THE UNRRA PROGRAM for China was the latest but not the last of a century-long series of American philanthropic attempts to improve the conditions of the Chinese people. The entire 19th-century missionary effort implied a degree of patronage not very welcome among the great majority of educated Chinese. Missionary success in the 19th century was confined largely to the lowest classes. In the 20th century, aid to China began to be institutionalized, taking the form of support for hospitals, schools, research institutes, and international scholarships. It was not really necessary for a Chinese to become a Christian in order to benefit directly from foreign philanthropy. Japan's invasion of China in 1932, her withdrawal from the League of Nations, and the second invasion (1937) brought American "Aid to China" to an important level of national interest and international politics. The manipulation of aid grants and credits became truly big business at the Chinese capital, invariably dominated by the Chiang-Soong group.
When the United States offered Lend-Lease aid to China, T. V. Soong insisted that the "dignity of the Chinese people" required that full legal control of aid supplies must rest in Chinese hands.
Mr. Yen Chia-kan, lately Chen Yi's principal aide for economic affairs in Fukien Province, served at Chungking as Director of Procurement for the Chinese War Production Board. This meant in effect the collection and redistribution of materials produced in China, an operation geared to the procurement and allocation of American aid supplies.
This was not a happy arrangement, for there were often times in China when American military units in desperate need were unable to use supplies -- aviation gasoline, for example -- stockpiled nearby but held under Chinese control.
When a United Nations Relief and Rehabilitation program was proposed for China late in World War II, the arrangements for it had to be made through Soong, at that moment the Minister for Foreign Affairs. When it was actually carried through, he directed it as President of the Executive Yuan, with his brother-in-law, H. H. Kung as Vice President.
The China Program was the largest "single country" program attempted by UNRRA anywhere in the world, and through it China received goods and services valued in excess of half a billion dollars, including $470,000,000 contributed by the United States. In effect we were trying desperately to salvage something of the ally who had been propped up in the Security Council of the United Nations as a "Great Power" but was in fact rapidly falling apart. Not much aid--as aid--went beyond the warehouses at Shanghai.
The United States, dominating UNRRA operations, adopted a thoroughly unrealistic approach to the China program. In Europe the international organization, cooperating with the host countries, retained control of all material supplies for relief and rehabilitation until they reached the point of "end use." Not so in China. Chinese spokesmen, led by Madame Chiang and her brother T. V. Soong, maintained that only Chinese knew how to operate in China, and again that the "dignity of the Chinese people" would not permit foreign interference. The United Nations organization would be permitted to operate in China only in an advisory capacity. They spoke with convincing sincerity as leaders who understood and could interpret the American way of life; they had dedicated their lives to bringing reform and democracy to their ancient country. We could deny them nothing.
Washington agreed and the United Nations had to accept the terms. It was an extraordinary arrangement UNRRA would relinquish title to all supplies the moment they left the ship's tackle and dropped to the docks in any port of China.
This was the price of admission to Chinese territory (including Formosa) and was in effect a gigantic blackmail scheme. The probable alternatives were clear, for without massive aid China would slide into chaos and communism. The American public was not told that Madame Chiang's family dominated the warehousing and shipping interests of China, including the China Merchants Steam Navigation Company which managed subsidiary shipping on China's rivers, and most of the principal warehousing facilities along the docks at every important riverport and anchorage in the country. These were the docks at which the UNRRA relief supplies would be unloaded and the warehouses into which they would be carried. UNRRA would be billed for both storage and transport.
Through the Executive Yuan (T. V. Soong, President) the Chinese Government created an organization known as the "Chinese National Relief and Rehabilitation Administration" or CNRRA (pronounced "Sin-rah") which was authorized to take possession of relief supplies and to carry through a rehabilitation program for which UNRRA specialists would make recommendations, but in which they would exercise no authority.
Insistence upon Chinese supremacy in the administration of relief was prompted in some degree by national pride and considerations of face. The Nationalists wanted to demonstrate that at least they were masters in their own house. In the distribution of aid goods within China great effort was made to conceal the foreign or international character of the postwar UNRRA supplies. Chiang wanted credit to accrue to the Nationalist Party Government; Kung and Soong wanted funds and materials to pass through the family's banks and warehouses.
Hardly less astonishing than the transfer of legal title (and consequent loss of control) were the arrangements which the Chinese devised to increase the value of the international gifts. Although a half-billion dollars' worth of goods and services were being donated to China, the Government complained that it could not afford to distribute relief goods. If anything were to be done at all, UNRRA had to agree that CNRRA could sell relief goods "at a moderate rate" to generate funds with which to pay for distribution.
In subsequent accounting to UNRRA, China charged off $190,000,000 as "administrative costs," and an enormous percentage of relief goods disappeared into private channels once they had passed through those yawning warehouse doors.*
UNRRA's only defensive weapon in these circumstances was a degree of authority to halt the entry of relief supplies into Chinese waters, a weapon extremely difficult to use.
The local UNRRA-CNRRA program began at Shanghai on November 1, 1945, when funds were appropriated for use in Formosa. Ultimately the Taipei CNRRA organization had a central office staff of about one hundred persons, including half a dozen foreign specialists assigned by UNRRA to work within the CNRRA organization.
