To Changhua with LoveThe Story of Medical Missionary David Landsborough

The lives of the three medical missionaries were spent largely in Taiwan, and together form an important chapter in the history of the island. In our last issue we featured a piece on George Mackay, marking the centenary of his death. This month we look at a remarkable father and son who between them devoted 68 years of their lives to Taiwan: David Landsborough, founder of Changhua Christian Hospital, and his son, also named David, who carried on where his father left off.

What was it like for David senior arriving in Taiwan 100 years ago, and why did the Landsboroughs, pere et fils, choose to devote their lives to Taiwan?

The Presbyterian Church of Great Britain has traditionally employed medicine in its missionary work, spreading the Christian message of love and redemption by saving people both body and soul.

Patients crammed into the waiting room at Dr. Landsborough's clinic. At the time he was seeing up to 400 patients a day, far more than any of Taiwan's most celebrated doctors today.

Endemic diseases

In 1865 Dr. James Maxwell, the first Presbyterian missionary to arrive in Taiwan from Britain, declared: "Medical missionary work is our best weapon for storming the redoubts of superstition and ignorance."

The first three Christian hospitals in Taiwan were those established by Dr. Mackay in the north, Dr. Maxwell in the south, and Dr. Landsborough in the central region.

David Landsborough senior was born in Kilmarnock, Scotland, in 1870. He was 25 years old and fresh out of medical school when he was assigned to the Presbyterian mission in Taiwan, where typhoid had just taken the life of his predecessor, Dr. Gavin Russell.

Along with a colleague, the Rev. Moody, Dr. Landsborough arrived in Taiwan in December of 1895, just months after Taiwan was ceded to Japan. Dr. Landsborough was to handle medical matters while Dr. Moody took care of missionary work.

The following November Dr. Landsborough commenced his medical missionary duties, from a practice based in the church in Changhua.

Central Taiwan was an unhealthy place to be in those days. Malaria, plague, typhoid and dysentery were endemic, and in his notes Dr. Landsborough recorded: "Malaria is the scourge of this island. Most of the farmer class suffer from it. They live and work among the rice fields, which are covered with a few inches of water for the greater part of the year. Nearly the whole cultivated plain of the island is like a vast marsh, and all the conditions favorable for the breeding of mosquitoes are present. It is sad to see the pale anemic faces of many of the men at work in the rice fields. Every year malaria claims hundreds of victims, who either die from acute attacks or from chronic malaria. Quinine relieves many sufferers, but for permanent cure they would require to leave their unhealthy surroundings."

After returning to settle in England, David and Marjorie Landsborough never forgot their many friends in Taiwan. They named their house "Formosa."

Matsu at the South Gate

Dr. Landsborough had a medical degree, but at the time of his arrival in Taiwan he had no clinical experience. To begin with, he had to do everything literally "by the book." In her biography Dr. Lan, his wife Marjorie recorded: "It was here that David was called on to give his first operation. He spent much of the previous day reading up the case in his text books, but it was to be an ordeal for him and he slept little that night."

Dr. Landsborough's clinic in Changhua was the only Western medical facility in central Taiwan at the time, and as word began to spread about the doctor's skill and kindness, he became regarded locally as a "living Buddha." In the town of Changhua a certain phrase became current: "There's the Matsu Temple at the South Gate, and Dr. Lan's clinic at the West Gate." As a result, his workload multiplied to almost unimaginable proportions.

Faced with growing numbers of people seeking treatment, Dr. Landsborough selected a plot of land and began planning for construction of an infirmary. The new facility opened in 1899, with beds for ten patients, an outpatient consulting room, an operating theater, a pharmacy and a church hall. But David Landsborough was the only doctor in attendance. In fact, he ran the place single-handedly, examining outpatients, performing operations, nursing inpatients and handling administrative matters. There was no-one to share the load with him.

