Tagged: Health

What makes his/her behavior “problem”? / 「困った人」は「困っている人」

February 5th 2016, Friday

I and my company colleagues are attending “Amenity Forum,” the largest forum of human services in Japan for two days. Lots of professionals dedicated to welfare services gathered to the forum, and made presentations about their services, newest research outcomes, and so on.

Our company named LITALICO runs more than 100 centers to provide people with disabilities with job support and education services so that they can find the way to learn and work that suit for them, and choose their own way to live.


I attended a symposium about severe behavioral disorder. in general, it is said that people with severe behavioral disorder makes “problems” such as screaming, self-injury, attacking others etc. But the speakers at the symposium said that, a behavior itself is not a “problem,” but a problem is caused by an interaction between people and surroundings. I agree with that. For example, if a man scream in his own room, that isn’t annoying for others. So it’s not a problem. But if he screams in a classroom, office etc. and that disturbs other people’s life. And, there must be a reason why he screams in the classroom. Something must have made him scream as an antecedent stimulus. So our mission is to replace such stimulus to other stimulus that doesn’t make him scream, or provide other options for him. To achieve the mission, we make detailed assessment on him and his surroundings. It is not easy, but if we never give up, gradually his behavior will change.

Now I’m not working as a field staff. My current job is research and management at office. But today’s session encouraged me so much. Whether field staffs or managers,all of us are working as professionals to improve qualities of lives of people with disabilities and disorders. They themselves of their behaviors are not “problems.” There must be signs they send to us, and we should catch them.




“強度行動障害児(者)とは、直接的他害(噛みつき、頭突き、など)や、間接的他害(睡眠の乱れ、同一性の保持例えば場所・プログラム・人へのこだわり、多動、うなり、飛び出し、器物損壊など)や自傷行為などが、通常考えられない頻度と形式で出現し、その養育環境では著しく処遇の困難なものをいい、行動的に定義される群” (1988年『強度行動障害児(者)の行動改善および処遇のあり方に関する研究』(財団法人キリン記念財団助成研究)より)








Leaders coming to NYC from Tohoku / 希望も可能性もまだまだそこかしこにあるなということとか

13th November, Wednesday 2013

Still having lots of work, packing materials for that works, I rushed out Brooklyn in the afternoon, and went to Midtown East, Japan Society. It’s also chilly cold today. I’ll take a overnight bus to Boston tonight. Boston must be much colder, I don’t wanna think about it. Anyway, today, 5 leaders who are dedicating themselves to business and community development in Northern East of Japan after the disaster in 2011 came to Japan Society, and talked about their projects and stories to New Yorkers. I was invited to the meeting and had discussion with them. It is as usual and no longer I surprise, but we had lots of mutual friends in near fields. Also a person who guided the leaders was my friend from college. Well, it still needs time, money and man powers to reconstruct cities damaged by tsunami as a whole, but if we work from a micro, specific issue or field, we can make a good project or business quickly and flexible. People, products and stories can spread across countries over the sea, and we can collaborate together. Still not enough, and still it looks like tiny changes, but every time, social or structural renovation starts from small changes. Today, I also had good conversations and made new relationships. Further ideas are already floating in my head.


ところで今回の彼らのNY訪問をアテンドしていた財団勤務のスタッフがなんと学部時代からの友達で。Japan-ASEAN Student Conferenceという2010年の企画で一緒だった子。もはやこういう偶然の再会には驚かないので、自分のリアクションもだいぶ薄かったと思うけど、会合が終わって、それぞれの夕方の用事を済ませてから夕食を食べた。日本やASEANの友達の近況を知っている限り共有したり、お互いの久しぶりのアップデートをしながら、ジュニアーズでチーズケーキを食べた。


Float on the city / ベンチから眺める街

28th October, Monday to 2nd November, Saturday 2013

The first week of my trip, I stayed in London. Most of the visits to specialists and organizations related to our research on home nursing were in Hatfield, a beautiful country area 30 minutes north from London by train, but had also good times in London in the evenings.

