z.

Wen, Ku Ya. “Anti-Malaria Policy and Its Consequences in Colonial Taiwan.” Disease, Colonialism, and the State: Malaria in Modern East Asian History, edited by Ka-che Yip, Hong Kong University Press, Aberdeen, Hong Kong, 2009, pp. 31–48. JSTOR, Accessed 30 Apr. 2020.

Liu, Shi-yung. “An Overview of Public Health Development in Japan-Ruled Taiwan.” Death at the Opposite Ends of the Eurasian Continent, edited by Theo Engelen et al., Amsterdam University Press, 2011, pp. 165–82. JSTOR, JSTOR,

Lee, Daw-Ming. “Enlightenment, Propaganda, and Image Creation: A Descriptive Analysis of the Usage of Film by the Taiwan Education Society and the Colonial Government Before 1937.” Early Film Culture in Hong Kong, Taiwan, and Republican China, edited by Emilie Yueh-yu Yeh, University of Michigan Press, 2018, pp. 101–33. JSTOR, JSTOR, doi:10.2307/j.ctt22727c7.8.

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