Blackfoot Diseases

 

Blackfoot disease first appeared in 1921 in Taiwan. At first it was just a few isolated instances, and no one really paid attention to it. In 1956, however, it was discovered that in the village of Fu-Jung, 490 of its 533 residents displayed a darkening of their skins. Between the years of 1956 and 1960, there was a dramatic increase of patients diagnosed with this unusual illness. Following widespread coverage of the media, the government began to pay attention to this strange illness, while the medical community also made research efforts.

Patients with Blackfoot disease were mostly from the four townships at the mouth of Pachang River: Hsuehchia and Beimen (now districts of Tainan City), and Putai and Yichu Townships of Chiayi County. These places share the geographic similarity of close proximity to the Taiwan Strait with high content of salt in the soil, which made it difficult to grow agricultural products. Most of the inhabitants in that area made their living in fishing or aquatic farming. Parts of the area along the sea coast did not have running tap water available, and people drew water from wells. The wells right by the sea had to be deep enough to yield fresh water. The water they drank was clear and tasty, but it turned out to be the main cause of Blackfoot disease due to high concentration of arsenic in well water. Chronic consumption of such water caused slow arsenic poisoning, which affected lack of circulation to the extremities and restriction of oxygen and nutrients to the body tissues. Gradually it leads to numbness, feeling of coldness, and in more severe cases patient experienced great degree of pain, blackened toes with ulceration, and even auto-amputation when the tissues are completely damaged. In such situation, only surgery can preserve life for the patient.

 

At that time Mrs. Lillian Dickson came to provide help patients with Blackfoot disease. She founded the “Door of Mercy”, a clinic that provided medical service free of charge. She invited Dr. Hsieh Wei from far away in Puli to join the effort of fighting the Blackfoot disease. Mrs. Dickson’s fund raising, along with Dr. Hsieh’s surgical skill and Dr. Wang King-Ho’s post-operative care and follow-up became the iron triangle of medical care for the Blackfoot disease patients in the early days.

 

What once was a dreaded disease gradually disappeared in Taiwan with the introduction of running tap water to these affected area.

 

Dr. Wang King-Ho

 

Born on April 23rd, 1916 in Beimen, Tainan, his family ran a fish and oyster farm raising business. In the early days education was a rarity in Taiwan. Most people were illiterate, including Dr. Wang’s parents who deeply felt the inconvenience of illiteracy and realized that education must be a priority of the family. Thus, they encouraged Wang King-Ho to study hard. He did not disappoint them, and with his hard work and diligence, King-Ho performed very well in school. After graduating from Chang Jung High School, he was further encouraged by his teachers to pursue study in Japan. Initially, he was admitted to Meiji College and became acquainted with Professor Chen Kung-Pei, who later became known as the Father of Public Health in Taiwan. Dr. Chen actively pushed for the laying of water pipes to provide a source of clean water for the people, therefore curbing the spread of Blackfoot disease.

 

At the age of 20, Wang King-Ho was admitted to Tokyo Medical School. He worked as a surgeon at Okubo Hospital in Tokyo after graduation. Later his mother fell sick and he returned to Taiwan at the height of World War II. The only doctor in Beimen recently passed away, Wang King-Ho ended up opening the King-Ho Clinic in his hometown as the only licensed physician trained in Western medicine. This was how he became closely associated with the Blackfoot disease.

 

Dr. Wang King-Ho practiced medicine for 50 years and cared for the patients with Blackfoot disease for 25 years. Some have labeled him as a fool because he gave up potential lucrative medical practice in big cities and instead was content to dwell in the small town of Beimen as an ordinary physician. Nevertheless throughout his journey, he was quite grateful and happy. When he was given the award for non-profit social and teaching service by the Ministry of Education, he still continued to share with everyone how God still wanted him to do more meaningful service for his country and for the society.

 

He passed away on March 13th, 2014 at the age of 98. Although we can no longer see Dr. Wang with his usual heart-felt smile, his lifelong sharing of love and his spirit of selflessness will always reside in the hearts of the people.

 

The fifties and sixties were an era of material scarcity and lack of proper education. The people of Taiwan generally lived in economic hardship. For those fishermen who lived by the sea coast, they could depend only on the Nature to survive, which was a much less stable way of life compared to that of large cities. All they asked for was earning enough living to fill their stomachs and good health. But such a simple desire became a dream that was so hard to reach for people with Blackfoot disease.

 

Due to the illness many of the patients suffered financially. Reduced income coupled with additional medical expense made their financial situation even worse. There was a lack of proper understanding of Blackfoot disease and the patients were subject to ridicule from neighbors and friends who thought the “black hands and black feet” were punishment by gods for their wrongdoing. With such internal turmoil and conflict they were experiencing some patients with Blackfoot disease gradually lost hope and decided to end their lives early.

 

In the story we see how Dr. Wang King-Ho treated patients with Blackfoot unlike how ordinary people would have treated them. He cared for them with a kind and loving heart, and we can see this from a few things. First of all, Dr. Wang also grew up as a son of a fisherman and truly understood the economic hardship of fisherman families. He thoughtfully gave a discount of his medical service to these families and did not want them to stop seeking treatment due to their financial difficulty. He even frequently forgave their outstanding debt, which often caused some displeasure from his wife. Secondly, people at the time misunderstood patients with Blackfoot disease and tended to stay away from them, but not Dr. Wang, who not only visited them in their home, but he also went as far as making simple caskets for families who could not afford a decent funeral due to their financial situation. He organized simple but orderly funerals for the deceased patients to depart with dignity. Thirdly, Dr. Wang determined not to allow the patients to feel like second-class citizens for staying in the free clinic for long periods of time, he regularly organized his children to clean up the hospital, doing his best to make the clinic like a comfortable home environment. Fourthly, Blackfoot patients who had their legs amputated could not work anymore. Dr. Wang and his wife started a handcraft workshop as an alternate way of providing for the patients economically so that they did not have to beg to survive. In the story we can see that a good doctor like Dr. Wang who treated his patients like family was really hard to come by, not to mention how he interacted with people in such a friendly manner. He never condescended to the patients because of his medical expertise. From the drawn pictures, we see Dr. Wang dressed in normal attire while seeing the patients in the clinic.

 

When Dr. Wang King-Ho was treating patients with Blackfoot disease, he never gave up because the course of treatment was complicated or it was time-consuming, or because he was unable to collect payment from the patients. He did not even transfer his patients to government clinics which were established later. Dr. Wang continued to provide care for patients who could not qualify for financial assistance from the government. He was faithful and consistent and single-handedly took up the challenge as the only physician trained in Western medicine in the entire Beimen Township. His life-long career of medical practice was marked by an infusion of personal conscience and social responsibility.

 

In the past we always look for stories of people with notable accomplishment from other countries to inspire our children; however, today we can instead share our home-grown experience in Taiwan with our children, and show them how Dr. Wang King-Ho, a seemingly ordinary physician, was able to accomplish something extraordinary during his medical career.