1. Introduction
The Peace Corps is a United States volunteer agency established by President John F. Kennedy in 1961 as part of his New Frontier policy. More than 240,000 volunteers participated in the Peace Corps from 1961 to 2023.1) The mission of the Peace Corps is “to promote world peace and friendship by fulfilling three goals: to help the people of interested countries in meeting their need for trained men and women, to help promote a better understanding of Americans on the part of the peoples served, and to help promote a better understanding of other peoples on the part of Americans.” In the 1960s, the Peace Corps was affiliated with the Department of State and selected young American citizens trained as volunteers for three months.2) A two-year cross-national volunteering opportunity follows this Pre-Service Training (PST). The countries that volunteers serve in are mainly developing countries, also known as host countries, which have requested skilled labor personnel. The Peace Corps responds by providing them with volunteers who have the appropriate skills they are seeking.
Kennedy’s Peace Corps was not a unique foreign aid program. Instead, it succeeded President Harry Truman’s Point Ⅳ program, which provided technical assistance to developing countries. However, the biggest critique of the program was that it was more geared toward helping the government and did not focus as much on the people living in the countries (Wetzel, 1966). The Peace Corps’ significant distinction from other aid programs is that young volunteers reside in their host countries for two years and are eager to engage in technical cooperation. In accounts that stressed the genuine idealism, toughness, and commitment of young Americans, popular media described the agency as an institution that revealed the deeply altruistic, fundamentally benevolent impulses of the United States (Latham, 2000: 110). On the other hand, Peace Corps volunteers were exempted from the draft, so joining was competitive during the Vietnam War.
In Korea, the Peace Corps initiated an agreement between the government of Korea and the United States in 1966. It withdrew its program in 1981 due to Korea’s economic development and a shortage in the Peace Corps budget during the Jimmy Carter administration. Over the fifteen years that the Peace Corps was active in Korea, volunteers provided technical cooperation in English education, public health, tourism, vocational training, special education, and more. Around 2,000 volunteers and administrative staff were admitted and resided in Korea. From 1966 to 1981, 50 groups3) of volunteer programs were implemented, and about 1,200 TESOL volunteers and 500 health volunteers performed their civic and altruistic duty in Korea.
Academic researchers in the fields of history, education, public health, and administration have paid less attention to the Peace Corps in Korea since it withdrew the programs in 1981. After the 2010s, several pieces of research in English education through the Peace Corps were conducted in Korea (Lee, 2014: Lee, 2016; Lee, 2019). These studies enable us to comprehend the impact of secondary school English instruction provided by the Peace Corps on the Korean educational system.
The Korean Heritage Library of the University of Southern California established the Peace Corps Korea Archive in 2017, marking a turning point in the research on the Peace Corps in Korea. Yoon examined the process by which the Peace Corps was deployed to Korea from 1961 to 1966 as part of the Cold War and international politics in “Activities of Peace Corps in Korea and its Implications(Yoon, 2019).” His research carefully analyzed actual diplomatic documents related to the agreement on the Peace Corps in Korea. However, regarding the Peace Corps’ Health Program, the study followed the arguments presented in “A White Paper on the Utilization of the U.S. Peace Corps” (1981) published by the Korean Ministry of Education and therefore failed to examine the actual operations of the health program. Seo presented not only the political dynamics surrounding the dispatch and withdrawal of the Peace Corps, but also the actual educational activities of Peace Corps volunteers through the use of oral history sources in “Strangers in the Classroom: The Peace Corps’ Educational Activities and their Impact in Korea, 1966-1981(Seo, 2021).” However, this work focuses on the educational activities of TESOL volunteers, neglecting research on health volunteers and volunteers in other fields.
Unfortunately, the Peace Corps health program in Korea has not yet been the subject of academic research. Over a fourteen-year period from 1967 to 1981, the Peace Corps dispatched approximately 500 health volunteers to Korea across 18 groups. The Peace Corps’ health auxiliary program received national acclaim from contemporaries for its significant contributions to improving community health conditions and addressing the shortage of healthcare personnel. During the 1960s and 1970s, several newspaper and magazine articles were published highlighting the efforts of Peace Corps tuberculosis workers and Hansen disease volunteers in Myun (sub-county) and/or Gun (county) health centers.4)
During the Cold War, the community health programs of the U.S. Peace Corps followed the modernization policies of developing countries. In the context of “modernization,” the primary challenges the Peace Corps confronted in Korea included health and human resources development and agricultural productivity. The development of infrastructure for health services in rural areas lagged behind other sectors of the Korean health system. This lag was due to insufficient funds for clinical services, a shortage of doctors and nurses in rural areas, and inadequate incentives to attract healthcare professionals away from larger cities (Peace Corps/Korea, 1972: 2).
A healthy workforce is a crucial element in a nation’s economic development. Although it did not prioritize health policy, the Korean government had been concerned about the health of the populace. Tuberculosis had been a persistent health threat in Korea since the Japanese colonial period, and was infamously referred to as “manggukbyoung,” which translates to “a disease that will bring a nation to its ruin (Kim and Park, 2019).” With the threat of tuberculosis largely eradicated, research on the disease in contemporary Korea has persisted (KNTA, 1998). Prior research has examined the conditions surrounding tuberculosis during the Japanese colonial period, specifically focusing on how the Japanese colonial government implemented tuberculosisrelated policies (Park, 2008; Choi, 2013; Park, 2019). Additionally, studies are advancing regarding the role of the World Health Organization (WHO) in tuberculosis control in South Korea after liberation (Kim and Park, 2019) and the contributions of health centers to tuberculosis control (Kwon, 2019). The comprehensive revision of the Public Health Center Act in 1962 led to the establishment of a healthcare organizational network known as “Health-Net,” with public health centers emerging as frontline institutions responsible for tuberculosis management and serving as the cornerstone of public health activities (Kwon, 2019: 726).
The year 1967, when the Rural Health Auxiliary Program of the Peace Corps was launched in Korea, was a period during which the Korean government was striving to establish a public health delivery system for tuberculosis control, focusing on the registration and treatment of tuberculosis patients. Analyzing the health auxiliary program of the Peace Corps entails an in-depth examination of the operational dynamics, development, and limitations of public health centers in Korea, while also providing a different viewpoint from that of American.
Furthermore, the Peace Corps claimed not merely the “donor-recipient” program but the “people-to-people” and “mutual exchange” programs. Even though the Peace Corps was established in the era of the Cold War, they explicitly insist on pursuing pure volunteerism. Consequently, it is necessary to evaluate the Korea Peace Corps Health Program in light of “modernization” and its actual legacy in the contemporary social history of Korea. It was also required to magnify the volunteer work with a microscope, as their activities.
However, there remains a significant gap in research concerning the impact of international assistant and aid organizations on tuberculosis control efforts in Korea. Moreover, the operational aspects of the health program and the activities undertaken by the volunteers are still under-explored in academic literature. Consequently, this paper aims to examine the early years of the Peace Corps’ activities in Korea, specifically from 1967 to 1970. It will address the program’s inception, the challenges encountered, and the strategies employed to overcome these obstacles, ultimately contributing to the establishment of a sustainable health program framework for the future.
