| The Island of Koje Do, South Korea, was chosen as the site for a project to study the effectiveness of a broad-based, community-centred health programme, consisting of family planning, public health, and some curative services. The Koje Do project, spons Commission, was to be carried out in cooperation with, and along the lines of, the Korean government's plans. Major capital investment in the project was to be avoided; the programme was to be adapted to community resources, such that self-support would become a feasible objective. The church congregation was to be involved as a motivating force at the village level. During its 3 years of operation, the project has gone through a number of development stages. Four of these stages are described: recognition of the inadequacies of institutionalized medicine; response in the form of reeducation (the physician must learn to think in terms of new methods, not just minor modifications to the old); trial and tribulation, resulting from the physician's traditional education, the diversity of demands made upon him, his incomplete of the new task, and his lack of experience in the local situation; and denouement, the point at which the project takes shape. Some examples of problems encountered as a result of mistaken assumptions are outlined for the benefit of future project developers. The author concludes thet, because of these problems, the scope of the project should be limited and that more emphasis should be put on education. A list of the project's accomplishments is included. |