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Social Science & Medicine 61 (2005) 1045–1058 Decolonization and the movement for institutionalization of Chinese medicine in Hong Kong: a political process perspective Stephen W.K. Chiu, Lisanne S.F. Ko, Rance P.L. Lee Department of Sociology, The Chinese University of Hong Kong, Shatin, Hong Kong Available online 17 February 2005 Abstract This paper focuses on the question of why the social and political acceptance of Chinese medicine has grown in the former British colony of Hong Kong since the late 1980s. To supplement the conventional explanations for the institutionalization of alternative medicines, we propose a political process perspective that highlights the effects of political changes amidst the decolonization process in Hong Kong. During the late 1980s and early 1990s, the weakening of the political position of the established elite, the opening up of political space for previously excluded groups, and the competition for support among the new political elite, all stimulated the indigenous Chinese medicine organizations to mobilize for the institutionalization of Chinese medicine. By the mid-1990s academics from leading tertiary institutions began to take over the leadership of the movement and in doing so carried it to a higher level. In the conclusion, we briefly consider the implications of this movement for the future development of alternative medicine in Hong Kong and other societies. r 2005 Elsevier Ltd. All rights reserved. Keywords: Alternative medicine; Traditional medicine; Political process; Hong Kong Introduction Since the 19th century, biomedicine has developed rapidly to replace indigenous medicines as the dominant medical system in most parts of the world. In the last few decades, however, indigenous medicines have been making a comeback. A similar process of rising social and political acceptance has also been observed in Hong Kong. While biomedicine—or ‘‘western medicine’’ as it is called in Hong Kong and other Chinese societies—has long been the orthodoxy, Chinese medicine has gained much official recognition, and Chinese medicine practi- tioners have become more professionalized and socially accepted since the late 1980s. Following Lee (2000a), we call this a process of institutionalization. In this paper, we focus on the growing acceptance of Chinese medicine by the social and political establishment as a central feature of the process of institutionalization. Our research question is: Why and how did this apparent institutionalization happen? Borrowing insights from theories of social movements, we shall focus on how the interplay between the political process and the mobiliza- tion by Chinese medicine organizations brought about the institutionalization of Chinese medicine in the mainstream medical system. The marginalization and institutionalization of Chinese medicine in colonial Hong Kong While studies of indigenous or traditional medical systems commonly observe that these systems coexist ARTICLE IN PRESS www.elsevier.com/locate/socscimed 0277-9536/$ - see front matter r 2005 Elsevier Ltd. All rights reserved. doi:10.1016/j.socscimed.2004.12.026 Corresponding author. E-mail address: [email protected] (R.P.L. Lee).

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Social Science & Medicine 61 (2005) 1045–1058

www.elsevier.com/locate/socscimed

Decolonization and the movement for institutionalization ofChinese medicine in Hong Kong: a political process perspective

Stephen W.K. Chiu, Lisanne S.F. Ko, Rance P.L. Lee�

Department of Sociology, The Chinese University of Hong Kong, Shatin, Hong Kong

Available online 17 February 2005

Abstract

This paper focuses on the question of why the social and political acceptance of Chinese medicine has grown in the

former British colony of Hong Kong since the late 1980s. To supplement the conventional explanations for the

institutionalization of alternative medicines, we propose a political process perspective that highlights the effects of

political changes amidst the decolonization process in Hong Kong. During the late 1980s and early 1990s, the

weakening of the political position of the established elite, the opening up of political space for previously excluded

groups, and the competition for support among the new political elite, all stimulated the indigenous Chinese medicine

organizations to mobilize for the institutionalization of Chinese medicine. By the mid-1990s academics from leading

tertiary institutions began to take over the leadership of the movement and in doing so carried it to a higher level. In the

conclusion, we briefly consider the implications of this movement for the future development of alternative medicine in

Hong Kong and other societies.

r 2005 Elsevier Ltd. All rights reserved.

Keywords: Alternative medicine; Traditional medicine; Political process; Hong Kong

Introduction

Since the 19th century, biomedicine has developed

rapidly to replace indigenous medicines as the dominant

medical system in most parts of the world. In the last few

decades, however, indigenous medicines have been

making a comeback. A similar process of rising social

and political acceptance has also been observed in Hong

Kong. While biomedicine—or ‘‘western medicine’’ as it

is called in Hong Kong and other Chinese societies—has

long been the orthodoxy, Chinese medicine has gained

much official recognition, and Chinese medicine practi-

tioners have become more professionalized and socially

accepted since the late 1980s. Following Lee (2000a), we

call this a process of institutionalization. In this paper,

e front matter r 2005 Elsevier Ltd. All rights reserve

cscimed.2004.12.026

ing author.

ess: [email protected] (R.P.L. Lee).

we focus on the growing acceptance of Chinese medicine

by the social and political establishment as a central

feature of the process of institutionalization. Our

research question is: Why and how did this apparent

institutionalization happen? Borrowing insights from

theories of social movements, we shall focus on how the

interplay between the political process and the mobiliza-

tion by Chinese medicine organizations brought about

the institutionalization of Chinese medicine in the

mainstream medical system.

The marginalization and institutionalization of Chinese

medicine in colonial Hong Kong

While studies of indigenous or traditional medical

systems commonly observe that these systems coexist

d.

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ARTICLE IN PRESSS.W.K. Chiu et al. / Social Science & Medicine 61 (2005) 1045–10581046

with modern medicine in most developing countries (see

Chi (1994), Leslie (1976), and Quah (1989, 2003), for

Asian cases; Good (1987), and Senah (1995), for the

African experiences), studies on European and North

American societies have reported a steady or rising level

of receptivity to alternative medicines (Eisenberg et al.,

1998; MacLennan, Wilson, & Taylor, 1996; Fulder,

1988). Governments have been relatively slow to

respond to this growing popularity of alternative

medicines but there has been some progress in incorpor-

ating them into the mainstream (Eisenberg et al., 1998;

Goldstein, 2000, 2002; Nahin & Straus, 2001).

Against this background of the widespread ascen-

dancy of alternative medicines in advanced societies, the

revival of Chinese medicine in Hong Kong becomes

more interesting. While Hong Kong has shared with

many developing countries the existence of medical

pluralism (Lee, 1980; Leslie, 1980), the institutionaliza-

tion of Chinese medicine has come at a very high level of

development. Does Hong Kong represent simply a local

manifestation of this global trend? Is the institutionali-

zation of Chinese medicine in Hong Kong a result of the

same set of factors as in other advanced societies? To

better understand the case of Hong Kong, we must first

review the history of the local medical system.

