The Formation and Reconfiguration of an Informal Medical Workforce: Hansen's Disease Patients Trained at the Sorokdo Medical Training School and Korea's Leprosy Healthcare System, 1950s-1980s.

This article examines the Sorokdo Medical Training School (Noksan Medical Training School) and the lives of its graduates, focusing on their role in Korea's Hansen's disease healthcare system between the late 1940s and the 1980s. Existing studies have primarily portrayed Hansen's disease patients as objects of medical intervention, segregation, and state control. While such perspectives have illuminated the history of confinement, stigma, sterilization, and discrimination, they have paid relatively little attention to the active roles that patients themselves played within the healthcare system. By analyzing hospital records, government documents, overseas reports, and oral histories, this study reconstructs the experiences of Hansen's disease patients who were trained as medical personnel and explores their contributions to the operation of Korea's leprosy healthcare system. Established in 1949 at Sorokdo National Hospital, the Medical Training School was designed to address the severe shortage of medical personnel in Hansen's disease institutions and settlement villages. Graduates were deployed not only to Sorokdo but also to leprosy hospitals and settlement communities throughout the country, where they performed a wide range of medical tasks, including laboratory testing, drug dispensing, wound care, surgery assistance, rehabilitation, and outpatient treatment. In many settlements, where physicians were absent or visited only occasionally, they effectively functioned as the primary providers of everyday medical care. Their activities were therefore essential to both the treatment of Hansen's disease patients and the implementation of the state's leprosy control system. The article argues that these graduates constituted a form of "informal medical workforce" operating within, rather than outside, the state healthcare system. Although they acquired substantial clinical experience and were highly valued in practice, they were never fully recognized as professional medical practitioners. As Korea's healthcare system became increasingly professionalized from the 1960s onward, their broad medical responsibilities were gradually restricted. Yet their story was not simply one of exclusion. While some lost their positions within medical institutions, others adapted to the changing system by becoming leprosy control workers, laboratory technicians, radiological technicians, medical assistants, or operators of pharmaceutical sales outlets. Their experiences reveal how the professionalization of medicine simultaneously marginalized and incorporated non-professional healthcare workers. Methodologically, the study combines institutional records with oral histories in order to examine both the administrative position of these workers and their own understanding of medical expertise. The oral accounts show that graduates built practical competence through repeated clinical work, anatomical training, and the transmission of skills among senior and junior trainees, while official records and overseas reports reveal how heavily Hansen's disease institutions depended on their labor. The study also traces their divergent trajectories after the school was abolished in 1961. Some continued to work in Hansen's disease hospitals and settlement villages, whereas others moved into newly institutionalized occupations such as leprosy control work, clinical laboratory technology, and radiological technology. These trajectories demonstrate that professionalization did not simply eliminate informal practitioners; rather, it redistributed their skills across newly differentiated occupations and institutional boundaries. By recovering the largely overlooked contributions of these patient-medical workers, this study challenges physician-centered narratives of Korean medical history and reinterprets Hansen's disease patients not only as victims of modern medicine but also as active participants in the making of Korea's healthcare system. The history of the Sorokdo Medical Training School demonstrates that Korea's leprosy healthcare system was sustained not solely by licensed physicians and state institutions but also by the labor, expertise, and agency of Hansen's disease patients themselves.