(以下は、シェアのクラウドファンディングの内容を英訳して掲載しています)

Imagine being sick in a foreign country where you cannot understand the language.
How difficult it must be to communicate your symptoms in a language that is not your own while enduring the pain and sickness.
Did the Doctor understand what I said? Are there any misunderstandings? What is this shot for? How much money will this cost? What happens if I don’t have medical insurance?


I am a nurse that provides health support to foreign migrants living in Japan.
I am Yuko Yamamoto, working at a Non-Governmental Organization called Services for the Health in Asian & African Regions (SHARE). While I was studying to be a nurse, I volunteered to teach Japanese to foreign migrants. From my new foreign migrant friends, I heard many stories about the difficulties they faced when they became sick. In one story, a migrant went to the hospital suffering from back pain. While not understating anything the healthcare service provider was saying, the migrant took many medical tests, and ended up with a JPY 500,000 (approximately USD 5,000) medical bill. In another story, a migrant asked the son attending a Japanese Evening High School to provide translation at the numerous hospital visits, as the migrant could not afford to hire a translator. The son, who missed too many school days in order to support his migrant parent at hospital visits, could not graduate.


From that experience, I realized I wanted to do something to help migrants facing barriers to healthcare.
While working at the hospital, I began to volunteer at place that provides free medical consultation to foreign migrants. Furthermore, as a Japan Overseas Cooperation Volunteer, I went to Honduras to work at a health center. In Honduras, I became ‘sick patient in a foreign country’. That experience hit home for me as for the first time, I understood the fear of being sick in a country where I could not understand the language. Through this experience, I decided on my lifework to help foreign migrants facing healthcare barriers.
YAMAMOTA07a



With your support, we would like to carry out the following to help foreign migrants:
1) Dispatch Medical Translators in Emergency Cases.
In countries such as the US and Australia, the provision of medical translators is guaranteed by law.* However, we have yet to realize the same in Japan. Beginning with Tokyo and surrounding prefectures, we set out on a challenge to dispatch medical translators as soon as we receive contact from a health service provider. We would like to use the know-how we gained from this challenge to help us when we eventually bring the medical translator system nationwide.
*laws may vary by state
gaikokujin_zainichi


2)Improve Health Telephone Consultation Services
I currently provide health consultation as a staff of the Migrant Health Program at SHARE. Consultation phone line opens 3 days a week from 10:00-17:00. Majority of the calls comes from healthcare service providers nationwide, facing difficulties with foreign migrant patients. Although the number of calls continue to rapidly increase, we only have two staffs that can provide health consultation. SHARE would like to increase the number of staff,
医療電話相談(イメージ画像)



3) Provide Seminars for Healthcare Service Providers
Where can we ask for translators? What are the differences among residency status? Can a migrant patient register for health insurance if he/she currently do not have one? How can we be culturally sensitive?
Healthcare service providers encounter a variety of problems and questions with a foreign migrant patient. They consult with SHARE to get information and find measures to overcome the problems. At the seminar, health care service providers will learn about the problems faced by migrant patients and learn the know-how to support the migrant patient. Furthermore, the seminars are a good opportunity for them to learn about medical translators. SHARE would like to hold two seminars a year to increase the number of healthcare service providers to understand migrant health.
DSCF8055



I Want to Be Proud of a Country that is Kind to Foreigners!
I decided on Crowdfunding because I want as many people as possible to learn about the problems faced by migrants in accessing quality health care in Japan. I hope that by sharing this problem with many people, we can come together to create a solution. The Tokyo Olympics takes place in less than 4 years. Many people from all over the world will come to Japan, and some will need healthcare support. Until that time comes, we need to build up our ability to support the health of foreigners. Even a small amount will make a difference. Please provide your support!


Message from the Dr. Toru Honda, Chair of SHARE
The National Migrant Health Program of SHARE began in 1991. SHARE provides face-to-face consultations and support activities with health care providers and migrants; free health consultations in Tokyo, Chiba and Kanagawa Prefecture; telephone consultations in multiple languages; and dispatch of medical translators. For over 25 years, throughout all our activities, we have always continued to emphasize quality, and understanding of the rights, needs and unique situation of each migrant living in Japan.

