The Nature of Colonial Public Healthcare: The Establishment of Sariwon Provincial Hospital.

This paper analyzes the structural limitations of the colonial public healthcare system by examining the establishment of Sariwon Provincial Hospital in Hwanghae Province under Japanese colonial rule. In the 1920s, Sariwon emerged as a central city in Hwanghae Province, driven by the development of railway transportation and commerce. However, modern medical institutions and public healthcare facilities remained severely inadequate. Under these circumstances, the local community of Sariwon initiated a movement to establish a provincial hospital. The movement, however, faced a crisis as the Government-General of Korea responded passively due to budgetary concerns. To persuade the Government-General to support the project, the Sariwon community proposed to bear a portion of the establishment costs. As a result, part of the financial burden was transferred to the local residents. These costs were distributed unevenly across different social classes and sub-regions, causing conflicts within the local community. The establishment of Sariwon Provincial Hospital demonstrates how colonial public healthcare was not a universal welfare system funded by the state, but rather a structure built upon the financial burdens of local residents. While shifting the fiscal responsibility onto the local community, the Government-General of Korea appropriated the visible achievement of constructing a modern medical facility as a means to legitimize its colonial rule. In this sense, public healthcare in local communities, represented by provincial hospitals, functioned as a low-cost, high-efficiency mechanism of governance.