This paper aims to examine the achievements and implications of Dr. Chang Sei Kim as a public health pioneer and participant in the independence movement. The contents of the paper are presented chronologically to aid reader understanding.

Chang Sei Kim was born on February 22, 1893 as the eldest son of Seung Won Kim, a farmer in Yonggang-gun, Pyeongannam-do.1 He graduated from Pyongyang Seomunnae Presbyterian Elementary School and Tokyo Kandaku Accelerated Policy School.2 Through his father's influence, who was a believer in the early Adventist Church in Korea, 16-year-old Chang Sei Kim became interpreter for Riley Russell, the first Adventist Church missionary doctor dispatched to Korea, in 1908.3 Through this opportunity, he was able to enroll at Severance Union Medical College (SUMC) in October 1910, with the Ad-ventist Church of Korea covering his education expenses.4 Yonsei University College of Medicine was formerly SUMC. At SUMC he received a systematic medical education by completing courses in basic science, basic medicine, and clinical medicine, allowing him to develop into a promising doctor. After he graduated from SUMC in March 1916,5 he worked at the Sunan Church Hospital run by the Korean Adventist Church. In 1918, Chang Sei Kim was dispatched to the Red Cross Hospital in Shanghai as a missionary, where he was a doctor in charge for Chang Ho Ahn and he endeavored to provide medical treatment to his compatriots in the Shanghai Provisional Govern-ment of the Republic of Korea, and he received much confidence and respect.14 In 1920, he participated in a medical missionary conference held in Beijing.5 While interpreting the lecture on “The relationship between health and the rise and fall of nations” by Dr. Yeol Min Si, assistant director of the Red Cross Hospital, he encountered the idea that a nation's rise and fall depends on their people's health, and this led him to see the significance of public health to Chosun under Japanese rule.135

While providing medical treatment at the Korean Red Cross hospital in Shanghai under the Provisional Government of the Republic of Korea (ROK), Chang Sei Kim played a crucial role both in establishing an attached nurse training school and in training nurses.5 The nurses of the time acted as both combatants, directly participating in the war for independence, and medical personnel, in charge of emergency treatment given the lack of doctors during wartime. Nurses received intensive training of 18 hours per week over a short period of three months. They participated in a wide range of independence movements, including the Mansei Movement centered on regional communities and hospitals, the Red Cross movement, health education and mass education campaigns, etc.5 In addition, in March 1920, as the husband of Dosan Chang Ho Ahn's wife's younger sister, Chang Sei Kim joined and participated in the Young Korean Academy, which Dosan Chang Ho Ahn founded in San Francisco (US). From May 1920, he also worked as a public bond raising official in the Provisional Government of the ROK department of public bond management.1

Chang Sei Kim, who actively participated as an independence movement activist through the Young Korean Academy and the Provisional Government of the ROK, applied for an internship to the Jefferson Medical College. With the support of the Adventist Church, he traveled to the US for a study abroad, where he first encountered public health as an academic subject.5 Especially persuasive was the lecture by Victor G. Heiser, a senior Rockefeller Foundation official, at the annual Jefferson Medical College dinner in 1922, during which Heiser outlined his goal of creating a paradise on earth, with humankind enjoying health and happiness through improvements in hygiene. Chang Sei Kim was thus prompted to major in public health. As a doctor yearning for independence of his homeland, Chang Sei Kim came to conceive of the “recovery of the health of the Korean people through improvements in the hygienic environment” as a concrete method of achieving independence.135 After enrolling at the Johns Hopkins School of Hygiene and Public Health in 1923, he began his full-fledged study of public health and received his Dr. in Public Health in January 1925 (Fig. 1).5 His doctoral study focused on mung beans, a common crop in Chosun that is high in protein and, thus, an ideal crop to improve the Korean people's health. The title of his doctoral thesis was “Some chemical and biological studies of the Mung Bean, Phassolus aureus Roxburgh”.5

After receiving his doctorate, Chang Sei Kim traveled through 13 European countries, the Balkan Peninsula, and Egypt, and he participated in the Far East Medical Conference in Tokyo, before returning to Korea on October 18, 1925.25 He later came to work as an assistant professor of bacteriology and hygiene at SUMC,5 where he proposed his own public health theory, established based on his experiences and the research he had completed.5 His “Theory of reconstruction of the Korean people in terms of physical constitution,” encapsulated the concept that, for the Korean people to succeed and secure independence, there was a need to reconstruct the Korean people's physical constitution. Chang Sei Kim believed that the funda-mental reason the Korean people succumbed to colonial rule was their lack of health. His theory was similar to the “Theory of nation reformation” proposed by Kwang Su Lee, another member of the Young Korean Academy, who posited that the Korean people were responsible for their decline.34 However, compared to the Young Korean Academy's activities, aiming to foster citizens similar to Western populations through cultivation of the mind, Chang Sei Kim's theory had the long-term goal of creating healthy citizens to build a westernized modern nation and the short-term goal of independence through growth in physical ability. Thus, Chang Sei Kim's theory help form the beliefs of the Young Korean Academy from a medical standpoint.4

