Photo/Illutration Staff at a public health center in Tokyo's Ota Ward are busy responding to citizens on April 21. (Asahi Shimbun file photo)

U.S. Army Col. Crawford Sams (1902-1994), arriving in occupied Japan in the immediate aftermath of its World War II defeat to serve under the Supreme Commander of Allied Powers in East Asia (SCAP), had no illusions about the sheer enormity of the challenges he faced.

Mosquitoes swarmed and homeless children roamed the streets. But what shocked him most was the pervasiveness of smallpox and other infectious diseases.

As chief of the Public Health and Welfare Section of SCAP, Sams embarked on the daunting task of reforming Japan's "hokenjo" public health centers.

The nation had the centers from before the war, but they were nothing more than rudimentary clinics in Sams' eyes.

He started with creating a model health center in Tokyo's Suginami Ward. Explaining its function as a critically important public office tasked with providing public health services to the community, he had more such facilities established around the nation.

"But after Col. Sams left Japan, personnel and budget cuts were affected immediately," noted Toshiyuki Ojima, 57, a professor of public health and epidemiology at the Hamamatsu University School of Medicine. "There was much lament about the 'twilight' of public health centers."

Ojima once served as the director of a public health center in Aichi Prefecture.

But in spite of their perceived decline, health centers have made significant contributions in postwar Japan, including curbing tuberculosis and lowering the infant mortality rate.

More recently, according to Ojima, the 1994 revision of the Health Center Law turned things around.

Under its new name of the Community Health Law, it placed medical examination and health consultation services under the jurisdiction of municipalities, and precipitated the restructuring and consolidation of health centers.

The reorganization reduced their number by about half, and there are 469 today.

And now, with the COVID-19 crisis requiring them to find hospitals for infected people and carry out contact tracing for close contact cases, staff shortages have become a serious problem at health centers in urban areas.

Overwork has forced some front-line caregivers to take temporary leaves of absence. Others are said to be hanging on, though barely, with help from staff from other sections and retired workers who have been called back to service.

I can never thank these people enough for their dedication.

Perhaps this is the first time since the occupation era that public health centers have come to attract so much attention.

They are low-profile institutions in normal times. But right now, their value is appreciated most acutely.

--The Asahi Shimbun, Sept. 6

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Vox Populi, Vox Dei is a popular daily column that takes up a wide range of topics, including culture, arts and social trends and developments. Written by veteran Asahi Shimbun writers, the column provides useful perspectives on and insights into contemporary Japan and its culture.

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