Chapter 1: How It Began

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Status: In Progress  |  Genre: Literary Fiction  |  House: Competent But Unfitted

Reads: 146

Blackfoot Village 





The narrow Hsikang Bridge stretched across Tsengwen Creek which was flanked by green farmlands making use of the fertile soil along the shores. The expansive creek bed was drying out; trickles of water drained lifelessly between the fields. A bus drove from Tainan City toward Nankungshen. After passing the bridge, it entered the Hsikang Village, part of the North Gate area which had been called Salty Land ever since the Japanese colonial era. 


Among the passengers on the bus was Dr. Franklin, a British professor of theology in Tokyo, on his way to the Academy of Tainan Theology. He had heard that of all the temples throughout Taiwan, the Nankungshen Temple was the original site for worshipping the Five Kings by sharing incense. He also heard that people in this area suffered severely from blackfoot disease, for which there was no available treatment. As a missionary of Jesus Christ, Dr. Franklin wished to see this area where the epidemic was at its worst. The Academy assigned Pastor Lin and Missionary Su to accompany Dr. Franklin. 


The bus drove slowly past narrow Hsikang Street. On either side stores had opened within the  two-story red-bricked buildings. Between Hsikang and Chiali a giant banyan tree with entangled but sprawling aerial roots shaded a red shrine by the road. Pastor Lin explained to Dr. Franklin that the giant banyan was considered a divine tree.  People from the six villages of the North Gate area often came to worship it and ask for blessing. Parents of ailing children would offer their suffering child to be the “foster child”  of the divine banyan tree in order to prolong the life of their unfortunate offspring. As a theology professor, Dr. Franklin understood such beliefs, although Jesus Christ was the only god in his mind. A tree was no more than a tree. 


After running through the blacktopped roads in Chiali Township, two thirds of the passengers got off, and about the same number of new passengers got on. Missionary Su told Dr. Franklin that Chiali was the busiest town in Salty Land, as well as being the transportation hub of the North Gate area. North Gate was the old name that dated back to the Japanese colonial era, and it included six villages or townships, namely Hsikang, Chiali, Chigu, Chiangchun, Hsuehchia and Beimen. Chigu and Beimen had the largest salterns in Taiwan, and soil in this area was relatively saline. People from these six villages or townships could take buses in Chiali bound for Tainan City, or transfer at Hsinyin for buses going all over Taiwan. 


The bus continued running on gravelly roads northward, accompanied by the noise of small rocks jumping about the wheels. Dr. Franklin noticed that once they entered the Salty Land on the other side of the bridge, evenly planted horsetail trees on both sides of the road were casting shadows on the graveled road. Further away were endless fields of sugarcane and a variety of grains.  Beyond that, mound after mound of earth for yam-growing constituted the typical landscape of the Chianan Plain. By the road a little boy was sweeping fallen leaves. 


“Is the little boy cleaning the road?”


“No, he is collecting leaves of horsetail trees to substitute for firewood.” Pastor Lin said.


“Children from poor families have to collect dried leaves as fuel.” Missionary Su added. 


“The Beimen area is in poverty.  There are more people than the farms that can support them. Many people have had no choice but to leave their homes to earn a living in the cities and send the money they make in the cities back to their families.”


Next to Chiali Township was Chigu Village, and Chiangchun Village was on the north. Pastor Lin introduced Dr. Franklin to the environment, pointing out salterns, fishing wharfs, and Chiangchun Creek which marked the border between Chiangchun Village and Hsuehchia Township.


The bus ran across the creek and passed Hsuehchia, turned left and arrived at Beimen Village, then turned right to head north. Fishing ponds and abandoned barren lands replaced the landscape of grain or sugarcane fields, but grids of salterns with shimmering water over them continued spreading afar. 


They got off the bus in order to visit the Beimenyu Church.  Dr Franklin’s companions introduced him to Dr. Wang Jin-He from the clinic next to the church.