The CNRRA Director for Formosa was Chien Chung-chi, who had been Governor Chen Yi's private secretary for twenty-five years. Three of the divisional directors under Chien had long been associated with the Governor on the mainland, knowing well his views, methods and standards of operation.
Two and a half months after they began to draw pay, the first CNRRA project was inaugurated at Taipei on January 22, 1946. A gang of coolies was set to work repairing broken water pipes, but when the work was finished (on February 11), it was declared unsatisfactory, and was done a second time around; too many pipes laid down in the day had been promptly dug up at night, and shipped off to Shanghai. Nine other projects of a like nature followed this one. All of them had to do with ditchdigging and trash removal.
In the first six months of operations CNRRA- (Taiwan) spent approximately 2,800,000 yen for field projects, and nearly 8,200,000 yen for "administrative expenses."
The UNRRA-(Taiwan) team, with much prodding, persuaded CNRRA to raise its sights and broaden its program, moving from temporary make-work unemployment-relief projects to long-range, basic rehabilitation programs. The island needed constructive rehabilitation rather than stopgap relief, and here a little relief should go a long way. They were soon disillusioned. As the UNRRA Team Reports Officer later wrote:
Our earliest surveys of Formosa indicated that the island required little if any relief, despite the rumors which had circulated in Shanghai. The problem was not that there was insufficient food, although food production had diminished through over-working the soil and lack of fertilizers -- but a matter of poor government.
The Chinese had failed to understand and make any attempt to continue in operation the Japanese rationing system which had insured not an abundant but an ample amount of food for everyone. The Chinese Government, had, rather, collected a large percentage of the basic food, rice, from the farmers and was hoarding it itself. The farmers had thought that the collection of rice had heralded a continuation of the rationing system by the new government. They did not like this system, but realized its necessity and therefore willingly sold the food to the government at a very low price (which for the most part was never paid to them). But rather than seeing that everyone received supplies of the rice, the Army and the Chinese Government smuggled the rice from the country to China where it brought high returns from the short coastal markets, or hoarded it on Formosa. This created an artificial shortage, raise prices, so that the government then received large sums when the rice was released, and put the food out of the reach of many.
This was the beginning of the aggravation of the problems of Formosa by the Chinese, a process which has continued up to the present. 
In summing up, the Director of the local UNRRA office reported to his superiors that his biggest battles were waged in a ceaseless effort to protect the chemical fertilizer distribution program from the scheming Commissioner of Agriculture and Forestry, and his efforts to outwit the Chinese Director of Public Health. Both were working directly for Chen Yi. One controlled the Farmers' Associations through which fertilizer must reach the peasant in the field, and the other controlled medical supplies, prized in every market in Asia. Underlying these specific areas of difficulty were the general conditions of corruption and waste in the administration of relief.
The picture was by no means sharply drawn in black and white-"good foreigners and Formosans" versus "bad mainland Chinese"-for some CNRRA employees were highly qualified mainland Chinese and of great personal integrity, but they were too few in numbers and too unimportant to present an effective check on "the system." Some had taken employment on Formosa because it appeared to offer an opportunity for genuinely constructive service. By the end of the UNRRA-CNRRA operation they admitted total defeat.
Nor were Formosans all innocent lambs-among-wolves; many found it highly profitable to collaborate with Chen Yi's men in dishonest schemes (it was much safer to cooperate than to criticize), and many were eager, independent, and highly successful operators in the black market for relief supplies.
UNRRA's Chief Medical Officer (Dr. Ira D. Hirschy) summed up the Government's attitude toward public service problems:
"... the aims of the two organizations UNRRA and CNRRA as well as those of the individuals within them, were not identical. Whereas UNRRA was attempting to fulfill its obligations by philanthropic giving, CNRRA could not get away from the attitude that it was a business organization whose chief concern was selling at a profit." 
After May 1, 1946, foreign specialists ranged freely over the island, saw conditions in each district and talked to people at every economic level. Of the Chinese who wanted to do a good job, a social welfare officer had this to say:
Mr.... of CNRRA was an unusual person. He said.... "We cannot and must not promise anything to these people unless we are sure we can fulfill the promise" and he adhered to this principle ... He particularly felt that progress for his people was quite impossible unless the corrupt regime was removed.
I talked to many Chinese who told me in whispers that they felt there was no hope for any kind of planning until they could free themselves of the corrupt officials at the top ... One said that he had given up all hope of accomplishment under his government on the mainland until he was offered an opportunity to work in Formosa. He thought maybe given a fresh start be could do something to get the factories operating again. He saw crime increasing because of hunger and idleness in his city. But when I saw him last he was trying to resign and was in despair ...
I talked with many Taiwanese women who were hard workers as well as courageous citizens. They were trying to reorganize nursery schools and service projects. They were interested in . . . homes for the aged and sick . . . We helped them to reorganize . . . but we never felt that any of our work would endure . . . The mainland Chinese do not seem able to maintain a plan even when they have worked on it and understand it. There are exceptions, of course., but certainly hospitals, schools, and institutions of public health and welfare were falling apart under their regime. Formosa could function happily with a minimum of social welfare planning. The people are responsive and eager to learn how to solve their own problems. 