With agreement by the United Nations and international society, Universal Health Coverage (UHC) is seen as a pillar of healthcare provision. The Japanese Government has been championing UHC worldwide as Japan has a proud historical legacy of providing national health insurance coverage for all its citizens after World War II. (However, the national health insurance does not necessarily include non-citizens depending on residency status.) SHARE is working for Universal Coverage that includes migrants so that Japan can be a more generous and prosperous society that can live together with people of different ethnicities. Please provide your support!

本田さん写真1

Toru Honda
Chair of SHARE. Doctor at Taito-Ku Asakusa Hospital. Volunteer at Sanya Sanyu Clinic.

Thoughts of Dr. Toru Honda
http://blog.livedoor.jp/share_jp/archives/cat_342979.html
Appearance on NHK Professional: Sanya o Sasaeru, Iryou no Magokoro
http://www.nhk.or.jp/professional/2013/0617/

Services for the Health in Asian & African Regions (SHARE)
SHARE is an international health NGO founded by doctors, nurses and students in 1983. SHARE strives to create a society where everyone has access to healthcare. SHARE currently works in Cambodia, East Timor and Japan.
http://share.or.jp

Breakdown of Expenses
1) Dispatch of medical translators: interpreter fee and transportation
2) Health telephone consultation: personnel and communication
3) Convene seminars for healthcare service providers: venue, transportation, speaker's fee and print materials


We, SHARE, are challenging "CROWDFUNDING", since we started it from Oct. 1, 2016.
Your kind donation is most appreciated to enable us to start the activities introduced here.
Please click the following Link for donation.





Yuko Yamamoto
Program officer, Migrant health program in Japan

このエントリーをはてなブックマークに追加
Below is the article I contributed recently to 'Global Health Check', Oxfam International's online forum on Global Health Issues. (Nov. 11, 2011) I hope the article can help readers understand how Japanese pioneers in PHC and Community Health were instrumental in establishing the UHC in post-war Japan.

The whole article of mine as well as the related Lancet's articles on UHC in Japan will be available from the following URL;

http://www.globalhealthcheck.org/?p=1705



UHC


Health Equity: Japan's Post-war strides towards Universal Health Coverage −From Grassroots Perspective

POSTED BY MOHGA KAMAL-YANNI ON NOV 11TH, 2014 IN UNIVERSAL HEALTH COVERAGE

On September 1, 2011, the Lancet featured Japan's 50th anniversary of Universal Health Coverage (UHC). In 1961, Japan formally kick-started its national health insurance system. The system comprised two main components; an employee-based insurance 'Shaho' and a community-based insurance 'Kokuho'.

Now Japan is lauded by WHO and OECD as one of the best countries in the world when it comes to healthy longevity of its population with relatively low medical expenditures. How was this possible? One key factor is the Japanese 'Peace Constitution' which underpinned universality and accessibility in health care services. Article 25 of the constitution stipulates that:
"All people shall have the right to maintain the minimum standards of wholesome and cultured living. In all spheres of life, the State shall use its endeavors for the promotion and extension of social welfare and security, and of public health".

The Lancet articles presented fair analyses and lessons learnt from the Japanese experiences, especially regarding public policy and health system formation. However there is one important factor that was missed in the Lancet articles- namely the Primary Health Care (PHC) approaches. Japanese forerunners struggled to supplement the health system's failures and shortcomings at the community levels by PHC.

This bottom-up approach has been tremendously important and instrumental than the mention in the Lancet articles. For the war-battered Japanese society, especially in rural areas where doctors have always been a rare commodity, PHC played a critical role.

I will describe the example of two persons who were role models for PHC:

Dr. Toshikazu Wakatsuki, a medical doctor and Mr. Masako Fukazawa, the mayor of Sawaguchi-mura village, who were great pioneers in setting up Community-health and UHC in Post-war Japan.

Dr. Wakatsuki was dispatched to the remote Saku region in Nagano prefecture to work in a forlorn hospital in March 1945 - just a few months before the surrender of Japanese Imperial Army to the Allied Forces. Although he was a gifted surgeon, he got deeply involved from the start in health promotion and preventive activities in the poor and mountainous communities. Since late 1940s, he had helped organize outreach health teams and community health volunteers and jointly started health counseling sessions for poor villagers using role plays pertinent to their everyday health issues and tried to raise health awareness among rural population. By 1980s, thanks to Wakatsuki and local people's joint efforts, Nagano prefecture saw the incidence of stroke and TB, the two major killer diseases at that time, drastically lowered and medical cost to the population considerably reduced. Even to this day, Nagano stays at the top level among the 47 prefectures and city governments in terms of both male and female longevity.

