CAMPAING: DEFINITIVE DEVOLUTION

1. The 44th CONVENTION OF NIKKEI & JAPANESE ABROAD (JICA Yokohama International Centre, 2F. Sept, 24-26, 2003. JAPAN) CAMPAING: DEFINITIVE DEVOLUTION Masayuki Okumuraokumura.h@uol.com.br BACKGROUND HOSPITAL SANTA CRUZ 1948, four Japanese “Flying Fish” that had just established a world swimming record, visited São Paulo. During the victory celebration, at a barbecue held at the county home of Dr. Hossoy, the idea surged among the physicians present or reacquiring the “HOSPITAL SANTA CRUZ” (HSC) for the JAPANESE COLONY. Physicians present included: Drs. Hossoy, Maria Tita Noda and Cho Kihara, Tomei Arakaki, Tomoyas Inague, Tucasa Adachi, Masahiro Yoshimoto, Hiroshi Kitadai, Yoshio Endo, Masagoshi Goto, Akira Noda, Kentaro Takaoka, Yashushi Takeda and Masayuki Okumura (freshman/University of S. Paulo Medical Center). From that time on, the group met every Saturday for lunch (feijoada/ traditional Brazilian bean dish) at the Pandoro’s Restaurant on Cidade Jardim. There, it was decided to found the “Associação Beneficente Nipo-Brasileira / ABENIBRA (Japanese Brazilian Charitable Association), and to set up a modest clinic at Rua Cunha Gago because many Japanese lived in the vicinity. By 1970, this Association already had the support of other well-known personalities from various professions, especially in the liberal, arts and university campuses. The General Assembly of ABENIBRA was held in Enkyo with the massive presence of the Japanese colony. Dr. Tucasa Adachi was elected President of the Executive Council and Dr. Masayuki Okumura President of the Deliberative Council. Various attempts to reacquire the HSC were unsuccessful, but we continued to assist the colony in the Clinic. Medical - Cultural Caravans were also organized to visit poorer villages always with the cooperation of university students and businessmen in general. Early in 1989, at a benefit barbecue in the S. Gonçalo Church, the attorneys Sieo Tokuda, Jorge Yamanishi, Senjiro Hirano, Takeitiro Takahashi were taking part in a Civic Movement. Takashi Imai and the Associação Nikkey Lions do Brasil and the Junior Brasil/Japan Chamber were also present. They asked us: “if the movement were sucessful, how could we open the Hospital since we were laymen in Hospital matters?” Our immediate answer was: “if the Japanese colony reacquires the HSC in one day, we guarantee that on the following day it will be functioning, since we the Physicians of the ABENIBRA, have conditions for a sucessful project”. The campaign by the Civic Movement for restoring the Santa Cruz Hospital to the Japanese Colony (formerly “Hospital Japanese de Beneficência) had a surprising outcome. We were invited to the inauguration on March 17, 1990, and were given the responsability of Emergency Service Assistance in the HSC. The hospital was received in a completely neglected and derelict condition. A letter written by Dr. Paolo Marcelo Re, responsible for Emergency Service Assistance, to Dr. Jorge Yamanishi: stated that “the hospital was deficient and discredited and the clinical staff morale was low. The hospital functioned only for triage of patients to respective specialist and they were neither hospitalized nor submitted to emergency surgical interventions”. At this time, only 6 to 10 patients were hospitalized. Thanks to the cooperation of a group of unforgettable altruistic physicians (*), in less than one year we filled the hospital. We could provide high standard care for clinical, surgical and out-patients, because we were able to requisition the best physicians from the “Hospital das Clinicas” (University of S. Paulo Medical School), Escola Paulista de Medicina, Santa Casa de Misericórdia de S. Paulo, Hospital da Beneficência Portuguesa and Instituto do Coração (INCOR). In August 1992, Prof. Kini-ichi Nabeya, President of the V World Congress of Esophageal Surgery, invite us to Kyoto. On returning to Tokyo we visited the Dental Medical Center and on the thirtheenth we contacted Prof. Shaw Watanabe. Dr. Gerson Hamada, at the time interning in the Epidemiology Division of the National Cancer Center Research Institute, escorted us. Prof. Watanabe (who had visited São Paulo several times, on a JICA mission and was intimately aware of the problems concerning the HSC) was his advisor. At two ó clock we participated at the First Meeting programmed with Dr. Sussumu Takahashi, Assistant Manager of the Toshiba Medical Systems Co. Ltd. Initially he offered us a user X ray machine but later thanks to Prof. Watanabe’s intervention, he consented to donate a new apparatus for the HSC. At four ó clock the Second Meeting took place at the Central Office in Shinjuku, with Dr. Yukio Nakajima, Director of Japan International Cooperation Agency (JICA). On the agenda was a proposal by JICA (author Prof. Shaw Watanabe), to turn the HSC into the JICA REFERENCE HOSPITAL FOR LATIN- AMERICA. The objective was to secure in S. Paulo former Latin American fellows upon their return from Japan for two years of their contract, completing their required residency without charge to the HSC. A five – year agreement of one hundred and seventy – five million yen (175.000.000) was designated to equip the HSC (**). At the end of the meeting, Professor Nakajima was impressed with the success achieved over a period of one year. The neglected and indebted hospital with 6 – 10 patients initially hospitalized was now fully occupied and he spontaneously offered another twenty – five million yen (25.000.000) toward the