| 摘要: | 沙眼在日治時期是公共衛生的議題之一，雖非法定傳染疾病，但仍引起一定的重視。而學童沙眼問題即是其中一部。沙眼問題涉及病患衛生條件和經濟程度，不論是現代還是日治時期，皆為醫界所知。本文主要以學校體檢制度、衛生用水和醫療資源負擔等三個方向進行討論。學校體檢制度可謂對學童身體健康的管控和調查，從而有關部門可得知學校衛生上對於沙眼問題的掌握程度。體檢亦為學校衛生實踐的手段，甚至沙眼體檢也成為防治措施的參考防治全臺沙眼的指標。對學童衛生乃至沙眼的監控，就衛生用水普及方面言，在日治時期推廣衛生用水有一定功效，其中學校水栓普及狀況甚至有時較日本本土佳，足見殖民者推展學校衛生之用心。儘管如此，初等學校方面，以水道水費用觀之，並非每間學校有足夠用水，連學童家庭也未必能充分使用，而當中也呈現臺人和日人的差異。至於醫療負擔能力，日治時期初等學校設有校醫負責健康事務，可是公學校校醫負擔較重，需負責較多學生之健康事務，且津貼亦不理想。此外，校醫人力配置不適當，都影響沙眼防治的績效。以校醫以外的醫療資源方面，公立醫療資源來說，官立醫院使用者多以日人為主，臺人多選擇公醫，公醫又需處理大量病患，負擔大。一般開業醫師則有藥價高的爭議，箇中原因與臺人和日人在於經濟能力的差異。雖然沙眼防治上衛生用水和病患經濟皆被納入考量，但這兩個部分卻未能對防治進行配合，進而使學童沙眼防治不易，甚至使學校衛生教育落實困難，沙眼成為殖民地的困擾。;Trachoma was one of the public health issues under Japanese colonial rule, though not a certifiable disease, still caused certain attention. And the trachoma of schoolchildren is among the part. Whether modern or Japanese colonial period, trachoma refers to the hygiene and economic level of sufferers, that are all known to the medical circle. This thesis proceeds the discussion mainly by three directions which are the school physical examination system, sanitary water and affordability of medical resources. The school physical examination system could be described as the control and investigation on the health of schoolchildren, thus the relevant department could learn about the grasp of the trachoma problem under school health. The physical examination also was the means to practice school health, the trachoma examination even became a reference of the preventive measures and a preventive indicator of the trachoma in Taiwan. For schoolchildren as well as trachoma surveillance, in the aspect of the sanitary water popularization, the promotion of sanitary water during the Japanese colonial period had a certain effect, and sometimes the popularization of school hydrant was even better than Japan, which proved the colonists’ intention of developing school health. Nevertheless, for the elementary schools, on the perspective of tap water cost, each school didn’t unlikely have enough water, and even the students’ family might not be able to use adequately, but also that appeared differences between Taiwanese and Japanese. As for the medical treatment affordability, under the Japanese rule, the elementary schools had school doctor to take charge of health affairs, but the school doctors in public schools burdened with the affairs more heavily, must be responsible for more students, and the allowance was not ideal. Moreover, the manpower allocation of the school doctors wasn’t appropriate, those reasons all affected the performance of trachoma prevention. For the medical resources excluding the school doctor, in the aspect of public health resources, the main users of the governmental hospitals were Japanese, and further, Taiwanese mainly chose the public health
physicians, which also needed to deal with a large number of patients with heavy burden. The common practitioners had high drug prices controversy, the reason was the economic capacity difference between Taiwanese and Japanese. Although sanitary water and sufferers’ economic capacity were taken into consideration, but those parts did not operate in coordination with trachoma prevention, and made the trachoma prevention of schoolchildren difficult, even causeed difficulty in carrying out school health education, so that trachoma become a troubled in the colony. |