The UNRRA staff carefully analyzed relief and rehabilitation needs and formulated recommendations for action. It was reserved to CNRRA to control and distribute relief supplies and services. In practice UNRRA's advice was received politely enough at weekly executive meetings at Taipei, but then it was often enough simply ignored. Many of the mainland Chinese seemed genuinely astonished that the UNRRA people should be so naive as to expect CNRRA to waste supplies on the Formosans. Nevertheless, the UNRRA group, restricted though it was to an advisory role, exercised some influence as a check upon CNRRA's actions, inhibiting as far as possible the subordination of relief to business.
Business, nevertheless, was very good. CNRRA's sales policies on wire cable supplied for industrial rehabilitation realized about 100 per cent profit (nearly six million yen). It will be recalled that China charged UNRRA $190,000,000 as "administrative expenses." This figure did not include the "administrative fees" earned in the field. At Taipei CNRRA was ordered to sell 10 per cent of the relief flour in order to finance free distribution of the balance. UNRRA discovered that in fact 75 per cent of the relief flour was sold on this pretense, realizing a neat profit of some $300,000.
The range and variety of fraud and speculation was limitless. One of Chen's highest officers took control of new breeding cattle imported by UNRRA -- and of course took charge of the millions of yen set aside for their care and management. Little was heard of either beef or yen thereafter, but the officer had taken over the confiscated Japanese ice-manufacturing and refrigeration business, among many other things, making these a personal asset in all but name. This led to a frontal clash with UNRRA, There was an acute shortage of ammonia for ice production. Ammonia could be extracted from certain types of chemical fertilizers being imported by UNRRA, and these Chen's commissioners were authorized to allocate and distribute.
We estimated that the Governor-General and his cronies would take millions of dollars in profit from the import, distribution and sale of the chemical fertilizers which were to be received in great quantity.
UNRRA headquarters at Shanghai had agreed that this gift fertilizer could be sold to the farmer on Formosa at a price which would cover the costs of distribution within the island. Chen Yi promptly had his men create a new (and quite unnecessary) organization to handle distribution. Fat salaries and administrative costs would of course have to be charged against the return from sales.
UNRRA (Taipei) demonstrated that the farmer should pay in local currency no more than the equivalent Of 3.6 to 5.0 cents per pound, according to the type of fertilizer, Despite this, when CNRRA distributed the first thousand tons they charged from eight to ten cents per pound, thus realizing an estimated profit of about $300,000.
While a second shipment Of 5000 tons was entering the island, UNRRA at Taipei tried to make a major issue of this bold exploitation of the Formosan farmer and of foreign aid. It was estimated that Chen Yi's men stood to make a profit of some $500,000 on this shipment. Moreover, CNRRA's loading, unloading, and storage records showed an astonishing 20 per cent loss in transit. Investigation disclosed a real loss averaging 0.4 per cent. Nearly 20 per cent of this gift fertilizer was going into hidden storage and black-market operations -- and to the Commissioner's ice-making machines.
To circumvent the foreigners' meddling at Taipei Governor Chen and his Commissioners cleverly proposed to have the Taiwan Government General purchase 200,000 tons of fertilizer from UNRRA at Shanghai under an arrangement which would keep it out of CNRRA's jurisdiction on Formosa, and hence beyond the embarrassing purview of the Formosa UNRRA team. If this move proved successful, Chen and his Commissioners could expect a profit to themselves of not less than $12,000,000 and possibly as much as $18,000,000, depending upon the type of fertilizer sent in as "relief supply."
The proposal was being negotiated when rebellion at Taipei broke in upon the Governor's career.
This vital fertilizer program affected every farming community, hence the UNRRA-CNRRA conflict was discussed in every village and farmhouse. The farmers were eager to obtain the precious chemicals at precisely the right time to apply them in the growing season. Chen Yi's men on the other hand were not at all eager to hasten distribution, for as long as the fertilizers rested in Government's warehouses, storage fees could be charged to the UNRRA-CNRRA budget. The farmers knew that the foreigners were attempting to speed the fertilizer to them, and that the Governor's men were causing the delay. They also knew that the foreigners were trying to check gross cheating in the quantities delivered and paid for.
When the UNRRA records at Kaohsiung showed abnormally high percentages of loss in transit an investigating UNRRA officer (Ray Shea) happened to notice that coolie girls sent into the ships' holds at dockside as "sweepers" seemed always to gain weight while at work. This was odd, and the weight-gain was oddly distributed on the maidens. Further investigation disclosed the widespread use of a peculiar type of pants which served as pockets, usually filled with more fertilizer than girl when the wearer came ashore.
Thus the UNRRA team watched swindle and cheating practiced at every turn in the administration of the rehabilitation program. With angry frustration the foreigners saw standards of living sink toward mainland levels as the basic opportunities for rehabilitation wasted away. There was a surplus of electric power, for example, but services were undependable, and rates were increased to a prohibitive level. One small Formosan mining enterprise which had paid TY 5000 per month for power in November, 1945, paid TY 160,000 in March, 1946. Many small shops and home industries could no longer meet the bills. Many homes returned to the 19th-century use of lamps and candlelight.
Ample supplies of coal were available and many smaller industries were ready to resume operations with minimum assistance if they could obtain fuel. But investigation showed that Chen Ching-wen's railway was doing such a roaring business with passengers it was often refusing to move freight which was more trouble to handle and yielded less revenue. The official excuse was that there was a serious lack of boiler tubes and lubricants, and this lack, of course, was blamed upon the United States and UNRRA.