To this end, this paper will investigate the background of the Peace Corps’ dispatch in Korea, with a particular focus on the characteristics of its health auxiliary program. Additionally, it will examine the initial pre-service training process, elucidating how ordinary American citizens in their early twenties were transformed into volunteers serving in health centers across Korea. Upon the arrival of the first health volunteers from the Peace Corps, they faced numerous challenges that ultimately led to a suspension of new volunteer recruitment. This analysis will explore these circumstances and assess the strategies for improving and implementing the health auxiliary program in response to the identified difficulties. To reconstruct the historical context of the early health auxiliary program of the Peace Corps in Korea, primary sources such as official quarterly and annual reports from the Peace Corps in Korea, the volunteer-published monthly newsletter Yobosayo, volunteers’ journals, photography, and reports authored by individual volunteers at health centers possessed by the Korea Peace Corps Archives of USC, have been utilized. Regrettably, it is exceedingly challenging to locate any Korean government documents concerning the Peace Corps health program, except for “A White Paper on the Utilization of the U.S. Peace Corps” that was compiled by the Ministry of Education in 1981. Records of the health program are likely to be missing or lost, as it was carried out by the health sub-center of Myun, while the TESOL program was predominantly managed by the Ministry of Education and local education committees.
To this work, this paper will investigate the background of the Peace Corps’ dispatch in Korea, with a particular focus on the characteristics of its health auxiliary program. Additionally, it will examine the initial pre-service training process, elucidating how ordinary American citizens in their early twenties were transformed into volunteers serving in health centers across Korea. Upon the arrival of the first health volunteers from the Peace Corps, they faced numerous challenges that ultimately led to a suspension of new volunteer recruitment. This analysis will explore these circumstances and assess the strategies for improving and implementing the health auxiliary program in response to the identified difficulties. To reconstruct the historical context of the early health auxiliary program of the Peace Corps in Korea, primary sources such as official quarterly and annual reports from the Peace Corps in Korea, the volunteer-published monthly newsletter Yobosayo, volunteers’ journals, photography, and reports authored by individual volunteers at health centers possessed by the Korea Peace Corps Archives of USC, have been utilized.
The author has conducted interviews with returned Peace Corps volunteers as part of the Academy of Korean Studies’ oral history project, “Korea-U.S. Relations and Grassroots Exchange,” since 2022. This research utilized oral history interviews of four returned Peace Corps volunteers. The interviewees were: George M. Cauthen, who served as a health volunteer in Jeongseon-gun (county), Gangwon-do (province); Sanford E. Gaines, who served in Cheongdo-gun, Gyeongsangbuk-do; Patricia M. Wilson, who served at Yeongcheon-gun, Gyeongsangbuk-do, under the K-4 program; and David J. Bachner, who completed the K-1 TESOL volunteer program and worked as a cross-cultural training coordinator in K-13 Pre-Service Training.
2. The Background of the Peace Corps Health Auxiliary Program in Korea
When the Peace Corps was established on March 1, 1961, the Korean government attempted to invite Peace Corps volunteers to Korea. The Ministry of Foreign Affairs sent an official document to the Ministry of Forestry, Ministry of Health and Society, Ministry of Education, and Ministry of Reconstruction on March 15, 1961. On March 17th and June 30th of 1961, a working-level meeting was held. U.S. Ambassador Chung Il Kwon sent an official letter to the director of the Peace Corps, Robert Sargent Shriver, asking about the possibility of initiating a Peace Corps Program in South Korea.5) Ambassador Chung stated that the “requirement of the Korean people, the Peace Corps is more strongly needed and desired now than at any time before in our history (October 20, 1961).” He apparently realized that the Peace Corps pursued practical activities at the grassroots level for social development. The Korean government desired several development projects, including an agricultural program, vocational guidance and development, teaching English, and a public health program. In December 1961, Chang Myung Ha, an Economic Affairs officer on the Economic Planning Board of the Bureau of Economic Affairs, sent a copy of “Peace Corps Volunteer Requirements in Korea” to the Korean Embassy and the Director of the Peace Corps in Washington, D.C. In the report, the Korean government formally requested a total of 147 Peace Corps volunteers: 55 individuals in the agriculture field, 26 individuals in the health and social affairs field (25 in Tuberculosis Control and 1 in Family and Child Welfare), and 66 individuals in the education sector (28 in English and 17 in industry).6) The Korean government had continuously prioritized education rather than public health.
However, in March of 1961, the Embassy of the United States of America in Seoul sent a letter to the Korean Ministry of Foreign Affairs stating that because the Peace Corps program was intended for countries that are less self-sufficient than Korea, a program there would not be feasible at the present time. The U.S. Embassy in Korea was hesitant to send Peace Corps volunteers for several reasons. 1) There were already between 60,000 and 65,000 American residents in Korea, including military, missionary, and United States Operating Mission (USOM) personnel. 2) Korea’s primary education and literacy rates were superior to those of other developing nations. 3) There was already a sufficient number of foreign-educated personnel. Due to these factors, the Peace Corps program for Korea became a low priority.7)
Consequently, the Peace Corps program in Korea did not begin negotiations until 1965. According to a memorandum from Secretary of State Dean Rusk to President Lyndon B. Johnson on May 17, 1965, the Peace Corps Program in Korea was suggested as one of the topics for discussion between President Johnson and President Park Chung-Hee of Korea (Yoon, 2019: 39). Rusk stated that “[t]he best appear to be an introduction of the Peace Corps into Korea, and/or an expansion of English-language training in Korea in the interests of worldwide communication.”8) In October of 1965, Ross Pritchard, a regional director of the Peace Corps for East Asia and the Pacific, visited Korea and spoke with American officials residing in Korea about how the Peace Corps would play a significant role in English Education(MacDonald, 1993). In March of 1966, a Korean news article reported that 90 Peace Corps volunteers, including teachers and technicians, would arrive in Korea in September of 1966.9) On September 16, 1966, the first group K-1 of Peace Corps volunteers arrived in Korea.10)
The initial Peace Corps groups in Korea were TESOL teachers tasked with teaching English in middle schools and high schools. There was a difference of opinion between the government of Korea and the Peace Corps/Korea office in Seoul. The Korean government placed greater emphasis on the TESOL program than any other program. Peace Corps/Korea documented that public health auxiliary in rural areas, education of health workers, science education, and vocational education rather than TESOL program were urgent problems facing Korea (The Peace Corps/Korea, 1966, 1971, 1972).
The Korean government regarded public health as less significant than educational programs such as TESOL in the implementation of the Peace Corps. However, in reality, public health was a critical issue directly tied to the survival of individuals and served as a fundamental key to securing the workforce. After the Korean War, the United Nations Korean Reconstruction Agency (1950-1958) attempted to rehabilitate the public health infrastructure. The Korean Ministry of Health and Social Affairs announced in October of 1961 that it had signed an agreement with the WHO to establish a five-year program for technical assistance in tuberculosis control. The program would include 125,000 USD in financial support.11) In addition, the proportion of primary school children carrying parasites differed greatly between urban and rural areas. For economic development, health should be prioritized by focusing on local community development, especially in rural areas. As part of community development, the health program represented a particularly valuable assignment for the Peace Corps’ programming division. Early declarations of the Peace Corps’ purposes emphasized the need for volunteers to fill a “middle-level manpower” gap in “developing countries (Latham, 2000: 122)”.
