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Vol.8 Sho Takahashi – Doctor of Rikuzentakata Hospital

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Talk for Recovery #8
Sho Takahashi,

Doctor, Rikuzentakata Hospital, Iwate prefecture
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Today’s guest is Mr. Takahashi. He came from Hokkaido to Rikuzentakata after the earthquake, and now he provides local medical services for the treatment and prevention of diseases. Our relationship began in Feb. 2012, and we became very close after having dinner together in a temporary house. This interview was held in the same room under the same circumstances as our hot pot party, which is referred to later on in this text.

 

  1. Coming to Rikuzentakata after leaving the medical specialist job in Hokkaido

Komori: Thank you very much for taking time out of your busy schedule. In this interview series, I will try to provide the first-person perspectives of people involved in reconstruction work in the devastated areas of Tohoku. I’d like to learn about the local medical services you (Mr. Takahashi) are became involved in, including “Hamarassen Farm”, whilst eating a Japanese style hot pot dish. [laughter] I’m really glad to have this interview with you.

Takahashi: Thank you for having me today. I don’t know how much my story will help you, but I’ll do my best, and I’d like to enjoy the hot pot also.

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Komori: Go ahead with the food, please. Your hometown is in Hokkaido, and you worked for a hospital in Otaru (in southern Hokkaido) before the earthquake. Did you have any relations with Rikuzentakata?

Takahashi: No, I didn’t have any relations with this town. I only visited Hiraizumi for a school trip in the third year of junior high school (it takes half an hour by car [to travel] from Hiraizumi to Rikuzenntakata). 2011 was the first year for me to come to Iwate prefecture of my own will (Rikuzentakata is in Iwate prefecture).

Komori: When did you come here for the first time?

Takahashi: It was the end of May, two and a half months after the earthquake. I decided to work for medical support somewhere in an affected area. I looked around Yamada, Miyako, Kamaishi and so on, in order to decide on the final destination.

Komori: Your first destination was not Rikuzentakata. What made you come here?

Takahashi: The damages in Yamada were hideous. But, I knew Yamada could expect a certain number of doctors to provide medical services. Moreover, Miyako and Kamaishi had some operating hospitals and could offer the minimum services. I thought I should go to an area where it would be more difficult to secure these services.

Komori: So, you came to Rikuzentakata.

Takahashi: Yes. The Medical care division of the Iwate prefectural government brought me here. Damages by the tsunamis were tremendous everywhere, and Takata Prefectural Hospital in Rikuzentakata experienced catastrophic damages, so medical services were being provided in a surviving community center. I specialize in digestive organs, and, by chance, the doctor in charge of endoscopes in Takata hospital was unable to return to work at that time.

Komori: So you found an opportunity to contribute to medical services in the field of your specialization.

Takahashi: In addition, a young volunteer doctor told me about his worries about his future. He said that he wanted to stay here to help out, but he couldn’t gain enough experience to become a specialist working here. I know doctors should have many experiences with patients in their specialty area in order to strengthen their expertise. I wanted to help him return to his hospital as soon as possible. I was employed officially on the first of September and arrived here on the fourth, which was a Monday.

Komori: Coincidently, I came to Rikuzentakata the same week! Many encounters at that time led to ongoing activities like “Komo’s Aloud English Reading Class”. It feels a little strange; perhaps it was destined? You and I became acquainted with Rikuzentakata at the around same time [laughter]…

Takahashi: What a coincidence! [laughter]

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Komori: How has your time been since arriving at Rikuzentanaka?

Takahashi: There were many patients demanding medical cars in Rikuzentakata, and the local medical network was struggling, so I felt that I was managing to help out the community. However, I didn’t find myself feeling fully satisfied.

Komori: You weren’t feeling fully satisfied?

Takahashi: Yes. I can’t explain it well, but I was not fully engaged in the services. There were many short-term doctors coming to the hospital from all over Japan, so it was managing to secure the minimal level of function and capacity.

Komori: I understand. By September, Takata Hospital was already in acceptable shape.

Takahashi: Usually, built-up stress after a disaster causes gastric ulcers in many people, and inspection with endoscope is necessary for its care. However, I had seen only a few cases of gastric ulcers after this disaster. A temporary hospital was opened in the end of July, but, endoscope equipment was not installed until November. In addition, Takata Hospital did not have adequate equipment when I arrived. Of course, the fact that I had seen only a few cases was a good indication.

Komori: You flexibly coped with various medical needs in the local medical service, regardless of your specialty.

