This month’s Close Up features HANDS (Health And Development Service), which was established in January 2000 in Hongo, Bunkyo-ku, and has been active worldwide to promote the development of locally-based healthcare systems and human resources. Yasuhide Nakamura, representative of HANDS, told us about the organization’s activities and future plans.
Dr.Yasuhide Nakamura, MD, PhD
(Representative, HANDS)

Masashi Yokota, Executive Director,
and Miyako Shinohara, PR staff

We mainly develop and implement healthcare systems in various countries such as Brazil, Kenya, Indonesia, and Sudan. Our goal is to realize a society in which local people of developing countries are willing to take leading roles to protect their own health. To achieve this, we focus on helping create an environment where local doctors and nurses can perform at their best, rather than directly sending Japanese doctors and nurses to those countries and let them provide with medical services and vaccinations. It is our belief that by passing on techniques and know-how, fostering human resources, and establishing a system in which better healthcare services are provided, we can contribute to more people in the long run. Then once a good system is established and local people are trained to maintain it, they will be able to continue providing healthcare services by themselves without our direct help.

I was aware of the importance of the MCH handbook when I was working as a pediatrician at a hospital in Japan. However, I came to realize its true value when I lived in a country where no such handbook was available. From 1986 to 1988, I stayed in Indonesia as a maternal-child healthcare specialist for a project by JICA. I was seeing children in a village where no power or water system was established. One day, a 2-year-old child with cerebral palsy came to see me with his mother. I asked the mother what she may recall from her pregnancy, but she could not remember any answers to my questions. Without any records, I had no way to learn how the pregnancy progressed or even the birth weight of the child. It was the first time that I realized how inconvenient it could be without the MCH handbook, the availability of which I had never questioned when I was working in Japan. I thought my job of caring for children and their mothers would go much more smoothly if I had a health handbook in which all records from pregnancy, delivery, and growth of the child are kept together.
In most cases, medical care staff who visited Japan learned about the Japanese MCH handbook system, loved it, took it back, and introduced it to their home country. In some countries, local people came across the Japanese MCH handbook which Japanese medical care staff had brought with them, learned about their benefits, and tried to start their own version. For example, the MCH handbook in Thai was born in 1985, thanks to the effort of a Thai doctor who learned about the handbook during his stay in Japan. The MCH handbook has been introduced to many other countries and regions, including South Korea, Indonesia, Vietnam, Cambodia, Palestine, the state of Utah in the U.S., and the Dominican Republic. Each version has been designed and developed to meet local needs.
We recognize that our role is to support and advance such local efforts in developing their own MCH handbook. Specifically, we offer training in Japan and also organize an international conference whose goal is to build a global network of the MCH handbooks. We believe it is very important to have a place where people from different countries and regions, whether they are already using a MCH handbook or are trying to launch their own, come together and learn from each other’s experiences.
In November 2008, we successfully held the 6th International Conference on Maternal and Child Health Handbook in Tokyo, with help and support of so many people. We had about 300 participants from 16 countries and regions, and had a very productive time together by joining panel discussions and listening to reports on current situations of the use of the MCH handbook in each country.
MCH handbooks from around the world

Indonesian MCH handbooks with different photographs on front cover

Yes. They are all unique and different from the Japanese edition, and are very interesting to compare. For example, the Thai edition uses lots of colored illustrations to make childrearing look fun and enjoyable. Its baby food information page lists papaya, which I think is quite unique to the tropical country. The Indonesian edition uses different photographs on the front cover of different regional versions, such as for East Java and Kalimantan, which I think shows the characteristics of the multiethnic nation.
I never get tired of looking at different MCH handbooks from around the world, each of which is created to reflect local uniqueness. I call myself a MCH handbook enthusiast, and I am not the only one in the healthcare field around the world who is passionate about advocating the benefits of the MCH handbook. It is the network of those supporters worldwide via which the use of the MCH handbook has been spread to various parts of the world.
HANDS collects MCH handbooks from around the world, and they are available for display if we receive a request in advance. Parts of our collections can also be rented out as one of our awareness-raising activities to let more people in Japan know about our international cooperation effort. Our collections have been introduced to junior high and high school students in home economy classes. We also had a college student who wrote about the world’s MCH handbooks for her graduation thesis.

Yes, there have been cases in which Japanese local governments revised their MCH handbooks by taking a hint from other countries’ editions. For example, while standard MCH handbooks are designed to keep a child’s health record up to age 6, both Komaki City, Aichi, and Hitachiomiya City, Ibaraki provide a “Parents and Children Handbook,” which keeps the child’s record for a longer period of time, up to age 15 and age 20, respectively. A variety of features have been added to improve the usefulness of the handbook, such as a blank space for a personal message from a parent to a child, or encouraging information for fathers to participate in childcare. Unlike conventional Japanese MCH handbooks which are packed with plenty of information, newer versions tend to be designed more user-friendly with more pictures and illustrations. I think it is a true example of an international exchange that the MCH handbook, which was first created in Japan, was exported to and improved in foreign countries, and eventually returned to its country of origin.

MCH handbook of Palestine

MCH handbook of Indonesia
Many MCH handbooks from foreign countries are designed with lots of colorful pictures and are easy to understand
On March 1 and 2, 2010, we plan to hold a MCH Handbook Kickoff Workshop in Nairobi, Kenya. The event became possible by teaming up with Dr. Miriam Were, who received the first Hideyo Noguchi Africa Prize. We are expecting participants from around Africa and, of course, welcome participants from Japan as well! It is a bit far to travel, however.
We also plan to organize and provide various training programs, symposiums, and PR activities. We will announce updated schedules and other detailed information on our website.
Entrance of HANDS office
HANDS staff members who helped the interview