During the interwar period the colonial government

began to play a more active role by establishing the first

medical school in the local university and the first

teaching hospital (Lee, 2000b; Li, 1974; Choa, 2000).

Health- and medicine-related ordinances such as the

Medical Registration Ordinance, Pharmacy Ordinance,

Midwives Ordinance and Nursing Ordinance were also

enacted (Choa, 2000). These educational and legal

changes led to the creation of a formal medical system

based solely on biomedicine.

Post-War developments further reinforced the dom-

inance of biomedicine and the activities of its practi-

tioners. First, the Hong Kong Medical Council was set

up in 1957 as a statutory body by the Medical

Registration Ordinance (Federation of Medical Societies

of Hong Kong, 1989). Second, the Department of

Medical and Health Services was established in 1952 to

provide a full range of medical and health facilities for

the community at large (Li, 1974). Third, the govern-

ment assumed more responsibility for health service

provision from the 1960s, including the promulgation of

two comprehensive health plans in the 1960s and 1970s,

the establishment of several new hospitals, and the

founding of the second medical school in the territory in

the early 1980s (Gauld, 1998).

Compared with western medicine, Chinese medicine

was much more marginal in the overall medical system

even though there was a long history of its use and

practice in Hong Kong (Tse, 1998; Topley, 1975). As

Koo (1998) summarized the situation, ‘‘no registry of

Chinese doctors was established; no formally recognised

Chinese medical school was built; no control over the

quality of care or qualifications of practising doctors

was given to the profession; no Chinese medical services

were offered in any of the government hospitals and

clinics; and little research on Chinese medicine was

conducted’’ (p. 682). All issues and problems involving

the use of Chinese medicine came under the control and

responsibility of the Secretariat for Home (formerly

‘‘Chinese’’) Affairs (Topley, 1975). The colonial policy

of non-interference and non-support for Chinese med-

icine was justified on the ground that it was part of the

indigenous customs and should therefore best be left

alone (Lee, 1980).

The ‘‘revival’’ of Chinese medicine in late colonial

Hong Kong is marked by policy and institutional

changes (refer to Table 1 for a chronology of events).

Most importantly, Chinese medicine has been given a

much more prominent place in major policies for

medical development. In preparation for the return of

Hong Kong to Chinese sovereignty in 1997, the Basic

Law (mini-constitution) of the post-colonial Hong Kong

Special Administrative Region (HKSAR) was approved

in 1990. Its Article 138 stipulates: ‘‘The Government of

the Hong Kong Special Administrative Region shall, on

its own, formulate policies to develop western and

Chinese medicine and to improve medical and health

services. Community organizations and individuals may

provide various medical and health services in accor-

dance with law.’’ The Chief Executive’s Policy Addresses

in 1997 and 1998 mentioned Chinese medicine, the first

time that it figured prominently in local policy state-

ments. Moreover, the Health and Welfare Bureau

included Chinese medicine in its year 2000 consultation

document on local medical development (Health and

Welfare Bureau, 2000). The Hospital Authority then

promulgated in 2001 guidelines on clinical research on

Chinese medicine and indicated that it would support

the development of Chinese medicine services in public

hospitals (Hospital Authority, 2001). With respect to

economic policy-making, the Trade and Industry

Department announced its 10-year Plan for the devel-

opment of a Chinese medicine-based industry in 1999

(Trade and Industry Department, 1999). The Innovation

and Technology Commission was also established under

the Trade and Industry Department to support, among

other projects, those in the area of Chinese medicine-

related research and development.

Changes have also been observed in the policy-

making process. The Working Party on Chinese

Medicine and the Preparatory Committee on Chinese

Medicine, for example, were established in 1989 and

1995, respectively, to review the practice and use of

Chinese medicine in Hong Kong and to prepare the

groundwork for the coming statutory body for Chinese

medicine. In addition, political parties and politicians

have expressed their views about the development of

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Table 1

Milestones in the development of Chinese medicine in Hong Kong

Date Event

Between November 1988

and January 1989

Deletion and re-instatement of an article about Chinese medicine in the Basic Law

February 1989 Poisoning incident due to the misuse of toxic podophyllum emodi, thought to be non-toxic gentiana

scabra (Lung Dam Cho), triggering subsequent regulatory actions

August 1989 Working Party on Chinese Medicine (WPCM) is formed by the government, the first public review of

Chinese medicine in Hong Kong

Autumn 1991 School of Professional and Continuing Education, The University of Hong Kong provide courses for

Chinese medicine practitioners

April 1995 The Preparatory Committee on Chinese Medicine (PCCM) is appointed by the Secretary for Health

and Welfare to formulate regulatory plans on Chinese medicine

October 1997 The Chief Executive of the newly established Hong Kong Special Administrative Region announces in

his first policy address the government’s commitment to developing Chinese medicine

November–December

1997

Consultative Document in the Development of Chinese medicine in the HKSAR was published

September 1998 Hong Kong Baptist University recruits the first batch of full-time undergraduate students for Chinese

medicine programme

July 1999 Chinese Medicine Ordinance is finally passed by the LegCo

September 1999 On the recommendation of PCCM, the Chinese Medicine Council is made responsible for

implementing regulatory measures for Chinese medicine

September 1999 The School of Chinese Medicine established at The Chinese University of Hong Kong in 1998 begins

admitting students

November 2002 The list of the first batch of 2384 registered Chinese medicine practitioners under the Chinese Medicine

Ordinance is confirmed

May 2003 Chinese medicine traders are invited to submit their application for licenses

Source: Archival materials and news reports.

S.W.K. Chiu et al. / Social Science & Medicine 61 (2005) 1045–1058 1047

Chinese medicine from time to time. The topic of

Chinese medicine has been raised as an agenda item in

more than 20 Legislative Council (LegCo) meetings

during the past decade.

Various social institutions have been transformed to

accommodate the development of Chinese medicine. In

the education sphere, new academic programs and

research centers focusing on Chinese medicine have

been initiated in local universities. Three out of the eight

local universities currently offer full-time bachelor

degree programs in Chinese medicine. More than half

of the local universities have set up related research

centers as well. Changes are also under way in the legal

system. In accordance with the stipulation of the

Chinese Medicine Ordinance in 1999, the legal and

institutional framework for regulating the practice, use,

trade and manufacture of Chinese medicine were

finalized. The first batch of registered Chinese medical

practitioners was confirmed in 2002 and the registration

assessment for eligible Chinese medical practitioners was

completed in early 2003. Chinese medicine traders were

also invited to submit their application for licenses later

that year. There are changes within the government

structures too. The founding of the Chinese Medicine

Council in 1999 under the Chinese Medicine Ordinance

is also part of the institutional changes for the further

development of Chinese medicine in Hong Kong.

