传染病防控与民国时期澳门地区城市治理的近代转型

Infectious Disease Prevention and Control and the Modern Transformation of Urban Governance of Macao region in the Period of the Republic of China

民国时期,澳门地区传染病防控经历了“以治疗为主”到“以防疫为主”的演变。在医防结合制度建构方面呈现三个特征:从“零散处置”转向“规模管理”的现代医疗体系;从“被动应对”变为“主动预防”的公共卫生应急机制;从“公共空间”嵌入“私人空间”,并倡导和养成文明健康的生活方式。此转向既与传染病防控相关的知识增进、观念更新、技术进步密切联系,又是热带气候、地狭人稠、人口流动性强等本地环境相适宜的积极选择。民国澳门地区传染病流行、防范、控制与城市治理紧密相连,市政当局主导的常态化防疫机制的制度支撑,民间社会和各领域协同联动,多主体跨地域的协作互济,共同构建澳门地区日渐形成上下贯通、左右联动、内外协同的城市卫生治理体系,折射出澳门地区社会近代转型的进程与趋势。然因澳葡当局缺乏长远规划、行政作风拖沓怠惰、地方财力有限、华洋隔阂难以消弭等不利因素,一定程度上限制其成效。

During the period of the Republic of China,the prevention and control of infectious diseases in Macao region evolved from“treatment-oriented”to“epidemic prevention-oriented”.The construction of the medical prevention system showed three characteristics:building a modern medical system turning from“fragmented disposal”to“scale management”,building a public health emergency mechanism turning from“passive response”to“active prevention”,and advocating a civilized and healthy lifestyle with the“public space”embedded in the“private space”.This shift was not only linked to the improvement of knowledge,the update of concepts,and technological progress in the field of infectious disease prevention and control,but also to a positive choice appropriate to the local environment,such as a tropical climate,and a dense and highly mobile population within a small area.The prevention and control of infectious diseases in Macao region during the period of Republic of China was closely linked with urban governance.The institutional support of the government-led regular epidemic prevention mechanism,the synergy of civil society and various fields,and the collaboration as well as mutual assistance of multiple entities across geographical areas,jointly built an urban health governance system in Macao region that was increasingly coherent,linked from top to bottom,and collaborative from inside to outside,which reflected the modern transformation process and trend of Macao society.Nevertheless,some unfavorable factors,including the lack of long-term planning by the Portuguese and Macao governments,the slow and lazy administrative style,the limited local financial resources,and the difficulty in bridging the gap between Chinese and foreigners,to a certain extent,limited its effectiveness.