Trends and Issues on Massage in South Korea

Korea
Speaker: Kim Young-il, Prof., Chosun University, Special Education Department
Title: Trends and Issues on Massage in South Korea

The purpose of this report is to share with conference attendees the developments and experiences of massage in South Korea. This report addresses four topics as follows: (a) history of massage in Korea; (b) the current system for training massage practitioners; (c) types of job settings and massage training; and (d) challenges for future developments. The first section describes the introduction of massage to Koreans with visual impairments, its development and termination, strenuous efforts for rebuilding the massage system and recent crisis. The second section compares the two massage training systems (i.e., school-based training vs. center-based training) in terms of their development, environment, curriculum and students. The following section reports on the current state of massage practices in different types of work settings such as massage service centers, massage clinics and other massage facilities. The final section concludes with a discussion of challenges that Koreans with visual impairments face in developing massage as a justifiable, productive and competitive job for the future.

I. History of massage operations

It is thought that about one hundred years have passed since massage operations were first introduced in Korea.  The history of massage operations during this time can be roughly divided into three periods, namely, the initial introduction and termination of the massage system, secondly, the movement to restore the system and, thirdly, the partial revitalization of the system and crisis.  I will describe each of these stages.

1. Introduction and termination of the massage, acupuncture and moxibustion system

The Government-General of Korea established the Saisei-In in 1913 and introduced into Korea a system of massage, acupuncture and moxibustion through education in massage, acupuncture and moxibustion provided to students of schools for the blind.  In 1914, the Government-General of Korea began issuing massage, acupuncture and moxibustion licenses to visually impaired persons who graduated from Sansei-In blind schools without any tests or certification.  By the time independence was gained in 1945, private schools for the blind had been established in Hanpu, Heshu, Pyongyang, Onsan, Pusan and other locations and education in massage, acupuncture and moxibustion was also provided at these regional private schools for the blind.  While the graduates of the Visually Disabled Children Department of the Sansei-In, a public institution, acquired licenses without any tests or certification, the graduates of private schools for the blind were able to acquire licenses by passing a test implemented by the provincial governor in each region.  There were about 800 visually impaired people who obtained massage, acupuncture and moxibustion licenses during the colonial period.  They established massage businesses together with visually impaired Japanese people, engaged in massage operations by walking along the streets at night while playing a flute or worked at hospitals.

The Health and Welfare Department of the United States Military Government in Korea abolished the massage, acupuncture and moxibustion system in 1946.  Even after the government of South Korea became established, it was necessary for visually impaired persons to promote a persistent movement for the restoration of the system in order to achieve its reestablishment.

2. Movement to restore the massage, acupuncture and moxibustion system
Although the United States Military Government in Korea abolished the system, education in massage, acupuncture and moxibustion continued without interruption at the Seoul School for the Blind and other private schools for the blind that began to be established at the time.  In other words, in spite of the fact that it was not possible to acquire certification of qualifications in massage, acupuncture and moxibustion or legally receive protection regarding the range of operations, the blind schools continue to offer education in massage, acupuncture, moxibustion and other therapeutic activities as occupations for blind persons.  It could be said that the continuation of therapy education itself was a type of movement for the restoration of the massage system.  Not only the educational world but also graduates of blind schools, blind adults and others worked hard to restore the massage, acupuncture and moxibustion system.  As a result, the massage system was restored.  However, the acupuncture and moxibustion systems have not even now been restored in spite of the persevering movement.

Even if massage practitioners did not have legal qualifications, graduates of schools for the blind that had received therapy education continued to provide massage service.  As in the colonial period, there were visually impaired persons who managed massage businesses; however, there were also those who were engaged in massage operations who would go out at night and walk the streets, especially in areas with concentrations of inns, while playing their flutes.

In the 1960s, massage lounges were established in public bathhouses and there were places that employed massage practitioners.  Instead of receiving requests by telephone and going to the customer’s place, massage operations changed to configuration in which customers came to them and, in 1968, massage service centers appeared in a form that combined the massage lounges of public bathhouses and inns.