There was a national initiative to enhance public health, especially in rural areas, and the 5-Year Plan for Economic Development was in progress in Korea. Just after the first 5-Year Plan, there was a revision of the Public Health Center Act in 1962.12) It was to expand the number of public health centers to the county level across the country. The establishment of a healthcare organizational network, “Health-Net,” aimed to take responsibility for tuberculosis control but it did not work well. Doctors and nurses were essential for work at health centers, but there was a shortage of medical professionals with specialized training. The public health centers needed personnel who could be trained in a short period of time to replace the shortage of nurses (Jung, 2024: 268). In 1963, the Medical Assistant Act was enacted and in 1966, the Medical Assistant Act Enforcement Regulations first legalized the nursing assistant profession. Nursing assistants (auxiliary nurses)13) were eligible to take the national exam if they had a middle school education or higher and had worked for two years or more at a healthcare institution. Meanwhile, MHSA was to establish a health sub-center in each Myun in order to provide these services (Lee, 1999: 141).
Less than a year after the initial group of TESOL program volunteers was deployed in September of 1966, the decision was made to dispatch the health program as well. From 1967 to 1969, K-4 was the first Peace Corps volunteer group of the health program in Korea. The program was aimed at the “rural” health auxiliary in Korea and was expected to be one of the most physically, intellectually, and emotionally challenging in the Peace Corps (Peace Corps/ Korea, 1967b: 4). From the first health program group in 1967 (K-4) to the final health program group in 1980 (K-51), 18 of the 50 Peace Corps/Korea groups were health programs, consisting of approximately 500 volunteers in total.
3. General Features of the Early Years of the Health Auxiliary Program
In September of 1967, 125 trainees for the K-4 Korea Rural Health Auxiliary were initially selected. 41 individuals were excluded from the Pre-Service Training selection process. Some applicants said they would not participate in the PST because they had already been accepted to law school, medical school, or had found employment. 84 trainees were supposed to go to Korea after the 14-week PST and would be stationed in a Myun health sub-center in Korea. During that period, tuberculosis was a significant issue in Korea, particularly in rural areas. As a result, the health auxiliary program placed a high priority on preventing tuberculosis and enhancing living conditions. The health auxiliary program in the Peace Corps was in response to MHSA’s new health plan.
The MHSA announced the establishment of 1,334 Myun health centers to eliminate doctorless villages.14) As a part of the second five-year Economic Development Plan, the MHSA announced a comprehensive health plan spanning five years in 1967. Particularly in rural areas, the government prioritized health policy at the time. The following were the five priority areas that the MHSA emphasized: 1) Maternal-child health services 2) Family planning 3) Control of communicable diseases 4) Environmental sanitation and personal hygiene 5) Program for public health education. However, by October 1968, the plan to eliminate doctorless villages would have already been delayed. Only 5.8% of the projected Myun health sub-centers were established because of a budget shortage.15)
The Peace Corps viewed the development of infrastructure for the provision of health services in rural areas to be an urgent issue. In addition, there was a dearth of adequate allocation of resources to deliver clinical services and a scarcity of physicians and nurses in the rural areas, coupled with a lack of incentives to attract them from the larger cities (Peace Corps/Korea, 1972:2). For this reason, the Peace Corps attempted to dispatch volunteers as a workforce to assist public health systems. The U.S. Department of Health, Education, and Welfare, the Public Health Service, and the Division of Indian Health, were involved with the first health group (K-4) and its Pre-Service Training. The Public Health Service was concerned with Korean modernization because public health was not only in the United States issues but throughout the world issues (Peace Corps/Korea, 1967b: 5).
The Korean government and the Peace Corps collaborated to enhance healthcare provisions in rural regions in Korea. As Rural Health Auxiliaries, volunteers would be assigned to Myun health sub-centers and collaborated with their Korean colleagues. The Peace Corps group decided to manage communicable diseases, maternal and child health, and record vital events using epidemiology and demography while assigned to Korea (The Peace Corps/Korea, 1967a). After attaining a greater level of comfort with the Korean language, they resolved to implement health programs within educational institutions and disseminate health education via community recreational activities. The Peace Corps volunteers’ official job title was “rural health auxiliary” (bogun-bojo-yo-won) which means they were not professional medical personnel. A rural health auxiliary was equivalent to a nursing assistant in Korea.
4. The Curriculum of Pre-Service Training for the Health Auxiliary Program
The Peace Corps aimed to be a source of middle-level labor rather than advisors or experts. Upon completing their college education, young individuals seeking adventure and international volunteer opportunities enlisted in the Peace Corps. The vast majority of the candidates approved for Peace Corps service were what the agency referred to as “B.A. generalists”; individuals who held only college degrees but lacked the specific training or professional employment sought by the host nation (Latham, 2000: 122). The term B.A. generalists, however, seemed to mock volunteers who lacked specialized skills. In the Kennedy era, B.A. generalists outnumbered other applicants by a wide margin, and by 1965, they made up more than 70 percent of the applicants invited to the Peace Corps training.16) While the majority of the generalists were assigned to teach English or another basic subjects, the Peace Corps channeled many of the liberal arts graduates into community development, an assignment that demanded “leadership ability, practical experience, and a sensitivity to human values” but did not require a specific skill (Latham, 2000: 161).
The health auxiliary program in Korea was in accordance with this circumstance. The health auxiliary program was involved in community development. According to the volunteer group’s bio-book, the majority of Peace Corps/Korea applicants before the mid-1970s were B.A. generalists. After that point, about one-third to one-half of health group volunteers graduated from a pre-med program or held a biology major. Before mid-1970s, specialized training was required to utilize the manpower of these generalists. 14-weeks of Pre-Service Training aimed to transform generalists into a middle-level workforce as health auxiliaries. Through the PST, the volunteers would obtain skilled positions ranging in expertise from scientific experts and unskilled natives. At the Myun and Gun health centers, they would merely fulfill their function as health auxiliary workers in service of MHSA’s five priority areas.
In the mid-1960s, tuberculosis was not a prevalent ailment in the United States. Consequently, the Peace Corps had to locate a suitable training site and develop a program allowing trainees to gain practical experience in dealing with tuberculosis. The Peace Corps had a partnership with the Division of Indian Health to train volunteers for the K-4, Rural Health Auxiliary program. Typically, the reservations of Indians and Alaska Natives were geographically and culturally secluded, resulting in relatively poor health conditions. The Division of Indian Health played a crucial role in enhancing the health status of the Indigenous population. The Division of Indian Health employed nearly 5,500 individuals, with approximately half of them working in health professions or allied health fields. Additionally, the division operated 51 hospitals, 49 health centers, and numerous clinics (The Peace Corps/Korea, 1967a: 6). At that point in the 1960s, the Division of Indian Health for several years had been conducting training programs designed to develop health staff and beneficiaries with health skills, all with the view toward developing capabilities of the Indian population to provide its own health needs (The Peace Corps/Korea, 1967a: 6).
