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Dr. Daniel Murphy (23/9/1944- 14/4/2020)
 May his spirit rest in peace in Timor-Leste.

Farewell to Dr. Dan
- Great physician with a big, warm heart

by Toru Honda (SHARE)

#1.Dan_ David et toru  Dili Nov_ 2011
(Photo #1 : Dan, David Werner and toru in Dili, Nov. 2011)

The man was tall, stout, earnest and smiling. It was October 1999 that I met him for the first time, just after Indonesian military and its subordinate Timorese militias had bolted Timor-Leste (former Portuguese colony) leaving the shambles of their ruthless scorched-land operation. No buildings or houses, including health facilities remained intact. Eighty percent of them were either burnt down or simply destroyed.

We Japanese team brought in from Darwin, Australia, some medicines, medical utensils and a large chair for consultation room of Bairo Pite Clinic, in Dili City. In a makeshift OPD (out-patient department) building, Dr. Dan consulted 300 hundred plus patients on average per day from 7 am to 7 pm, every day except Sunday. So he needed a solid, comfortable chair to sit and work. With fluent Tetun and Portuguese, he kindly and warmly talked with and treated each and every patient.

#2 Aftermath of scorched-land operation, Dili Oct. 1999 TL
(Photo #2 : Aftermath of scorched-land operation, Dili Oct. 1999)

Dan was born in 1944 in Iowa, USA. His father was also a respected country doctor like the ‘Country Doctor’ depicted in Eugene Smith’s masterpiece photographs under the same title.

All through his days of youth, he was literally a basketball boy and devoted his whole energy and passion into this sport. It is vividly chronicled in his autobiography entitled ‘Breakaway’.

From late 1960s up to early 70s, Dan was kind of trapped in Vietnam War and he fiercely fought against this unjust war. President Nixon intended to invade North Vietnam and almost 1 million demonstrators surrounded the White House to stop him. Dan and his close girl-friend Janet (later she became his wife) were both arrested and temporarily put in jail.

Although he was drafted by the US Navy to go to Vietnam as a novice medical officer, he disregarded this order and became a conscientious objector.
His father was deeply sorrowed by the fact that his son was against the War. He couldn’t understand why his son had objected to the call of the nation. I hear Dan’s father was engaged in the Pacific War with Japan.

Instead of going to prison for his aversion to military service in Vietnam, he was ordered by the local court to serve as a volunteer doctor for underprivileged populations in California, like immigrants from Latin America, discharged criminals, drug addicts and homeless persons. That’s how Dan got interested in health care for poor people with different ethnic and cultural backgrounds and he learned Spanish and Portuguese quickly.

In 1980 Dan and his wife and their two sons went to Mozambique, a former Portuguese colony and served there for 3 years. He was not only devoted in clinical work but also very enthusiastic in nursing education. But alas! He and his family were inevitably entangled in the military invasion of Apartheid Government of South Africa and its local proxy. The family was forced to evacuate from the country.

After getting back to US, he reunited with his father in Iowa and stayed there for some time to help him work as the country doctor. This reunion with his dad, deepened Dan’s respect for him and two persons were eventually reconciled. Dan was amazed to see his father remember all the names of three generation families and their major life events in the community and affectionately mingle with them. Dan was proud to know how much his dad was loved and respected by fellow farmers in the area.

Dan said that he had paid serious attention to Timor-Lest since 1974 when Portugal finally gave up its colonial grip on the Island and Indonesia militarily invaded and annexed it in 1975. Finally in 1998, he was dispatched by civic and Catholic groups in Australia and US to Timor-Leste. On his arrival, he immediately started working in a bloody, hectic clinic attached to Motael Church in Dili. How so? Because social and political situation in the capital had already been quite tense and worsened each passing day. Many people were brought in the clinic with severe injuries by machetes and bullets. Motael clinic was practically the only place in the island that could provide emergency medical services for the population. Obviously, the Indonesian military was not happy with what Dan and his team were doing for the victims. The church had long been the symbol of the non-violent resistance against the invaders and the medical activities there naturally drew in many foreign journalists. In August 1999, during the period of UN-supervised popular referendum, he was forcibly kicked out of the country on the pretext of visa expiration.

One memorable episode in 1999 was when he took me to a boarding care home in Dili where a girl in her teens was staying for convalescence from serious miliary TB (Tuberculosis). She was pulled back from the brink of death by Dan. The doctor affectionately smiled at the girl and I could easily understand how happy she was to be with him.