3. Restoration of the massage system and crisis

The massage system was reinstated in 1973, twenty-seven years after the abolition of massage, acupuncture and moxibustion system.  Regulations regarding Massage Practitioner Licenses were enacted and promulgated in 1963, setting forth the basic rules, making it possible for visually impaired persons to acquire qualifications as massage practitioners.  However, the regulations were invalidated two years later.  The Medical Treatment Law was amended in 1973 and it was in October of that year that provisions were newly established in the law regarding “massage practitioners” and the Regulations regarding Nursing Assistants, Medical Treatment Assistants and Massage Practitioners were formulated and the massage system was reactivated.  The regulations stipulated that only persons with visual impairments were allowed to work as massage practitioners.  For the next thirty three years until the decision by the Constitutional Court in May of this year that the regulations were unconstitutional, visually impaired persons received legal protection at least with respect to massage operations.  Even though the massage system was restored, the acupuncture and moxibustion systems were not restored in spite of the persistent efforts.  However, the official interpretation that class 3 and lower moxibustion could be used as stimulation therapy was secured.  In the 1970s and 80s, there were visually impaired persons who were engaged in moxibustion operations making use of moxibustion technology learned through education at schools for the blind.  However, they were prosecuted for engaging in illegal activity and subjected to enforcement and, currently, there has been a broad decline in visually impaired persons who chose to provide acupuncture therapy.

After attempts to establish massage service centers as a new form of massage operations in 1968, their numbers have gradually increased to the present, building up a status as a major business configuration of Korean massage operations.  In the latter half of the 1970s, the honorary director system of massage service centers in which ordinary citizens, as directors of the facilities, invested capital and hired visually impaired persons have been increasing.  Since the 1980s, massage service centers have become more luxurious and have selected business strategies as amusement operations and, as a result, they have become subject to regulation.  The reason for the increase in massage service centers was the fact that they earned better income than massage clinics and because it was possible to live and work in one place without the risk of walking about.  Though only persons with visual impairments are recognized as having qualifications as massage practitioners and the right to establish massage operations, there has been a rapid increase in the number of people who engage in sports massage, meridian massage, foot massage and other quasi-massage operations without any qualifications.  People who engage in these illegal quasi-massage operations have raised objections in court, culminating in a court decision that Article 3 of the regulations regarding the certification of the qualifications of visually impaired persons only is unconstitutional.

II. Training system for massage practitioners

According to the Regulations of Massage Practitioners, persons who receive certification of qualifications as massage practitioners are, first of all, visually impaired persons who have completed physics education at a school that provides education equivalent to junior high and high school level schools for disabled children and, secondly, visually impaired persons who have received education at a level above junior high school and have completed a massage training course of two years or more at a massage training institution designated by the manager of the Department of Health and Welfare.  Furthermore, in Korea, massage practitioners receive training first at schools for the blind that receive the support and management by the Ministry of Education & Human Resources Development and, secondly, at a massage training institution affiliated with the Korea Massage Practitioner Association designated by the manager of the director of the Ministry of Health and Welfare.  Currently about 3,600 of the 6,000 members of the Korea Massage Practitioner Association are massage practitioners who graduated from schools for the blind and about 2,400 who received training at a massage training institution.  In this section, I will provide a simple introduction to and compare the schools for the blind and the training institutions.

1. Schools for the blind

There are thirteen schools for the blind nationwide, which had a total of 504 students as of 2005.  There are some among the students who graduate from junior high school and advance on to a higher level and there also adults who became blind later in life with academic achievements at the high school or higher level.  High schools for the blind basically offer a three-year course; however, a two-year therapeutic rehabilitation course was established for the first time in 2001 for those students who already have academic capabilities beyond the high school level and there were six schools in operation as of 2006.  In addition, schools for the blind initiated the full-scale introduction of specialty therapy courses in 1955 and, as of 2006, there were five schools providing these courses.  The graduates of these special study courses, who are considered to have acquired massage practitioner qualifications, are given the opportunity to receive doctoral degrees as therapy professionals without the need to acquire any additional qualifications.