Furthermore, a Chinese Medicine Section was set up

in the Government Laboratory in 1998. A new division,

the Chinese Medicine Division and a new post of

Assistant Director of Health (Traditional Chinese

Medicine) were also created in the Department of

Health in the same year. We can conclude that although

by no means challenging the dominance of bio-

medicine, Chinese medicine has received a rising level

of political support and public acceptance and experi-

enced increasing institutionalization as a form of

alternative therapies.

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Explaining the institutional revival of alternative

medicines

Goldstein (2000) has described the several dimensions

of the growing acceptance of alternative medicines in the

United States. The most obvious dimension is certainly

growing utilization in the society. The second one is at

the ideological level, including the acceptance of the

term ‘‘alternative medicine’’ by conventional practi-

tioners and the recognition of the right and freedom of

individuals to choose different forms of healing prac-

tices. A third aspect is the ‘‘political acceptance’’ or

recognition ‘‘by the government and other quasi-official

bodies through laws, licensure, and regulations’’ (p.

289). This political process is important because it

‘‘frequently lead[s] to even greater levels of general

acceptability for CAM [complementary and alternative

medicine] because of how they are interpreted by the

public, or because of legal requirements that demand a

certain degree of societal acceptance of legally sanc-

tioned activities’’ (p. 289). In this paper, we focus on this

last dimension although we will also touch upon the

issue of its utilization and cultural conceptions.

The literature on alternative medicines and their

revival is voluminous, but the focus in most cases is

not on the causes of the revival but more on describing

the revival and the implications for the contours of the

medical system (for examples see Goldstein, 2000, 2002;

Lock, 1990; Sheehan & Brenton, 2002). In the limited

number of studies concerned with explaining the current

resurgence of alternative medicines, four distinct analy-

tical perspectives can be identified: cultural legacies,

functional and practical need, structural power relations

between various parties, and an alternative postmodern

ideology.

In the cultural legacies perspective, how people handle

their health problems is basically conditioned by their

own cultural contexts. Efforts to maintain health and to

cure illness are supposed to resonate with certain

cultural premises and vary substantially from one

cultural/ethnic group to another (Chen, 1981; Chi,

1994; Leslie, 1976; Nyamwaya, 1987). Li (1998), for

example, observes that among Chinese, the utilization of

a plurality of treatments from both Chinese and western

medicine is consistent with the cultural legacy of

harmony and equilibrium in the natural world. The

weakened position of traditional medicine in Taiwan is

said to be related to the decline of Confucianism as a

dominant societal ideology (Chi, 1994). A similar

argument has also been developed to account for the

rise of alternative therapies in the advanced societies.

Rising migration flows to these societies result in the

formation of ethnic communities. New migrants to these

communities are claimed to bring their cultural customs,

including preference for using alternative medicines,

from their country of origin (Kaptchuk & Eisenberg,

2001). In the case of Hong Kong, for example, the inflow

of new migrants from Mainland China might have

stimulated the social acceptance of Chinese medicine, as

migration has indeed accelerated since the 1990s.

The second type of argument is that the revival is

based on pragmatism and functional necessity. As long

as indigenous medicine provides people with pragmatic

solutions to health problems, it is almost guaranteed to

survive and accepted by the social and political main-

stream. Quah (1989) calls this the ‘‘triumph of practi-

cality.’’ Receptivity to alternative medicines will grow if

the dominant medical tradition no longer meets the

needs of people. Studies therefore have reported how

people have become more aware of the limitations of

biomedicine, dissatisfied with it and find alternative and

indigenous medicines an attractive option (Fulder, 1986;

Kaptchuk & Eisenberg, 2001; Lee, 1980).

The third type of argument is that the revival of

alternative medicines is a result of new consumer choices

spurred by a new ideology or set of beliefs. In other

words, the resurgence is viewed as a product of ‘‘cultural

revolt’’ (Goldner, 1998; Lupton, 1997). The new

ideology on health emphasizes, among other things, a

holistic understanding of health and illness and indivi-

dual choices and responsibility for health care decisions

(Goldstein, 2000; Kelner & Wellman, 1997). This new

ideology can be traced to the post-materialist or post-

modern values found in many advanced societies and

the transformations of the lay public from passive

patients into knowledgeable consumers of health care

services (Cant & Sharma, 1999; Inglehart, 1990).

A common feature of these approaches to Chinese

medicine is that they are more ready to answer the

question about utilization than institutionalization per

se. The structural arguments attempted to address this

issue more directly and were initially proposed to

account for the hierarchical relations between biomedi-

cine and indigenous medicines in many non-West

countries. The argument is that biomedicine was made

to be structurally superior to indigenous medicines

primarily as a manifestation of the political–economic–-

cultural hegemony through colonization and professio-

nalization (Elling, 1981; Saks, 2001; Unschuld, 1975).

Cho (2000) analyzes the relationship between the

traditional and biomedicine professions from a structur-

al perspective that emphasizes the institutional bases of

interest and power conflicts. Lee (1982) also argues that

this hierarchical health pluralism could be understood in

terms of the concepts of ‘‘functional strength’’ and

‘‘structural superiority’’. Western medicine enjoyed a

superior position through institutional means, while

Chinese medicine still prevailed because of its practical

value. This created an inconsistency between functional

strength and the structural inferiority of Chinese

medicines in Hong Kong that prompted pressures

towards greater harmonization of the two aspects. Lee

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Table 2

Percentages and rates of persons having consulted a medical practitioner by types of practitioners between 1982 and 2001a

Time points Type of practitionerb

Chinese medicine Western medicine

% c Rate d % c Rate d

1982, May–July — 7 — 77

1982, November–1983, January — 8 — 86

1983, July–September — 7 — 80

1989, January 6.7 9 93.3 122

1990, July 6.1 6 93.9 86

1992, August–September 6.3 7 93.7 97

1996, May–June 7.5 11 92.5 138

1999, September–November 19.9 28 86.5 122

2001, January–May 16.9 27 89.0 143

Sources: Census and Statistics Department (1983, p. 16, table 5), Census and Statistics Department (1992, p. 54, table D1c), Census and

Statistics Department (1996, p. 71, table 5.4d), Census and Statistics Department (2000, p. 41, table 4.3a), and Census and Statistics

Department (2002, p. 41, table 4.3a).aIn 1982 and 1983, the analysis was based on the consultations during the past 7 days before enumeration. In other years, it was

based on the past 14 days before enumeration.bIn 1982 and 1983, it is the type of the first three doctors consulted during the previous 7 days. In 1989, 1990, 1992 and 1996, it is the

type of the last three doctors consulted during the previous 14 days. In 1999 and 2001, the types of all the doctors consulted are

analyzed. Since it is unlikely that people will consult more than three different types of doctors during a 14-day period, the changes in

definition should not affect the comparability of the results.cThe percentages for the years 1999 and 2001 do not sum to 100 as a person might consult both types of doctors.dThe rate in all years is per 1000 persons in the respective enquiry periods.

