GINOWAN, Okinawa Prefecture—With the distant sea in the background, majestic buildings jut up from the base of a gently sloping hillside that was part of what is considered the world’s most dangerous military facility.

The buildings being constructed are for the Faculty of Medicine at the University of the Ryukyus and the university’s hospital.

The site, previously called the Nishi-Futenma residential area, is being transformed into the main health and medical center of Okinawa Prefecture.

The green 50.7-hectare used to be dotted with one-story buildings that served as residences for U.S. military service members.

According to the Defense Ministry, U.S. military facilities cover about 18,500 hectares of Okinawa Prefecture, or 8 percent of the prefecture’s land. That means Okinawa Prefecture hosts around 70 percent of U.S. military facilities in Japan.

Following a meeting of the Special Action Committee on Okinawa, the United States in 1996 agreed to return to Japan about 5,000 hectares of land used by the U.S. military, including the U.S. Marine Corps Air Station Futenma in Ginowan.

The Nishi-Futenma residential area was included in the 5,000 hectares.

The air station is considered extremely dangerous because it is located in a densely populated residential area of the city.

The owner of the Nishi-Futenma land had been considering redeveloping the military residences into luxury homes or even high-rise apartment buildings when the real estate was returned to Japan.

However, the governments of Okinawa Prefecture and the Naha prefectural capital in 2015 abruptly announced plans to create an “international medical center” on the site.

The area is large and will be returned ahead of other U.S. military sites located south of the Kadena Air Base, and the local governments wanted the Nishi-Futenma site to become a model case of how to transform a former U.S. military facility.

The landowner’s idea was pushed aside.

In 2012, the prefectural government under Governor Hirokazu Nakaima announced its first long-term promotion plan called the “Basic Plan for 21st Century Vision of Okinawa.”

The plan included the goal of making the prefecture a cutting-edge medical hub in Asia.

At that time, heavy ion radiotherapy, which is said to be more effective than X-rays and can treat cancer without surgery to remove cancerous parts, was attracting attention.

Based on that plan, the prefecture decided that the Nishi-Futenma area should feature heavy ion radiotherapy facilities to keep up with the times.

The buildings of the University of the Ryukyus Hospital, located in the Nishiharacho district beside the Nishi-Futenma site, were in need of repairs. The buildings were constructed in 1983 and often experienced water leakages.

In fiscal 2023, 22 of 42 national hospitals across Japan incurred financial losses, including the University of Ryukyus Hospital. It faced difficulties covering the repair costs on its own.

The hospital was asked about the possibility of relocating to the Nishi-Futenma area.

“If the Nishi-Futenma site will become the center of heavy ion radiotherapy facilities, there should be a hospital there to provide cancer treatments. So, we were asked if we wanted to relocate to the site. That was the first proposal,” said Yusuke Oya, head of the hospital.

The hospital relocated to the Nishi-Futenma site, even though the facilities for heavy ion radiotherapy were not built because of an expected worker shortage and low profitability.

The name of the planned facility was changed from “international” to “Okinawa” health medical center.

BECOMING A MODEL CASE

The closure and return of the Futenma air station has long been delayed due to local opposition and several problems at its planned replacement facility in the Henoko district of Nago also in the prefecture.

However, construction has proceeded at a quick pace at the Nishi-Futenma site, and the hospital is scheduled to open in January 2025.

The project site has received 120 billion yen ($800 million) in funds from the Cabinet Office, the education ministry, a subsidy from the Defense Ministry, and a government financial investment and loan program under the pretext of being a model case for transforming land used by the U.S. military.

The facility will house the first advanced critical care and emergency center in Okinawa Prefecture, as well as enhanced surgery and ICU rooms and a rooftop heliport for airlifting patients and medical staff.

In addition, residential homes for 1,100 people are being built around the new University of Ryukyus Hospital, along with 11 hectares of parks, greenery and pedestrian walkways.

Okinawa Prefecture used to have the highest life expectancy in Japan but it receded to 43^rd place for men, likely because of a lack of exercise and dietary habits.

“That’s why the Ginowan city government tried to make the area around the hospital building a comfortable place to walk,” Oya said.

The municipal government plans to leave the slope, castle ruins, spring water site, and forests as they are.

Okinawa Prefecture has been converting former military base land into large business complexes or mid- to tall-sized residential buildings, which tend to spoil the original landscapes.

In contrast, the Nishi-Futenma site has preserved its original features.

This blueprint might be used when the land of Marine Corps Air Station Futenma is finally returned to Japan.