Each grid of the expansive salterns contained a layer of ink blue sea water. When it was evaporated by the heat of the sun, white salt crystals emerged, like shiny miracles. Sun illuminated the borderless salterns and the footpaths running through them. The sea water rippled over the surface on each grid; it was actually the process of salt production. 


White salt emerged on the bare earth roads.  Some of the small salt mounds on the roadsides were not covered by straw.  They shone in sunlight, so bright it hurt the eyes. 


Weeds barely lived on the empty lands by the roads.  Land here was complete barren because the soil around the shore was too salty to grow any grain. 


The group of four walked past the salterns and ascended the slope next to fish farms. The embankment was about a person’s height, and  the path under it was paved by oyster shells. Deep fish ponds were positioned one after another, with lifeless grass dotting the banks. White egrets with thin, long legs landed from time to time.   They walked, necks craned, and pecked something with their long beaks every now and then, maintaining a leisure air even when hunting for food. 


Dr. Wang walked in front, leading Pastor Lin, Dr. Franklin and Missionary Su down the slope.  A straw shack stood on the almost empty land. As they neared the shack, sharp cries of pain were heard. Dr. Wang led them inside. A bony man in his fifties lay in bed, his face was taut and dark, his eyes inflamed and misty. He was covered by a stained and tattered quilt with his skeleton-like legs sticking out. His left foot was dressed with herbal medicine, and flies were humming over it. He had to shake it endlessly to avoid flies. In the dim shack, the visitors noticed the smell of rotten meat in the salty air.


“Welcome.” The man stopped his crying and greeted them with a voice betraying his suffering. “Doctor, please have a seat.” His pain must have made his sight sluggish, his eyes inflamed. Nevertheless, he gazed with great respect at the three men following Dr. Wang.


“Please sit down.” Now he tried to sit up with his wrinkled hands holding on to the bed. Dr. Wang stooped over to support him so he could lean on the wall. 


“Don’t be so polite,” Dr. Wang said sympathetically.  “These visitors are Dr. Lin, Missionary Su and Our British friend who is a professor of theology in Tokyo.”


They exchanged warm words as Dr. Wang brought two bamboo stools from outside for all to sit, but they remained standing. They noticed that all the toes on his right foot were gone, and his left leg was blackened from his knee to the sole of his foot. Dr. Wang bent to unbind the dressing made of crude cloth with flowery patterns.  When it  was loosened, they saw there were two toes missing, and the remaining three were festering and purulent. A stank that reminded them of dead rats wafted in the air. 


Dr. Wang explained that the patient had contracted blackfoot disease on his right foot eight years ago.  The pain lasted more than one year until the infected toes dried up and then completely fell off. He recovered after the wounds were cleaned and dressed. Unfortunately, his left foot got infected around half an year ago. Dr. Wang squatted down to check the patient’s left foot.  He pointed out that the infection now endangered the man’s life.


“There are worms!” Pastor Lin cried out, trying to suppress his anxiety.


“How come this happens?” Franklin inquired.


“Flies have invaded the ailling foot.” Dr. Wang explained. 


Franklin took out a match from a matchbox by the lamp, and squatted down to use it to pick out the worms from the ulcering tissue between the patient’s big toe and second toe. One by one, Franklin picked out the wriggling white worms that are usually found in restrooms. The patient clenched his teeth in pain as Franklin probed deeper and deeper into the entangled, infected tissue being eaten by the hidden worms. 


“It hurts all the time, twitching and cramping all night, so that I never can fall asleep at night.” He clenched his fists and moaned. 


“Is there any way to send him to hospital for treatment?” Franklin asked. 


“These are poor people. The hospital of the National Taiwan University treated seven patients without charge, but then they began charging fees from the eighth patient.   Neither side can afford the expense.”


“Is there any other choice?” Franklin inquired further.


“So far there is not any medicine that can cure blackfoot. Dressing is not helpful; the only way to relieve the pain is amputation. But they can’t afford surgery, either, so the tissue continues festering. For those who are lucky, the wound might cure after all the toes fall out, but some of the patients get worse and worse. And even patients who have recovered might still relapse.” Dr. Wang said.