S.W.K. Chiu et al. / Social Science & Medicine 61 (2005) 1045–1058 1049

(1982) further postulates that the structural disadvan-

tage of Chinese medicine in Hong Kong could be

mitigated as Chinese medicine underwent modernization

and professionalization.

1Some people consulted both Chinese medicine practitioners

and western medicine practitioners . In the 2001 survey, 5.8%

of all those who had consulted a doctor reported to have

consulted both types of doctors. Discounting this 5.8%, the rate

of consulting a Chinese medicine practitioner was 17.7 per

thousand persons, still substantially higher than the pre-1999

figures.

Towards a political process approach

Space limitation does not allow a detailed evaluation

of these arguments. Suffice to say is that while the

existing arguments usefully highlight certain facets of

the increasing popularity of Chinese medicine or

alternative medicine in general, they are at best

incomplete in accounting for the institutionalization

process. Our question here centres on the incorporation

of Chinese medicine into the institutional mainstream of

the society and the conferral of a legally and politically

sanctioned status. A key assumption in the existing

arguments is that increasing utilization would lead to

political acceptance. Yet this argument rests on two

problematic premises. First, it is doubtful whether

utilization had risen prior to the institutionalization.

As reported in Table 2, successive official surveys show

that the percentage of people consulting a Chinese

medicinal practitioner or using Chinese medicines and

herbs has remained largely constant in the two decades

prior to the late 1990s. Between 6% and 11% of the

population had consulted with a herbalist, bonesetter,

and acupuncturist or used Chinese herbs or medicines

from 1982 to 1996. These findings are confirmed by

many other territory-wide surveys (see the review in Lee,

2000b). Only since 1999 and after the apparent

momentum for institutionalization, has the utilization

rate (per 1000 persons) increased significantly.1

Second, the linkage between utilization and institu-

tionalization is never direct, for it is mediated by a

political process. For a government to change its policy

there has to be a political motivation. This study

therefore proposes to incorporate the insights of the

existing approaches into a political process model,

drawn from social movement studies, since we believe

this model can offer a dynamic account of the political

acceptance and institutional revival of Chinese medicine

in Hong Kong. In this paper, we treat the political

acceptance of Chinese medicine as the result of a social

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ARTICLE IN PRESS

2Our analysis is broadly consistent with her observations but

our political process approach puts more emphasis on the

mobilization for collective action among stakeholders and their

interaction with the state. Furthermore, we also have a broader

view on the relevant stakeholders to include academics at the

higher education institutions.3See Ko (2002, Appendix 2) for the profiles of the informants.

S.W.K. Chiu et al. / Social Science & Medicine 61 (2005) 1045–10581050

movement waged by Chinese medicine practitioners and

other stakeholders over the 1990s.

Already a voluminous literature has been generated

from this perspective (cf. Klandermans, 2001; McAdam,

1999; McAdam, McCarthy, & Zald, 1996; Jenkins &

Klandermans, 1995), but the most important concept in

the political process approach is the ‘‘political opportu-

nity structures:’’ ‘‘consistent—but not necessarily formal

or permanent—dimensions of the political environment

that provide incentives for collective action by affecting

people’s expectations for success or failure’’ (Tarrow,

1998, p. 74). Jenkins and Klandermans (1995, p. 4),

among others, suggest that the organization of the state,

the system of political representation, and the cohesion

and alignments among political elites are important

components of the political opportunities structure that

shape the emergence and development movements.

Provided that the political structures are vulnerable,

action protest initiated and formed under a common

perceived threat by those indigenous organizations

(usually the aggravated groups) may produce an impact.

Applications of the approach to the study of social

movements in the context of decolonization and

democratization in Hong Kong can be found in Lui

and Chiu (2000).

Several important insights follow from this model.

The first is that the social movement to achieve the

institutionalization of Chinese medicine is largely con-

ditioned by the broader political context. The mutable

political opportunity structures act as triggers for all

collective actions. Second, a social movement exempli-

fies a continuous dynamism. How insurgent groups

make use of major political transformations, change

their structural power relationships with other social

groups, and advance their interests are the basis of these

dynamics. During this process, several factors are of

importance to sustaining a social movement. Organiza-

tions are needed, for example, to initiate the first

collective action, while more robust organizations are

in a better position to mobilize resources and mount

more actions to maintain a movement. Moreover, the

role played by various social groups in the develop-

ment of a movement is not fixed but mutable. A transfer

of leadership roles from one group to another with

greater organizational strength is also possible. The

various stakeholders have also forged shifting alliances

among each other. In this case, the political process

model also directed our attention to the increasing

support by the established elite for the movement

to institutionalize Chinese medicine, just as Jenkins

and Eckert (1986) discuss the effect of ‘‘elite patronage’’

on the rise of a black social movement in the United

States. Finally, the political process model is also

appropriate for the study of the constitution of the

medical system because as Mechanic and Rochefort

(1996) point out, ‘‘politics and government deserve

special consideration as variables influencing the orga-

nization of national medical care system.’’ Similarly, Ho

(2002) highlights changes in the agenda-setting process

in regulating Chinese medicine as a result of democra-

tization and decolonization.2 By highlighting the inter-

actions among various societal actors and the state, the

political process approach recognizes that in all modern

societies the state is instrumental in providing or

regulating medical services. In a sense we are not writing

off the existing explanations to the revival of alternative

medicines but seeking to set them against the context of

broader changes in political opportunities and the

process of collective mobilization by the various

stakeholders.

