Conducting a health check in rural Japan
By Laura Haapio-Kirk, on 22 August 2018
Earlier this month I was invited to help in an annual health check in a rural town in Kochi prefecture. I had wanted to find a rural comparative site to my main fieldsite of Kyoto, so when Dr Yumi Kimura, a researcher at Osaka University, invited me to participate in the health check, this seemed like the perfect opportunity to establish myself in a rural community. I arrived in Kikuyama* on a Sunday afternoon along with my research assistant, Lise Sasaki, and about 50 other researchers, students, doctors, and dentists. The five-hour train and bus journey from Kyoto ran alongside sparkling clear turquoise rivers winding their way through lush mountains.
We were first briefly taken to a scenic spot to view rice terracing; breath-taking luminous green tumbling down the mountainside. But that was the limit of our sightseeing; we soon got down to business. We were expecting to welcome about 300 people to the health check over the next five days so we spent that Sunday afternoon preparing. The health check was to take place in a large hall adjacent to the town’s health clinic. We set up distinct areas for different kinds of medicine and tests, including areas for dentists, cardiologists, gynaecologists, mobility and dexterity tests, dementia tests, driving tests, blood tests, and a space for general practitioners to give consultations at the end of the visit. The area where Lise and I were stationed featured a machine called InBody which we used to measure body fat and muscle percentage.
The machine works by running a small electric current via electrodes placed on the fingers and ankles. Over the course of the week, while we attached and removed electrodes, we had a chance to chat with people about their health. This was a great opportunity to meet a large number of people in a short space of time and to establish myself as a known person to this community. Many were very surprised to see a foreigner, and some even asked to touch my hair, telling me it was the first time they had seen someone with fair hair and skin up close. Given the hectic nature of the health check we were only able to have long conversations with a few people, most were limited to about five to ten minutes. However, we managed to get a sense of the topics that were most insistent and frequently occurring in relation to health: work, food, luck, and community. Identification of these key topics will direct my conversations that are scheduled during my return trip in October, when I am planning to conduct more in-depth interviews and also do filming. Without participating in the health check I feel it would have taken much longer to build up trust with this rural community, especially as a foreigner, but now we have many invitations to visit people in their homes.
I will save a longer discussion of the above mentioned topics for a blog post after my second visit to the site, but for now I will briefly explain why the topic of work appears so pertinent to understanding how health is conceived in this community. Most people we met were rice farmers or foresters, often still working well into their 80s. The foresters had extremely big hands which were often missing fingers, and the rice farmers were deeply tanned from spending their days in the fields. This is hard work which leaves its mark on the body, yet when asked what is the secret to staying healthy and energetic (genki) in old age nearly everyone said that daily work is key. Men and women appeared to be equally committed to farming, while all of the foresters were male. For some farming had been a life-long career, and for others they had taken it up after retiring from other jobs. While the physical nature of strenuous work appears to benefit the physical health of these strong elderly people, I am particularly fascinated by how the sociality of work affects people’s emotional and mental health. Farming requires communication, not only with suppliers and buyers, but also with fellow farmers about how to cooperate and to manage seasonal fluctuations. People also mentioned that they socialise with people who do the same work: a rice farmer will go and have sake now and then with fellow rice farmers in their association. The significance of work for health in later life appears to be about more than staying active or having an income, it seems to be central to maintaining a sense of belonging within a community. I look forward to further exploring this topic, along with the others, in the months to come.
Text and Illustrations by Laura Haapio-Kirk
*A pseudonym is used in order to protect privacy.