Chang Sei Kim emphasized public health education as a concrete methodology for his theory, realizing that its effective implementation relied upon support not at the personal level but, rather, at the society and national level.5 However, under Japanese colonial rule, it was not easy to tolerate that, in this case, this meant Japan. In this political climate, Chang Sei Kim believed that the self-government movement, which had been launched to cultivate political ability in the early 1920s, was the means to achieve a breakthrough and implement his theory at the national level.5 Although it had the limitation of acknowledging Japanese rule, Chang Sei Kim had high expectations Korea would secure the right of autonomy for three principal reasons: health policy could be planned and implemented at the national level independently, without the Japanese Government General's oversight; the main leaders of the Young Korean Academy, Chang Ho Ahn and Kwang Su Lee, supported the self-government movement; and between 1925 and 1927, the Japanese Government General was considering granting the right of autonomy to facilitate Japan's long-term stable rule of Chosun.14 However, the self-government movement was stymied by Korean ethnic movement forces demanding immediate independence, preventing Chang Sei Kim from realizing his dream through gaining the right of autonomy.14 However, he did not despair at this point; instead, he submitted an official request for support to the Rockefeller Foundation, proposing a plan for cultivating the public health industry and personnel in Korea. However, though the Rockefeller Foundation was providing financial support to public health businesses through its International Health Board, it only financially supported businesses when invited and supported by governments. As it did not provide funds to private institutions, it could not support Chang Sei Kim's projects.14 Furthermore, SUMC did not have sufficient financial resources to support his plan.14 Chang Sei Kim was discouraged by both the elimination of the self-government movement, removing the possibility of participating in the establishment and implementation of a health policy, and his failure to gain resources from the Rockefeller Foundation to establish an independent health research facility. The situation that he faced became increasingly difficult.14 After enduring hard times, Chang Sei Kim eventually ended his stay in Korea in August 1927, leaving for Shanghai, where he believed he could kindle new hope, as foreigners' activities were guaranteed. He was appointed the field director of the Shanghai Health Education Association in November 1927.5

Having earlier been discouraged by the various restrictions under Japanese colonial rule, Chang Sei Kim actively participated in such activities as supporting exhibitions, lectures, etc. at the Shanghai Health Education Association to overcome his frustrations as a Korean. Especially from 1927 to 1928, hygiene movements were being implemented in 25 Chinese cities, and Chang Sei Kim actively supported these efforts.14 China, which endured continued pillaging from foreign countries, was aiming for “the construction of a new nation through the recovery of health,” and dreaming of independence for its people. Chang Sei Kim, who aimed to implement his theories on a national scale, worked passionately in China.14 However, as the political atmosphere in China also became unstable, it became impossible to continue the activities of the association forming the basis for Chang Sei Kim's work; eventually, this led to him opening a hospital in his own home in 1929.2 He became especially interested in tuberculosis patients. This was said to be because Se Woong Na, a fellow member of the Young Korean Academy, had opened a tuberculosis clinic in Hangzhou (China) where he was working to treat patients. Although Chang Sei Kim's clinic was overflowing with tuberculosis patients, he did not remain there for long; in fact, he closed his doors to con-tinue his research into hygiene and tuberculosis, before returning to the US.124

Having left Shanghai to present on “Soy milk as a substitute for milk” at the International Medical Conference in New York, US in January 1930, Chang Sei Kim worked even more actively in the US.124 In 1931, collaborating with the offices of the Mayor of New York, he created a medical facility in Chinatown and was hired as Director of the Department of Health. He was also appointed as the head of health for the Boy Scouts of Manhattan.5 In addition, in Baltimore in 1932, he also worked tirelessly as an activist for independence, alongside members of the Korean National Association and important figures, such as Philip Jaisohn (Jai Pil Soh). In this regard, he filed petitions to the US government, Congressmen Borah and Goldberg, and the Federal Council of Churches; for clemency for Chang Ho Ahn, who was arrested immediately after the death of Bong Gil Yoon.1 However, on March 16, 1934, The New York Times reported the death of an Asian doctor.2 The person found dead, suffocated by gas the previous day, was none other than Dr. Chang Sei Kim. His death came as a great shock, as he had always been the most hard-working person. He left his last will and testament to his family and friends, and chose to end his own life. Another newspaper that reported his death stated he had been worried by an inability to bring his family to the US and that he was being threatened by assassins dispatched by the Japanese Government General.2 Chang Sei Kim was only forty-two when he took his own life, drained by disappointment and loneliness during his time wandering from Korea to China and from China to the US without properly settling down.2

During his lifetime, Chang Sei Kim was not able to participate in establishing and implementing a public health policy, nor was he able to receive financial support from foreign foundations supporting public health works, because he was not a citizen of an independent nation. In these circumstances, his active participation in public health activities in China was probably because he was free to pursue the common goal of “independence through achieving health”; moreover, in China, he could be appointed an official for public health, which was not possible in Korea. Ultimately, Korea's situation as a Japanese colony led to this promising public health activist being unable to settle in his own country and, ultimately, to his untimely death at the early age of 42.

On September 5, 2001, in recognition of his distinguished service, Korea honored the independence patriot Dr. Chang Sei Kim with the National Foundation Medal, which was presented to his remaining family.26 The medal presentation was attended by Chang Sei Kim's children, including his fourth son Richard Kim and his wife, who live in the US.2 In his speech at the ceremony, Sung Chul Yang, Ambassador to the US, honored the services of Chang Sei Kim, who had died in New York while actively participating in the independence movement in the Shanghai Provisional Government of the ROK in Los Angeles, Baltimore, and New York.6 By receiving this recognition for his distinguished services nearly 67 years after his death, Chang Sei Kim was able to return as a citizen of Korea.

The biography of Dr. Chang Sei Kim, who devoted his life to the independence of Korea and the health of its people under the colonial rule, should remind us of the spirit of Noblesse Oblige once more.