Like most other researchers of social movements, we

have used qualitative methods in our data collection and

analysis. For this project, we collected over 1500 news

reports on the development of Chinese medicine in

Hong Kong since the 1970s and consulted a large

number of publications by Chinese medicine organiza-

tions gathered from organizations, individuals and local

libraries. To obtain in-depth information on the Chinese

medicine movement, we conducted 17 intensive inter-

views (averaging 2 h in length) of key informants who

were involved in the movement, including Chinese

medicine practitioners, biomedical doctors and univer-

sity professors involved in the promotion of Chinese

medicine.3

Decolonization and the changing political opportunity

structure in Hong Kong

The British government pursued the agenda of

political reform and a ‘‘graceful’’ retreat. Since the late

1980s, on the other hand, the Chinese government had

made it clear that the existing colonial political structure

would be preserved to a certain extent and full

democracy would not be achieved overnight after the

handover. The China government proposed the concept

of ‘‘one country, two systems’’ with the idea of making

Hong Kong a Special Administrative Region under the

sovereignty of China with limited democracy to counter

the colonial government’s attempt to create a political

fait accompli. It is in this situation of transitions and

constant flux that actors supporting the promotion of

Chinese medicine found the political opportunities to

propel it to the medical mainstream.

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The changing political opportunity structures for Chinese

medicine

In spite of the limited democratization, however,

decolonization opened up opportunities for political

access for those previously excluded from the established

structures. New political structures had to be designed

and new political elites had to be recruited. Pro-China

elite groups previously excluded from the colonial polity

were thus co-opted into the new establishment. Some

individuals belonging to the traditional elites—the rich

and formerly pro-British—were also co-opted into the

pro-China camp (Lam, 1996). They were to serve as the

countervailing force to the liberal political forces created

by the colonial government through the three-tiered

administrative structure of the District Boards, Urban

Council/Regional Council, and Legislative Council

(LegCo).

Because of this political fluidity, openings were

created for Chinese medicine organizations to make

their voices heard for four reasons. First of all, the

superior positions of the established elite groups were

threatened and their power base began to shrink.

Moreover, ‘‘participation in formal institutional politics

had given rise to divisions among the loosely connected

active groups’’ (Lui & Chiu, 2000, p. 11). The Tianan-

men incident in Beijing in 1989 further exacerbated the

cleavages, leading to the consolidation of the schism

between pro-democracy and pro-China conservative

forces. The divided political elites then engaged in a

long power struggle as they jostled for political influence

in the transitional period and after (Lam, 1996).

Second, McAdam (1982, p. 43) notes that when

groups previously excluded from the political process

are given access to political structures, they might gain

‘‘a net increase in the political leverage’’ during the

structural changes. Local Chinese medicine societies, for

example, were for the first time given a chance to

participate in an institutional structure during this

political transition, notably on the Basic Law Con-

sultative Committee that was to draft the mini-constitu-

tion for Hong Kong. This conferral of status was

unimaginable under the British colonial rule. Apart

from the Basic Law Consultative Committee, Chinese

medicine societies had their own representatives in the

400-member Selection Committee to select members of

the Provisional Legislative Council as well as the 800-

member Election Committee to elect the Chief Executive

of the future SAR. They also participated in those

statutory bodies responsible for designing the regulatory

systems for Chinese medicine.

Third, Chinese medicine societies found many new

influential allies. By combining their claims with the

language of ‘‘national heritage’’, ‘‘cultural reunification’’

and ‘‘patriotism’’, the Chinese medicine societies had

secured an effective platform to gain the general public’s

support since these resonated with popular discourses in

the transitional period. The report of the Working Party

on Chinese Medicine certainly echoed this sentiment.

The report began by referring almost obligatorily to the

position of Chinese medicine in Chinese history and

culture: ‘‘Traditional Chinese medicine has a history of

over 5000 years, with written records dating back some

2000 years. It is an integral part of Chinese culture. The

use of traditional Chinese medicine has developed

through centuries of clinical experiences into a medical

system with theoretical basis and different treatment

modalitiesy . The development of traditional Chinese

medicine has been particularly significant in the past few

centuries’’ (1994, p. 4). A Legislative Council member’s

speech also reflected the same sentiment: ‘‘ytraditional

Chinese medicine is an important part of the rich

Chinese culture. If we are able to utilize such valuable

resources properly, the health of the people of Hong

Kong will be better protected’’ (Hong Kong Legislative

Council, 1995, p. 1620). As the political elites struggled

for power and influence in the transitional period, they

eagerly grasped any opportunities to demonstrate their

patriotic and nationalistic credentials.

Even members of the mainstream western medicine

establishment ceased to stand in the way of the advance-

ment of Chinese medicine for the fear of appearing to be

political incorrect. Furthermore, the two most prominent

physicians in the LegCo had been enthusiastically giving

concrete and strategic support to Chinese medicine. For

example, between 1989 and 1999, one of these physicians

gave speeches or raised questions in relation to Chinese

medicine on 11 occasions in LegCo meetings.

Fourth, Chinese medicine societies, having been an

excluded group in the past, had experienced a ‘‘benign

neglect’’ at the hands of both the then colonial

government and the Chinese government. They were

given much freedom to mobilize support for Chinese

medicine. Moreover, Chinese medicine is an officially

recognized medical tradition in mainland China and has

been accorded a status equal to that of western medicine

(Croizier, 1976; Quah & Li, 1989; Rosenthal, 1981).

Although there is no evidence that the China govern-

ment mandated Hong Kong to adopt the same policy,

this had directly influenced the views of Hong Kong

politicians towards Chinese medicine. Local politicians

generally believed Chinese medicine was no longer a

politically sensitive issue but rather had become a

‘‘politically correct’’ topic. In this respect, the attitude

and strategies adopted by these two governments

created a favorable condition for Chinese medicine

societies to mobilize support.

Mobilization by Chinese medicine societies

Against these backdrops, Chinese medicine societies

responded vigorously to two challenges in the transitional

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period: the drafting of the Basic Law in 1988 and the

Lung Dam Cho incident in 1989. Both events were

initially viewed by the Chinese medicine societies as

potential threats to their status, thus triggering off

mobilization for collective actions to defend themselves

in the face of the perceived common threat.

In the first case, the Chinese medicine societies were

caught by surprise when they found out that a provision

concerning the development of Chinese medicine had

been deleted from the first draft of the Basic Law. They

held joint meetings among themselves, appealed to other

Chinese medicine practitioners for support, formed a

committee and petitioned the Basic Law Consultative

Committee to reinstate the clause. Nine Chinese

medicine organizations and 308 individuals signed the

petition (Sin-Hua Herbalists’ and Herb Dealers’ Promo-

tion Society, 1996, p. 30; Tam, 1994, p. 24).

