The Hokkaido Welfare Federation of Agricultural Cooperatives runs a total of 15 hospitals including six general hospitals. Each hospital constitutes a nucleus of medical care facilities for people in each region of Hokkaido, Japan's largest prefecture. In addition to daily medical consultation, examination and treatment, they are carrying out extensive programs associated with health control for inhabitants in agricultural districts and care for the aged, whose number is increasing at a fast clip. In this paper, the author will review their activities in the past and present, and dwell on the future.

View full abstract

The Japanese Association of Rural Medicine (JARM) was established in 1952. In those years, the living standards of rural communities were poor, contagious diseases were prevalent and rural people fell with malnutrition. As the Japanese economy began to grow at a high pace in or around 1960, rural communities have drastically changed, enabling farmers to enjoy a better life. With farmers having access to jobs other than agriculture, their cash incomes increased, rural manpower drifted to cities, and the number of farming families has since been on the downswing. It is inconceivable that agriculture, which forms part of the primary industry, will die out, and authoritative sources agree that there will appear an international food crisis toward the 21st century.
When it comes to “agricultural medicine” in Japan, I must point out, more than anything else, that deaths in labor accidents become increasingly frequent. The safety measures are inadequate, so are the measures to compensate for labor accidents. In the ongoing development of agricultural technology, meanwhile, it is noted that there appear new types of health disorders and diseases. They include pesticide poisoning, greenhouse diseases, abortions caused by vibrating cultivators and pollinosis. The future question is to compensate for them as “agricultural diseases.” As regards “rural health, ” it must be pointed out that there are cases of family disruption and many cases with stress diseases in the midst of the ongoing trend in which farmers try to have access to better side jobs. The most crucial issue is the rapid pace at which aging is in progress in rural communities. How do we deliver care to bedridden old people and those with dementia? How to organize such community care? Those are questions we have yet to find solutions.
In the past, there were struggles against diseases caused by pollutants (such as Minamata Disease and Itai-Itai Disease). There will be the need for a positive campaign for the protection of water and green in the rural environment. Environmental issues have to be taken up in an international perspective. On the question developing countries is a major causative factor. We are no longer able to discuss about agricultural medicine and rural health without relevance to the developing world.

View full abstract

Although there are two different types of echinococcosis, either unilocular or multilocular, what is prevalent here in Hokkaido is multilocular echinococcosis. This type of echinococcosis is malignant in nature with frequent metastasis and poor prognosis, thereby being often named as “malignant echinococcosis.” Most of patients develop in the form of hepatic echinococcosis. The risk of wide spread of this parasite disease all over Hokkaido has recently been in rise, producing a serious medical and social problem. One hundred and sixty (75.4%) out of total 212 cities and towns in Hokkaido have been designated as an “infected area”, a place where host animals have been found to have this parasite in the body, and this number has been even increasing these days
On the other hand, as Hokkaido has become more popular than ever among tourists, more travelers are now at the risk of becoming infected with echinococcus. Since the latent period of this infection is relatively long (5-15 years on average), the development of multilocular echinococcosis may become evident even in the least expected part of Japan, after infected patients may have forgotten the mementos their trip to Hokkaido. This problem, therefore, is not limited to Hokkaido. This is why I have chosen this particular topic for my special lecture, hoping a number of people to have an adequate interest and understanding of this parasite disease. I described the following topics: 1) History and infectious root of echinococcosis in Hokkaido; 2) Profiles of patients with echinococ -cosis; 3) Pathophysiology and clinical stage; 4) Points of diagnosis; 5) Present state of treatment; 6) Preventive measures and elimination ways

View full abstract

The farm trade negotiations, being carried out as part of the GATT-sponsored Uruguay Round of multilateral trade liberalization talks, would end up in failure. Farm produce is quite different from manufactured goods. The proposed package lumps them together. Ample consideration should be given to the positions of importing nations and industrially developing countries. As for Japan, a national consensus is yet to be reached over the decontrol on farm produce-especially rice-imports. That's an important factor. Agriculture is not a mere sector of industry: It serves to protect the environment, maintain cultural tradition and support regional economy.
If exporting countries are glutted with farm produce, they should convert part of it from foodstuffs to materials for use in pharmaceutical, biotechnology and other industries. In this way, they will be able to find expanded outlets for agricultural products.
Should Japan accept the across-the-board tariffication proposal, some portion of the funds for the so-called official development aid to developing countries should be used. Needless to say, the government must protect the health of the people from the harm of post-harvest chemicals by checking farm produce imports in accordance with the standards for the level of agricultural chemicals residues.
To help farmers curtail the costs of farming, the following measures should be taken:
(1) Encouragement of large-scale farming through the farmland banking system of the agricultural cooperatives;
(2) Promotion of farmland improvement with funds provided by the national and local governments;
(3) Long-term, low-interest financing instead of the provision of subsidies thatserves only to increase debts;
(4) Utilization of robots and light aircraft;
(5) Lowering of input goods prices; and
(6) Introduction of CATV and other means of information and overseas news service.

View full abstract

A survey was made of the state of home care for healthy old folks and those elderly patients who have been disabled by illness or injury, and the care provided by institutions in six areas throughout the nation.
The number of healthy old people was larger in women than in men. However, men had the edgeon women in Activity Daily Living (ADL). Compared to the healthy aged people, many ill or disabled elderly patients receiving home care were found to be suffering from anemia, low cholesterol level, hypoproteinemia, and poor glucose-tolerance. The major cause of disability was cerebral apoplexy. Recently, the cases of cerebral hemorrhage have decreased in number, and the rate of death in acute stage has notability declined ; however, the incidence of cerebral infarction is on the increase among the aged.
There are limits to care for disabled elderly patients at home by the family because of the aging of their spouses and the increasing trend toward the nuclear family. Many of those who look after the sick persons are crying for expert help and services capable of coping with a sudden change in the patient's condition. Hence the need to establish a 24-hour home care providing system. It is desirable to establish old people's homes, as residential care institusion, in alignment with hospitals. This system would facilitate hospitalization in case of emergency. To execute care programs more effectively, close collaboration will be necessary among hospital, home care services, clinics, local governments, agricultural cooperatives, and neighborhood associations.

View full abstract