Japan Overseas Cooperation Volunteers (JOCV) are really acting as independent pioneers rather than individual volunteers in their mundane lives in developing countries. Their passionate crusades spearhead an innovative betterment of the health and the society. Their natural practices and challenges reflect us how the international health development should be. In this feature section, we will face the gap between the reality and the hope in the genuine experiences of JOCV and will learn how the authors sprouted out their efforts under the mutual friendship.

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I was a JOCV(Japan Overseas Cooperation Volunteers)first generation of clinical nursing in Mongolia in 1998, and worked in the National 2nd hospital in capital of Mongolia, Ulan Bator, for two years. At there it was possible to know the Mongolian medical situation. There were 3 main problems, as follow: (1) Medical facilities were old, (2) Medical equipments were poor, (3) Medical textbooks were fewness. Expressly, I consider the nursing textbook and the teaching video with some medical workers the reason from the 3rd problem. I held the study class that used a nursing textbook for nurses in a hospital. In this report, the process of such action is important to get good cooperation of workers in a hospital, and necessary, the activity of a member of JOCV shows opinions to them, to get cooperation with them and do endeavor to know each other.

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Between July, 1998-July, 2000, data was collected regarding the health of Tanzanian school children. The purpose of this report is to describe how this research activity as a JOCV fostered my professional development as a public health nurse. Through the health examinations of pupils and the collection of health data, I was able to understand the importance of prioritizing health issues in the community, in order to create a health plan. This type of data was also useful in choosing activities and estimating their potential effects. Moreover, it became clear that if we can get cooperation from the school, we can change pupil's health behaviors through education and environment with little cost. This was proven in my study of health education and hand washing.
This experience has enhanced my awareness of the problems of implementing a health program due to inefficiencies in staff, supplies and budget constraints. The benefits and impartiality of the Japanese health care system and the abundance of social resource became obvious. However, many of the problems I thought specific to Tanzania I have also noticed on returning to Japan. Therefore, if we exchange experience of health activity between Japan and other country, it complements our skills and knowledge, and inspires and motivates health care workers.

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[Background] Japan Overseas Volunteer Cooperation (JOCV) pharmacists have been sent to Malawi. There were two big reasons. One was there were no colleges to train pharmacist. When people want to be pharmacists, they have to go to abroad to have education. However many of them never come back to Malawi after finishing the course. Thus a lack of pharmacists was severe. And almost pharmacy staffs were untrained. Another was medicines had been stolen by insiders. At that time hospital in charge wanted to be managed by credible outsiders. I was also one of pharmacists in Malawi. However I often heard Japanese pharmacists were dull to be faced the rigid situation of Malawi health sector and the difficulties of mutual understanding even they had been full of hope. [Aim] The aims of this study were to explore the activities of Japanese pharmacist's volunteers in Malawi and to investigate our problems and solutions. [Method] Project cycle management (PCM) method was adopted. Participants were 10 members of the Malawi JOCV pharmacists committee. The JOCV volunteer coordinator and the JICA expert took part in this discussion as observers. Those statements were categorized into each category. [Results] Japanese pharmacists have had the clams and complaints against their missions. Their clams and complaints were separated to three. One was the problems of Malawi side, which were un-cleared Japanese pharmacists' position and insufficient infrastructure. Other was JOCV side, which was lack of communication with Malawian. And the other was both sides, which was an absence of mutual understanding. When we ignored these problems, the opportunities of international aids by pharmacists would be decrease. [Conclusion] According to the results, Malawi JOCV pharmacists committee recommended to JICA Malawi office reconsidering about sending pharmacist volunteers and made efforts to appeal their actions.

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The Dispatch of Japan Overseas Cooperation Volunteers (JOCV), a program of Japan International Cooperation Agency(JICA), performed the 40th anniversary foundation in 2005. About half of 3,703 volunteers of the health and hygiene field dispatched by the end of August, 2004 are nurses. The tendencies of recent JOCV are increase of the number of volunteers based on liberal arts, increase of volunteers with high educational background and increase of the number of female volunteers.
The volunteers who live and work with local people do not remain in simple man power, but show a faithful work and a manner as a careerist. There are a problem to be able to see, discovery of a local method simply because they work among the people, and we should pay attention to a characteristic and the effectiveness of such a volunteers' activity more.
By investigation(n=397) for volunteer nurses, 36.5% receive higher education after return home. It is expected that volunteers study after return home and then engage in international health focusing on a public level as well as upper persons in developing countries.