One significant characteristics of UK’s health system is that medical service, provided by NHS basically for free and social service, provided mainly by local authority are clearly divided. Home care, especially for elderly care is a point where both sector come across and contact the same person, an individual who live in their own home and community, and have various needs based on their daily life, which includes both medical services and domestic/personal services (bathing, cooking, washing etc.). Since our main focus was a nursing service, we visited related professionals and organizations, but at the same time, I had always paid attentions to other sectors and comprehensive systems, though it was too complicated. We met faculties of the University of Hertfordshire, and NHS hospitals/community services, the Royal College of Nursing (trade union for nurses), and the Queen’s Nursing Institute, a organization for support and advocate of home nursing. As I mentioned, there is a fragmentation of the overall health system in UK, and varieties across local districts, so even for specialists or organizations in UK, it was difficult to gain figures or materials of all the necessary information such as workforce, service delivery. Thus, it was important to know what is missing pieces and how to infer that. …Still my brain is storming after lots of visits and additional documents, I try to grasp the overall picture and build our final report to client.

Anyway, despite fragmentation of the system, and huge decrease in budgets and workforce, especially for district nurse, a key player of home care in community, I was impressed with lots of efforts by practitioners and organizations. A district nurse, with whom I visited several homes of local residents, who had various diseases and needs, showed me how she communicated with each of them, and also their relatives and other actors such as social workers. Her caseloads looked very large, and it sounded partly because of recently decrease in human resources (but still she worked so hard every day every week). The Queen’s Nursing Institute impressed me with how they made research by themselves such as surveys to practitioners, and advocate to policy makers to approach problems in the field. The quality of their reports and pamphlets were so high, and that told me their professionalism to fight to realize their goal, not just criticizing the government.


In the evening, though half of time I fell down asleep after back to the hotel, I could met my friends living and studying in UK. It was so happy for me, cos they showed me parts of their daily life here, what they see, what they love, how they feel and do, while walking around the town with them. Not only here, I always feel myself a foreigner, or drifter. I never imagine, so far now, to settle in one place for long time, say 5, 10, or 20 years. So wherever and whenever I visit some town, I look and walk around the town with an eye of observer, never a inhabitant. My thoughts and feelings tend to float, and that’s why I respect each of you, who settle in a community, keep your own rhythm and tempo of your life and work, and warmly welcome me, with happy smiles telling me what you love in our town. Though short stay every time, I never forget your kindness. Thanks a lot, and hope to see you someday somewhere again.











Need to settle on the ground / 夜を置き去りにして空かける

October 26th, Saturday to 27th, Sunday, 2013

October is passing so fast, I cannot. believe it’s almost the end of the month… Though it is fortunate, honorable, and exiting that both my works and studies go well, and thatI have lots to do, I worry my breath, and therefore thoughts being shallower. Thus it was so good for me that one of my friend invited me to a Japanese tea ceremony. In a tatami-mat room, taking every step to be in a polite manner in that world, and having delicious tea, gave me both tension and comfortableness. Quietly listening to sound of water, and tea processing, I realized, I as a Japanese do need such a time. I love New York, but this town has a too quick tempo and rhythm, and if I won’t be careful, I easily lose a time and opportunity for meditation.

But ironically, immediately after quiet and slow time at the tea room, I rushed to the Newark International Airport to get on an airplane to London, for the purpose of my research trip on home nursing services in UK and Sweden, as my research job…! I should have done all of my preparation and midterm papers at school before the departure so I can enjoy movies, but it never happened. I brought a bunch of copies of documents necessary both for my research trip and solving midterm assignments on the plane, and needed to read. Well, anyway, I should enjoy. I’m at the same time an easy-going New Yorker not only a Japanese.


木村カエラのSwinging Londonとか頭の中で流しながら街を歩いた。





Happy Hour with Ethics class, 3-semester is too short / 駅のおじいさんを抱きしめたい

October 19th, 2013, Saturday

Today was the last day of Healthcare Ethics class by Professor Heather Butts. She’s a wonderful teacher and the class was the best for me this semester. Last week and today each of us did presentation on case each of us chose by ourselves, related to ethics. Each of classmate’s presentation was interesting. Those who had clinical background presented about some cutting edge surgical technology to deal with difficult condition with ethical dilemma caused by uncertainty on possibility to save or prolong life, difficulty in trials to evaluate, and ethical debate to justify it or not. Other one presented about HIV, introducing a video narratives by HIV patients on the advocacy website SERO.