With the breakdown of power and transport services the island retreated toward the 19th century, but with the interruption of the normal food supply came the real danger of rebellion.
The only "famine areas" were in the over-crowded, infertile Pescadores Islands and in fishing and salt-field villages along Formosa's barren southwestern tidal flats. During 1946 seaweeds, potato leaves and the dried remnants of the 1945 sweet potato crop became the standard diet. Many families could afford to eat even these meager foods only once each day. More than half the Pescadores population was left unemployed when the Japanese withdrew from the Makung naval base.
An UNRRA team surveyed the problem, reported to CNRRA, and attempted to speed relief to the channel islands.
The "meddling foreigners" soon found that CNRRA was not interested in an area in which people were too poor to pay even minimum charges for relief supplies, and certainly unable to pay squeeze. The issue of "Relief for the Pescadores" became symbolic of the conflict between the foreign workers and Chen Yi's government.
The total population of the Pescadores exceeded 73,000 persons. There were fifteen doctors on the six small islands, but nine of them were in Makung town which had a population of 25,500. In one rural area there was one doctor for nearly 14,000 people.
At Makung the electric generating plant operated only from seven to eleven o'clock each evening -- four hours -- because of a lack of diesel fuel. Normally ten tons of diesel oil were required for minimum operations each month, but although there were forty tons on hand when the UNRRA team investigated, they were controlled by city government men (mainland Chinese) who were not interested in "wasting" fuel.
The town had running water only three hours a day, in the early morning.
The public health and medical situation was extreme. Among 200 cholera cases in 1946 there had been 170 fatalities. The isolation hospital was discovered to have two rooms for patients and one for examination. That was all. The Provincial Hospital was inactive. Dr. T. S. King, Director of the Taiwan Provincial Health Bureau, had ordered the local hospital to accept no more than one free patient for every five paying patients. At the time of the UNRRA investigation there were only three in-patients, hence the hospital administrators maintained they could treat no patients free of charge.
It was discovered that private physicians (Formosans) operating private hospitals and out-patient clinics were entirely overworked. One man was doing much more work for free patients than the entire Government medical organization in the Pescadores.
Government and relief supplies were in storage or not accounted for. There were 200 cases of malaria under treatment, but only 60 patients had been able to obtain any of UNRRA's Atabrine tablet supply, although millions of donated tablets were stored away at Taipei. The UNRRA supplies which had reached Makung (after great difficulty) lay about still crated. Of 50 cases of dried soup powder which had been shipped to Makung, only 10 had arrived.
Every pressure was brought to bear to force CNRRA action. Formosan leaders showed outspoken concern and repeatedly made it an issue in the local newspapers. At last CNRRA published an announcement that 7000 sacks of flour had been shipped to relieve Makung, but UNRRA at once called attention to the fact that only 750 sacks had been shipped, that they had been shipped unaccompanied, and that they could not now be accounted for.
On July I CNRRA shipped 1400 cases of biscuits from Tainan to Makung, but there Customs Officers refused to allow them to enter, sent them back to Tainan, and reported that the application for a local (Pescadores) import license read "food" instead of biscuits. Five months later (at the end of November, 1946) the head of the Makung Customs Office consented to send the documentation back to Taipei for "correction." Meanwhile hundreds of Makung residents had been starving while government agencies charged "storage fees" on the biscuits at Tainan.
In the course of this "Pescadores Incident" an UNRRA investigation disclosed that all relief shipments leaving the main island (through Tainan port) had to be cleared for export through no less than five offices there, and upon arrival at Makung a second series of five offices insisted on issuing import clearances. This included the office of the Commander of the Makung Naval Base. There were outstretched hands at every clearance desk. Ten agencies required payments of some sort before relief goods, donated by China's allies, could move forward 30 miles to a starving community.
After three months' effort UNRRA secured 500 tons of Siamese rice in Hong Kong, to be delivered to the Pescadores aboard a British freighter. En route the vessel stopped first at Keelung. UNRRA officers were delighted to find room aboard for 800 tons of fertilizer desperately needed by the Pescadores farmers. But CNRRA refused to cooperate, "regretting that all fertilizers have been allocated." Inquiry disclosed the truth; since the Pescadores farmers were too poor to pay anything whatever for relief supplies, the Chinese organization did not intend to waste a valuable commodity at Makung. Furthermore, said the CNRRA officers, "it is illegal for foreign ships to carry cargo between Chinese ports." Domestic inter-port freight services were the prerogative of the China Merchants Steam Navigation Company or its subsidiaries.
When UNRRA wished to ship phosphatic rock to Formosa for the hard-pressed local fertilizer industry, the Navigation Company demanded $32.00 per ton for the shipment. UNRRA officials refused to pay such an outrageous sum, and after long negotiation brought the Chinese figure down to $4.00 per ton which even so provided profit. The difference indicated the margin of profit demanded, and suggests the problems faced by individual Formosan shippers who had not the leverage which UNRRA enjoyed in dealing with Soong's agency. A bribe in the right place, however, could always move one's interest a little forward, but by the time squeeze was paid all along the bureaucratic line there was nothing left of profit to justify an initial effort. Small trade withered quickly under these conditions.