Takahashi: Exactly. I had good responses, because I energetically visited sparsely populated mountainous regions for home visit cares. I think doctors must know about the everyday life of a patient in order to provide him or her with specific treatments and medical advice. However, after some time, I began asking myself whether this job was something that could be done only by me.

Komori: I understand your feeling. You quit your job in your specialty in Hokkaido. But, I think home visit care is suitable for you [laughter]. I can almost see it.

Takahashi: [Laughter]. I have enjoyed speaking with elderly people since I was young.

 

2. New idea -“Evacuees and Farms = Physical and mental health”

Komori: It was the middle of February in 2012 when you emailed me for the first time. It was also the time when you were asking yourself about whether you should continue with home visiting care.

Takahashi: That’s right. I happened to find a flier for “Komo’s Aloud English Reading Class” when I stopped by “Riku Cafe” after a home visit. I was reading medical reports in English at night at that time. I wanted to submit a paper to a medical journal, because I had some good research results for evaluation criteria in stomach cancer during my Hokkaido era. But I had some concerns about my English skills… I didn’t have enough English skills to complete the report. I emailed you with “evil thoughts” that you might help me finish it [laughter]. .

Komori: [laughter] With evil thoughts. But I felt a peculiar bond. I can understand English in the medical field better than ordinary people, because I was a business consultant in that industry. I thought “It is a message from God. I should do something for you.” So I together with Mr. Miyata, who is a member of “Hanaso-Fund”, I helped you translate the thesis.

Takahashi: I have been a student of “Komo’s English Class” since March of 2012. I tried to brush up on my English skills at the class once a month, communicating with you for the translation.

Komori: It was the end of April when we met up to finalize the translation. After we finished it, you asked me whether I wanted to see the damaged Takata Hospital. I said “Sure”. It was a very valuable opportunity for me, because the building was in a restricted area. We looked around inside the hospital and recognized again the dreadfulness of what had happened.

Takahashi: I was not here when the earthquake occurred. So, I can only tell you what I heard. I try to explain “what exactly happened” to staff assistants coming from other areas to Takata Hospital, showing some pictures taken by our staff just after the earthquake.

Komori: After the hospital visit, we went to a cafe called “Clover” located on the road which takes you up to Apple-road in Yonezaki.

Takahashi: We did. Now, Clover has moved to the Apple-road area.

Komori: At the cafe, you asked me what I was going to do that night. I said that I was going to have dinner with my close friend O-san at a temporary house. And you asked to join. I said “Sure”.

Takahashi: We stayed there until 11:30 pm, talking about various things over a hot pot dinner. I saw you falling asleep during the gathering [laughter]. The night was amazing for me. Come to think of it, it was the first time I spoke with local people in a friendly atmosphere, though I was seeing many people, including medical staff members. Additionally, you brazenly dozed off at the suffering person’s temporary house. I was relieved to find out that it was ok to be like that.

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Komori: The next day, you saw O-san again and joined a Hanami (a cherry blossom viewing party) at a temporary house. I heard from O-san that you really got drunk and were popular among the people. Also, she said “people can change”! She was surprised by your change.

Takahashi: I became aware that something changed in my mind. I had spent some days with local people as a doctor. I was keeping a slight distance from them as a doctor. However, I fit in with the local people more deeply after that day.

Komori: When you joined the Hanami party, you saw the farm next to the temporary house, didn’t you?

Takahashi: Absolutely. The owner of the farm is O-san. She provides it for suffering people at no charge. I heard that the people using the farm there were happy and friendly even as evacuees. It was becoming a problem that communities was destroyed everywhere, because local people were dispersed to temporary houses in different areas after the earthquake. But harmony among people had been restored earlier at the temporary houses. The farm helped it.

Komori: Then, you came up with a new idea “Evacuees and Farm = Physical and mental health”.

Takahashi: Not yet, at that time. I just felt that they were very lively in a farm. Then, I thought I’ll try it for myself.

Komori: I see. You tried it yourself first.

Takahashi: I went to “Sato seed shop”, which you introduced me before, and I bought vegetable seeds. I think they were seeds of Japanese mustard spinach called “Yokatta-na”. Mr. Sato advised me about how to plant the seeds, then I planted them in a planter on the balcony of my dormitory.

Komori: I recall that you posted about the excitement of seeing sprouted seeds on Facebook.

Takahashi: I came to understand why evacuees in temporary houses were lively when I felt the pleasure in planting seeds, and then seeing them sprout and grow. I got the same feeling as the evacuees, and I found out why they managed to live happily.