Since I don’t have any clinical or medical background as specialist, all of their presentation was impressive for me. So, I, as a writer or community activist, thought how to contribute to this class, then chose one favorite movie “Never Let Me Go.” It is a story of three young persons, grown up in a isolated house “Hailsham.” In a fictional world where medical breakthrough achieved beyond 100 years human lifespan, they are told to keep them healthy, being told that “you are special,” but they exist only as organ donors for transplants and will die in their early adulthood. They are human clones, and have ‘originals.’ I touched those points (but didn’t go into details of the movie cos I really wanted them to watch it by themselves. Professor Butts also loved this movie, or original novel), and mentioned to three ethical perspective to judge social justice, utilitarianism, liberalism and communitarianism. I was happy to hear that they and professor enjoyed my presentation and some of them said “I will watch the movie.” Professor Butts told me she will put the novel as a reading material for the next year class.

As I liked this class so much, I suggested to the professor to have a happy hour after the last class, today. We went down Broadway, and entered one pub near the campus, and had beers and cocktails.

There was another guy in class who made presentation also focusing on philosophical theories or philosophers such as Socrates, Plato, or Spinoza. He is a film writer. I talked to him at the pub, and said we or our interests are not on the mainstream. Academic or scientific debate needs to cut each components as small as possible, with internally validate definition, but process of writing is opposite. We learn from and pick up lots of stuffs, and harmonize them into whole one context or story. But it’s still good for us to be in MPH program, cos we can learn from real-world, field practices, as I mentioned above. I think philosophy or ethics is a centerpiece of public health field, where theories and practice intersect, and that’s why at this ethics class, both of us physicians and writers can make good discussion.

I will graduate in this december (but may stay until March), and will be back to Japan for my new job from April. So they said “let’s have dinner before you go!” I felt so happy about that. At the same time, I felt 3-semester was too short. Especially for international student like me, the first semester was a terrible time. I was overwhelmed with courseworks (readings and exams), and didn’t have time to talk with classmates so much. Also, it took time to enable me to actively participate in class discussion and be accustomed with presentation, being relaxed. But from the second semester, I was gradually fit into the campus life or NY life, and rapidly made friends with them. But, oh my god, it’s already the final semester for me. If I had time more, I could know about my friends more… But anyway, time is irreversible, what I just can do is do my best in the limited time, and enjoy the time with friends.

そんなわけで、土曜日のHealthcare Ethicsの授業は今学期一番楽しい授業だったので、今日も良い日だったのだけど、昨日から開いた吉本ばななが尾を引いてか、内面は並行してstill messed upであった。そんな時に限ってやっぱり泣きたくなるような出来事は起こるわけで。それは42nd Street, Aトレインに乗り換えるPort Authorityのホームでのことでした。

階段からホームに降り立つと、背の低くて丸い身体のおじいさんが取り乱し気味に、”How can I get to Queens!? Tell me what to do!!”と言っている。聞くまでもなくここはQueens方面Uptownの電車が来るホームであり、それは看板にも書いてあるのだけど、そのおじいさんの様子を見るに、それはたぶん、彼がなんらかの精神疾患か障害かを抱えているゆえの不安と取り乱しであるようだった。


それで泣きそうになっていたら電車がやってきて、やっぱりおじいさんは”Is this train to Queens!? Tell me!”と不安がっていて、ドアの前でオロオロしている。僕は駆け寄って一緒に電車に乗り込み、肩を抱き支えながら、「大丈夫、大丈夫、きっとQueensへ行きます、信じましょう」と一緒にオロオロしたかったのだけど、あぁなんということだ、その電車はEトレイン!僕はこれからAトレインに乗って大学に行かなきゃならないのだ!



Practicum Day / 舞台ではみな平等

October 11th, 2013, Friday

It was a Practicum Day, when every MPH student gather for each department and make presentation about each of their own experience and learning during the summer internship (called as ‘practicum’). We met up at a large lecture room, and broke out into a small group of 7-8 students and 2-3 faculties. It was a whole day long event. Each student spend 15 minutes for presentation and another 15 for Q&A. In my group, most of classmates worked in US hospitals, consulting firms, and community services, one went to Uganda and conducted Qualitative research analysis, and I worked at an unique venture think tank focusing on social marketing of health promotion in Japan.

A common challenge those worked in US large organizations was a fragmentation of US medical system, and bureaucratic decision making process that blurred who’s in charge of what. It happens also in Japan.

I talked about my research project of international comparative study on home nursing service in Europe. For comparative study, merely collecting data on interested service (home nursing in this case) is not enough, because historical and cultural background and health systems behind the service are hugely diverse. To find lessons that are actually applicable to my own country, I need to develop common standard for comparison based on understanding of whole systems in each country. My presentation was the last one, and they looked enjoying it, with comments of ‘terrific presentation’ from professor.

