The 54th General Assembly of the Japanese Association of Rural Medicine was held in Karuizawa, Nagano Prefecture, on October 20 and 21. The autumnal air was crisp and refreshing. Presiding over this annual meeting was Dr. Shusuke Natsukawa, director of the Saku Central Hospital affiliated with the Nagano Prefectural Federation of Agricultural Cooperatives for Health and Welfare. Nagano, the venue for five annual congresses in the past including the monumental first one, played host to the latest event for the first time in 20 years. With “the return to the starting point of rural medicine” as its main theme, the 54th meeting was opened with the speeches and lectures by the General Assembly president and others. Symposia were so excellently performed and papers presented by JARM members were so rich in substance that, I think, the scientific meeting was very valuable for all the participants. Moreover, President Natsukawa and staff members of his hospital and the people of the Nagano Prefectural Federation of Agricultural Cooperatives for Health and Welfare showed warm hospitality to us so that the general assembly turned out to be an unforgettable heart-warming gathering.
Sixty years have elapsed since the Saku Central Hospital was established in 1944, or the year preceding the end of World War II. That year, the 20-bed hospital began to deliver medical care with only two physicians. It has now developed to a point where it has a staff of 1,682 employees, including 193 doctors, with 1,193 beds. In the immediate years that followed poverty-stricken rural communities were left far behind the times, and not blessed with benefits from the government's policy of economic rehabilitation and development which led to the emergence of modern industrial society. In attempts to save rural people and their environment and health from a wide variety of postwar social distortions attendant upon the production-first policy, the hospital staff dedicated itself to the delivery of comprehensive health care under the leadership of Dr. Toshikazu Wakatsuki, the then hospital director, with the cooperation of many like-minded health professionals and local residents. The fact historically stands forth that the Saku Central Hospital, keeping in close touch with the community and making sure of their needs, was always quick to come out with health care of the kind they really wished to have. The impelling force is organizational management in tune with the spirit of cooperatives' movement with the involvement of its workers' union in the hospital's management and a great variety of cultural activities in the rural communities. The health care-related industry is now a key industry in many regions. This fact is tied in with the creation of job opportunities for youngsters in those districts that are distressed by depopulation, turning out to be an indispensable factor for the building and management of a healthy community. Given the recent exposures of corporate irregularities and medical errors, we are determined to become a hospital trusted and chosen by locals by reviewing hospital care from a standpoint of obligations to society and incorporating quality-first principles, assurance of safety, transparency and accountability, and users' satisfaction in the management system.