Shipments moving either way, to or from Shanghai, were subjected to exploitation. Cement for reconstruction purposes was in high demand throughout China and throughout Asia. A large reserve was surrendered on Formosa. The Kaohsiung Cement Works were quickly rehabilitated and returned to full production of 15,000 tons per month in 1946; nevertheless, cement was available on Formosa usually only on the black market. UNRRA discovered that amounts far in excess of normal prewar and wartime Japanese needs had been turned over to three offices under the Department of Communications, which controlled sea transport.
UNRRA also discovered that it cost three times as much to move bulk cargo by sea between Kaohsiung and Keelung as it did to move it overland by rail. When the Department of Mining and Industry decided to market a trial cement shipment of 1000 tons at Shanghai, it was first shipped overland to Keelung and thence by sea to the mainland. The railway freight charge alone was TY 2500 per ton. To this was added the charges for warehousing, transfer, insurance, and sea-freight, and at Shanghai Formosa's cement was expected to compete in the market with American cement, selling then in Shanghai at the equivalent of 3000 Taiwan yen per ton. Each agency along the line from Formosa to Shanghai had taken its squeeze and its excessive profit. The longer the rail haul the higher the profit to the railway officials, the longer the delay in warehouses the greater the profit to insurance and warehouse agencies.
The traditions of integrity which had once marked the China Customs Service (under foreign management, to be sure) did not survive under Nationalist control in Formosa. Of ten agencies squeezing UNRRA relief shipments from Tainan to the Pescadores Islands on one occasion in 1946, at least four were branches of the China Customs Service. Government agencies, UNRRA, and private concerns were charged heavy "import duties" when they attempted to ship materials from one Formosan port to another.
This scramble for bribes choked overseas trade. In November, 1946, it was announced that clearance for ships desiring to leave Keelung port could be completed only during certain limited office hours, and not at all on weekends and holidays. Ships' captains and foreign shipping agents soon discovered that key officials often "stepped out of the office" at critical moments within the posted working hours, but underlings made it known that with special consideration (i.e. bribes) the difficulties of port clearance could be surmounted promptly. The alternative, of course, was equally expensive, for high port fees had to be paid as long as a ship lay in harbor.
The Customs, the Quarantine Services, and the Harbor Police were each under a different agency. Complex and sometimes quite contradictory regulations offered many opportunities to confiscate goods on the pretext that import or export rules had not been observed. For example, on one occasion supplies for UNRRA personnel were confiscated and then offered for sale to the UNRRA consignees with an additional charge laid on for "interim storage."
By late 1946 an orderly import and export trade was no longer possible, the entire island economy lay at the mercy of newcomers who controlled the ports and were able to interpose regulations profoundly affecting the use of relief and rehabilitation supplies.
But where regulation was most needed, there was none; the Quarantine Services were neglected and the offices stripped of medical supplies and equipment. As the entire economy sickened, there was a general breakdown of the health and welfare services, most dramatically demonstrated when cholera and bubonic plague entered Formosa in epidemic proportions.
Here was a threat to life itself.
Doctors, nurses, food specialists and welfare workers on the UNRRA team promptly won the respect and cooperation of Formosans and of some CNRRA colleagues, but they had come late -seven months late - to the scene. The cities had slowly begun to take on the appearance of China's squalid towns. When Chiang's "Peace Preservation Corps" commandeered Taipei's garbage truck fleet in 1945 to transport stolen goods to the waterfront, huge piles of rubbish accumulated in the parks, side streets and alleyways. A primitive system of handcart collection, substituted for the motor trucks, could remove only about one-tenth of the daily accumulation of trash. The rat population multiplied fantastically.
Formosa's larger towns had at one time maintained regular sewage disposal and house-to-house disinfecting services, carefully supervised, paid for out of taxes, and available to all. Now under the mainland Chinese the work was farmed out on the concession basis. Each householder had to negotiate for service and pay directly to the collectors. As living costs soared the collection fees increased, and if not paid promptly upon demand there was no collection. Overflowing cesspools raised a stench and led to dangerously unhealthful conditions.
In 1937 there were no less than ninety-eight city and town waterworks in operation, with an additional twenty-eight planned or under construction. These supplied 1,270,000 people or a quarter of the island population.
UNRRA representatives were deeply disturbed by the Chinese failure to rehabilitate these public water systems. CNRRA's first feeble attempts to restore Taipei's water supply failed because of the widespread theft of plumbing fixtures, including both public fire hydrants and faucets and piping from unguarded private homes.
Unchecked loss of water made it impossible to maintain adequate pressure in crowded areas. Unfiltered water was turned into urban systems to mix with treated water. In some instances the chemicals intended for use at the reservoirs and pumping stations went instead into the black market.
Malaria, smallpox and tuberculosis were serious problems. An UNRRA survey showed that from 60 to 90 per cent of the schoolchildren examined were suffering from malnutrition. Wartime privation had lowered physical resistance in the urban population, and thousands of teen-age boys, sent in 1944 and 1945 to keep watch on the beaches, had developed either malaria or tuberculosis, or both, after long exposure in dugout shelters or inadequate tents and shacks hastily constructed in the countryside.