今日はあれだ、Practicum Dayっつって、MPH生は夏休みにどこかしらへインターンするのが修了要件なのだけど(それをPracticumと呼ぶ)、その報告会的なやつ。小グループに分かれてひとりずつプレゼンして、夏の経験をシェア。まぁ、fun eventだよね。

HPM(Health Policy and Management)の学部単位でみんな同じ日時に開催。朝早くに集まって、朝食を食べてから担当教授のイントロトークを大教室で。その後7,8人の小グループ10,11組ぐらいに分かれて小教室へ。夕方までひとりずつプレゼン&質疑応答30分ずつでどんどん回していく。僕らのグループは、そのPracticumの担当教授が当たった。恰幅の良いアメリカのおじちゃんって感じなんだけど、けっこうバシバシ鋭い質問を浴びせていて、みんな割りとタジタジになってた。

MPHって、実務と学問の重なりあったような大学院だから、ビジネススクールと違って、バリバリ実務って人ばかりでなく、アカデミアよりの人もけっこういる。プレゼンもアメリカ人だからってみんな上手ってわけでなく、字数多すぎの詰め詰めスライドに、抑揚なく速いテンポでひたすら喋るだけって感じの人もいた。あんまりオーディエンスを意識してないんだなぁという感じ。研究発表とかならそれぐら情報量詰めても良いんだろうけど。質疑応答の時に教官に「Executiveに報告するつもりで3つの要点だけ言え」って言われて、まぁあんまりスラスラ答えられなかった人が、”You are not a student now, here you are a professional”って言われてひえーってなってた。


終わったあとはまた大教室に集まってwrap up. 各グループの担当教官がグループごとの全体講評をしていった。なんつーか、こっちの先生、みんなキャラ立ってて魅力的だって思うよね。日本の予備校講師ほど濃くはないけど。最後のグループの教授が、”Now I’m standing between you and matini”とか言ってて、気の利いたジョークだなと思った。


Dental clinic at school / 親知らずを抜いたこととか、気になったニュースあれこれ

October 8th 2013, Tuesday

At last I enrolled a student dental plan and went to a dental clinic at Columbia Dental School. Even after taking an antibiotics, swelling of my gum didn’t get better. I knew the cause, wisdom tooth left long time. The lower right wisdom tooth had grown in a bad angle. Early in the morning, I submitted an registration form, made a payment for the insurance, and told a staff my pain is urgent. They treated me as emergency, so soon I was directed to be diagnosed by doctor. Though I had to pass a class in the morning, I could successfully let the tooth pulled out. So now, my under right cheek is a little large. Nothing I could eat today…

By the way, I rarely go to hospital, because I’m generally in a good health. But whenever I go there, I feel a little tragic, or nervous, by seeing someone suffering. While I was waiting on a seat, an old lady groaned frequently. I didn’t what’s wrong with her teeth, but could guess her mental wasn’t in good state. Another lady kept putting her hand on her cheek. It must be painful. Every people coming to hospital have any kind of pain, anxiety, or fear. I know that is a hospital, but I’ve never accustomed with such mood.

In the evening, I attended an meeting of CJR, Consortium for Japan Relief (though friends told me “Why you come today!? Keep in bed!” by seeing my cheek), and discussed our activities this fall. We’re planning to hold some documentary film screening and panel discussion event this and next month. Now we think it is a time to further collaborate with other organizations, not exclusively related to Japanese 3.11 disaster, but more generally, persons and organizations that dedicate themselves with a field of disaster relief or management. Lessons from 3.11 disaster in Japan must be utilized to other countries’ cases, and on the other hand, we can learn something from others.

I came back home at late night. I like the mood of night Brooklyn, with trees along the street dimly illuminated by light.

