HUMANITARIAN MISSION: Doctors make biennial medical visit to hibakusha

As part of the ongoing dedication to hibakusha, survivors of the atomic bombings during World War II, the 18th biennial medical examinations of American survivors of Japanese and Korean descent was held on July 16 and 17 at the Sister Mary Philippa Health Center at St. Mary’s Medical Center San Francisco.

Since 1977, the Hiroshima Prefectural Medical Association (HPMA) has sponsored a biennial visit to the United States to conduct examinations in Japanese. According to Jitsuro Yanagida, MD, this year’s team leader, the first visit came at the request of the American Society of Hiroshima-Nagasaki A-Bomb Survivors (ASA), formerly the Committee of Atomic Bomb Survivors, in Los Angeles. The effort began after the group of Japanese American survivors lobbied and failed to secure help from the American and Japanese governments for support.

The HPMA, an independent organization composed of medical professionals and institutions in Hiroshima Prefecture, initially agreed to conduct the visits out of their own pockets. Yanagida said the HPMA initially paid for the screenings. “Hiroshima Prefecture, Hiroshima City and the Japanese government have since then, gradually taken on the burden,” Yanagida said.

The visits are fully supported by the Japanese government as of 2004.

The visits were originally made to survivors in Hawai’i, Seattle, San Francisco and Los Angeles, but trips are now also made to South America and the Korean Peninsula.

According to the HPMA, a total of 219,400 survivors live around the world today. Approximately 1,000 of those survivors currently live in North America, the second largest concentration of survivors outside of Japan. Some 2,000 survivors live on the Korean Peninsula. The remaining 216,000 survivors live in Japan, with 68,886 of them residing in Hiroshima City.

 

A Survivor’s Story

Many of the survivors in North America were Kibei Nisei and Sansei who were caught in Japan during the war. There are as many as 722 survivors living in California today.

One such survivor is 80-year-old Jack Dairiki, an outspoken activist for the rights of hibakusha. He was born and raised in Sacramento, Calif. and is a Nisei hibakusha. He said he has previously attended at least 10 of these screenings.

Dairiki left for Japan in the summer of 1941 on the Tatsuta Maru. He left his mother and the rest of the family behind as he and his father visited family in Japan. The trip became an indefinite stay when they tried to return to the United States in September and found that boats were no longer leaving.

Dairiki, meanwhile, enrolled in a Japanese elementary school and continued through junior high school. He stayed with his family in the city of Kure. The city had a naval shipyard, and was located outside of Hiroshima.

When Kure was firebombed, the city of Hiroshima feared they were next and ordered a firebreak to be made. Workers, including Dairiki, were ordered to the city center to help.

Dairiki boarded a train that left at 7:30 a.m. His life was likely saved by a 15-minute delay on the train. The bomb detonated at 8:15 a.m. while he and his group were just outside of the bomb’s epicenter.

He and those around him ran to a bomb shelter, and were physically unscathed. By the afternoon, however, victims from the bombing shambled toward them, hair singed off and skin melted.

Dairiki was 14 at the time.

Dairiki and his father raised money to return home by working as interpreters for the U.S. service men during the occupation of Japan. Dairiki also attended school in a blown out school building.

They returned to Sacramento in January of 1948.

Since then, he served in the Korean War, studied architecture at UC Berkeley, and became an anti-nuclear proliferation activist.

“At first, I didn’t believe I needed screenings,” Dairiki said. “I was too healthy for screenings.”

However, he decided to participate to keep a record for future generations and to learn about himself. “You don’t realize how your body changes without regular checkups,” he said.

Luckily, he discovered the early onset of prostate cancer. He had an operation in 2001, and according to Dairiki, has had a full recovery as of this spring.

Dairiki is among the 117 survivors in San Francisco who the visiting doctors screened. The team also screened an additional 48 survivors in Seattle.

Yanagida hopes the checkup may allow for an early diagnosis of any problems, and that the consultations conducted in Japanese give the survivors peace of mind.

The San Francisco Medical Society and St. Mary’s Medical Center sponsor the doctors, who normally are not allowed to practice medicine in the United States.

 

Local Support

As a member of the San Francisco Medical Society (SFMS) and an attending physician and member of the medical staff at St. Mary’s, Dr. John Umekubo helps welcome the doctors from Japan and supervises their screenings.

“The Hiroshima Prefectural Medical Association and the San Francisco Medical Society have a sister relationship. It was first formed because Japanese physicians do not have a medical license to do the examinations in America,” said Umekubo.

He has been a part of the program long enough to forget how he joined in the first place. “I’m pretty sure someone I knew called me and asked if I would help,” he said with a chuckle.

Initially he volunteered, helping the Japanese doctors as an assistant, though now, he provides administrative support.

Umekubo was central to St. Mary’s move to host the screenings. While he recalls volunteering for the visit since the 1980s, the examinations were initially held at the University of California, San Francisco.

In 1995, the SFMS was told the college campus was not available for the screening. Umekubo’s fellow doctors asked him if St. Mary’s would host the visit. St. Mary’s agreed, and has done so since then.

Since 1993, the number of hibakusha has steadily declined. Yanagida, however, said that the HPMA hopes to continue these biennial visits as long as they can.

“We’ll be coming to North America as long as we are welcome and there is one survivor left for us to see,” Yanagida said.

He stressed that, while the screening entails a routine health inspection, the key component to their visit is that they offer counsel to survivors in Japanese.

The president of the HPMA, Shizuteru Usui, MD, Ph.D., stated in a letter to the medical mission that he had “a strong impression from previous exams that survivors in North America are awaiting for doctors that could speak Japanese.” He hopes that the examinations aid in recording the health of those affected by the atomic bombs, and serve as a humanitarian mission.

 

Higher Cancer Rates

As the program enters its 34th year, the survivors’ situation has changed somewhat. The aging population reflects their decline in attendance. The prevalence of cancer has also increased, and many survivors are more concerned about their health.

According to the Radiation Effects Research Foundation (RERF), an international research organization dedicated to studying the effects of radiation on the survivors of nuclear fallout, cancer rates are proportionally higher for survivors of the bombs the closer they were to the epicenter.

A study released by the Foundation, said one gray of exposure — the amount a person received standing 1.3 kilometers (0.8 miles) from the epicenter of the Hiroshima blast — increased the likelihood of leukemia by 4.92 times and 1.29 times more for all other cancers. While leukemia was first to develop following exposure, it has since decreased since the 1950s to normal levels.

The prevalence of other cancers remains higher than normal. The Foundation’s Website notes that someone exposed to the atomic bomb at age 30 will be 1.5 times more likely to develop cancer and die by the age of 70. The Foundation also reports higher rates of non-cancer diseases with similar dosages of radiation.

For some, however, their access to health care has improved. For many years, health care providers turned hibakusha away. As the population has aged, access to Medicare has made this situation “a little better,” said Yanagida.

Dairiki is covered under his wife’s health plan. “I’ve heard of many others who can’t get health care when they mention they were in Hiroshima or Nagasaki during the bombing,” he said. “It’s good they have access to Medicare now.”

Even those hibakusha with health insurance, however, welcome the visits, and the continued support. The next visit will be in 2013.

 

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