Port quarantine services were disrupted in the last days of war, and whatever was left of equipment or supplies went the way of all movable loot in the late 1945 "scavenger period" of petty pilfering. The new Government was not much interested in the enforcement of quarantine checks and restrictions upon traffic to and from the mainland. Incoming Chinese brought a particularly virulent form of smallpox which became epidemic. Despite public clamor, nothing was done to resume the compulsory vaccination system which had been in force before surrender. UNRRA doctors ascertained that some Chinese garrison troop units had a venereal disease rate of 90 per cent and that in some areas 25 per cent of the civil population was now infected.
Medical supplies were scarce, equipment was obsolete, and the Government showed little interest in repairing heavily damaged hospitals. There were approximately two thousand registered doctors available, including many newcomers, but there were few adequately trained nurses. Fortunately the Formosans -- trained in Japanese medical schools and short term institutes -- cooperated well with the Japanese doctors and public health officers who wished to remain in Formosa if they could. Both groups were eager to welcome UNRRA specialists bringing in new ideas, new techniques, new equipment and medical supplies. Here and there Japanese trained in the old German tradition offered resistance to change, but on the whole the foreign specialist could rely upon support at every level of activity.
In developing an UNRRA-CNRRA medical program only the Chinese Director of Public Health -- a Johns Hopkins man refused cooperation.
Reasonably enough the Governor had transferred the Public Health and Welfare services from the Police Bureau to the Department of Civil Affairs. The new Director, Dr. T. S. King (trained as a physiologist and pharmacologist), had been running a drug concern in Shanghai in which the Governor was interested. He had no previous experience in public health administration. Soon he showed that he had no interest in public health; he had been brought to Formosa to look after Chen Yi's drug interests as General Manager of the Taiwan Drugs and Surgical Instruments Company, a subsidiary of the Department of Mining and Industry.
In his public capacity Dr. King controlled the licensing of doctors, nurses, pharmacists, and medical services. He controlled confiscated hospitals, clinics, medical supplies and equipment. It was within his power to license drug imports and the local manufacture and sale of medicines. He was therefore in a strong position to exclude or restrict the local use of medical supplies (including relief supplies sent in by UNRRA) if they competed in any way with his own or the Governor's private interests.
In his "private capacity" Dr. King promptly organized a new pharmaceutical manufacturing center and a distributing company on behalf of Chen Yi. The sale of patent medicines and prescriptive drugs was an enormously profitable business. To the management of these enterprises the Director of Public Health and Welfare devoted most of his time. One of his first private undertakings was the production and sale of a patent curative for tuberculosis, put on the market under his own name.
It was inevitable that the UNRRA specialists should come into open collision with the Director of Public Health. He in turn took every occasion to belittle UNRRA's services and the qualifications of foreign personnel, bringing pressure to bear upon the University Medical School, the hospitals, and the Taiwan Medical Association in jealous efforts to restrict public or professional access to lectures, demonstrations, and films which the foreign specialists were prepared to offer. For example, during the 39th annual meeting of the Taiwan Medical Association some seventy papers were presented, after which Dr. King caused the following comment to be printed in the Government newspaper:
... However, the article by Dr. Hirschy of UNRRA entitled "The Prevention of Contagious Diseases" is comparatively of a preliminary nature. It is merely common sense. It seems to be unsuitable to be read at the meeting of a medical association, for it is a waste of time. Some of the people are of the opinion that foreign medical doctors should try to acquaint themselves with the medical standards of the province. 
In another context Dr. King strove to impede the free distribution of Atabrine tablets in the anti-malaria campaign, and to prevent competition which freely distributed foreign aid supplies offered to his private mercantile interests. Some 45 million Atabrine tablets were in the warehouses, but Dr. King proposed to put his Pharmaceutical Company into the quinine business. King's successor as Director of Public Health, on the other hand, later proposed that the 45 million tablets be handed out to everybody on Formosa -- about six tablets per person -- thereby "quickly wiping out malaria throughout Formosa." They had been lying in the warehouses for more than one year, while the Government collected storage fees indirectly charged to UNRRA.
The so-called Mukai Incident profoundly disturbed relations between Formosans and the incoming Chinese. Dr. Mukai, a Japanese gynecologist, maintained a private hospital long conceded to be the best in Taipei -certainly the best there in 1946. The wife of a prominent mainland Chinese official became a patient, underwent a Caesarean section, and then refused to abide by Dr. Mukai's instructions concerning postoperative care. She died. The husband then refused to remove the body, making huge demands upon Mukai for "consolation Money."
Soon other patients had to leave; Dr. Mukai was arrested, his hospital was confiscated, and promptly turned over to an incompetent woman from the mainland who was supposed to have a medical degree.
Formosan and Japanese doctors throughout the island saw the dangers implicit in the "Mukai Case"; banding together they gave financial and legal support to Dr. Mukai on the one hand, and on the other threatened to withhold all medical attention from all mainland Chinese unless guarantees were forthcoming that there would be no more incidents of this type.