先週抗生物質を処方してもらったものの、1週間たっても全然腫れがひかない。夏に同じ状況になった時は数日飲んだらおさまったのだけど、これはいよいよ限界か、と、朝イチで大学のDental Schoolに駆け込む。アメリカでは医療保険と歯科保険は別々。入学した時に学生向けの医療保険には入らされたのだけど、ここでStudent Dental Planというものに改めて申し込むことに。Emergencyだと言って、その日の午前中に抜歯手術をしてもらうことができた。保険加入で$180(年間プランのみだけど、12月卒業3月帰国だからちょっともったいない…)、今日の手術はディスカウントされて$108。安いんだか高いんだか。まぁ良心的な値段にはなっているのだろう。



先日、東京でNoh×Contemporary Artのワークショップ&コンサートを主催した青木涼子さんが、今日からスペインのマドリッドでオペラに出る。テアトロ・レアル王立劇場の「メキシコの征服」という演目だそうだ。青木さんの役はマリンチェという女性。演目はメキシコの最後の王モンテズマとスペインの将軍のコルテスとの出会いが描かれたもので、マリンチェは、実際に存在していた、二人の通訳を務めていたメキシコ人女性で、コルテスの愛人であったとのこと。青木さんからのご案内のメールでは、”オペラでのマリンチェの役割は、movement(動き)とsilence(沈黙)で、二人の間を行ったり来たりします。モンテズマとコルテスが西洋人のキャストなので、それと全く違う次元からの素材がマリンチェには必要である、またアントナン・アルトーが能に影響を受けていたこともあり、日本の能の役者、そして女性であることから、今回のキャスティングが決まりました。”とのことだった。先日観に行った東京でのコンサートは、まさmovementとsilenceの芸術で、とても感動した。

アピタル 内部被爆通信 《83》 診察に来たあるお母さん 坪倉正治 (つぼくら・まさはる)





毎日新聞 生きる物語:「弱さ」の向こう側/6 研修医の大きな壁 2013年10月08日




The Diplomat, “In Japan, Will Hafu Ever Be Considered Whole?” J.T. Quigley
記事でも紹介されている映画監督(彼女自身もハーフ)が、『ハーフ』 というドキュメンタリーを撮った。10/9-10/18に渋谷UPLINKにて上映。くそー行きたいなこれ。

Jヴィレッジのいま – 2013.6.8訪問














炊き出しや仕出し等飲食業を行う鳥藤本店の専務である藤田さんは、現在富岡町からいわき市に避難している。いわき市の四倉に移った事業所を訪ね、お話を聞いてから車で出発する。国道6号線を走り、久ノ浜、末続と北上し、双葉郡に入る。そこから広野町、楢葉町、富岡町と進んだ。以下に写真と共にその道のりを紹介する。大雑把な地形イメージがつくように、こちらに双葉郡のGoogle mapのリンクを貼っておく。また、「福島民報 minyu-net」では「帰還困難」「居住制限」「避難指示解除準備」区域のマッピング(2013年5月28日現在)を見ることが出来るので、こちらもリンクを貼る。

広野町と楢葉町の境目あたりにあるガソリンスタンド。この辺りから避難指示解除準備区域になる。ちなみに、避難指示解除準備区域で出来る活動はこちら、平成24年5月9日付 原子力被災者生活支援チーム 「避難指示解除準備区域内での活動について」にまとめられている。日中の通行や住民の一時帰宅、ガソリンスタンドなどの一部の事業活動(飲食、小売、宿泊業などは禁止)、除染・災害復旧など公益のための活動が可能だ。居住制限区域になると活動は更に制限され、事業活動も要件を満たす例外的なものしか許可されない(参照: 平成24年6月18日付 原子力災害現地対策本部 原子力被災者生活支援チーム 「居住制限区域における例外的な事業継続・再開の運用について 」 )。








引用元は同じく上記で紹介した福島民報 minyu-net 「富岡町の避難区域再編」(2013年4月1日現在)


関連ニュース記事も紹介。Yahoo!ニュース 福島民報 5月28日(火)10時22分配信 「双葉町で区域再編 バリケード107カ所に増」


 帰還を前提とする国の方針に疑問を持つ藤田さんは「現状を見て感じてもらえば同じ目線で会話できるのでは」と警戒区域が解除された自宅や勤務先を案内する。(毎日.jp 毎日新聞 2013年05月30日 01時29分 「記者の目:いわき市 避難者と市民の溝=町田徳丈」)

(参照: 毎日.jp 毎日新聞 2013年05月24日 東京朝刊 検証・大震災:福島・いわき市の現状 共生遮る誤解の連鎖)





気になる方もいると思うので参考までに放射線関連の情報と補足説明を。放射線低線量被曝に関しては僕自身の専攻である公衆衛生(Public Health)が大いに関わる分野であり、それなりに勉強してきてはいるので、近いうちにまとまった解説記事を書きたいと思う。