Tuberculosis wasn’t such a big issue in the United States, but we were trained in kind of how to help the local people with their medical issues. How to understand what the health problems, and to go with American nurses and health professionals. We’d go to visit even smaller villages away from the clinic and talk to people about and also health education tries to get people about the safe preparation of food and all these kinds of things (Gaines, 2023).
In the PST of the first group of health programs, K-4, the administrative office was composed of a project director, a project training officer, a cross-cultural coordinator, a language coordinator, and a technical coordinator, and there were many staff members under the coordinator. The project director was John G. Todd, a Sanitarian and M.P.H. at the Division of Indian Health in Oklahoma. The project director oversaw another Peace Corps Health Program after the Korea Peace Corps PST was over. The technical coordinator was much more important than the project director because even after the PST was over, the technical coordinator went to Korea with the trainees (volunteers) for several years to work together on the practical implementation of the health program.
The technical coordinator was James W. Justice, M.D., M.P.H., a graduate of New York Medical College in 1958, who participated in public health initiatives. He resided in Alaska for several years, where he was accountable for the health of Native Alaskans within the Division of the Public Health Service. He created a training program to employ native Alaskans as public health workers after choosing to focus on preventive medicine and completing a year in the residency program at the University of Oklahoma. The Peace Corps contacted Justice, who then visited Korea for two weeks to establish a public health training curriculum for K-4.
A total of 58 training professional staff oversaw 84 trainees in the K-4 PST. Among the 31 staff members, 3 Field Assessment Officers specialized in clinical psychology. They were responsible for the evaluation and selection of trainees during the training program. There were 27 Korean language instructors. They received Korean language teaching methods training for foreigners from the Foreign Language Institute at Yonsei University and were subsequently invited to the Peace Corps’ training site in the United States. K-4’s training site was the Ghost Ranch, which was located in Abiquiu, New Mexico, because the ranch was close to the Indian Navajo Hogans and Sioux Teepees village.
The PST prepared trainees to be multi-purpose health workers in Korea (The Peace Corps/Korea, 1967b: 14). The objectives of the K-4 PST were as follows:
1. To assist the trainees to prepare for living and serving in rural Korea.
2. To assist the trainees to speak and write in the Korean language.
3. To assist the trainee to function as a health auxiliary in the fields of maternal and child health, including family planning, communicable disease control including tuberculosis, environmental health, health education and health planning for the community.
4. To assist the trainees to be able to contribute to the goals of the Peace Corps.
The PST consisted of three major subject areas: language training, technical training and cross-cultural training. The initial area involved language training, during which the volunteers were allocated time to learn the designated language. Health volunteers’ language proficiency held greater significance than the TESOL volunteers. TESOL volunteers were required to use English in their work, while health volunteers were expected to communicate with local Korean patients. The Korean language has been recognized as one of the most challenging languages for English speakers to learn. Of the three areas of training for the PST program, the language instruction segment constituted the largest portion.
The subsequent area entailed the advancement of technical training. The volunteers acquired knowledge of their duty. TESOL volunteers acquired knowledge of teaching English to individuals who were not native English speakers. The health volunteers acquired knowledge regarding their clinical skills. As previously stated, the majority of volunteers were B.A. generalists. In order to fulfill their voluntary duty in the host country, it was necessary for them to acquire a specific skill. Furthermore, technical training was essential not only for theoretical studies but also for practical application in their fields. To prevent the transmission of communicable diseases, including tuberculosis, it was imperative to conduct X-rays on both confirmed and suspected tuberculosis patients, as well as collect sputum samples for testing. The trainees acquired knowledge in the classroom (base training site) as well as in the field, such as the Indian reservations and their clinics.
We learned how to give injections. We had to be vaccinated ourselves. And we got to practice how to use the needle and administer an injection. So all that kind of basic training and health techniques (Gaines, 2023).
The final area focused on cross-cultural development. The volunteers assigned to the Korea mission had to familiarize themselves with Korean culture. Before being assigned to Korea, few of these volunteers possessed substantial knowledge of the country or proficiency in the Korean language. To them, Korea was primarily perceived as a small East Asian country defined by stereotypes associated with the Korean War. They ate rice for each meal in the Korean posture and slept on the floor mats instead of beds (The Peace Corps, 1967b: 16). In addition, volunteers would have to use a squat toilet instead of a flush toilet. They required a thorough understanding of underdeveloped, uncomfortable, and less technologically advanced societies. Table 1 is the summary of times devoted to major subject areas. During the 14-week PST, the total hours of training activity were 725 hours.
To enhance the effectiveness of the training, the pre-service training emphasized field practice methods. Each trainee spent five weeks at field training sites to experience functioning as a health auxiliary. The field experience sites were at the Division of Indian Health located in Lawton and Clinton, Oklahoma; Winslow, Chinle, Keams Canyon, Tuba City, Arizona; and Taos, Dulce and Stanta Fe, New Mexico (The Peace Corps, 1967b: 28).
As shown in Table 1 above, the subject area with the largest allocation of time in the K-4 PST was language instruction. Next, technical instruction, which was the actual health education, was allocated slightly less than half the time of language instruction. K-4 sought to improve the health of the public rather than targeting a specific area. The K-4 health auxiliary program was divided into five main areas according to MHSA. However, it is difficult to acquire competent skills in these five areas with only 195 hours of training over a 14-week PST.
The Peace Corps’ PST emphasized two key principles: initiative and the integration of intellectual and experiential learning. Trainers were encouraged to be self-directed, resourceful, and self-reliant, with the training providing diverse learning opportunities that trainees could choose to engage with. Assessment was a collaborative process involving both staff and trainees, serving as a constructive educational tool. Intellectual knowledge about Korea was combined with practical experience to ensure effective learning, requiring trainees to actively adapt and respond to varied situations (The Peace Corps, 1967a: 24-25).
The K-4 PST, which began on September 5, 1967, at Ghost Ranch in New Mexico lasted 14 weeks and ended on December 11. Eventually, of the 84 trainees, only 69 who passed the assessment and selection were able to board the plane to Korea. The 69 volunteers arrived at Gimpo Airport on December 17, where they were able to make a fresh start as volunteers of the K-4 Rural Health Auxiliary Program of the Peace Corps in Korea.