Komori: You understood what you saw by doing the same thing.

Takahashi: Around the same time, I heard about some local people lamenting their bad luck because they could not work on a farm after the earthquake. When I pointed out the lack of exercise for the treatment of adult disease, some said that they used to exercise through working on a farm before.

Komori: Perhaps you heard many of those laments before, but, when you experienced farm work for yourself, you got to realize the real sense of the term.

Takahashi: Then, I naturally came up with the farm project. My idea was a local health promotion project by Takata Hospital that provided farm work to people in the temporary houses. I submitted the proposal to a hospital director, Mr. Ishiki, on the 24th of May. This was the “Hamarassen Farm Project”. “Hamarassen” means “welcome” in the local dialect. We intended to put a warm message saying “We can enjoy together. Join us”! in the project name.

Komori: How did the hospital director react?

Takahashi: He simply agreed with it. He immediately understood the intent and purpose of this project, because he had been involved in some activities that broadly promoted local health care before the earthquake. The project was approved as an official health promotion program.

Komori: Doctors working in a major local hospital provide a local health care program promoting farm work next to temporary houses. It was a memorable moment: a unique project was born in a whole devastated area.

 

3. Steps for launching the Farm

Komori: “Hamarassen Farm” was born from a mixture of experiences and hearings from Rikuzentakata locals when you warmly communicated with them. However, at first you needed farmland. You negotiated the land lease yourself, didn’t you?

Takahashi: Yes, I did. I just went forward. I visited temporary houses and interviewed evacuees about their needs for a farm. I also negotiated with land owners when I found an open area near temporary houses.

Komori: A doctor of a prefectural hospital did door-to-door visits for those interviews!

Takahashi: I was feeling a strong conviction about the needs, doing those visits and interviews. I called and took advice from the chairman of the temporary house resident union in Rikuzentakata in order to gain more comprehensive information.

Komori: It was an entrepreneurial approach. You got an idea, set up a project, moved it forward and received feedback. In addition, you tried to collect information comprehensively.

Takahashi: It was easier than a volunteer activity, because it was an official project of Takata Hospital, and it had credibility. Even when I knocked on someone’s door or called someone, I could naturally communicate as a promoter of “Health Promotion Project of Takata Hospital”. Some said “An interesting doctor! Join us for dinner” or “Stay at my house!” I thankfully accepted those proposals and tried to connect with them more deeply.

Komori: A prefectural hospital doctor walking around trying to borrow farmland. It must have been really hard work.

Takahashi: It wasn’t an easy job, but I didn’t have as much trouble as you’d think. Many owners pleasantly rented their lands. They did not charge for rent. I enjoyed doing my best for the smiles of people in temporary houses.

Komori: When was the first “Hamarassen farm” born?

Takahashi: It was the end of June (in 2012). The first place was in Yokota district. I was very happy. I carefully tried to match the needs of evacuees wanting to gain farm job experience with the generous offers of land owners to rent their land.

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(Photo: The first “Hamarassen Farm” in Yokota)

Komori: How many farms did you produce in the end?

Takahashi: We produced eight farms by Bon holiday (the middle of August). I thought Bon holiday was the deadline because we had to set up the farms by the fall sowing.

Komori: You completed eight farms in just a few months! I sometimes see signs of “Hamarassen Farm” when I drive my car in Rikuzentakata. I am very surprised about how quickly gained knowledge about the timing of fall sowing. After all, you just started growing vegetables in May.

Takahashi: In fact, I went to “Sato seed store” twice a month after that. I had good advice about when to seed.

Komori: Great! You got the knowledge yourself by going to “Sato seed store”.

Takahashi: I realized that there are some other issues when I proceeded with this project. For example, how should we get farm tools and fertilizers? I initially thought we might be able to provide them. But, if we did so, we had to provide all the tools to all the farms. On the other hand, we had some beneficial advice, saying that “Farmers should implement the tools themselves, because farm job starts from doing that” or “We should not provide anything more, because aid is becoming too great in temporary houses.” I seriously worried about where I should draw a line between project operators and evacuees regarding the burden of expense.

Komori: I heard that an old woman gave up because she saw a snake in one “Hamarassen Farm”. You cared about those things, though it is impossible for you to keep snakes away from farms.

Takahashi: There were some ups and downs. I felt a little bit responsible for the snake case as an initiator, because I had not visited that farm often. However, after that, the woman returned to the farm. They enjoyed harvesting a lot of vegetables in all the farms. I saw the smiles of farmers many times. I was really happy to see it.

