Counselor for A-bomb microcephaly patients to be assigned to Hiroshima

by Sakiko Masuda, Staff Writer

Can care be provided to patients nationwide?

A-bomb microcephaly patients, who were exposed to radiation in their mothers' wombs, are now 64 years old. In order to provide more support for them as they begin to grow old, the national government has laid out a policy by which it will assign a counselor for them to the City of Hiroshima starting next fiscal year. This is a partial response to the urgent request of the Mushroom Club, a group of microcephaly patients, their families, and supporters. At this stage the national government has decided that the assignment of the counselor should be carried out by the City of Hiroshima and has said it will merely subsidize the personnel costs. In that case, will microcephaly patients who do not live in Hiroshima get comparable, thorough care?

Aging patients, diverse lifestyles

In late July, the Mushroom Club asked Hiroshima Prefecture and the City of Hiroshima to call on the national government to assign a medical social worker to provide support for the A-bomb microcephaly patients.

The reasons behind their request are the aging of the patients, who will soon be turning 65, and a shift in those who provide support to them.

Three of the 18 members of the Mushroom Club lost parents this year. "The illnesses of the patients themselves grow more complex as they grow older. Meanwhile, as support of the patients shifts from their parents to their siblings, in some cases things don't go smoothly," said Sugako Murakami, 65, a medical social worker and professor at Hyogo University.

And the patients' lifestyles and the obstacles they face are not the same. Some of them are married, while others are living in care facilities. Depending on their circumstances, some require support not only with their health care but also with everyday activities such as going to and from the hospital and shopping. One patient had to be supervised around the clock for a while in order to prevent him from wandering off.

Because the families of the patients fear discrimination and prejudice, they tend to have few ties to their communities and are isolated, Ms. Murakami said.

She explained the importance of providing counseling, saying, "Health care and welfare services are complicated, and without specialized support it is difficult for the patients to make use of those services," she said. "A medical social worker with specialized knowledge and extensive experience can look out for the patients in every area of their lives."

In light of this situation, in its budget request for fiscal 2011, which was released in August, the Health, Labor and Welfare Ministry included an allocation of approximately 3 million in personnel costs for a counselor for the A-bomb microcephaly patients. Specifically, the proposal calls for the City of Hiroshima, where the most patients reside, to assign one medical social worker, and the national government will subsidize half of the counselor's personnel costs. The government will reportedly provide a detailed proposal within the year.

But welfare and health care policies and systems vary in some respects from municipality to municipality, and the Relief Division of the city's Atomic Bomb Survivors Relief Department has indicated that it will be difficult for one social worker to address the needs of all of the microcephaly patients in Japan. The division has stated that it would like to discuss this issue with the national government.

Can comparable, adequate care be provided to patients, who reside in various areas around the country? In late August members of the Mushroom Club visited the Health, Labor and Welfare Ministry and requested that a social worker be assigned at the responsibility of the national government. "The patients are victims of the war," said Naomasa Hirao, 47, executive director of the Mushroom Club. "In that sense as well, it is the responsibility of the government to address this issue."

The club further proposed that the government set up points of contact in Nagasaki, Tokyo, and other cities for patients residing outside of Hiroshima Prefecture.

"The assignment of a social worker for the microcephaly patients will be a breakthrough, and I hope better counseling services will be provided to all of the atomic bomb survivors as they age," said Ms. Murakami.

Woman in Osaka

Growing distress, no one to turn to

A 64-year-old A-bomb microcephaly patient living in Osaka has been hospitalized four times in the last five years. She suffers from congenital dislocation of the hip, and in the winter when she was 59 she underwent surgery in which a metal pin was implanted in her hip in order to make it easier for her to walk. Since then she has been undergoing treatment for an infection that developed at the time of the surgery.

Each of her hospitalizations lasts about six months. Most recently she was hospitalized in February of this year and discharged in mid-August.

In late September two visitors from Hiroshima called on the woman at the hospital in Osaka where she is being treated: Yoshio Nagaoka, 61, president of the Mushroom Club, and Sugako Murakami, 65, the medical social worker who provides support to the club.

Mr. Nagaoka, whose brother suffers from microcephaly, explained the background behind the Mushroom Club's request to the national government to assign a medical social worker. "If the social worker can provide care to patients throughout the country, things will be easier for everyone. We just have to make one final push," he said.

"I'd like you to help us think about how we can provide proper support for those who live a long way from Hiroshima," Ms. Murakami added.

The woman was exposed to radiation in her mother's womb 1.2 kilometers from the hypocenter in Tanaka-cho, now part of Naka Ward. At the age of 22 she moved to Osaka where she, her husband, and daughter live together and provide each other with support. The woman said her daughter suffers from autism and her husband has cirrhosis of the liver, which is worsening. "Here in Osaka, far from Hiroshima, even if I wanted to consult with the local government or other agencies, they don't understand microcephaly, so it's difficult."

The woman's repeated hospitalizations are costly, and she worries that she is a burden on her family. Family finances are tight, and the woman is also concerned about her daughter's future. She revealed that she has contemplated committing suicide when she felt that she could no longer bear her anxiety alone. "If there were someone I could talk to, it would be like a dream come true," she said with anticipation.


A-bomb microcephaly
Some unborn babies that were exposed to a heavy dose of radiation near the hypocenter of the atomic bombing early in the pregnancy were born with microcephaly. The circumference of the heads of individuals with microcephaly is smaller than normal, and they may also suffer from mental and physical handicaps. According to the Ministry of Health, Labour and Welfare, there are currently 22 A-bomb microcephaly patients in Japan. Thirteen of them reside in Hiroshima Prefecture with 10 of those in the city of Hiroshima. Of the others, three live in Nagasaki Prefecture, including two in the city of Nagasaki. There are two patients in Osaka and one each in Yamaguchi, Tokyo, Kanagawa, and Fukuoka prefectures.

(Originally published Oct. 18, 2010)

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