hospital resurgence. He apologized for offering “only” that amount, because it was not mentioned in the initial agreement, but that we should have this plan approved by the Itamaraty (Brazilian Diplomatic Agency) and Japanese Embassy in Brasilia by the end of the month so that it could appear in the JICA budget for 1993. His wish was to begin cooperation immediately (at the time the value corresponded to BILLIONS OF CRUZEIROS). The fact was communicated to the Director of Hospital Santa Cruz, on our return to S. Paulo, calling his attention to the urgency of the request. Our intention was to communicate the auspicious notice to our collegues during the meeting of the Consultive Medical Council (CMC). At this time we were told that the President of the CMC, did not think it worth while to communicate this news to the CMC. He tought it might interfere with the Board’s actual plans (the HSC workplace continued fairly tense, due to the discontentment of the old staff members). Although we didn’t agree with the idea, we had to accept it. Since we found that it was important that we went in to partnership with JICA and HOSPITAL SANTA CRUZ. This important communication was officially sent to the Council only in November of that year, a little over two months after our arrival from Japan. Paulo Yokota, Seigo Tsuzuki, Kenji Nakiri, Walter Amauchi e Milton Ozaki leiving of the hospital, they wanted to send me away for fear of my causing any inconvenience Two days after this event, we were advised of our termination with the HSC. From the beginning we were simply volunteers and had never received any professional fees from the HSC. At this time, the Director of HSC already had a ticket to Japan where he would receive twenty – five million Yen (25.000.000) and would formalize the agreement. The intention was to transform the HSC from a general hospital forcare of the Colony to a tertiary one specialized in cardiac surgery, mainly for heart transplantation. EMERGENCY SERVICE ASSISTANCE; PHYSICIANS 1-MASAYUKI OKUMURA 2- KAVAMOTO KAZUTOMO 3- MITSUNORI MATSUDA 4- FERNANDO ODA 5- SHINITI MORITA 6- JORGE NAKAUCHI 7- RAUL F. MARINHEIRO Jr. 8- AKIE YAMADA 9- MASSAMITI TAGOMORI 10- JULIO YAMANO 11- JORGE MIYAZATO 12- FERNANDO GUATURA 13- LUIZ OYAGAWA 14- VINCENZO PUGLIESI Presented on July 27, 2001 XI COPANI Convention of Panamerican Nikkei, The Roosevelt Hotel. New York, NY. BACKGROUND PLANNING AUGUST 25, 1992 Up to the present time, 2,867 Brazilian fellows have been trained in Japan in various specialities through the JICA, so that an Association of former fellows has been organized in Brasilia, Rio de Janeiro, Recife, S.Paulo, Belem, Curitiba and Porto Alegre. Over 500 former fellows were trained as medical specialists. However, the lack of an organization to share their personal experience after their return to Brazil promote a sense of isolation. In Brazil, cancer of the digestive system is the major cause of death from cancer, therefore, concrete measures are necessary. The creation of a recycling and exchange center with a nucleus of former fellows could result in important contributions, in radiology, endoscopy, pathology, epidemiology, etc. The “Hospital Santa Cruz”’with its excellent location is capable of involvement in such a project. It would be the Center for diagnosis, prevention and treatment of cancer of the digestive tract. The establishment of the recycling and exchange center is markedly necessary and important OBJECTIVES: Organize the former fellows of various medical/biological specialties that are scattered throughout Brazil, and carry out a pre training program that could respond to the need for an advanced, high qualify medical treatment. Realize meetings and periodic scientific workshops to promote exchange in medical research and technology problems. Organize the site and equipment for this purpose. The focus would be on cancer of the digestive system, but in the future it can be developed in other areas, contributing toward Japanese-Brazilian cooperation in biomedical research. LOCATION The project will be developed in the “Hospital Santa Cruz” Information regarding hospital size, structure and architectural project, etc, can be provided. Employ blueprints that will be useful for the project. Example: RESPONSIBLE COORDENATORS Project leaders: Dr. Tsuzuki, Okumura and Iriya Radiology... Endoscopy... Ultrasonography... COUNTERPARTS National Cancer Center: Dr. Keizo Suemasu (President) and Shaw Watanabe Radiology... (undetermined) Endoscopy... (undetermined) Ultrasonography.. (undetermined) EQUIPMENT (35.000.000 /yen/year) 1st year..... X rays 35 million yen 2nd year Ultrasonography and endoscopy 35 million yen 3rd year .....Angiography 45 million yen 4th year..... 30 million yen 5th year.... 30 million yen EXCHANGE PERSONNEL Three young physicians of determined specialties would go to the National Cancer Center as fellows each year. RECYCLING In order to complete the system of retraining (recycling) in Brazil, a specialist from the National Cancer Center would be asked to come to Brazil for a one-year period. EXPECTED RESULTS After returning from Japan, to their respective homes, the former Brazilian fellows will meet with regional differences in medical care and creating differences in technological aspects. Improvement in efficiency of technological transfer within Brazil and the promotion and diffusion of advanced and good quality medical care would be possible with the former biomedical fellows in Japan as a nucleus. Shaw Watanabe.