There are about one hundred teachers who are in charge of therapy education at schools for the blind and therapy subjects include anatomy and physiology, pathology, health, massage finger pressure, electrotherapy, Chinese herbal medicine, acupuncture and moxibustion, physical therapy, diagnostication and practical training.

2. Massage training institutions

Massage training institutions were first established in 1972 and nine had been established by 2006.  There was a total of 201 students studying at the institutions as of 2006 and, as the primary characteristics, first of all, their average age is 44 and, secondly, in terms of scholastic abilities, 34.0% have graduated from junior high school, 46.4% from high school and 19.6% from university.  Thirdly, males comprise 72.9% of the total and females 27.1%, fourthly, 86.0% have previous occupational experience and, lastly, 77.9% have visual acuity of 0.04 or less.  The institutions provide a two-year training course and persons with junior high school level academic capabilities are permitted to enter.  Those who graduate from the training course are recognized to have massage practitioner qualifications but are not considered to have qualifications as high school graduates.

There are about thirty teachers who are in charge of therapy education at the institutions.  During the two-year course-work term, there is a total of 124 credits for subjects in which they receive instruction including twelve credits in rehabilitation education, eighteen credits in liberal arts education and 94 credits in therapy education.  The therapy education is about the same as that given at schools for the blind, though there are no classes in acupuncture or moxibustion.

III. Current state of massage operations

As of March 2006, there was a total of 194,056 people with visual impairments registered at the Ministry of Health and Welfare, of which some 6,000 are engaged in massage operations.  Though the ratio of persons engaged in massage operations is low overall, the ratio of those engaged in massage operations among persons with serious visual impairments at the age of economic activity is quite high, revealing the fact that massage operations are the most important occupation among the visually impaired in Korea.  It is possible to broadly divide the massage operations being implemented in Korea into massage service centers, massage clinics and a variety of other massage facilities.  Massage service centers are the most typical among them and that is also the category in which the majority is employed.

As of May 2006, there were 982 massage service centers.  The total floor space of their operations extends to a maximum of 830m2 and, other than massage rooms, it is also possible for them to set up bathing rooms and saunas as supplemental facilities while it is also possible to install shower facilities with an area of 5m2 or less in massage rooms.  The operators of massage service centers with five or more massage rooms must hire two ore more massage practitioners and 80% of the total 982 facilities use the honorary director system.  Meanwhile, about 20% are facilities with capital and management provided directly by visually impaired persons.  The average monthly income of massage practitioners is about 3 million won, which is almost the same as the monthly household income of an urban family of four working in a city.

There is a total of 91 massage clinics.  In floor space, they are as large as a maximum of 115m2 and are permitted to also establish bathing rooms and saunas as supplemental facilities.  They are not permitted to have massage rooms in the clinics with anything other than simple partitions between them for male and female users.  The business income of massage clinics is relatively low.

There have been attempts lately to establish various types of massage facilities.  They are being set up in cooperation with welfare centers, department stores, hospitals and other facilities, though it can be said that they are still at the trial stage.
　
IV. Issues confronting the development of massage operations

Issues confronting the development of massage operations in Korea can probably be divided into three major areas and, in this section, I would like to concisely discuss these various issues.

First of all, while enforcing illegal quasi-massage operations, they are fighting for an amendment of the law stipulating massage as an occupation solely for visually-impaired persons.  However, illegal massage operators with no qualifications have mobilized powerful organizational strength and are demanding the opening of the massage business.  The general market for massage is gradually changing direction toward demands for the opening of the market and competition.
　
Secondly, it is necessary to establish a new system of therapy education in order to train capable massage practitioners and it is also necessary to raise the minimum academic level of massage practitioners to receive certification of their qualifications.  In other words, there is a need to provide therapy education in specialized courses designed for students with a higher level of academic capabilities than about high school level.
　
Thirdly, it is necessary to develop a business model capable of competing against massage service centers.  It is also necessary to formulate a diversity of business strategies for massage operations that will open the way for the employment of massage practitioners at massage clinics, welfare centers, hospitals, department stores, private sector companies, public institutions and other facilities.