In 1957, Mr. Fukazawa of Sawauchi-mura village, in the Iwate prefecture, was elected as mayor. The village is in northern Japan and is mostly immersed in snow with bad roads and no doctors. He first introduced state-of-the-art bulldozers into the village to remove deep snow from the roads and thus facilitated the transportation of the villagers to clinics, schools and shops during winter. He also started prenatal counseling and toddlers' regular health checkups free of charge. In early 1960s Fukazawa introduced free medical consultation for infants under 1 year old and elderly persons above 60. His do-it-alone measure was severely criticized by the then central and prefectural governments because the national health insurance law did not allow such a policy. But Fukazawa proudly declared "Although I know what I did for the infants and the elderly was against the health law, I know it is in accordance with our Constitution, article 25."

In five years' time, villagers as well as policy makers were astonished to know that the infant mortality rate in Sawauchi was brought down from 69.6 per thousand to zero!. This marvelous achievement was accompanied by less medical costs compared to neighboring villages in the same prefecture. Eventually the Central Government adopted the same policy. Like Dr. Wakatsuki in Saku, Mr. Fukazawa was also eager to strengthen health promotion and preventive activities. He set up a village health committee and asked the villagers for active participation. For him, UHC was not only about making medical services free but also creating a sustainable and participatory mechanism in the community.

As physician and public health researcher, Julian Hart correctly pointed out in his famous article:


"The availability of good medical care tends to vary inversely with the need for it in the population served. This law operates more completely where medical care is most exposed to market forces, and less so where such exposure is reduced."


This law is still valid to remind us of the fundamental factors that undermine the availability of health service. It emphasise that optimistic reliance on market forces must be challenged when establishing UHC both in the community, national and global contexts.

As a member of global society we must contribute to realizing better health for peoples in the developing nations. Our past experiences in UHC could offer important lesson for other countries and UN agencies that governments role in shaping the national health policies is without a doubt of paramount importance. Yet our experiences also shows that grass-roots level initiatives can also make a huge difference to improving the quality of UHC.

Written by Toru Honda, MD, Chairperson, SHARE

honda


donate_now
このエントリーをはてなブックマークに追加
Hello, everyone. This is Yuko Yamamoto, in charge of the Health Support Project for foreigners in Japan. It has been five years since I started this job. Some people may think international cooperation happens only abroad. However, SHARE works in Japan as well, different from other NGO groups, to eliminate "health disparities." My project is based in Tokyo, so actually I am one of the few nurses at the Tokyo office.

Our community health consultations for foreigners has entered its twenty second year, and it has been held together with local communities, NGO groups, churches, and communities of foreigners. Every year we have about nine consultations such as in Tokyo, Chiba, and Kanagawa. 427 people from 36 countries participated last year.

Why do so many foreigners visit us?

Because going to the hospital is quite hard for non-Japanese living in Japan. They have no idea which hospital to go to, they don't have enough money, no health insurance, and nobody to ask. But the biggest problem is language. Even if they can use Japanese in ordinary life, many problems happen in the hospitals, such as understanding medical terms, explaining what is wrong, and reading and writing Japanese. Imagine a situation where you have an excruciating stomachache. Can you tell the doctor exactly what's wrong?

Our interpreters have supported foreigners for many years as volunteers. So the participants can speak in words of their own and speak at their own pace. In addition, our various professional staff, such as doctors, dentists, dental hygienists, nurses, health nurses, nutritionists, and social workers help out the foreigners. Professionals come in and talk about leading a "healthy life," going beyond hospital work, like advice on brushing teeth, lifestyle guidance for participants who have high blood pressure, and diet advice for overweight people. That's why people keep coming even if they have health insurance and no problems going to the hospital. This is a picture of the front desk at our event. Nothing looks unusual, but we have medical records and medical interview sheets in 16 different languages.

44
(Front desk at Health Consultation Jan.13 at Shinjuku)

Our event is supported by volunteers who all have different backgrounds. Why don't you join us?

Yuko Yamamoto, Health Support Project for Foreigners in Japan

donate_now
このエントリーをはてなブックマークに追加
Hello, everyone.I am Miwa Omori at Kesennuma Office.