As his wife Marjorie, who he met and married later, wrote: "Patients came from near and far, and on outpatient days the number increased rapidly until over 400 a day crowded into the hospital. Nor did the doctor have respite in his lonely little house, even when he could get there-for it being near the hospital the patients or relatives would come and call him whether by day or night. Neither did he refuse visits to sick people in their homes.

"Alternate days were for surgical operations-usually about twelve cases in the morning. Two or three of these would be major operations."

Little wonder that, as Marjorie wrote, "he would come home for lunch pale and worn, almost too tired to eat."

In 1952 David Landsborough junior, who was born in Changhua, returned to work at the hospital founded by his father. Local people still remember the sight of him bicycling around the town with his doctor's bag.

Difficulty adjusting

Learning the local language is a mandatory task for missionaries, and Dr. Landsborough was no exception. When he came to Taiwan he began studying Taiwanese with a local scholar named Lin Yen-chen. But as Marjorie wrote: "David found the acquiring of the Chinese 'tones' difficult. The slightest change of 'tone' in a Chinese word gives it a completely different meaning, and David, having little discernment of pitch, found it terribly difficult to distinguish one sound from another."

The doctor came to master Taiwanese eventually, but physically he had great trouble adjusting to the environment.

Taiwan is a subtropical island with a humid climate, an environment which caused considerable problems for the early missionaries. Many endured repeated bouts of malaria and dysentery, and Dr. Landsborough himself suffered through several debilitating attacks which brought him close to resigning from the mission.

A painting on the theme of "a skin graft with love" by Huang Ying-yi, portraying Mrs. Landsborough's donation of a section of her skin to save a patient.

"A skin graft with love"

It was in 1907, while suffering the recurrence of an old complaint, that the doctor cabled church headquarters in London with the following message: "Landsborough in poor health, resigning in about a year. Urgently necessary to fill up vacancy at once." However, he gradually regained his health and the following year he cabled again to withdraw his resignation. In fact, he was to stay on in Taiwan for nearly three decades more, establishing a remarkable legacy of achievement.

The most celebrated event in the story of David and Marjorie Landsborough, is the one that came to be dubbed "a skin graft with love."

The patient at the center of the story, Chou Chin-yao, eventually published an account of the incident entitled A Skin Graft with Love (1984). "Each time I recall the extraordinary grace that Dr. and Mrs. Landsborough bestowed on one so sick, it brings me to tears, even though half a century has passed since then. Words cannot describe the intensity of my gratitude. I know that I can never repay them for their compassion."

In 1928, when Chou was 13 years old, he stumbled on a rock and grazed his right knee. When the wound became badly infected, Chou's father dressed it with a concoction of hair oil and herbs. But this only aggravated the problem. Finally they were persuaded to try Changhua Christian Hospital and seek treatment from Dr. Landsborough.

Young Chou was given careful attention, and his condition improved. His life was out of danger, but the wound had by then ulcerated, forming a foot-long lesion that wouldn't heal. Any deterioration and the leg would have to be amputated.

Dr. Landsborough had read about skin grafting in the medical literature, and felt that such an operation might be feasible. But Chou Chin-yao was in no fit condition to provide skin from elsewhere on his body, and his father was considered unsuitable as he had to support the family and take care of Chin-yao. At this point Mrs. Landsborough bravely volunteered herself as the skin donor.

Years later, Chou Chin-yao recalled the scene. "During the operation the anaesthetic began to wear off and I suddenly came to. I caught a glimpse of Dr. Landsborough cutting away a flap of skin from Mama Landsborough's leg. The sight gave me a jolt, like getting an electric shock. What Mama Landsborough had said to me was true, then. She really was going to have a piece of her own skin cut away to stick onto my body!"

At the time, they didn't know about the rejection of allografts, and the four strips cut from Mrs. Landsborough's thigh, each three inches long and one inch wide, didn't take when applied to Chou's wound. The operation was declared a failure.

One month later Dr. Landsborough performed a second operation, this time using some of Chou's own skin, and the situation improved dramatically. Another operation followed four months later, and after a year Chou Chin-yao was well enough to be discharged.