#3 Dr_ Dan and a girl cured from miliary TB 1999

In autumn one year, when I visited Bairo Pite, the doctor immediately invited me to his room, picked up a thick medical book from the shelf and showed me one page. It was Lippincott’s textbook of Tuberculosis and the page he pointed to, was the photo and the life history of Mori Ogai, one of the greatest literary figures in modern Japan.
Mori was not only the eminent novelist and poet but also Japanese Imperial Army’s surgeon general. In 1887 as a Government-sponsored student overseas, Mori visited Dr. Heinrich Hermann Robert Koch, the great microbiologist and discoverer of TB bacteria, with Dr. Kitazato Shibasaburo in Berlin. He studied for one year under Dr. Koch about Tuberculosis and microscopic examination of TB bacilli by acid-fast stain.
Historical irony goes that after returning to Japan in 1888, Mori seemed to have developed TB himself. This important life event for Mori is depicted in his autobiographic drama, entitled ‘The Mask’. Tragic fact was that the doctor in the drama had to conceal that he was infected by TB even to his family or close friends till the end of his life. In real life, Mori lost his first wife by TB, presumably he transmitted the disease to her.

He died at the age of 60 from renal failure due to kidney TB. I think Lippincott editor wanted to show by Mori’s case how long and how strong TB has been associated with stigma. Even the best scientist and medical officer at the time like Mori had no other way but hold back the fact that he was a TB patient.

Dr. Dan always said that the single most important job for him as a doctor was to diagnose as many TB patients on the island, give them and their families proper treatment and educate the whole community.

#4 Dan at ease reading Japanese Zen book after a busy consultation 2007
(Photo #4 : Dan at ease reading Japanese Zen book after a busy consultation)

In 2006, the country was again thrown into the crisis, this time by different military groups antagonizing with each other. Many soldiers, police officers and civilians lost their lives. There seemed to be communal conflicts of interest in the background. Tens of thousands of people were forced to evacuate and swarmed around the routes to the Comoro International Airport and Metinaro Subdistrict. We SHARE alongside Bairo Pite Clinic extended a modest support for displaced persons in the refugee camps. Again, I witnessed miraculous power and leadership of Dan in conducting the medical relief activity.

A boy at the age of 4 was rushed to Bairo Pite on one such tumultuous day. Fleeing from crossfires, the boy spent almost one month with his family outdoors in the hilly area of Dare. When he finally arrived in the Clinic, he was in a shock state and lost his consciousness. His temperature was over 40℃. Blood smear proved that he was doubly infected by both Plasmodium Falciparum and Plasmodium Vivax.
Dan was quick to save the boy’s life. He started IV Ringer’s solution and Artemether injection. Two days later the boy got awake again and started talking and eating.

#5   In 2007 Dili a boy with two malaria
(Photo 5 : a boy in serious condition from double Malaria infection 2006)

In November 2011, we invited David Werner, another mentor on Primary Health Care for me to Timor-Leste to ask him to facilitate workshops, lecture sessions and on-site visits in Dili and Aileu District. It was the superb workshops for both Timorese people and SHRE staff and we learned a lot from him. In Dili Dr. Dan kindly chaired and translated two sessions by David. Dan always referred to David’s ‘Where There Is No Doctor’ and recommended the book to grass-roots health workers in Mozambique as well as in Timor-Leste.

#6 David at Dili work shop 2011
(Photo 6 : David in one of the workshops in Timor-Leste 2011 ‘Gourd-boy doll’ to explain diarrhea and dehydration)

Toward the abrupt end of his life, for a few years, he suffered a lot from financial difficulty keeping Bairo Pite afloat. I don’t know the exact reason(s) why his Australian supporters severed assistance to the Clinic. It was so sad that such a great and heroic doctor like him had to shoulder extra burden of raising fund to keep the clinic up and running aside from his busy clinical work. But I am convinced that he kept his courage and upbeat spirit until his last breath on earth.

Hope Bairo Pite continues to uphold Dr. Dan’s legacy and serve the poor people in the Island.

Please visit the following websites of Bairo Pite and encourage the health workers who wholeheartedly try to follow the path of Dan.

■ http://bairopitecliniclanud.com/?fbclid=IwAR1kLwlY30mZj7-z4BKgGGdjX9zHNFb-iqGD-biz7bbn1Rpn2t60AVYnLeA

■ https://www.facebook.com/pages/category/Health---Wellness-Website/Bairo-Pite-Clinic-Lanud-1864674177164833/

#7 Dr. Dan’s funeral in Biro Pite Clinic
(Photo7 : Dr. Dan’s funeral in Biro Pite Clinic)

Personally, I wanted to talk with Dan about what was really behind the current coronavirus pandemic. He used to have a very keen awareness on global warming, ecological breakdown and unfair distribution of wealth and information in the world.