5. Challenges Leading to the Suspension of the Health Auxiliary Program
The K-4 volunteers were 69 in total: 30 males, 34 females, and 4 married couples. They spent 25 days in Seoul for orientation, during which they observed the operations of health centers for 4 days and examined the activities of international health organizations in Korea. In January 1968, they departed for their designated locations: Chungcheongnam-do, Gangwon-do, Jeollabuk-do, Jeollanam-do, and Gyeongsangbuk-do. A total of 36 volunteers of the next health group, K-6 arrived at Gimpo on Jan 29th, 1968. Unlike the first health auxiliary volunteer group K-4, which underwent PST at Ghost Ranch near the New Mexico Indian Reservation, the second health auxiliary group, K-6 attempted PST in the city. K-6 conducted PST at the University of Washington from October 19, 1967, to January 24, 1968. While K-4 learned technical skills for rural community health, K-6 learned technical skills for urban health, including maternal and child health, family planning, nutrition, and laboratory procedures, while staying in the dormitory of the University of Washington in Seattle. Most of the K-6 operation staff were also made up of doctors and professors from the University of Washington, School of Medicine hospital. The K-6 volunteers were also assigned to the Myun health sub-center in Chungcheongnam-do. In October 1967, the MHSA directed the governors of each province to designate a local Myun health sub-center and accommodations for the Peace Corps health volunteers near their workplaces. They were supposed to support MHSA’s comprehensive five-year Health and Medical Development Plan.
The volunteers’ monthly newsletter Yobosayo, published in December 1967, welcomed the arrival of the first health Peace Corps volunteers and described in detail the Health Program, which was different from the existing TESOL program..
However, from January 1968, the newsletter began to express fundamental concerns about the new health program. The editorial of Yobosayo described the “brutal truth” of what K-4 volunteers would experience in Korea. In contrast to TESOL volunteers, who were typically assigned to urban secondary schools and held esteemed teaching positions, health volunteers would face a more challenging adaptation process. This was due to language problems and food challenges in the Myun area, and they did not have a two-month vacation. Robert Graff, a health volunteer for the Peace Corps in Korea, noted that health volunteers were regarded poorly, as Sangnom, whereas TESOL volunteers were esteemed highly, as Yangban.17)
A significant issue emerged less than a year following the initiation of the Peace Corps Rural Health Auxiliary Program K-4 and K-6. During the initial years of 1968-1969, the absence of clear operational guidelines resulted in significant variability in the work patterns of Peace Corps volunteers across different regions. In general, each Myun health sub-center employed two young female health workers. One was responsible for the control of tuberculosis, while the other was responsible for family planning. The availability of nursing auxiliaries at each Myun health sub-center was inconsistent, with some being qualified and others not. For instance, at the Cheongdo-gun Health Center where Gaines was employed, two women who had completed their studies at a nursing school in the city were assigned. Gaines, a Peace Corps volunteer, conducted X-rays with the two health workers at the Cheongdo-gun Health Center, which already had an X-ray facility. Furthermore, they were assigned the responsibility of conducting follow-up visits to villages to verify that patients who had been previously registered for tuberculosis were adhering to their medication regimens. The physical demands of the task of traveling by intercity bus to follow up on patients were not limited to Peace Corps volunteers; they also extended to young, unmarried female workers (Gaines, 2023).
The work patterns of Peace Corps volunteers in the health sector were highly variable depending on the region (provincial level) during the early days of 1968–1969, as there were less defined work guidelines or manuals. In certain regions, their qualifications and capabilities were misjudged, resulting in their assignment to rural village offices. These offices were responsible for emergency medical care, general medical services, health counseling (health education), environmental hygiene, and occasionally the identification and quarantine of infectious disease patients, among other responsibilities, which were tailored to the unique expectations and demands of each region. Nevertheless, the volunteers lacked specialized knowledge in public health or medicine, as previously indicated, and the basic knowledge they had acquired through a few weeks of training was insufficient to accomplish these tasks. Furthermore, they encountered communication difficulties with their Korean colleagues (Myun sub-center health workers), which resulted in confusion and frustration as the staff was uncertain about how to manage the Peace Corps Volunteers or allocate appropriate tasks. (Ministry of Education, 1981: 84-85).
However, the volunteers faced considerable challenges in fulfilling these responsibilities, as they relied solely on fundamental knowledge gained from several weeks of basic training, which was insufficient for expertise in medicine or health. In addition, there were no senior staff members at the health sub-center, which had just been organized, to demonstrate professionalism. In the sub-center, which had no doctors, the only available manpower were Korean female nursing auxiliaries who had just turned 20 and Peace Corps volunteers.19) On the other hand, many volunteers had communication problems with their Korean co-workers. In a survey conducted in March 1968, 75% of volunteers responded that they had problems with their co-workers. The volunteers tried to implement the sterilization technique and better planning they learned at PST, but the Korean co-workers expected the volunteers to be more aggressive and assume more leadership by demonstration if not by language. In fact, the volunteers were also B.A. generalists and had only learned technical skills in a 14-week health auxiliary program. The Korean co-workers occasionally saw the volunteers as experts in the health field. Most K-4 volunteers were told that lack of health sub-centers’ budget made it impossible to buy more needles. It was common to sterilize a single needle and vaccinate dozens of people. The boiling instrument for sterilization was also not well-equipped, so there were concerns about the transmission of hepatitis and secondary infection.19)
According to the report of Peace Corps Korea Health Project, the early termination of the Peace Corps Health Program was raised as an issue (The Peace Corps/Korea, 1969a: 2). In the last quarter of 1968, 33 of the health volunteers left Korea and as of April 8, 1969, the cumulative number of early terminations reached 59. Of the 105 total health volunteers, 56.1% left the country before completing their two-year duty. More fundamentally, the K-4 and K-6 Peace Corps health auxiliary program, which was implemented in 1968-1969, had to declare “the breakdown of volunteer job involvement” due to the early resignation of volunteers (The Peace Corps/Korea, 1969a: 3).
The early termination of the volunteers resulted in a more fundamental reevaluation of the function of health auxiliary volunteers. James W. Justice, who was the technical coordinator for the K-4 PST and subsequently supervised the Health Project in Korea, visited five of the ten sub-centers where issues were reported (The Peace Corps/Korea, 1969a: 4). The volunteers favored performing microscopic work in the laboratory. According to the newsletter, Yobosayo, volunteers reported the health programs had lost their major synthetic qualities and switched over to being an experimental laboratory in which individuals or groups of individuals were each trying in their own way to do something constructive in the field of health.20) For instance, some volunteers worked on rat control, patient records systems, baby-weighting services, and at various levels.21) Others were working alone in the Myun health sub-center in the rough outlines of the original objectives of the health program without financial and/or personnel support. The diversity of involvement in many health areas made it impossible to make predictions about the success of the program as a whole because the direction of the program had changed a lot.
Until 1967, the economic and administrative independence of health centers was not guaranteed. The health centers had insufficient budgets, making it difficult for them to operate independently. A lot of health centers relied on local government funding to cover their operating costs, but the public health center directors had to cover the health workers’ salaries out of their own pockets (Kwon, 2019: 727). Geographically, health centers were located near city halls and county offices, making it difficult to escape the influence of the mayor or county governor. The mayor or county governor exercised authority over the personnel of the health center and frequently transferred employees, making it difficult for the health center to maintain consistency in its work.22) For example, Patricia Wilson, who worked at the Yeongcheon-gun Imgo Myun health sub-center, experienced difficulties in her work compared to other volunteers working at the official health center in the Gun area.