In the second incident, two people became seriously ill

after mistakenly taken the toxic podophyllum emodi

which was thought to be non-toxic gentiana scabra

(Lung Dam Cho). In response to the incident the

government set up the Working Party on Chinese

Medicine to review the use and practice of Chinese

medicine. At first Chinese medicine societies adopted a

stance of diplomatic non-cooperation when receiving a

request from the Working Party to supply information

on the herbal medicine trade. Then they gradually

gathered their forces and became more vocal, especially

after their success in the Basic Law drafting process. In

1990, representatives from Chinese medicine profession

were co-opted into the Working Party. Chinese medicine

societies gave press interviews, and wrote to the Work-

ing Party and local newspapers to express their opinions.

They now recognized that whether they liked it or not,

the Preparatory Committee on Chinese Medicine would

develop a framework for the regulation of Chinese

medicine in the near future. If they did not make use of

the chance to voice their opinions in the design of the

rules for the statutory body, they would have to follow

in the future whatever was laid down for them. A

Chinese medicine practitioner recounts vividly the

change in attitude among his colleagues:

[It was] just like watching something on fire across

the rivery . In the past, though it was still burning, I

felt safe standing on the opposite side. But now, the

fire is spreading almost up to my housey . So they

[Chinese medicine practitioners] were very angry

about it. They strongly urged their chairmen to fight

against ity. (Interview).

They began to make broader claims. For instance, in

response to the report of the Preparatory Committee on

Chinese Medicine issued in 1997, some Chinese medicine

societies urged the government to include Chinese

medicine in local public health services (Hong Kong

Daily News, 1997) and the school curriculum (Wen Wei

Po, 1997). Some made more specific requests, such as for

lenient requirements for registration of Chinese medicine

practitioners (Hong Kong Economic Journal, 1997), and

for inclusion of Chinese medicine practitioners into a

new LegCo functional constituency (Sing Tao Daily,

1997). The openings in the political opportunity

structure therefore offered new space for Chinese

medicine societies to mobilize their constituencies in

order to advance their interests.

All these set the stage for subsequent collective actions

of Chinese medicine societies and individual Chinese

medicine practitioners in the 1990s. Many individual

Chinese medicine practitioners and societies responded

actively and positively to government measures on

Chinese medicine. They frequently formed formal and

informal coalitions among themselves. Some Chinese

medicine practitioners turned to individualistic strategies

and sought to obtain an official qualification in Chinese

medical training from the universities. Still, the most

remarkable change was the rapid growth of organizing

activities by Chinese medicine societies. Drawing from

information in Tse (1998), the Working Party on

Chinese Medicine (1992) and publications of various

Chinese medical societies, an average of one new

Chinese medicine society was founded per year between

the mid-1980s and the mid-1990s. The number climbed

to a total of 16 between 1995 and 1999. In 2000–2001,

the number further surged to 32. Attempts were made to

overcome this organizational proliferation through

amalgamation within the profession. The founding of

the Association of Practitioners of Chinese Medicine

General Chamber Hong Kong Limited through an

alliance of five existing societies in 1990 is one example.

Elite support and positive societal responses

Mobilization by indigenous organizations had pro-

vided the initial impetus for the institutionalization and

revival of Chinese medicine in Hong Kong. Yet these

organizations lacked the capabilities to continue mobi-

lization efforts over a longer period of time. Their loose

organizational structures were one of their serious

handicaps. Moreover, they suffered from a chronic lack

of resources such as charismatic leaders, committed

membership, adequate finance, structured solidarity

incentives and communication networks, all essential

for any large-scale mobilization. Internal cleavages also

surfaced time and again in an endless circle. Although

the historical ideological division between pro-China

and pro-Taiwan Chinese medicine societies had appar-

ently been fading away, a new basis for schism gradually

emerged around mid-1990s between Chinese medicine

practitioners who had undergone formal training and

those who entered their practice via self-learning or

apprenticeship (learnt from their parents or masters).

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Under these circumstances, any collective action would

likely be ephemeral and relatively ineffective. By the

mid-1990s, however, the Chinese medicine movement

looked set to enter a new phase in which new and more

resources actors becoming more important in its

development.

One thing the incipient Chinese medicine movement

managed to achieve in the early 1990s was to frame the

whole movement successfully as a nationalist movement

by arguing that the structural inferiority of Chinese

medicine was a disgraceful product of colonialism.

References were often made in Chinese medicine

publications and press conferences to support by Main-

land Chinese officials. Chinese medicine thus emerged as

a desirable political currency in the transition to Chinese

sovereignty. As a result, new players joined the move-

ment when they perceived opportunities to advance their

own interest from the process of mobilization in favor of

Chinese medicine.

Among interested parties, politicians were most

sensitive to the shifting political context and structures.

They would support any position that could increase

their political assets. Since Chinese medicine had

achieved, respectively, as a signifier of cultural reunifica-

tion, how could these politicians resist the temptation to

jump on the bandwagon of Chinese medicine? The

signaling effect of the Basic Law is paramount in this

connection. After the inclusion of Chinese medicine in

the Basic Law in the early 1990s, LegCo members,

members from the District Boards and the two

municipal councils, local advisors of China, political

parties and the like all lavished their support for Chinese

medicine in speeches at council meetings, in newspaper

interviews and at public forums. As a Legislative

Councilor remarked in a 1995 speech:

The Basic Law has stipulated [for the recognition of

Chinese medicine]y . It is for this reason that the

government should not take a negative and dismis-

sive attitude towards the development of Chinese

medicine in Hong Kong (Hong Kong Legislative

Council, 1995, p. 1612).

The mass media were similarly enthusiastic. Through

extensive discussion in both newspaper editorials and

public forums, they helped shape public discourses on

Chinese medicine development. At least 13 newspaper

editorials were devoted to the topic of Chinese medicine

between 1997 and 2000, nine of them in 1999 alone. The

upshot was that the mass media contributed to the

creation of a climate of public opinion that was

conducive to the development of Chinese medicine.

It was not until the participation of business

enterprises, however, that the fascination with the

commercial potential of Chinese medicine and the idea

of an ‘‘international centre of Chinese medicine’’

become widespread. During the economic downturn of

the late 1990s, those firms sitting on piles of cash from

other businesses like real estate and manufacturing

generally believed that Chinese medicine could become

the ‘next big thing’—comparable to the Internet boom.