Such was his gratitude, Chou made up his mind to devote himself to the church. He became a pastor when he grew up, and has since served as chairman of the Taiwan Gospel Association, chairman of Tainan College of Theology, and chairman of the general synod of the Taiwan Presbyterian Church.

The operating table and washbasin in Dr. Landsborough's operating theater in Changhua were both imported from abroad.

Train waits for man

Construction of Taiwan's north-south railway line was completed in 1905, and Changhua became a transport hub for the central region. As a result, even more patients were able to make their way to Changhua Christian Hospital for treatment.

Dr. Landsborough recruited two Taiwanese graduates from medical college in Taipei, where most medical students at the time were Japanese, to help at the hospital. The newcomers were extremely conscientious but the patients, by and large, didn't want to be seen and treated by one of their own. Such was everyone's faith in Dr. Landsborough that it was said: "One look at 'Dr. Lan's' face, and you are already half well."

In order to reduce the pressure on himself, Dr. Landsborough began limiting the daily throughput of patients and taking a nap after lunch. All treatment at the hospital had been free up until then, and while it remained free for the first 150 patients every day, a token fee of one yen was applied for those who followed. Thanks to this new regime, the doctor's own health improved.

After finishing up at the hospital every day, the doctor often spent the evening making house-calls in the surrounding countryside. He reached nearby locations by bicycle, but for trips further afield, such as to the town of Lukang, he traveled by train. There weren't a lot of trains running in those days, and on one occasion the stationmaster, being well aware of the doctor's travails on behalf of his patients, kept the train waiting for nearly an hour until the doctor arrived to board it.

While keeping up a remorseless schedule of surgery and consultations, Dr. Landsborough also managed to find time to teach his students. As yet there was nowhere in Taiwan specially training Taiwanese doctors, and Dr. Landsborough was the first in Taiwan to train apprentices in Western medicine.

To begin with, the missionary society to which the doctor belonged assigned two Christian youths to study medicine with him. Then he took on five more students, and subsequently he taught 70 or 80 more. Holding class in the evening, he taught them chemistry, anatomy and physiology. Among the many outstanding new doctors he nurtured in this way was Yen Cheng-sheng, father of Yen Chun-hui, a former director-general of the Department of Health.

Dr. Landsborough's wife, Marjorie, worked as a missionary for the church in Tungkang. The children in this picture grew up to become Christian pastors.

Blessed with a helpmeet

What with examining patients, doing operations, making house-calls and teaching, the doctor's every waking hour was accounted for. He was 25 when he arrived in Taiwan, and for 17 years lived a spartan existence with little in the way of creature comforts. Those who knew him came to doubt that he would ever marry. But then God smiled upon him and he met Marjorie Leanner, a young Englishwoman who had spent two years on missionary work in central and southern Taiwan.

David and Marjorie married at the British Consulate in Tamsui, on November 22, 1912, the bride arriving Chinese fashion for the ceremony. As she wrote in Dr. Lan: "The Consulate sedan chair manned by four Chinese in British naval uniform arrived to convey me to the wedding. I seated myself in the open rattan armchair [and] was hoisted high into the air. Jogging up and down, veil floating in the breeze, I was swung smiling along the lines of goggle-eyed schoolgirls."

"On 16th December 1914 our son David was born. Great was the rejoicing in Changhua among Christians and non-Christians alike. The news quickly spread all around: 'Dr. Lan has a son.' From this time on his parents dedicated him to be a missionary doctor," wrote Mrs. Landsborough

David and Marjorie's dream for their son came true. David junior grew up to become a medical missionary, and even followed in his father's footsteps by returning to Changhua Christian Hospital, where he served for 28 years.

Dr. Landsborough was the first in Taiwan to offer apprenticeship-type Western medical training. Here he is shown with his first group of students.

Eternal Formosa

The people of Changhua had a strong emotional attachment to Dr. Landsborough. When he turned 60 a grand celebration was organized in the town. "On the great day my husband arrayed himself in ceremonial 'frocko-coato', and the other three of us also donned our best clothes. At 10 a.m. two cars arrived. One of them was occupied by our church brass band, which was to escort us along the streets of Changhua playing their instruments through the open door."

