The island area in Tokyo refers to the Izu and Ogasawara Islands, and has about 26,000 inhabitants on 11 inhabited islands. Tokyo Metropolitan Hiroo Hospital, as the main island hospital in Tokyo, has been working to respond to a wide range of medical needs on these remote islands, including emergency patients. There are no doctor-free inhabited remote islands in Tokyo, as all islands have medical institutions with doctors. The islands are roughly divided into three groups according to population size. At present, emergency patients in the island area of Tokyo are transported mainly by the Tokyo Fire Department’s helicopter, in the case of the Izu Islands, and by the Maritime Self-Defense Force aircraft and helicopters via the Iwo Island, in the case of the Ogasawara Islands. This system for emergency transport of emergency patients on islands by air was the first of its kind in Japan. Its history dates to the enforcement of the Remote Island Promotion Law in 1953. To date, only one accidental landing incident has been reported. The number of transport cases per year was 272 on average from 2009 to 2018, and has been slightly decreasing over time. The average number of hospitalizations at Hiroo Hospital was 219, accounting for 81% of the total. The number of transport cases is generally proportional to the population size. For Oshima patients, the time between the request and arrival at the hospital is over two hours, and for those in the Ogasawara Islands, nearly 10 hours. Distance and travel time are roughly proportional. Cerebrovascular, cardiovascular, and digestive diseases are the leading reasons for hospitalization, and a wide range of emergency disease cases were treated, including orthopedic trauma cases and respiratory diseases, followed by decompression sickness and otolaryngology cases. There are two major issues that need to be addressed: controlling the number of transport cases and innovating the transport system.

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In Miyakojima, Okinawa prefecture, all of the water resources necessary for life, agriculture and industry depend on groundwater. However, because of the entire island of Miyakojima is formed by Ryukyu limestone, it is hard to collect groundwater though there is much rainfall. In the past, it was experienced “waterless agriculture” during major drought. For this reason, in Miyakojima, the large scale underground dam was constructed at first for the purpose of securing agricultural water. As the result, it has provided a stable supply of agricultural water by the underground dam. In recent years, Miyakojima has been visited by many tourists due to the crosslinking of the Irabu Bridge in 2015 and the opening of Shimojishima Airport in 2019. In addition, the number of people involved in construction of tourist facilities and residences is increasing. Therefore, groundwater consumption will also increase. In the future, stable water stored in underground dams should be supplied for drinking. One such technology is the groundwater membrane filtration system. And also, comprehensive management of water stored in underground dams and natural groundwater should be considered. As the method, this paper proposes PFI (Private Finance Initiative) for the overall groundwater management in Miyakojima.

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Bluefin tuna aquaculture started in the late 1990s and spread worldwide during the 2000s. It is now conducted in many countries including Spain, Croatia, Malta, Turkey, Mexico, and Australia, not to mention Japan. Tuna aquaculture has grown into an important industry in some regions, creating certain economic outcomes. Tuna aquaculture, however, greatly affects wild tuna stocks because it relies on wild capture of young fish as seeds. In addition, the risk of environmental deterioration possibly caused by the large amount of feed has been recognized. The bluefin tuna stock is reported to have substantially recovered, thanks to the strict fisheries management regulations set by the International Commission for the Conservation of Atlantic Tunas (ICCAT), the organization in charge of tuna stock management. Given the increased total allowable catch (TAC) for bluefin tuna, production of cultured tuna is expected to grow. On the other hand, higher production may cause not only a price drop but also environmental problems, another tuna aquaculture-related issue. In this paper, I discuss the case of the Republic of Malta, which is the biggest tuna farming country in Europe, to show the status and challenges of tuna aquaculture as well as related environmental management. Our research on the status showed that the Republic of Malta produces 14,000 tons of cultured tuna annually, most of which are exported to Japan. It also suggested that although the price of cultured tuna is likely to fall owing to the global increase of their production, it might not have a substantial impact on tuna aquaculture businesses as the price of seed fish drops because of the increased TAC set by ICCAT. However, I found that tuna aquaculture was carried out without adequate preventive measures against adverse environmental effects and that residues of processed tuna were not removed properly.

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