They began to collaborate actively with local universities

and mainland Chinese medicine institutes on research

and clinics. New companies focusing on Chinese

medicine and other bio-technological ventures were also

formed. For a while after 1997, new bio-tech firms,

including those devoted to Chinese medicine, enjoyed

the same status as Internet start-ups in the marketplace.

Even the Government jumped on this bandwagon

during the late 1990s. It found the nationalistic overtone

of Chinese medicine appealing and was eager to exploit

the commercial potential of Chinese medicine in order to

revive the economy after the Asian Financial Crisis. In

his first policy address in 1997 (at a time when the full

impact of the Crisis was not yet apparent), the Chief

Executive stated,

For the protection of public health, we aim to

introduce a bill in the next legislative session to

establish a statutory framework to recognise the

professional status of Chinese medicine practitioners;

to assess their professional qualifications; to monitor

their standards of practice; and, to regulate the use,

manufacture and sale of Chinese mediciney . I

strongly believe that Hong Kong has the potential

to develop over time into an international centre for

the manufacture and trading for Chinese medicine,

for research, information and training in the use of

Chinese medicine, and for the promotion of this

approach to medical care (Tung, 1997).

Since this statement was included under the section on

‘‘a compassionate and caring society’’. It was supposed

to be a health care issue, but the Chief Executive also

stressed the economic value of Chinese medicine to

Hong Kong. China responded positively to this strategic

move. The most popular topic in the pro-China press, in

this period concerned how China could help Hong Kong

develop into an international centre of Chinese medicine

(Ta Kung Pao, 1999a, b). Others relevant themes

discussed in the Chinese press included how to make

Chinese medicine a scientific subject and the future co-

ordination between Chinese medicine and western

medicine (Wen Wei Po, 1999a; Ta Kung Pao, 1999b).

After the reunification, cooperation and exchanges

between the Mainland Chinese medicine establishment

(universities and hospitals) and that in Hong Kong

became legitimate and hence much more frequent. The

much higher level of development and institutionaliza-

tion of Chinese medicine on the Mainland also helped

endow local Chinese medicine bodies with a gloss of

respectability.

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Once Chinese medicine was perceived as a commodity

that could be marketed internationally, interest in it was

no longer confined to individual Chinese medicine

practitioners and societies. Questions such as how to

incorporate scientific methods into the study of Chinese

medicine and how to commercialize Chinese medicine

began to preoccupy academic researchers and business

enterprises. A coalition among universities, enterprises

and the government gradually emerged, with university

professors taking on the leading role in sustaining the

movement for the development of Chinese medicine.

Among elite groups that lent their support to Chinese

medicine, academics and tertiary institutions were most

important to the second phase of the movement. It was

especially after a series of Chinese medicine poisoning

incidents occurring between the late 1980s and the early

1990s that they began to play an active role as Chinese

medicine experts in statutory advisory bodies for

Chinese medicine. New political opportunities enabled

these actors to gain access to more information about

the policy processes and enhance their leverage in

political bargaining. Through the exchanges and inter-

actions in these bodies, Chinese medicine practitioners

and academics certainly developed greater rapport and a

common understanding on the future development of

Chinese medicine. Individual professors in privileged

institutional positions could then advise their universi-

ties to modify their strategies accordingly so as to exploit

the opportunities that were emerging from the Chinese

medicine movement.

Apart from the above-mentioned political opportu-

nities, local universities were comparatively well pre-

pared for the mobilization (see Lee, 1980). They had

supported studies relating to Chinese medicine dating

back to the 1970s, but it was not until the early 1990s

that these universities embarked on major organiza-

tional initiatives. Rigorous formal structures and

schools devoted to the teaching and researching of

Chinese medicine were founded in three local univer-

sities in the latter half of the 1990s. The smooth transfer

of power from Chinese medicine societies to universities

made the movement sustainable. On the one hand, more

universities began to realize it would serve their own

institutional interests to become involved in Chinese

medicine education and related research. If universities

were successful in upgrading Chinese medicine and

turning it into a ‘‘normal’’ discipline, they would then be

in a stronger position to receive resources from various

parties, including government and private enterprises.

When discourses about Chinese medicine shifted from

cultural reunification to professionalization and its

potential as a new engine of economic growth, local

universities were more than willing to play an active role

in the transformation and turn themselves into training

bodies for Chinese medicine professionals. On the other

hand, Chinese medicine societies were well aware of

their own limitations. They were thus inclined to solicit

support and resources from outside bodies from the very

beginning. They knew that credentialism was a major

element of professionalization and that only universities

could grant them recognized qualifications. More

individual Chinese medicine practitioners had enrolled

in courses offered by universities. The almost fatalistic

attitude in the profession at that time towards this shift

of leadership can be gleamed from the following

comment of a Chinese medicine practitioner:

Universities have to do something in this regard

(training of practitioners)y . In the final analysis,

universities are the most resourceful agenciesy .

They did nothing to advance Chinese medicine

education from the 1950s to the end of the

1980sy . But after the implementation of govern-

ment registration, all the candidates for registration

have to be university graduatesy . In other words,

there will be no place for all those privately owned

training institutesy . But there is no alternativeythe

standards of practising Chinese medicine practi-

tioners have to be raisedy . Many other similar

Chinese medicine training institutes have to be

eliminatedy(Interview).

In short, Chinese medicine societies gradually surren-

dered their leading role to local universities in exchange

for a higher status for Chinese medicine and upward

mobility for its practitioners.

Academics at the Chinese University of Hong Kong,

Hong Kong Baptist University and Hong Kong Uni-

versity, all leading universities in the colony, had in fact

attempted since the 1990s to mobilize for the institutio-

nalization of Chinese medicine research and education

through the establishment of Chinese medicine schools

and programs in their universities. Progress was slow at

first but by the latter half of the 1990s, university

professors finally succeeded in taking advantage of the

structural opportunities to achieve their goals. For

instance, universities continued to expand their Chinese

medicine courses in continuing education programs and

to develop formal schools of Chinese medicine and

related research institutes. Most of the courses proved to

be popular among practitioners and the general public

(Hong Kong Baptist University, 1999; Wen Wei Po,

1999b). They also began to operate their own clinics

both for student placements and as a public service.

Moreover, they continuously leveraged support from

their mainland Chinese counterparts in course designs,

teaching and so on. Joint ventures between local and

mainland Chinese medicine institutions became much

more commonplace.

