Tagged: Public Health

Shovel again / 昼夜逆転、長い1日

January 5th-6th 2014, Sunday-Monday

It’s getting colder and colder. Snow keeps mounting. Owner of the building told me it was not enough that I shoveled snow yesterday. Yes, sorry, I wrote I did snow shoveling yesterday, but actually I never knew enough what is snow shoveling. Yesterday I saw other community residents just moderately shoveled snow so people at least managed to walk through, so I did the same. But it’s not enough. If I left small amount of snow on surface of the street, it would ice up during the night and cause people slipping, that’s too dangerous. A senior man in the same building taught and helped me shoveling again, asking me “Where’s your hometown?” I answered Kobe, west side of Japan where snow rarely piles, and he said “that’s why you don’t know how.”

This is how I should have done.

Even just for living a day, there is a plenty of learning.

In the afternoon, I worked at our new gallery, J-LABO Brooklyn. I painted pipes by white paint. It looks easy and simple job, but still needs some knowledge about accurate mix of paint and water to paint smoothly each material at each situation, without letting color splattered on clothes, walls and the floor. After struggling with Sunday DIY job, the owner gave us warm and delicious soup for dinner. Outside is still awful cold.

先月に大学院が一段落ついてから、調査研究の仕事にようやく本腰を入れられるようになり、年末からほとんど机に向かって過ごしている。日本の人と一緒にやっていて、あちらの1月7日にけっこう大事な中間報告のタイミングとして検討会があるから、ここ数日は特に激しい追い込み。だんだんと昼夜逆転気味になってくる。5日と6日は2日間というより長い1日だったという感覚がある。ともあれ、こちらの6日夕方、あちらの7日朝には一段落ついた。精度の国際比較というのは難しい。まずもって言語の壁がある。英語ならまだ良いのだけど、僕が担当している国のひとつはスウェーデンだから、なかなか大変。Google Translateにお世話になっている。また、一次データの収集方法も違うから、相互に比較分析可能なようにデータを整理するのが重要だ。最後に資料や報告書をまとめる段階には、脚注をしっかり示さなければならないのだけど、普段からの整理整頓を怠っていると、メモ書きの引用元がどこにあったかと探すのにまた時間がかかる。振り返ると色々もう少し効率的に早くできたなと反省することもしばしば。調査事業は3月までで、現地調査は昨年秋に行った。あとは本当に報告書をまとめるペーパーワークの段階。緻密に、丁寧に、調べてまとめてのプロセス。しっかりやろう。

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。


Fall deepens

October 9th 2013, Wednesday
It’s a clod day. Fall deepens. 朝晩冷え込んできた。

On Wednesday, I have a Strategic Communication class, by senior lecturer Alan P. Levenstein, who has a brilliant career as a business person and knows much about marketing (and also, every time humorous and wearing dandy suit). This semester we took a case of gun control and developed a communication strategies for Mayors Against Illegal Guns, and at last made a presentation to a officer from the organization.

Whenever I study about U.S. social issues, gun control, Obamacare, soda ban, tobacco etc., I see huge difference of between US and Japanese system and culture. Whenever political debate come to regulation on anything, US public debate (esp. from repub.-oriented persons) shows concern on, or allergy to, governmental regulation on individual freedom. It appears less time in Japan. Also there are huge varieties and autonomies between states under the federalism system. That makes them so difficult to realize nation-wide gun control or national health insurance. Japan tends to prefer equalized standard for everyone. It’s not a good or bad question, just a characteristics of each country, and it’s almost impossible to radically change the culture because of deep-rooted history (e.g. Independent War from Britan, defeat on WW2 and rule by US after), but at least give me interesting lessons.


ET Luv.Lab., 「横浜の創造力の舳先に」茂木 隆宏 – ノガン株式会社 コンサルタント















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。