A vigorous legal defense secured Mukai's release. He was then "hired for operations" in his own hospital, but it was quickly, apparent that he could not work under the new management. Although Formosan women organized an appeal to him and petitioned the Government to retain him and restore his hospital, he had had quite enough.**
Private hospitals and clinics were extremely valuable properties; the majority were swiftly taken over, sometimes by presentation of a handful of red-sealed confiscation orders, or more abruptly by raiding parties who simply walked in. Doctors about to be repatriated to war-torn Okinawa petitioned to be allowed to take their medical kits with them so that they could contribute their skills to rehabilitation there, rather than to reach Naha without a means of livelihood. The American Consulate refused to consider such appeals or to raise the question, even informally, with the Chinese authorities.
In midyear 1946, four cases of bubonic plague were discovered at Tamsui and in the Hsinchu district. The victims had come in aboard Chinese junks and had not been quarantined.
The Formosan press broke into an uproar of protest; there had been no bubonic plague among the civil population for nearly thirty years. Here indeed was a threat, directly traceable to the collapse of the quarantine system so strictly enforced under Japanese administration. Houses which had sheltered the plague victims were burned to the ground. Some feeble steps were taken to reactivate quarantine services at the ports, but in these no one had confidence.
As summer approached cholera reappeared in Formosa.
Within a few days it had spread beyond control in the southwest. It had not been known in epidemic proportions since 1919. The Director of Public Health made no move to recognize the threat, but UNRRA doctors and nurses, aided by CNRRA personnel, Formosan doctors and public health employees, promptly moved to Tainan and Kaohsiung, cut through extraordinary official red tape (deliberately spun out to embarrass them) and promptly reduced the death rate from 80 per cent to 29 per cent of all known cholera cases. After a long summer fight cool autumn weather brought relief, but by November 1 the UNRRA team had recorded 2690 cases, with 1460 dead.
The Public Health Director's studied indifference was shared by the men be placed in control of government hospitals at Tainan. At the height of the epidemic, which centered there, they continued to observe regular office hours, refused to receive or treat cholera patients brought in between five o'clock in the afternoon and eight o'clock in the morning and flatly refused to release medical supplies beyond the allotted issue -- small enough -- indicated for "normal" times.
The UNRRA team set up special isolation barracks, but when it was discovered that human excrement from these wards was being dumped into nearby commercial fishponds, the Director of Public Health was asked to have something done about sewage disposal. He was also asked to ban the sale or distribution of fish from local sources until the epidemic came to an end and the polluted fishponds were properly cleansed. He refused to do more than to have a press statement issued advising the public to be careful in cleaning fish.
Dr. King's undisguised obstructionism prompted UNRRA doctors to threaten to make an international issue of it. To one, the Director of Public Health blandly observed that "after all, only the poor people are contracting the disease."
The "official American attitude" during this crisis was very little better than Dr. King's. UNRRA team members and consular employees were besieged with appeals. Formosans in every walk of life sought American help. Some leaders suggested that we should bring the Generalissimo's attention to conditions in Formosa through the good offices of his friend, the American Ambassador, and others asked us to appeal to the United Nations.
For example, we received a postal card bearing this brief appeal, painfully spelled out:
Alas the enemy of civilization, pest, penetrated into Taiwan.
Very sorry much. It is regrettable story. We cry to America
[for] the prevention of epidemics formation.
But appeals such as this, from "unofficial persons" embarrassed the Consulate, and reinforced a view that the natives were an ignorant lot.
American members of the UNRRA team, the Vice Consul and the Director of the United States Information Service considered this merely a small straw among thousands that were beginning to stir in the winds of popular resentment. Political tensions, already dangerous, were heightened perceptibly by the intrusion of cholera and plague. After so many years of well-publicized American investment in public health and medical services in China, this seemed hardly the time to present an official show of studied indifference. Self-interest alone seemed to dictate some concern that cholera and plague had reappeared in an area adjacent to Occupied Japan, where the United States had stationed very large forces, and had assumed a monumental responsibility for some eighty million Japanese people. The dread diseases should not be allowed to spread there.
I was directed to incorporate a notice of the epidemic in the routine monthly report. When I urged the need for a telegraphic report to the Embassy in China, to Tokyo, and to Washington, the response was curt; it was explained to me that a telegram would be irregular; the newly opened Taipei Consulate had no official questionnaire forms to guide us in making a public health report.
When I insisted, a compromise was reached; I was to sign my name rather than the Consul's to the irregular telegram, and in a follow-up report I was to explain carefully our failure to conform to the printed questionnaire required by Foreign Service Serial No. 188, of June 9, 1944, of which no copies, alas, were available at the Taipei office.
Popular concern with public health problems roused by this intrusion of plague and cholera was heightened when it was realized that Formosa's lepers were no longer being confined, registered, or treated. An American on the UNRRA staff reported on a visit which she had made to the Government Leprosarium some distance inland from Taipei. It had been established by the Japanese and was well organized to provide schools and work in addition to medical care. Provision was made nearby for the children of leprous parents and there was an inn for visiting relatives. Periodic clinical examination of all registered lepers was a legal requirement. At this Leprosariurn there had been about 700 patients when UNRRA staff members first visited it in 1946. Nine months later there were less than half the number, the clinics were closed, and no provision was made for the non-leprous children of the patients. Said the UNRRA officer:
The Director (a Chinese without interest in lepers and with no training for the job) said "They just wandered away."
I reported the above facts [to the UNRRA Medical Director, who took up the matter with Chen Yi's Director of Public Health, Dr. King]. Dr. King felt that all lepers should be shipped to some far away island, existing only in his mind, and left to shift for themselves. 
