The 1976 Ramon Magsaysay Award for Community Leadership

CITATION for Toshikazu Wakatsuki

Ramon Magsaysay Award Presentation Ceremonies
31 August 1976, Manila, Philippines

Japan today is thought of as a giant among industrialized states with an avid commitment to everything new. Yet, despite price supports for some produce, toward farmers and fishermen attitudes persist reminiscent of the feudal view--"neither let the peasant live nor die." Farmers, in turn, continuing to believe it is their lot to suffer, encourage their children to leave the land. An offshoot of this belief is that farmers often seek medical assistance too late for effective treatment; they are further deterred by fear of the profit motivation of many city doctors and hospitals.

TOSHIKAZU WAKATSUKI is that rare kind of person for whom backwardness offers opportunity. A graduate of Tokyo Imperial University, he was drafted into the Army in 1937 and assigned to Manchuria. Invalided out for tuberculosis after two years, he was later jailed for his socialist anti-war activities. Upon his release in early 1945 his revered professor Dr. Kikuo Otsuki found constructive obscurity for him as one of two doctors at a small clinic supported by a farmers' cooperative at Usuda, in the mountainous rice and fruit growing country of Nagano Prefecture northwest of Tokyo.

At this remote, very simply equipped clinic, WAKATSUKI, in 1946, performed the first surgical operation in Japan for tubercular spinal caries and organized the first blood bank. His goal became total health care to farmer families on a 5-3-2 formula: "five parts of our ability are devoted to care of inpatients, three parts to outpatients and two parts to outside-the-hospital medical care and public health and hygiene service." In over 150 papers for national and international medical journals and conferences he has shared his trials and errors in rural doctoring and his central finding: farmers' support can be gained by educating them to an awareness of their needs and by offering them high-level medical practice. In a popular play he elaborated his philosophy that a physician's true professional satisfaction comes only through honest and devoted service to patients.

In 30 years Dr. WAKATSUKI'S enterprise has become the 937-bed Saku Central Hospital in Usuda, with 60 fulltime physicians, 300 nurses and an equal number of other staff. Clinic and hospital branches are located in Komoro and Koumi. A new National Training Center for Rural Health--for doctors, nurses and dietitians--will complement the School of Nursing, the Institute of Rural Medicine--researching the environmental hazards of farmers, the Rural Health Study Center, and the headquarters of the Japanese Association of Rural Medicine.

More significant than these splended facilities--sponsored by the Welfare Federation of Agricultural Cooperatives of Nagano Prefecture-- is their pervading spirit. Visitors remark upon the easy camaraderie between staff and patients, credited by associates to 65-year-old Dr. WAKATSUK1'S conviction that "rural medicine should be social medicine." Increasingly, the movement emphasizes preventive medicine and "well aging." Indicative of community response is the Hospital Festival celebrated every spring by the 15,000 citizens of Usuda and their prefectural neighbors. Morning, noon and evening chiming of bells, and the organ of Saku Central Hospital playing the melodious "Together with Farmers," elicit lifted heads and smiling countenances from the country people.

In electing TOSHIKAZU WAKATSUKI to receive the 1976 Ram on Magsaysay Award for Community Leadership, the Board of Trustees recognizes his bringing to his country's most depressed citizens the highest type of technically competent and humanely inspired health care, thus creating a model for rural medicine.