By 1936, several provinces had some type of public health administrations or hospitals that promoted public health. Hunan, Gansu, Ningxia, Qinghai and Zhejiang had provincial public health experimental stations (sheng weisheng shiyanchu 省卫生实验处), Jiangxi had a provincial public health department (sheng weisheng chu 省卫生处), and Shanxi had a public health committee (weisheng weiyuanhui 卫生委员会). In addition, Jiangsu, Henan, and Guangxi had provincial hospitals that promoted public health throughout the province.228
Several provinces also had established provincial midwifery schools by the 1930s. According to Liu’s 1937 report on the National Health Administration, the National Health Administration and the Central Field Health Station in Nanjing helped to establish provincial midwifery schools in the late 1930s in Fujian, Jiangxi, Gansu, and Ningxia.229 The 1943 Yunnan
xingzheng jishi (Records of the Yunnan Administration 云南行政纪实) states that the National
Health Administration also assisted Kunming in establishing a provincial midwifery school as early as 1933.230 Zhejiang had started a provincial midwifery school attached to the provincial hospital (Zhejiang shengli zhuchan xuexiao 浙江省立助产学校) under the provincial civil administration department (minzhengting民政厅) in 1928, and it was approved by the
227 Neizhengbu, Neizheng Nianjian, G201-03. Liu, "National Health Organization," 338. 228 Neizhengbu, Neizheng Nianjian, G4.
229 Liu, "National Health Organization."
230 Yun Long et. al., eds., Kunming Xingzheng Jishi, vol. 22, Weisheng, Kunming shizheng (Kunming: Yunnan
zezhengting yinshua, 1943). The school was started in 1928 but, according to the report, did not receive NMB assistance until Minguo 23 (1934).
Department of Education in 1931. During that year, the hospital delivered 296 infants.231 Furthermore, in 1933 Hubei province opened a provincial nursing school in the provincial hospital, a midwifery school (zhuchan xuexiao 助产学校), and an old-style midwife training program (chanpo xunlianban 产婆训练班) under the provincial public security department (gonganju 公安局). There may be other claims to National Health Administration assistance in building midwifery training schools in additional provinces.
The following year Jiangsu and Hunan opened not proper schools but provincial
maternity hospitals, by 1935 Shanxi had its own midwifery school and maternity hospital,232 and in 1933-34 the First National Midwifery School provided technical assistance to the Shaanxi Provincial Midwifery School in Xian.233 Jiangsu’s commoners’ maternity hospital (pingmin
chanyuan 平民产院), part of its larger provincial hospital, was administered by the Jiangsu
provincial public health affairs department (Jiangsu sheng hui weisheng shiwusuo 江苏省会卫 生事务所) under the public security department (gonganju 公安局). When the maternity hospital opened in 1932, there were six beds with three patients, and deliveries numbered about 15 per month, including home deliveries.234 There were plans in 1932 to establish 10 maternity homes with antenatal and postnatal supervision in 10 different counties within two years in Jiangsu province. Its goals, aside from the obvious of improving maternal and child health in rural locales, was to open up areas in which the Jiangsu Provincial Midwifery School graduates could obtain practical experience. The Jiangsu provincial government also began training old-
231 "Second Annual Report, FNMS, Beiping, July 1, 1930 - June 30, 1931," (Beiping: First National Midwifery
School, Beiping, 1931), box 222, series 3, sub-series 601L, RG 5, RAC, p. 24.
232 Shen Jiaying, "Report on the School and Lying-in Hospital (Ben Xiao Chanyuan Liang Zhou Shixi Zhi
Jingkuang)," Shanxi shengli zhuchan xuexiao niankan (1935): 91-92.
233 "Sixth Annual Report, FNMS." 234 Ibid., Appendix III, xix.
type midwives in May 1932, the instructors of whom were graduates of the FNMS.235 Hunan’s maternity hospital (Hunan chanyuan 湖南产院), administered by its civil administration office, was the “central organization established to ‘move forward’ and manage the whole province’s midwifery work” (tuijin ju guanli quan sheng zhuchan gongzuo zhi zhongxin jiguan推进及管理 全省助产工作之中心机关).236 We can assume that these institutions engaged in formal or informal midwife training to staff their hospitals. As we have seen above, many Western missionary hospitals provided at least casual training of assistants, and these maternity hospitals were modeled on Western methods and equipment.
It is unclear whether or not all of these schools and hospitals had the support or assistance of the National Health Administration, which brings us to consider the disarray and deficiency of some early twentieth- century Chinese government documents. Although the National Health Administration existed to govern public health, and the National Midwifery Board to oversee maternal and child health projects, due to China’s unstable political and social conditions, reporting to these government offices was often inconsistent or nonexistent. It seems as though many provincial governments jumped on the public health bandwagon in the 1930s, but the extent and efficacy of their programs was usually lacking due to funding and administration problems.
Liu Ruiheng’s 1937 report to LON-HO states that nine out of 18 provinces had established provincial health services, with three in stages of advanced planning. However, according to Liu, traditional Chinese medical practitioners still attended over 65 percent of patients, and 26 percent of sick people were estimated to die without treatment each year.
235 "Fourth Annual Report, FNMS, Beiping, July 1, 1932 - June 30, 1933," (Beiping: First National Midwifery
School, Beiping, 1933), Appendix I: Suggested Plans for Places Surveyed, xi-xiii.
Furthermore, it was hard to get qualified doctors to live in remote rural areas, battle traditional beliefs, and compete with TCM practitioners. There were also the continuing shortages of funding and resources, corruption, and lack of transportation for medical supplies and people. 237