As the months passed the Formosan people looked more and more often to foreigners to represent their interests and to press for change. The heroic effort to stem the cholera epidemic earned a measure of profound gratitude, often and freely expressed. Efforts to compel CNRRA to make an honest distribution of relief goods and to carry through a constructive rehabilitation program were widely appreciated.
Inevitably the UNRRA team was considered an American group, and credit for its good work accrued to the United States, for American members were in the majority, and most relief supplies entering Formosa were of American or Canadian origin. As the Formosans saw it then, this - "American" team was attempting to give substance to all the propaganda which had promised a "New China." Thus the "good things" of postwar life were inescapably identified with the West, and principally with the United States, and the "bad things" - the hardships and disappointments -- were identified with mainland China.
Chen Yi's men -- led principally by American college graduates Stanway Cheng and Huang Chao-chin -- did all that they could to undermine the popularity of the UNRRA group. With the full cooperation of the CNRRA office they gave credit for relief supplies to the "generosity" of the Nationalist Party and Government, and when things went wrong they blamed "foreign employees of CNRRA." When there was outspoken Formosan criticism of the quality, quantity, price or distribution of CNRRA supplies, Chen's Information Office or its agents placed blame on the "meddling" UNRRA team or upon the United States. In its own defense UNRRA prepared a series of stories for the local press, explaining the origin and purposes of the United Nations program, but when they at last appeared in print, the "United Nations" identification was deleted, and the stories significantly tampered with. As the year wore on the attempts to blame the United States for worsening conditions within Formosa became so flagrant that even the American Consul endorsed a report to the Embassy on the issue.
The UNRRA team continued to function at Taipei until December, 1947. Relief supplies worth approximately $25,000,000 before delivery to China had been off-loaded at Formosan ports. The UNRRA team watched the distribution and sale of these donated materials, and saw that the Formosans were required to pay exorbitant prices in many instances. Relief goods sent to Formosa generated profits many times 25 million dollars in value for the China National Relief and Rehabilitation Administration, responsible to the Executive Yuan (T. V. Soong, President).
But UNRRA team members had brought into Formosa something far more valuable than bulk shipments of fertilizer, mine cables, or flour; they had provided an image of democracy at work far more important than material supplies.
* No time was wasted; a Norwegian ship's captain
told me that he had docked at Shanghai one morning with an UNNRA
cargo including some rather unusual brands of tinned food. He had
supervised cargo discharge before noon. In the late afternoon he
saw this distinctive food-brand being hawked in the streets near
the dock. It was possible that a stray carton or case had "slipped
overboard" but he thought not; checking, he observed carters
hauling the shipment out from one end of the warehouse as fast as
it was being brought in from the ship at the other.
[Back to the text]
** The Formosan lawyer who successfully
conducted Mukai's defense caused the Government prosecutors and
their client the official to "lose face" by airing the truth. As a
consequence he lost his life in 1947.
[Back to the text]
1. The Summary of UNRRA-CNRRA activities and observations is based principally on the following:
(a)Twenty-four personal letters addressed to Paine and Kerr by UNRRA-CNRRA team members.
(b)Twenty weekly reports from the Formosa Regional Office to the Office of the Economic and Financial Advisor, China Office (Shanghai) UNRRA; 133 pp., mimeo.
(c) Special Reports to Walter D. Fitzpatrick, Director, Taiwan Regional Office, by E. E. Paine, Reports Officer, n.d.
(d) Summary Report, Taiwan Regional Office (Taipei), Sept. 15, 1946, 15 pp.
(e) Reports on Industrial Rehabilitation, by Allen E. Shackelton (UNRRA-New Zealand), Taipei, 1946, 14 pp.
(f) Reports on the Work of CNRRA, Taiwan Regional Office (April 1, 1946), CNRRA's Emergency Sanitary Engineering Project (September 11, 1946) and on Public Welfare Projects (August, 1946), Taipei, 27 pp. mimeo.
(g) Special Report on Government-CNRRA Handling of Hainan Repatriates. UNRRA-Taiwan Regional Office (Taipei, Oct. 11, 1946), 2 pp.
(h) Report on the February 28 Incident and Subsequent Events to 15 March 1946. UNRRA-Taiwan Regional Office (Taipei, March 17, 1947), 9 pp.
(i) History of the UNRRA-Taiwan Regional Office (Taipei, n.d.), 25 pp.
(j) Allen E. Shackleton: "Formosa - Unhappy Golden Goose," World Affairs (Quarterly journal of the UN Association of New Zealand), Vol. 4, No. 2 (June 1948), pp. 28-29.
2. Edward E. Paine (UNRRA Reports Officer): Notes on the UNRRA Program, 1946-1947 (n.d.), 10 pp. mimeo.
3. Ira D. Hirschy, M.D. (Chief Medical Officer, UNRRA, Taiwan): "The World is Sick, the Cure is Difficult," Plantation Health (Honolulu, Hawaii), Vol. XII, No. 2 (April 1948), pp. 9-15.
4. Mary Mumford (Public Welfare Officer, UNRRA, Taiwan), letter dated July 6, 1948.
5. Hsin Sheng Pao (Taipei), May 2, 1946.
6. Mary Mumford, loc. cit.