“What is the cause of this disease?” Franklin turned his look from the patient to Pastor Lin and Missionary Su.


“The cause is still unclear.” Missionary Su said.  “We only know that it is related to the consumption of arsenic through drinking water. Arsenic in the blood will clog the ends of veins, resulting in the death of cells and the festering of tips of limbs. Amputation is the only way to restore the blood circulation.”


“My god! If Jesus were still around, He should come to Beimen.” Franklin sighed. 


Franklin, Dr. Wang, Pastor Lin and Missionary Su began to talk about the possibility of establishing a charity hospital in Beimen to provide free treatment.  Franklin asked, “Why are there so many patients specifically in Beimen and Hsuehchia in the county of Tainan, and Budai and Yichu in the county of Chiayi?” 


“The underground water of these four townships contains too much salt.  They had to dig wells as deep as 50 meters to get fresh water. But water that deep contains arsenic.”


The three visitors left the patient’s home, and as they walked away they heard his moans of pain again.  Dr. Wang led them toward the Nankunshen Temple where they saw many people squinting their reddened eyes, as if they were having problems opening them. Some of them had tears in their eyes. Dr. Wang explained to Franklin, “This disease is called Red Eye Sockets by local people. It started from contact with the polluted, sandy wind in this area, which infects the inner eyelids. In the past, 80% of the population in this area had either an eye infection such as trachoma or a skin disease such as blackfoot. Some blackfoot patients had trachoma that worsened to blindness. These days as the hygienic conditions are improved, trachoma is under control and the number of patients is much reduced. But since skin disease is related to the arsenic in drinking water, the incidence rate for skin disease is still high.“


When they arrived at the square in front of the Nankunshen Five-King Temple, Missionary Su pointed toward the creek at the north of the temple and said, “This is Fast Water Creek, Beimen’s northern border. The southern border is Tsengwen Creek running under the Hsikang Bridge. Budai Village of Chiayi County was at the north of Beimen. Hsuehchia, Beimen, Budai and Yichu are the shoreside villages with the worst blackfoot disease.”


“I was told that Nankunshen has the largest population of worshippers in Taiwan.  Is that true?” Franklin asked. 


“The Holy Empress enshrined in Beigang of Yunlin County and this Five-King Temple in Nankunshen are most popular. In Tainan there are as many as 49 temples that “share the spirits” of the five kings. They attract a lot of tourists as well as pilgrims everyday,” Pastor Lin explained. 


The sculpture of dragons and phoenixes on the temple eaves looked triumphant, and at the back of the temple was a garden as well as a pavilion. The trees, flowers and rocks by the artificial pond made a compact but magnificent scene. Next to the temple was a small shrine called Wanshan Hall, standing in front of Wanshan Park. They walked in a circle along the palace-styled corridor and back to the Wanshan Hall.  On both sides of the corridors were beggars.  They were either blind or missing one leg or one arm. Some of them had festering limbs; some of them had lost all their limbs. They begged in hopeless murmuring. 


“Most of the beggars suffer from blackfoot disease.  They have no relatives, no money. They can’t access medical treatment, can’t make a living.  Begging is their only option,” Dr. Wang said. 


“Doesn’t the Five-King Temple receive a great amount of donation money from pilgrims every year? Why doesn’t the temple  make use of its wealth to set up a hospital to take in these patients? Why doesn’t it create a charity to save these wretched people in its territory?” Franklin wondered.


“It’s a pity that local religions in Taiwan don’t have such a practice. I am from Beimen, which is in the blessed territory of the Five Kings. I came back from Japan after the war and was determined to take care of my poor village people, so I opened my clinic here. I also had worked as a  Beimen Village Chief and two terms as a Tainan County councilor, but I was so disappointed by the power-wrestling in politics. Now I focus on my medical practice only. Our religious institutes lack any worldly concern, and it frustrated me. That was the reason I converted to Christianity.” Dr. Wang said.


