We held the 48th meeting of the Japanese Association of Agricultural Medicine and Rural Health in Matsue, Shimane Prefecture in November, 1999. The main theme of this meeting was “Strategies of Agricultural Medicine and Rural Health with a Perspective toward the 21st Century”. The attendants of the meeting held discussion about four subthemes with the relation to the development of rural communities: environmental crisis and the human existence, medical high technology and humanism, human dignity and the quality of medicine and welfare, and the co-existence of rural and urban communities. The presidential lecture, which is reported here, treated the international trend of rural medicine and health care, our practice of rural medicine in San' in District, Japan, and some measures against aging society practiced by us in San' in District. The lecture also discussed about problems presented to the rural medicine in the 21st Century, and proposed several objectives to be carried out: integration of health care, medical care, welfare and education in rural districts, promotion of healthy lifestyle in rural districts, corporatism between administrators and researchers in medical care and welfare, policy-making for healthy rural communities and the protection of enviroment and eco-system.
The large-scale mercury contamination has occurred in the Amazon river basin in Brazil. Also, I have visited Tanzania, the Philippines and other countries a number of times, and I convinced that similar problems are spreading worldwide. A numbers of gold-miners already suffer from inorganic mercury poisoning. None of the fishermen living downstream of the gold mine showed symptoms of Minamata disease. However, the mercury content of their hair indicates that the situation is becoming dangerous. Serious arsenic poisoning is occurring on a large scale in various areas of Asia. This is attributable to the use of great quantities of underground water in the large-scale agriculture, particularly in West Bengal (India). In developingcountries, various industrial sectors are developing simultaneously, such as refining, chemical, pulp, petrochemical and high-tech industries, causing complex environmental contamination such as at the Weonsan Industrial Park in Korea. The residents of Weonsan district tended to suffer from combined poisoning that it should be called Weonsan disease instead. The hazardous technologies and industrial plants being transferred from developed countries to developing countries are major cause of industrial poisoning and environmental contamination. Examples of such cases are the Onjin case of Cabon disulfide poisoning in Korea, the gas leak at the agricultural chemical plant in Bhopal, India and radioactive contamination in Ipho city, Malasya. Health damage due to industrial and environmental contaminations is often masked by the effects of unsanitary living condition and health effects of novel chemicals and complex contamination are also frequently invisible.