Individually we who had an honor to be his disciples, will have to learn from his work ethics and pursue the way to pass his torch to young people wherever we reside and work.

With Love and Solidarity, Sayonara Dear Dr. Dan.

(May 17, 2020)

New Coronavirus infectious disease is spread in and outside Japan. Accordingly it is assumed that people’s lives are changed. It was reported that mass infection outbroke at Eizyu General Hospital which is located a few minutes’ walk away from our office. We feel that New Coronavirus is approaching to us. Currently in principle SHARE Tokyo Office is working from home from March 30, Monday based on the press conference by Tokyo on March 25. We learn day by day the following, it the beginning that we should be careful not to be infected and to save our own lives. Today Ms. Hirono in charge of supporting foreigners in Japan will report the current status of the Division.

Transmission of information through homepage and facebook

SHARE is working on transmission of information under the current situation of New Coronavirus infectious disease. Mr.Nakasa, Joint Representative of SHARE and Doctor is playing an important role in transmitting the information of New Coronavirus infectious disease, among others the information which is not often reported in Japan, twice in a week for Japanese version, once in a week for English version. In English version URLs of transmission of information in many languages including English by various organizations are listed. Also the support Division for foreigners in Japan quickly opened English facebook and started to transmit information. With the cooperation by people who are continuously helping the activities of SHARE, we are planning to transmit information in Nepali and in Vietnamese from now on. We sincerely hope that people in various communities can receive such information but we have to make further efforts to identify detailed needs. We would like to enrich the contents further from now on.
(Please refer to URL of English information and so on in the end.)


 English facebook of SHARE migrant health program 
(Click on the image to go to facebook)

The voice from foreigners and supporters
Acceptances for sending translators to medical institutions through “ Medical Telephone Consultation for foreigners” and usual consultations are currently suspended. But we are still receiving the consultations from foreigners and supporters through various routs. Major consultations are the following, by the influence of spread of New Coronavirus infectious disease pregnant woman who was planning to go back to her home country cannot go back due to flight cancellation and she worries about unplanned medical examination and birth or medicine for chronic illness from home country cannot be got due to flight cancellation and so on. SHARE is coping with such situations each by each by getting information from health care workers and social workers in such regions.
Further we would like to establish the system to listen to the voice each by each.

From the statement of the UN agency
Office of the United Nations High Commissioner for Human Rights (OHCHR) /
International Organization for Migration (IOM) / Office of the United Nations High
Commissioner for Refugees (UNHCR) / World Health Organization (WHO) announced the joint statement “ The rights and health of refugees, migrants and stateless must be protected in COVID-19 response)” on April 4 . (https://www.unhcr.org/jp/25247-pr-200404.html)
It says that people forced to move such as refugees, stateless persons and many immigrants are exposed to high risk. Also it says that it is very important that all people including immigrants and refugees can equally access to health services and are effectively covered by each country’s countermeasures including prevention, inspection and treatment of New Coranavirus infectious disease to contain the spread of such disease. That announcement refers to the immigrants and refugees living in the developing countries and regions where health care system is tight and insufficient. Also in Japan foreigners often suffer a disadvantage in language, residence qualification and available information. Even though they would like to protect their own health, they face many barriers. SHARE shares the spirit of this announcement and continues our activities to provide necessary support with people in foreign communities through continuous improvement support of the access to health services for foreigners in Japan.

English facebook of the support for foreigners in Japan

■English Information COVID-19 from SHARE
No.1 https://share.or.jp/english/news/information_of_covid-19.html
No.2 https://share.or.jp/english/news/information_of_covid-19_2.html
No.3 https://share.or.jp/english/news/information_of_covid-19_3.html
No.4 https://share.or.jp/english/news/information_of_covid-19_4.html
No.5 https://share.or.jp/english/news/information_of_covid-19_5.html
(2020.05.1 Release)

■Useful URL Multi-language Information COVID-19


Fumiko Hirono


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.

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

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,

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.

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!


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

Thoughts of Dr. Toru Honda
Appearance on NHK Professional: Sanya o Sasaeru, Iryou no Magokoro

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.

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

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;



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


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


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.

(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