Five years later, on reaching 65, Dr. Landsborough retired. The people of Changhua were deeply saddened to see him go.

Early one morning in the middle of spring, Dr. and Mrs. Landsborough boarded a train for the port of Keelung, to catch their ship home. As the church choir serenaded them, singing "God be with you till we meet again," and "The Lord bless thee and keep thee," they waved farewell to their friends and to their beloved town of Changhua. But that wasn't the last of the Landsboroughs in Taiwan.

After retiring, the couple settled on the outskirts of London. They named their house "Formosa," showing that the island of Taiwan, to which they had dedicated their working lives, was never far from their thoughts.

In 1957, at the age of 87, Dr. Landsborough passed away in England. By then his Changhua-born son David, and wife Jean, had been back in Changhua for five years. The son was to spend 28 years in the town, furthering his father's good work at the hospital he had created.

Dr. Landsborough pictured with patients in front of the hospital. Reclining invalid chairs were used instead of adjustable hospital beds, which were not yet available.

Saintly spirit

With the passage of time Changhua Christian Hospital became a modern medical establishment, and the privations of the founding days faded into history. But what never changed, thanks to the dedication of the missionaries, was the commitment to treating patients as if they were one's own kin-the spirit of the "skin graft with love." During David Landsborough junior's tenure as superintendent, the hospital was known for exemplifying the saintly spirit characterized by Jesus when he washed the feet of his disciples. Medical treatment, missionary work, service and teaching became the guiding principles of the hospital.

After Drs. David and Jean Landsborough themselves retired, and returned to the UK to settle, their attachment to the hospital and their love for Taiwan remained strong.

In 1991, David Landsborough junior was honored with the Taiwanese-American Society's Award for Social Service. At the presentation ceremony in California he introduced himself in Taiwanese, saying: "I am a Taiwanese person from Britain, who grew up in Changhua." At that moment, the eyes of many in the audience were moist with tears.

In 1996, at the age of 83, David Landsborough junior traveled back to Taiwan to receive the Order of the Brilliant Star with Violet Grand Cordon, presented to him by President Lee Teng-hui. As he said at the time: "Everyone has their roots, the place where they are born and raised. I have roots in Taiwan. People here remember my family well, and many still recall my parents."

Changhua Christian Hospital, the first modern hospital in Taiwan's central region, was originally built in 1907. This staff photo was taken in 1956, before the old building was demolished to allow for reconstruction.

An example for us all

The Landsboroughs, father and son, gave to Changhua-and to Taiwan-a piece of everlasting love. It is something which the people of Changhua cherish greatly.

The David Landsborough Memorial Church, designed in a traditional octagonal style by Marjorie Landsborough and her son David, is known locally as the "Christian Temple." Two years ago the building was turned into the Changhua Christian Hospital Museum of History, featuring displays of objects and photographs from the hospital's early history. It is a good place for visitors to acquaint themselves with the hardships endured by David Landsborough senior during the hospital's pioneering days.

Museum director Chen Mei-ling planned and designed the museum herself, and spent two-and-a-half years writing A Skin Graft With Love-Dr. David Landsborough and 100 years of Medical Missionary History. On the legacy that Dr. Landsborough bequeathed to Taiwan, she says: "What we have today-it's enough. Now it's time to offer something in return!"

Huang Chao-sheng, current president of Changhua Christian Hospital, says: "The Landsboroughs, father and son, served Taiwan for a total of nearly seven decades. We owe thanks for their deep affection towards Taiwan, and at the same time we should learn from them. They responded to God's love and came to care for and serve the people of Taiwan, setting the very best example for the rest of us to follow."

"Matsu Temple at the South Gate, Dr. Lan's Clinic at the West Gate." As a medical missionary, David Landsborough quietly devoted 40 years of his life to Changhua. His memory lives on in the town. (Hsueh Chi-kuang)