Recently, Fumie had sent me an episode of Jounetsu Tairiku (“Continent of Dedication”). This one was on Naoyuki Kawahara, a Japanese doctor who presently works in the Sudan. There are many foreign doctors who forgo their financial futures to treat patients in developing countries, and all are truly heroic, in the deepest sense. However, Dr. Kawahara’s story was inspiring to me.

He had originally been a rugby player, then suddenly deciding to enter medical school in Kyusyuu. After two failed attempts at passing the grueling entrance examination to Kyusyuu Daigaku’s medical school, he got in and obtained his medical degree in surgery. He then spent a year in Sudan working for the Japanese Foreign Ministry as a diplomat, making an incredible sum of money.

At the time, the Sudan was accused of harboring Al Qaeda related groups and Japan has suspended all aid. Despite being restricted from seeing patients due to sanctions, Kawahara would covertly practice medicine in his free time after seeing the deplorable level of medical care in that country. It is truly sad that the health and welfare of poor individuals would be used as a leveraging tool to get governments to crack down on terrorists who threaten the health and welfare of citizens of wealthy countries (Aid to Sudan from Japan has recently been reinstated).

After some time, Kawahara decided that seeing patients was much more rewarding than being a diplomat and left the Foreign Ministry to practice medicine full time in the Sudan, despite having a wife and three children in Japan.

Now he works to set up rural clinics in the Sudan. In a country where doctors are few and the doctors who are there remain in the urban areas, rural regions who experience the most serious disease burden are neglected. Kawahara wishes to encourage the development of rural health clinics and the creation of conditions that will help Sudanese doctors to move and practice where they are needed most. In all of the arguments about health care here in the US, one forgets that medical conditions in Sub-Saharan Africa are deplorable. Clinics operate with no electricity or water. Rural clinics often have no system of record keeping where women often don’t even know when their children were born. In addition, the worst areas are continually upset by regional conflicts and warfare. Despite the incredible challenges, the bravery and dedication of African physicians is sometimes not enough to overcome the challenges to venturing into troubled areas. Dr. Kawahara deserves special mention.

Money is not the answer to Africa’s problem. The knowledge, skills and dedication of trained individuals to helping create conditions which combat the vast and deep structural difficulties are essential.

Here is the video, it’s in Japanese, which isn’t a problem for me but…

As an aside, I am reminded of an interesting lecture given last night by Nobel Laureate Elinor Ostrom. Her work has been primarily to combat deforestation worldwide using local village level administrative resources to develop protective systems. These systems work not by using heavy handed governmental enforcement to discourage forestry poaching, which contributes to global and local climate degradation, but by using indigenous tribal resources to empower local persons to act as managers and protectors of local forest resources.