At the end of March, SHARE completed direct restoration support project for victims of the Great East Japan earthquake, which has carried out in Kesennuma since March 2011. With the completion of this work, I have retired from SHARE, but will remain in Kesennuma as a staff member of NPO Life Support Project K, which has carried out a joint project with SHARE. Thanks to the support of many people, SHARE was able to complete its activities in three years as initially planned. I greatly appreciate it.

Working at a hospital in Tokyo around 2000, I began participating as a nurse volunteer in SHARE's Community Health Consultation for foreigners living in Japan. There, I did both office work and field work. In 2011, I was an assistant for Domestic Health (supporting foreigners living in Japan) Project in the Tokyo office. Since January 2012, I have been in Kesennuma as a project coordinator.

sIMGP8007
(In July 2012, in Hashikami Community Plaza during a mobile zoo event )

Since it was my first job as a coordinator, I had many difficulties and sometimes things didn't go as expected. I could be positive and overcome the problems thanks to the support of people around me. Through the project, I not have only attended meetings but also studied about facilitation and tried to communicate with residents by gathering an extensive amount of information for necessary support, studying dialects, customs and ways the residents think. During these two years and three months, I have been able to learn a lot of things I never could have if I were working at a hospital.

This year, the number of people who are supposed to leave temporary housing to their reconstructed houses may increase. Because of it, the burden to keep supporting each other may get heavier for the people remaining in temporary housing. It is also thought that people will move and create a new community when they move into public housing (affordable rented housing for victims of the disaster) after March 2015, and that there's a need for support for a successful transition.

I will do my best with the residents, government and other groups to overcome each problem that comes up.

sトレイラーハウス
(Miwa Omori (Left) and Project K Muneko Saijo of Project K (Right) at Trailer House in Hashikami Community Plaza)

Miwa Omori, Project Coordinator of Kesennuma

donate_now
このエントリーをはてなブックマークに追加
Hello. I'm Miki Nishiyama from Tokyo office. I'm in charge of both the Great East Japan Earthquake Restoration and the Deputy Director of SHARE.

It has been three years since we started working in Kesennuma. It all began from helping Livelihood Support Project K (Project K), a local NPO, to get started. I've helped resident community and local people so that they can have a better environment in temporary housing. At the end of the month, it will be the last time for SHARE to support locals directly. Project K will take over the work. Three years has passed so quickly, even though it seems like a long time.

On March 23, when cherry blossoms started blooming in Tokyo, I went to Kesennuma. I attended the joint steering meeting of SHARE and Project K, which is held once every three months. Kesennuma was still cold enough that snow from the previous day remained. It felt like winter had come back.
Board members of SHARE have also helped manage Project K as board member and auditor-secretary. Meetings have included people who are in charge, like me, and this was our final meeting.

Sometimes it is said that it is best to "let local people recover on their own." It is easy to say, but hard to do.

SHARE has paid attention to "who has to be in charge for restoration" when we supported Project K starting-up. It was the first time for SHARE to have an office and work with a local NPO for a long period of time after the emergency phase, in other hand it was the first time for Project K to work as an NPO. It was a full of challenge for both organizations. At the beginning, I was sometimes confused during activities. When residents started to move into temporary housing, we faced several problems. It got more difficult to deal with activities because the situation surrounding housing was changing by the minute. At first, I felt we were too careful with each other many times during meetings.However, in recent days, we have gradually begun to engage in honest debate. Also, during this meeting, I felt that the policy of future activities had been made from the view of Project K which has residents' needs in mind. Therefore, I believe they can take over the activities with ease.

Though the activities over these three years, I have seen local people facing restoration with strong determination, since they wanted to change Kesennuma for the better. I could listen to people's feelings about Kesennuma, and watch their changes in regular meetings. Through these experiences, I felt that I could be involved in the process of "restoration by local people" as a member of SHARE. This is because we were able to conduct activities with them as partners.

However, "Restoration by local people" is still incomplete. We, SHARE, will keep reporting you about what is happening in Kesennuma. Our role will be to increase supporters of Project K. We are going to report you Project K's activities though this blog and newsletters. We are looking forward to your continued support.

P1060114
(Board members and staff of Livelihood Support Project K and SHARE)

Miki Nishiyama, Deputy Director and in charge of the Great East Japan Earthquake Restoration Project

donate_now
このエントリーをはてなブックマークに追加