 

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4. Marunouchi Gyoukou Market event in Tokyo

Komori: Some of the vegetables were sold in the Marunouchi Gyoukou Market. An article about “Hamarassen Farm” appeared in the national press of Yomiuri Newspaper that day. I was very surprised. How did you reach the market?

Takahashi: I just called the organizer of the event directly. I watched the TV program “Adomatikku Tengoku” and happened to learn of Marunouchi Gyoukou Market through that. I came up with the idea of participating in the event, which I thought would be exciting.

Komori: You made a direct approach, again! You are brilliant.

Takahashi: I called them and explained our project. I visited them in Tokyo, and they accepted our proposal. It was the end of October (in 2012).

Komori: When did you participate in the market?

Takahashi: On the 22nd of November. We had just three weeks after we got accepted to participate in the event, so we quickly started to prepare. The evacuees working in farms were excited to decide which vegetables to bring.

Komori: When I went to the event at around 19:00 after work, all the vegetables were sold out. I saw you going hoarse because you were attracting customers from noon to the evening. Nobody would have imagined that you were a doctor. So which vegetables did you bring, and how many?

Takahashi: Well, we brought a lot. 120 Japanese radish, 30 Chinese cabbage and carrots, green onions, spinach, Tsubomi-Na, Japanese mustard spinach, sweet potatoes, potatoes, and so on. In addition, a land owner provided apples and a confectionery shop owner living in a temporary house gave us Daifuku (rice cakes stuffed with bean jam). O-san’s relative lent us a van. We loaded the van up with vegetables and brought them.

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Komori: Three farmers from the “Hamarassen Farm” came to the event also, didn’t they?

Takahashi: Yes. They came to Tokyo at their own expense. They had no intention of earning money. Most of the farmers also thought so. I thought they could feel happy just by having people from other regions enjoy buying and eating their vegetables. Some said they would not provide vegetables if the purpose was for money.

Komori: There is a service-minded culture here that “they want to help someone” and “they want to provide something”. I realized it through visiting Rikuzentakata several times. I really appreciate their culture that they feel pleasure in being thanked by others through giving or doing something.

Takahashi: I agree with you. The farm may be a trigger to restore not only the pleasure of growing vegetables but also the pleasure of doing something for someone.

Komori: I really think so.

 

5. Confirmation of medical effectiveness

Komori: Did you find medical effectiveness in “Hamarassen Farm” for maintaining both their physical and mental health?

Takahashi: Yes. We have researched how their lives improved, because this is an official project of Takata Hospital. We found a statistically-significant improvement of motivation in life before and after “Hamarassen Farm”, when we carried out a questionnaire survey on the farmers living in temporary houses. We earned an award for the best effort at a local medical care research conference in Iwate prefecture held on the 10th of November in Morioka.

Komori: Wonderful! I saw a certificate of the appreciation on the following weekend, as I came to Rikuzentakata for “Komo’s Aloud English Reading Class”. I was really moved.

Takahashi: The award wasn’t something to make a big deal about. In addition, we carried out research comparing the density of the bones of farmers and non-farmers among evacuees with similar exercise volumes. The farmers had a better statistical result. Their density had improved.

Komori: “Motivation in life” and “Density of bone”. As a result of both mental and physical researches, the positive effects of “Hamarassen Farm” were medically confirmed. I think there were even more positive influences in various aspects in addition to those two effects just mentioned.

Takahashi: We held a thank you party on Christmas Eve as the last activity in 2012. Many participants came to the party and enjoyed sharing information about their farms. I appreciated the participation of women who made big contributions to the success of the project. The Red and White Singing Contest on New Year’s Eve on NHK picked up the farm and broadcasted it. They said thank you to us for many events.

Komori: You decided to launch this project in May and started the direct interview at first, and you accomplished many things by the end of the year. This is a wonderful down-to-earth project. I think you have given a substantial indication about how local health care should be in the future, including preventive health care.

Takahashi: What we did was not something that we should boast about. In a way, we just tried to recover what they used to do before the earthquake. However, the change that occurred as a result from the project has some special importance.

Komori: When we look at a blueprint of recovery plan, we find that especially those with a big scale are delaying. There are various conflicts, even if many people want to develop the plans. Under this situation, “Hamarassen Farm” provides a good example of a meaningful change even though it is a small project. I hope these interactive activities will become more and more widespread going forward.

Thank you very much.

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(End)

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