Although arriving relatively late on the scene in the

late 1990s, private enterprises also began to capitalize

more on the appeal of Chinese medicine. They included

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a few prominent property developers and some Chinese

medicines manufacturers. Their participation was gen-

erally believed to be a response to the continuing

promotions made by the HKSAR Government. It was

undeniable that the Chief Executive’s policy addresses in

both 1997 and 1998 and subsequent policy changes had

given these enterprises much hope. These enterprises

were made to believe that, with the support of the

government, Chinese medicine could be developed into a

flourishing industry. This gave Hong Kong a glimpse of

hope in the economic downturn following the Asian

Financial Crisis. Businessmen recommended strengthen-

ing connection and co-operation with China, conducting

research on some potent Chinese drugs, developing

Chinese medicines into healthy products, and so on.

They also supported local universities and mainland

Chinese medicine institutes in doing research on Chinese

medicines (Hong Kong Economic Daily, 1996), and they

opened Chinese medicine clinics either by themselves

(Ming Pao, 1999) or in co-operation with local

universities (Hong Kong Economic Daily, 1999). In

short, by the turn of the new century the entire society

was heated up by the discourse of ‘‘international centre

of Chinese medicine’’ because of the arrival of private

enterprises. Besides, their financial support to local

universities had given the latter a great boost. Only then

could the universities implement adequate organiza-

tional structures to replace Chinese medicine societies in

sustaining the development of Chinese medicine.

Discussion and conclusion

The growing acceptance of alternative medicine has

been widely observed in all the advanced societies. Our

paper has sought to contribute to the understanding of

this phenomenon by paying particular attention to the

changing political process and opportunities it created

for concerned actors to promote the institutionalization

of alternative medicine. As Tilly (1978) has argued, a

period of political transition often produces a realign-

ment of power and interests among different groups and

creates in the process a ‘‘power vacuum’’. It is in this

period of political fluidity that groups previously

excluded from institutionalized access to power begin

to challenge their exclusion. The power of the estab-

lished elite groups is threatened or begins to diminish.

The maintenance of their power becomes even more

precarious if these elite groups are divided among

themselves. In contrast, the political leverage of the

excluded groups (the indigenous groups in particular)

grows—provided they can gain increased political access

and attract influential allies and if the state’s capacity to

repress them declines. A movement may therefore be

generated if these groups are able to capitalize on the

available structural opportunities. If however these

indigenous groups are not endowed with sufficient

organizational capacity to sustain and advance mobili-

zation, support from outside these groups becomes

essential for the viability of the movement. The recent

social and political resurgence of the Chinese medicine

movement in Hong Kong well exemplifies how these

political processes affect a social movement. Our

political process approach also allows us to identify

the crucial turning point in the development of Chinese

medicine: that is, why following a long period of

dormancy, the indigenous Chinese medicine organiza-

tions sprung into action in the 1990s and why the

societal response to the mobilization for Chinese

medicine development had become much more favor-

able towards the end of the 1990s than previously.

Existing models explain the re-emergence of indigen-

ous medicines by using concepts of cultural inertia, a

cultural revolt or relative power of interest groups. Our

approach complements these lines of thought by looking

at the interactions of different sets of cultural values and

the political context. For Asian societies still undergoing

the long process of modernization however, it has been

argued that modernization is likely to weaken the hold

of traditional medicine (Chi, 1994; Lee, 1982). The Hong

Kong case suggests that under favorable conditions,

traditional medicine has made use of modernization and

its ideological manifestation of nationalism as the

overarching frame for breaking into the medical main-

stream (Croizier, 1976). More pertinently, in Mainland

China, Chinese medicine has been pushed by the

Communist revolution to the mainstream medical

system because the Communists can use traditional

medicine to symbolize the continuity of Chinese culture

to counter Western bourgeoisie science and technology

(Croizer, 1976). In other words, cultural values and

ideologies are important but their impact is also

conditional on the broader political context and whether

they are ‘‘mobilized’’ by the stakeholders to achieve a

particular objective.

As for the power argument, a clear relationship

between the structural positions of different interest

groups and the changing political opportunities is

evident. Under relatively favorable conditions, stake-

holders will mobilize for collective actions and seek to

shape political outcomes. In particular, Hong Kong’s

decolonization spurred the alliances between Chinese

medicine practitioners and a number of established elites

such as university professors, biomedical practitioners

and politicians. The power resources available to specific

groups are of course related to the broader political

system and process. In most developing societies,

colonial rule is the critical political context shaping the

structural position of traditional medicine vis-a-vis

biomedicine. There is a substantial literature on tradi-

tional medicine in colonial societies which attributes the

marginalization of the former by the social and political

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influence of biomedical practitioners. Less attention,

however, has been put on the decolonization era when

the subordination of traditional medicine became

unsustainable and traditional medicine was revived

and then institutionalized (e.g., Flint (2001) on South

Africa).

Our study complements these studies by examining

the case of colonial Hong Kong in which a coalition of

traditional healers and other stakeholders put pressure

on the government to recognize and regulate Chinese

medicine. The case of India also suggests that decolo-

nization often created impetus for practitioners of

traditional Ayurvedic and Unani medicines to lobby

for more recognition and support by the postcolonial

government (Leslie, 1976). Nevertheless, the Indian case

also suggests that we should not take the post-colonial

revival for granted because after independence, the new

government had not put much effort into the institutio-

nalization and promotion of traditional medicine (Bane-

rji, 1981). Decolonization may create the political

opportunities for the social and political revival of

traditional medicine, but the outcome is never prede-

termined. Romero-Daza (2002), for example, highlights

a variety of postcolonial experiences in incorporating

traditional medicine into primary health care. The

World Health Organization (2001) also offered evidence

for the open-ended nature of the institutionalization of

traditional medicine in developing societies. Our analysis

here points to the importance of the mobilization by

stakeholders and the coalition of interests that pushed

Chinese medicine towards the mainstream. The emer-

gence of supporters from among the elites was also

critical for the relatively successful institutionalization.

Perhaps more comparative research on the development

of traditional medicines in postcolonial societies would

help toward a understanding of the dynamics of the

institutionalization of traditional medicine in the devel-

oping world.

Acknowledgements

Authors’ names are arranged alphabetically to in-

dicate equal contribution. We are grateful for the

support of a small grant from the Department of

Sociology, The Chinese University of Hong Kong. This

is part of an on-going project on the development of

traditional medicine in Hong Kong.

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