‘I’d like to do something for these patients. I can treat poor patients  I don’t need to get paid, but if I did get paid I could use it for medication. But blackfoot disease is not curable; neither internal nor external medication can fix it. It agonizes the patients day and night. Since this disease is associated with poverty, and people who suffer from it have poor nutrition, vitamins provided by American Aid seem to be helpful. Some patients who have been given vitamins have shown progress, and perhaps with better nutrition the circulation in their feet would improve. But at this point most of the patients are unable to afford any treatment, much less surgery, so they just stay home and wait for the call of death.  All I can do is pray to Jesus to save them.”


“The Nankunshen Temple receives so many offerings, but people here are destitute and pained by diseases. So what do the gods do for them?” Pastor Lin questioned.


“Lord, if you hear us, please come to Beimen.” Franklin took a glance at the extravagant temple, and thought to himself, “Christian churches in Taiwan are not doing any better in helping these blackfoot patients.”


It was the 15th year after the World War. March 27, 1960. 



April 7, 1960

A short, voluptuous white woman came to Dr. Wang’s clinic, accompanied by three men. She introduced herself, then the three men. She was Lillian Dickson, a missionary, and the president of the Taiwan Theological School. Her husband was James Dickson. She explained that after reading Franklin’s proposal of assisting blackfoot patients, she had invited three medical professors from the hospital of National Taiwan University to join her in visiting Dr. Wang.


“I want to bring treatment  to the patients as soon as possible, to relieve their pain. I began working on this after I read Franklin’s report and have contacted the Christian Hospital in Pindong. I hope my Christian fellows will assist me in hospitalizing the patients there, and I will take the responsibility of raising funds for their treatment. Franklin wishes to set up a free clinic in Beimen.  I am also in charge of fundraising from churches outside of Taiwan.” Lillian Dickson spoke Chinese with an American accent. 


So Dr. Wang took them to see several patients and their families. The three doctors were to conduct pathological studies to find out the causes of blackfoot disease, and as she stated, Ms. Dickson determined to raise funds overseas to set up a free clinic for these patients. 


Dr. Wang also began contacting friends from the Christian churches to escort patients to the Pindong Christian Hospital. At the same time work began on repairing an old house belonging to the church for the free clinic. Nearby houses were rented to serve as sick wards. 


On May 23rd, the clinic for blackfoot was inaugurated. Ms. Dickson engaged Dr. Hsieh Wei, who also was a pastor, to travel to Beimen from Nantou every Thursday. Dr. Hsieh Wei was not paid, even though he worked extensively, sometimes even performing surgery on patients. Dr. Hsieh and Dr. Wang had been classmates at the same medical college in Tokyo.  His Thursday trek from Nantou to Beimen covered more than three hundred kilometers, and he didn’t travel alone.  Every week he hired a taxi and took his brother, a pharmacist, and a nurse from his own hospital to conduct operations in Beimen. 


More and more patients came for help. Patients from sixty villages all over Pindong, Kaohsiung, Chiayi and Tainan poured in. Dr. Wang had to expand to a two-story building behind the church in order to take in more than one hundred patients. Patients here did not have to pay for their treatments, and were provided free meals, thanks to Ms. Dickson’s effort in raising money for the growing expense. 


Nevertheless the money was still insufficient for all the expenses. The patients received their treatment, lodging and meals for free, and Lillian Dickson kept the accounts.  The sick wards supported by the Beimenyu Church were roughly built, and the hospital did not expand again until 1972 when Lillian Dickson’s Christian Network Development Association moved to the south end of Beimen.


Since that time whenever Nankunshen worshippers arrive in Beimen after turning at the Diliao Village by Hsuehchia Creek, they see a row of long white two-story buildings. It is a British style of hospital for the treatment of blackfoot disease.


And stories about the blackfoot disease began decades earlier.

Yang Ching-Chu is one of the most acclaimed Taiwanese writers. His literary career focuses on the underprevillaged groups of people in Taiwan's society. He was also an activist for democracy during the period of Martial Law, his campaign for free speech had resuted in his four-year incarceration after the Formorsa Incident in 1979. 

Submitted: February 16, 2021

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