Well, there wasn’t really a Bogeonso (health center). There was some little dinky little building that we went to when we first got there when we were in Daegu, but we didn’t. There was a village office in Imgo Myun. Then there were 27 little villages around. So Imgo Myun was where I stayed, and it was basically the Myun office. So, there were the apple people and the rice people and everybody in the office. And I just sat there, and then there was my family planning worker and a TB worker. And I worked with them, and we would sometimes go out on visits. This was in December and January. It was freezing cold. So, we went out to some villages. I mean, some of the villages would be, you know, a couple of hours’ bus ride and then a couple of hours walking, you know, out to... So, some of them were so far out, we didn’t go. And then people would come to the office there to get injections, like, for different diseases. So that was what we were doing. It was very difficult. Most of the people in the Myun office spent most of the time around the little fire, the little, it was sawdust, I think. No heating, no electricity, no water (Wilson, 2023).
For these reasons, health volunteers felt more frustration and loneliness than the TESOL volunteers who felt the dynamism of the development of education in Korea. Occasionally, it also affected the volunteers’ personal health conditions, physically and mentally. Major or minor illnesses could have serious effects on both morale and ability to work in Myun health sub-center.23) Consequently, the massive early termination of health volunteers caused not a single problem but a knot of complex problems.
The health program faced challenges, and this situation required multifaceted problem discovery. Before finding a solution, it was necessary to diagnose the problem situation. First of all, the role of volunteers in Myun health-sub centers was not clearly described. For the health auxiliary program to succeed as technical assistance, it was not just supplying mid-range manpower in the form of Peace Corps volunteers. If the work of health auxiliary volunteers was too simple, it could be substituted easily by Korean health workers and there would be no need for volunteers to come to Korea. Additionally, the continuity of work was not guaranteed after the volunteers departed if the work of health auxiliary volunteers was excessively distinctive to the point that Korean workers could replace it. Moreover, the health auxiliary volunteers were neither health science majors nor medical professionals. Additionally, they were not nursing assistants certified by the Korean Ministry of Health and Social Affairs. However, Peace Corps health volunteers were probably the most educated personnel in rural areas, particularly in the Myun. Despite the fact that their sole instruction consisted of a 14-week Pre-Service instruction, they were still four-year college graduates from the United States. Although they were not health experts, they were not entirely devoid of knowledge. Consequently, their responsibilities included serving as quasihealth professionals or social scientists to enhance the health of the local community. The health auxiliary volunteers were required to work in close collaboration with the Korean personnel and to ensure that the field of public health administration could be continued by the Koreans after the health volunteers had departed. The public health administration of the Myun health sub-center was tasked with establishing a precise epidemiological method of the local community. Specifically, a unified record system was required to conduct a meaningful analysis of the issue.
The problem was identified and resolved through close collaboration with medical personnel in Korea and the Korea National Tuberculosis Association. In order to accomplish this, it was necessary to implement more meticulous curriculum development and volunteers’ education, as well as to collaborate with Korean health workers and supervise the program at the national level in Korea. The Peace Corps Health Auxiliary Program was unable to recruit new volunteers or conduct Pre-Service Training until a concrete curriculum and operating system was reestablished. Typically, the Peace Corps dispatched five groups of volunteers to Korea annually. However, the health auxiliary program, which was experiencing challenges, suspended the dispatch of new volunteers after December 1967 and January 1968, when K-4 and K-6 were dispatched.
6. Improvement and Implementation Strategies for the Health Auxiliary Program
The Peace Corps Health Auxiliary Program had encountered problems with a lot of volunteers’ early termination, but the remaining volunteers who carried out the activities played their part. Some health project reports by the health volunteers were published. Among the reports that remain, the focus had been placed on the “Pong San TB Project”24) at the health sub-center in Bongsan Myun, Damyang-gun, Jeollanam-do, and the “Pre-school B.C.G. Vaccination in a Rural Area” in Inje-gun, Gangwon-do.
A K-4 volunteer, John Carter, who was employed at the Bongsan Myun health sub-center in Damyang-gun authored a report (Carter, 1969). It was a 93-page report that consisted of six chapters and an appendix: 1. Concept and preparation, 2. Continued preparation, 3. Implementation and execution, 4. Public relations, 5. Budget, and 6. Conclusion and inferences. K-4 volunteers, James Dougrey, Charles Perkins, Jack Hart, Bernice Paar, Karen Boyle, and Terry Boyle worked in tuberculosis control at the Jeollanam-do health center and collaborated with the initiative at Damyang Gun health center. In particular, the Bongsan Myun sub-center held a pilot program and case study for a small community, with the objective of identifying tuberculosis in new patients and conducting previous patients’ follow-up. The Peace Corps’ volunteers and Korean health workers mobilized 1,500 of the county’s 10,500 residents for five days from July 21 to July 25, 1969, in order to identify new patients. Simultaneously, a health worker was assigned to each of the 26 natural villages to conduct preliminary health education prior to the screening. This project was a result of the close network and leadership of Dr. Gil Byung-hwa of the KNTA and Dr. Justice, the Peace Corps practical adviser, and was a collaboration among the Jeollanam-do Provincial government, the KNTA, Damyang Gun health center, and the K-4 Peace Corps health program in Korea. Consequently, the “Pong San TB Project” identified and registered numerous new patients by conducting intensive door-to-door sputum collection and operating two X-ray vehicle trucks. The initiative also gathered a significant amount of data that should be considered in the delivery of public health services. This data included the demographic and geographical characteristics of small communities like Rhi and Burak, as well as the local fiscal and transportation conditions. The data would be utilized in the future.
Meanwhile, K-4 volunteer, Fred Toomey employed at Kirin Myun Health sub-center in Inje-gun, Gangwon-do authored a 9-page report, “Pre-school B.C.G. Vaccination in a Rural Area.” Over a span of 10 days, Toomey visited seven out of the 12 elementary schools located in Kirin Myun, a town with a population of 12,000, where he administered 335 PPD skin tests for tuberculosis and provided 660 BCG vaccinations (Toomey, 1969). At that time, a significant number of elementary school students had not received vaccinations, making these skin tests and vaccinations crucial in the prevention of tuberculosis. Furthermore, the initiative that required students to bring their younger siblings (preschoolers) to the elementary schools during their visits proved to be particularly effective. This public health program had underscored the importance of cultivating empirical knowledge that its success relied on strong collaboration among community health centers, schools, teachers, and the families of the students who were the recipients of the vaccinations. Bongsan Myun and Kirin Myun served as exemplary cases, demonstrating effective implementation due to their exceptional cooperation with the Gun health centers and their directors.
In collaboration with the Seoul branch of the Korean National Tuberculosis Association, 57 K-4 health volunteers recorded and released the album “Tomorrow without TB”25) in November 1969. The song, “Tomorrow without TB” was enlightening and significantly altered the public’s perception of tuberculosis and the significance of public health. A K-4 volunteer, Garry Rector created the song so anyone could sing along, using Korean lyrics set to psychedelic tunes that were popular in the West. The lyrics are as follows.
(The health and development of the people/ which is the strength of the nation/ and the strength of production. Don’t say I’m not going to get a checkup. A better tomorrow without TB in Korea. Tuberculosis is a scary disease/ that is transmitted without distinction of age or gender. There are many people/ who become patients without knowing it. Sputum test, I should get both X-rays/ everyone, including adults and children, together/once a year without fail/go to a health center that provides free checkups and treatment/and check my health, not brag about it.)
