[Objectives] This study aims to analyze women's health issues in post-conflict Cambodia and to discuss the impacts of conflicts on women's health. [Methods] We collected a wide range of literatures and analyzed the historical background and the situation of health and health services in Cambodia. We visited the Ministry of Health, international agencies and health facilities in urban and rural areas for collecting information. We conducted semi-structured interviews to community women, health staff and married men, as well as focus group discussions (FGD) among women. [Results and Discussions] During Pol Pot regime in the late 1970s, most people were subjected to forced migration and hard labor, and many of them, particularly intellectuals, were killed. As a result, most people are still suffering from physical and mental problems, and the reconstruction of the health services delayed due to shortage of skilled personnel including physicians. Health services have been improved dramatically since 1990s by receiving various international aids. However, gaps between the rich and the poor have been widened. Although most women told that they had some health problems, those who were very poor or separated from their husbands seemed to suffer more seriously than those who had no family problems, and to be unable to control their emotions while talking about experiences during the conflict. This might be caused by unhealed psychological trauma, which, in turn, disturbed the reconstruction of their lives. Most women recognized that conflicts affected their health status and they also admitted that poverty and ill-health formed a vicious cycle. Possible interventions should empower women so that they can develop their latent capacities and rebuild community networks. [Conclusion] It is important to focus on the access to the basic health services for the rural and urban poors. It is also important to improve mental health support, so that the poor women can get over the past experience.
Biomedicine has a global power to spread its philosophy all over the world. This article examines how the globalization of biomedicine is associated with the localization of illness by the people of Yemen, from a cultural anthropological view. Since the 1990' s, the Yemeni government has developed a strategy to promote good health along with international organizations and the cooperation of developed countries. Yemenis currently are familiar with biomedicine due to the development of the medical infrastructure and health publicity. The globalization of biomedicine is making progress in Yemen. At the same time, Yemenis interpret biomedical names of diseases as their own illness in association with the traditional view of illness in Yemen. Then, they choose the actions against illness or care suitable to their society. This is a localization process of illness for people who must live with their own suffering. This result implies that it is necessary to consider how total health care, in addition to biomedical diagnoses and treatment, provides for ill people who have locally identified illness.
In the 1990s, community development approach has been taken in implementing health promotion programs in many parts of the world. Many Japanese international health practitioners, however, are not familiar with this approach and not aware of the difference between the Community Development (CD) and the Community-Based (CB) approaches. To better leverage the power of these two approaches, Japanese agencies for international health should recognize the importance of current CD approach and the difference between CD and CB approaches. In the 1950s and 1960s, CD programs were implemented in a top-down method in many developing countries, in particular, in India. However, in the late 1980s and the 1990s, development practitioners began using it as a bottom-up approach. Today, CD programs require beneficiary community initiative, allowing these communities to independently sustain health programs launched by external agencies. On the other hand, CB programs are usually initiated and implemented by external agencies alone. Thus, when external agencies remove their supports, the health programs tend to phase out. When defining a health program implementation strategy, agencies must first identify the health problems with the beneficiary communities, and then determine whether a CD or a CB approach is appropriate. By recognizing the current CD approach and the differences between CD and CB approaches, Japanese international health agencies can use the two methods effectively and appropriately in their practice of health activities in developing countries.
Medical doctors in the United Kingdom who wish to work overseas have severe problems such as job security on return, childcare, and uncertain career due to lack of institutionalised career path in the field of international medical cooperation. The same applies in Japan. It is, however, different from Japan that media for job opportunities and career related information have been far developed. Recently, Department of Health, the UK has started to encourage human resource development in the field, which hold out the hope to extricate from severe situation of human resources in the future.
A major earthquake in Bam, Iran, which occurred on 26th of December,2003, claimed more than 26,000 deaths and most of the medical facilities were destroyed or left inoperative. Although many relief organizations left Bam after the initial stage of the disaster, the necessity of medical support continued with the condition of many victims still desperate. Therefore, medical assistance was provided by HuMA in the recovery phase, and four prefabricated buildings were donated to an Urban Health Center (UHC) for use as a clinic. Essential medical equipment was provided to emergency centers in Bam. In addition, surveillance study was conducted to investigate how environmental health conditions could be improved and effective assistance be given during the recovery phase of the disaster. From monitoring of onsite disaster relief in Bam, it is concluded that the donor agencies should make efforts to continue their activities not only in the acute phase but also in sub-acute and recovery phase and if necessary to cooperate among different agencies according to their capability. Furthermore, it is suggested that close cooperation between NGOs and government agencies would lead to much faster and much more effective disaster relief for victims.
In the early 1960s, the WHO developed a tuberculosis control policy whereby tuberculosis services (including regular and complete treatment of infectious cases) could be integrated into the general medical institutions distributed across a country. This control policy was deemed the best way to effectively reduce the tuberculosis problem within a community.
In late 1960s, the Philippines successfully developed a National Tuberculosis Program, based on WHO recommendations, that was integrated into the general health services. But due to inadequate management, it was not effectively implemented. The Government of the Philippines requested that the Japanese Government cooperate in improving its effectiveness. So, in 1992 JICA initiated a technical cooperation project in tuberculosis control. The total period of the project is from 1992 to 2007. During the cooperation, the project made major contributions to the introduction and expansion of WHO strategies throughout the country. Among the reasons for its success, the most important was that the Philippines had already developed a primary health care infrastructure throughout the country. In addition, the following factors should also be mentioned: 1) the strong commitment of the Philippine government in tuberculosis control, 2) the JICA project led to the coordination of other international aid agencies, 3) the Research Institute of Tuberculosis (Japan Anti-Tuberculosis Association), which has ample experience in tuberculosis research and international cooperation, was involved in the planning and operation of the project.
However, the Philippines' governance is still weak at the central, regional and provincial levels. The strengthening of their ability to administrate will be a key factor in the future success of the program.
This article deals with the study results of the research project titled "Developing Technical Approaches for the Master Plan of the Health Sector International Cooperation". The government project was supported by the Japanese Ministry of Health, Labor and Welfare which was to be implemented for the duration of three years from 2002. The purpose of this research project was to determine the orientation of future DS in the health sectors by reviewing the studies experienced so far and by introducing various study methods and analytical methods for developing health policies and health planning techniques. The substance of this article was presented by the author as the president discourse at the 19th Annual Meeting of Japan Association for International Health.