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This study aims to analyze the perinatal care provided to non-Japanese speakers in one hospital in Tokyo from 1990 to 2001. It attempts to identify critical issues in perinatal care services and to recommend measures which should be taken to improve them.
Two major problems were identified: firstly, communication difficulties between health-care providers and the women and, secondly, a severe lack of information available to the women regarding health, medical and welfare services in Japan.
In particular, communication difficulties were a big burden for health care providers in that they presented an obstacle to collecting medical histories, to finding out about symptoms, to establishing good rapport with the patients and to providing spiritual support. It also made it difficult to provide health care based on informed consent.
Systematic assistance from medical interpreters is urgently needed in order to provide foreign women with the same level of care as that provided to Japanese patients.

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Introduction
Folk medicine is practiced in most countries for the purpose of treating illnesses, preventing from ailments and promoting health. When people immigrate, they bring and practice their medical experience and knowledge in the new country. They integrate their culture and traditional medical practices to those of their new home country.
Methods
Forty five foreigners from three different countries i.e. China, Philippine, Brazil, living in Japan were interviewed in-depth, in order to compare the differences of their traditional health behavior.
Results
The results show that Chinese have more knowledge, practice traditional health behavior more and suffer less from ailments than Philippinos and Brazilians, during the one year period prior to the date of interview. Most respondents practice traditional health behavior for health promotion and prevention from ailments while they chose either traditional or modern medicine for treatment according to the symptoms or diseases. All respondents consciously took certain drinks for promoting and maintaining their health. Only Chinese practice the "hot-cold" classification in illness management and diet. The concepts of opposition and balance are only some of the several approaches used in treating illnesses. Philippinos and Chinese use traditional health practices for maternal and child care more than Brazilians. More than 30% of Philippinos suffered from severe morning sickness and 20% of them gained excess weight rapidly during pregnancy. Respondents from all three countries took special traditional meals to recover from tiredness and produce adequate breast milk after childbirth.
Conclusions
All three different groups have integrated their own traditional health behavior to the Japanese life style not only for promotion and prevention from illnesses but also to complement medical services in Japan. It was found that some traditional practices were in common and others were very unique among the three countries. Suggestions for further research are made.

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Many people have been killed or physically disabled during twenty-year internal conflict in Cambodia. People still get injured due to remained land mines and unexplosive ordnances, even a decade after the cease-fire. This paper aims to examine the situation of the physically disabled and assistance programs in Cambodia by analyzing published documents and visiting activity sites, and to discuss future challenges. In this paper, the physically disabled mainly implies adults and children with orthopedic impairments.
The major causes of physical disability are: land mines; unexplosive ordnances; traffic accidents; occupational accidents such as falling down from palm trees; infectious diseases, etc. Casualties of land mines and unexplosive ordnances were 50,915 (13,686 were dead) between 1979 and 2000. Recently, the number of land mine accidents has been declining, while that of traffic accidents has been increasing.
Since 1980s, many international NGOs have assisted land mine victims through providing with artificial limbs, prostheses and rehabilitation services. However, the assistance for the disabled people of other categories has been neglected. The international NGOs provide services based on their own interests, therefore, the participation of the disabled people and their family in the assistance programs has been limited. The government plays only limited roles to endorse the activities of the international NGOs, and has not had any specific strategies to prepare for the future withdrawal of the NGOs.
Disabled people require assistance not only for health, but also for education, employment, etc. On the other hand, it is also very important to empower and build capacity of them, so that they can contribute to the development of the Cambodian society. Additionally, means of prevention should be considered as one of the key perspectives. Sustainable supporting systems should be established by the government and domestic NGOs through participation of the disabled themselves.

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To identify methods for improving reproductive health in developing countries, we reviewed recent family planning issues in Japan. Findings showed that the process of approval for oral contraceptives in Japan has been influenced by sociopolitical discussions without much focus on women's needs for effective contraceptives. We next analyzed recent abortion trends and conducted surveys on unintended pregnancy. Results showed unintended pregnancy to be highly prevalent, which suggested an association with child rearing outcomes when carried out to term. Additional epidemiologic data is needed to document women's health status and to promote evidence-based health services.
Given that Japan and Vietnam share several common characteristics related to reproductive health, we are currently conducting a prospective study of pregnant women in both countries to determine the impact of pregnancy intention on child rearing. Prior to the survey, we started a training program to improve capacity of local health professionals to carry out epidemiologic studies. When assisting developing countries in reaching their health goals, it is important to increase local capacity in collecting scientific evidence and to promote its application in health practice.

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