This album was proposed by Kim, Dae-kyu, who was the secretary general of the KNTA Seoul branch. Sinsegi Records Co. Ltd. released 2,000 copies of this album, and volunteers actively promoted it. The K-4 volunteers donated 500,000 won in sales proceeds to the KNTA on January 15, 1970. Through the implementation of the program, the Peace Corps public health program published the “1970 Guidelines for Tuberculosis Control in Korea” with the Korean Ministry of Health and Social Affairs. This volume was adopted as the specific guidelines for Peace Corps volunteers in Korea to implement tuberculosis control. Previously, a substantial quantity of work knowledge was reliant on a temporary piece of paper; however, this book facilitated the accumulation of integrated knowledge.
After completing their two-year duty, the remaining health auxiliary workers from the K-4 group returned to the United States on November 24, 1969, and those from K-6 returned on November 27, 1969. Beginning in 1970, the Peace Corps Health Program initiated the development of a new health curriculum under the leadership of Dr. Justice. This initiative aimed to address the shortcomings identified in the previous K-4 and K-6 programs and, more specifically, to enhance collaboration with relevant authorities, including the Korea National Tuberculosis Association.
In February of 1970, K-13, a new health program of the Peace Corps, was reopened in Korea. The coordinating committee for pre-service training commenced operations on February 2nd, and staff training commenced on February 15th. The PST site was Pepeekeo, Hawai’i, and on March 9th, 53 trainees convened at the training site to commence the training. The volunteers entered Seoul via Japan on May 19, 1970, after concluding the training on May 16 (The Peace Corps/Korea, 1970a). The orientation in Korea commenced on May 22, and the PST in Korea was administered from May 23rd to July 5th. Starting with the K-13 group, certain PSTs were conducted locally to accommodate the conditions in Korea, rather than previous PSTs which were conducted in the United States. Subsequently, all volunteers were assigned to health centers in Korea.
The training program for K-13 was entirely different from the previous health program. First of all, the most notable shift in the K-13 PST was the adoption of tuberculosis control as a primary objective, distinguishing it from prior programs. Joseph Kennedy, the regional director for East Asia and the Pacific at the Peace Corps, stated in a memorandum that the previous K-4 and K-6 “program failed to work out as promised.”26) The objectives of the previous health program were to allocate work at the Myun sub-center level as multipurpose health auxiliary labor. In the PST for K-4 and K-6, one of the objectives of the educational program was “to assist the trainee to function as a health auxiliary in the fields of maternal and child health, including family planning, communicable disease control including tuberculosis, environmental health, health education and health planning for the community.” However, their duties were excessively extensive. The 14-week PST was unable to convert B.A. generalists into public health experts. PST was insufficient to acquire the fundamental skills required for tuberculosis control. From K-13, the health programs of Peace Corps had targeted one group to one specific area such as tuberculosis control and leprosy control. Mother and child health and family planning were exclusively allocated to female volunteers. During K-4 and K-6 projects, tuberculosis control was considered to be the most effective program, and KNTA was willing to co-work with the Peace Corps. Consequently, the K-13 PST curriculum and implementation plan focused on tuberculosis control in the rural areas. Previous programs aimed to provide support in the form of health auxiliary volunteers to Myun health sub-centers, which were the most terminal network for maintaining public health. Beginning in October 1961, the WHO’s technical assistance for tuberculosis control adhered to a community-based approach. This approach prioritized the establishment of terminal health networks such as Myun health sub-centers and emphasized patient monitoring and management within the community through a horizontal, rather than vertical, strategy (Kim and Park, 2019: 122). Contrary to expectations, the Myun health sub-centers were not equipped with skilled health personnel, including doctors and registered nurses, and securing nursing assistants to work alongside Peace Corps volunteers proved challenging. A particularly difficult aspect was finding personnel capable of communicating effectively with the volunteers, who were not proficient in Korean. However, the implementation of Myun-based tuberculosis control faced challenges due to the inadequate staffing of these health sub-centers. Starting with K-13, the approach shifted to deploying volunteers to Gun health centers and small city health centers, which were higher-level institutions, rather than the administrative and personnel-deficient Myun health sub-centers.
The second significant shift was the collaboration with official institutions in Korea. Cooperation with the MHSA was already in place, however, it was not fully realized until the PST. Consequently, the K-4 PST was collaboration with the Public Health Service and the Division of Indian Health, and the K-6 PST was collaboration with the University of Washington and the UW Medical School Hospital. Nevertheless, these two institutions lacked access to precise information regarding the public health situation in Korea, as well as knowledge of the health center administration system and communication methods. This time, in order to address the challenges of K-4 and K-6, it was necessary for the parties to collaborate with the advisor, who was more specialized and had a thorough understanding of the local situation in Korea: 1. The tuberculosis section of the Ministry of Health and Social Affairs, with the assistance of the WHO advisor for tuberculosis control, was the central cooperation system on the Korean side of the PST of K-13. 2. Officials from the Korean Provincial Bureau of Public Health 3. Foreign Service Institute and Korean Language Institute . Furthermore, the Peace Corps in Korea was requested to establish a close working relationship among the volunteers, the public health advisor for the Peace Corps, and Peace Corps Public Health Advisory Committee, which were composed of members from colleges of public health and other institutions. Furthermore, a collaborative system was implemented with other agencies, including the Korean Red Cross, USAID, Scandinavian Missions, UNICEF, CARE, Population Council, and Planned Parenthood Federation of Korea (PPFK). The MHSA provided for the partial cost of 4 to 6 weeks of in-country training.
The Peace Corps thought here is a good idea because it’s very smart and rational and Korea thought, let’s do it. They all agreed WHO, Peace Corps and Korea, three thinkers thought this is good. Let’s design it. So, they designed forms that were easy to use a list of duties each person does. So public health is about management, too (Cauthen, 2023).
The cooperation initiative delineated specific roles encompassing administrative, financial, and human resources functions, along with the provision of drugs, health education materials and various other supplies. Since its enactment in 1968, the Tuberculosis Prevention Act had significantly advanced the tuberculosis program by securing dedicated funding for tuberculosis initiatives. This legislation emerged from a consensus between the private sector and the government, highlighting the necessity of an independent law for tuberculosis prevention (KNTA, 1998: 623). The Act laid the groundwork for addressing longstanding issues faced by health centers, particularly in terms of staffing, equipment, and the provision of treatment drugs, which had been ongoing concerns since the early 1960s. Notably, in 1965, the budget allocated by the MHSA for tuberculosis control was 115,019,000 won. By 1970, following the enactment of the law, this budget had increased more than fivefold to 591,511,000 won (Kwon, 2019: 738; MHSA, 1981: 62).
The MHSA’s proactive stance following the enactment of the Tuberculosis Prevention Act, facilitated implementation of the Peace Corps health program. The MHSA contributed to the partial funding of 4 to 6 weeks of in-country training and supported full-time personnel positions within the Hawai’i K-13 PST. These experts were Jang Kyungsik, a director of tuberculosis prevention at MHSA and Kim Sungjin, a director of Central Inspection Institute at KNTA. They joined the K-13 PST particularly in-country training program as health educators (KNTA, 1998: 516). Additionally, the MHSA allocated approximately $10 per month per volunteer for living expenses, along with approximately $3 per month for work-related travel costs. The American Korean Foundation was also involved in in-country training.
Moreover, contributions to tuberculosis control, including drugs and supplies, were sourced from organizations such as UNICEF, WHO, and the KNTA, and from the national health budget. The level of material support exceeded the current capacity of Korean personnel for effective utilization. Health education materials and supplies were provided by the National Tuberculosis Association, CARE, USAID, Scandinavian Missions, and PPFK. Peace Corps health volunteers were expected to develop a 35mm slide presentation for health education purposes.
The third major change was hiring of core staff who possessed empirical knowledge about Korea and Korean public health conditions. By the 1970s, a significant number of Peace Corps volunteers had acquired experience in Korea and went back to the United States. Some of these individuals became integral to Peace Corps staff, not only within the PST programs but also at the Washington headquarters. For instance, John Middleton, a former K-1 TESOL volunteer, served as a training officer involved in Korean operations in the East Asia and Pacific Region at Peace Corps Washington, acting as a liaison between the Washington headquarters and the Peace Corps in Korea. David Bachner, the coordinator for the K-13 Pre-Service Training, was also a returned Peace Corps volunteer from K-1. As Project Director, he supervised training projects in tourism and T.B. control for Peace Corps volunteers bound for Korea. And in the K-13 PST, the role of assistant project coordinator was held by Steve Gallon from K-3.
Another Peace Corp Korea volunteer named John Middleton. He had gotten the job in Washington as the Korea desk officer, the liaison officer. And I called John and said, are there any training programs because I think I’d like to do another training program. And he said we have an opening as cross-cultural coordinator for a program in Hawaii. So, I went back to Hawaii, and I stayed for, I stayed for three or four years, and I went from doing Korea projects, cross-cultural coordinator to project director for a couple of Korea projects. And then there was one position at the Peace Core Training Center then had become the University of Hawaii’s Center for Cross Cultural Training and Research long name, but I became the training officer. So basically, I supervised all the training directors not just for Korea but for Thailand, Fiji, Samoa, Nepal all the programs that were being trained in Hawaii it was not just Korea (Bachner, 2023).
Among the 19 PST instructors, 12 were Korean language instructors, and six of the remaining seven were returned Korea Peace Corps volunteers: Fredrick Blair (K-1), James Dougrey (K-4), Gary Hedrick (K-6), Samuel Householders (K-4), William Shanahan (K-4), and Katherine Stubbs (K-4). Notably, the instructors from the former K-4 and K-6 cohorts were able to impart valuable tacit knowledge in the areas of Korean public health and effective communication with local communities (The Peace Corps/Korea, 1970a).
7. Conclusion
During the Cold War, the Peace Corps sought to influence the modernization of developing countries as part of soft power strategy. The Health Auxiliary Program implemented in Korea had significant implications for public health, which was crucial for improving citizens’ quality of life and providing a stable and sustained workforce for economic development. However, it cannot be said that the early Health Auxiliary Program during the late 1960s led to a substantial decrease in the number of tuberculosis cases. This period was devoted to identifying new tuberculosis patients who had previously gone undetected, resulting in an overall increase in reported cases. Nevertheless, the discovery of these new patients was foundational in integrating them into the administrative management of health centers, thereby establishing a system for future treatment and medication.
The initial Health Auxiliary Programs in Korea, specifically the K-4 and K-6 programs, were not only unsuccessful but were nearly regarded as failures. The role and impact of the Peace Corps health volunteers were unclear from the outset, as they began their service as B.A. generalists lacking specialized health advisory expertise. Consequently, the successful implementation of this program necessitated a thoughtfully crafted pre-service training curriculum in conjunction with strong collaboration with relevant authorities in Korea.
The challenges encountered in the early years of this program cannot be attributed solely to the mistakes of either the United States or Korea. The Peace Corps commenced its operations in Korea without a precise understanding of the public health situation or the functioning of health centers. Similarly, although there was initial planning regarding health center governance and technical assistance from the WHO, the Korean government struggled to effectively implement these initiatives as the primary agent. It was not until many health volunteers expressed dissatisfaction with their work and experienced cultural adaptation challenges, leading to early terminations, that both the Peace Corps and the MHSA clearly recognized these issues.
A crucial turning point occurred with the enactment of the Tuberculosis Control Act in 1968. This legislation ushered in a new phase for tuberculosis control, facilitating financial, administrative, and human resource cooperation between donor and recipient countries, and improving communication systems. Following the K-13 program, the Peace Corps health program operated more reliably and expanded its focus beyond tuberculosis control to include leprosy, maternal and child health, and various other public health areas.
One of the main focuses of this study is the position of Peace Corps health volunteers as B.A. generalists. Were they immature amateurs or were they experts in Korean health sub-center? Despite the fact that Peace Corps volunteers were not health specialists, they were educated personnel in Korean rural areas and quasi-health professionals who worked in community health centers to address tuberculosis control, family planning, etc. They were not skilled nursing assistants in the medical field for many years. The term “B.A. generalist” had been used critically regarding Peace Corps volunteers, but it also represented the versatility shown in Korean health centers where specific duties were not clearly defined. The role of B.A. generalists was particularly maximized in the social sciences, including health policy and administration. Reports prepared by some volunteers at Myun sub-health centers —on the current status of tuberculosis control in the community, implementation details, and mid to long term plans—demonstrate that they had adequately fulfilled their roles as B.A. generalists and mid-range manpower in Korea.
Indeed, a significant number of volunteers who participated in the health program of the Peace Corps in Korea, upon their return to the United States, pursued a Ph.D. in epidemiology, or became medical doctors or registered nurses. For instance, George M. Cauthen, who was interviewed for this study, obtained a Ph.D. in epidemiology after his Peace Corps health volunteer experiences in Korea and had researched at the CDC in the United States till 2000. This was due to the knowledge and experience the volunteers acquired while working at health centers in Korea.
This study addressing the early health auxiliary program of the Peace Corps in Korea, has several limitations. It utilized not only public sources but private sources such as interviews or letters from volunteers who experienced the health program in Korea. Volunteers often report discrepancies between their personal perspectives and those of the Peace Corps headquarters or the Seoul office, sometimes expressing conflicting views on the same situation. While personal experiences of these volunteers were partially incorporated through the newsletter Yobosayo, they were not sufficiently reflected in this analysis. Second, the research does not encompass the entirety of the Peace Corps health program, particularly post-1970 developments following the K-13 initiative. The long-term impact on Korea’s health situation and public health system was not examined in this study, as it concentrated on the initial challenges of the Peace Corps health program. From 1970 to 1981, the Peace Corps health program, specifically the K-13 to K-51, operated consistently and influenced the improvement of public health conditions in Korea. Future research will provide an overview of the entire Peace Corps health program, addressing discussions that could not be incorporated into this study.
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