Two prominent environmental public health crises that occurred in Japan was the tragic Itai-Itai disease and Minamata disease. The former was due to industrial waste dumped in the Jinzu River, and chronic cadmium poisoning afflicted the residents from ingestion of the contaminated water. The most significant symptom was osteomalacia, which is the softening of bones from rapid loss of Calcium and excruciating bone pain. The government placed economic growth post World War II as a priority over the health of the public and the residents suffered for decades even after the source of the illness was identified. This was one of the first epidemiological studies conducted traced the environmental point source contaminant.

Minamata disease is caused by methylmercury poisoning and the route was ingestion of contaminated fish. The Chisso Cooperation produced chemicals and dumped the excess materials into the Minamata Bay which is what the local fisherman relied on for their livelihood. The disease manifests with neurological symptoms, numbness in extremities, general muscle weakness and is fatal. Minamata Disease was termed “dancing cat fever” as the cats lost coordination, walked erratically, and subsequently drowned in the Bay and at this time the citizens did not know the cause for this disease that plagued them. We had to opportunity to hear from a speaker who was born with fetal Minamata disease.  Nagamoto-san was a kind man, and shared his experiences while growing up such as bullying in school, and he was ostracized by peers. He told us about his work today as an advocate for equal treatment of those born with disabilities and people in society with rare diseases. There was a negative stigma surrounding Minamata disease because originally it was thought to be contagious, but the negative stereotypes continue to haunt the city. For example, people fear moving into the region or others fear marrying native Minamata residents.

The objective of this program is to understand how Japanese society, culture, history, and environmental influence human health issues. Public Health is a relatively new field (gained popularity due to the pandemic) and was established when urbanization occurred around the world in order to take care of health on a population level. Through the tours of the museums and storytellers, I was able to gain a deeper understanding of the complex interplay between the environment, anthropogenic stressors, and burden of disease on a population through an international lens. This trip strengthened my decision to pursue my master’s in public health.

The takeaway from these key public health events is to take preventative measures to protect population health. With the technology and knowledge, we have today it is crucial to protect the public’s health and have environmental control legislation in place to prevent such tragic incident from ever occurring. The Japanese government has since implemented stringent environmental controls to protect the public’s health. This is picture of us outside the Itai-Itai disease museum.

Cultural humility is an ability I strive to embody in my daily life. The world has many different ethnicities, religious background, languages and food (and other factors) that contribute to identity.  It is important to be accepting and open minded of cultural differences.  Whether you are traveling or just to school or work (etc.), we are all individuals with different experiences, thoughts and emotions that create the beauty we see in the world. The insights gained from interacting with people different from myself are important because there is a lesson or new perspective to learn from. It was so fun to meet with Azabu University and University of Tokyo students and I appreciate their openness and inviting nature. I attached a picture of one night when we got dinner in Tokyo. Everyone was kind and we were all excited to share and learn things about each other’s culture. In my opinion, life is about making bonds and from this study abroad experience I created memories and connections I will treasure forever.

Although people may have different physical features, eat different food, or speak different languages as humans we have language to communicate our experiences.  Communication one of the most important skills because it is essential to build relations and connections with others. At the beginning of the trip there were cross-cultural communication difficulties with the university students, but with patience, persistence, and (sometimes) google translate we were able to convey what we wanted, and we all got along so well.

Traveling, especially internationally, provides so many opportunities to adjust your mindset, and gain new perspectives if you try everything with an open mind. One of my favorite things about this trip (there were so many favorites) was observing the daily routine and local’s life. During our stay in Tokyo, we would religiously go to the 7/11 konbini to get breakfast or snacks. It was interesting to see people of all ages doing their daily routine, from young kids going to school, adults getting on the metro going to work, and elderly doing errands to start their day. There was a sense of peacefulness and I enjoyed staying in the Yoyogi area during our time in Tokyo. I also appreciated the time and effort all the restaurants would put into our food and it was all so delicious. It is a Japanese custom that no tips are allowed because workers take pride in their products and their professionalism and work provide high quality food and service.

This study abroad program is unique due to the nature of the program itinerary where we had the chance to travel to multiple regions of the country. Unlike other programs that focus the time within a city or one region, in our case, we saw the suburban and more rural areas while traveling via the Shinkansen. This journey was unforgettable. I am beyond grateful to experience so many aspects of Japanese culture, made amazing friends, and blessed to have had such hard goodbyes..

A major difference from American and Japan early schooling, is the focus on proper waste methods, and recycling. On May 23^rd, we visited the Hikarigaoka incineration plant which is 1 of the 23 plants that takes manages waste in the city of Tokyo. Japan’s limited land area means they cannot rely on landfills for waste disposal; thus incineration is the main waste disposal method. We learned about the various steps of the process. For example, the removal of harmful substances from the fumes created while burning trash, and the ashes from incineration are repurposed for other uses such as incorporation into industrial materials. This application aligns with reuse aspect (Reduce, Reuse, Recycle) and illustrates the deeply-rooted commitment in Japanese society to reduce wasteful practices, and protect the environment.

Furthermore, the lack of trash cans in public spaces is an interesting concept because it can be attributed largely to cultural norms and the efficient, albeit, complex waste management methods (and other factors but these two are most relevant). First, Japanese culture and norms place a strong emphasis on cleanliness, and personal responsibility. So to throw away trash in public spaces is not encouraged because the government wants citizens to be mindful of waste. Everywhere we traveled, starting Tokyo and ending in Sendai, it was prevalent across the prefectures that the locals take care of public spaces to promote a clean environment. Next, the recycle and waste sorting practices are strict and highly organized so public trash cans would need to align with this system, so cities reduce the number of public trash cans to encourage citizens to sort waste in their homes.

I have never considered the implications of having trash cans so readily available in society. An example that we as students at The Ohio State University can relate to is Thompson Library. Every floor has multiple trash cans and one thing I thought after traveling to Japan is how wasteful this is and what does this imply about values on a societal level regarding trash/waste. Single use plastics is harmful to the environment, but the ease of these plastics mean they are used very frequently. Their prevalence creates an enormous amount of waste, and some countries have taken initiatives to reduce such waste. But a key difference is the mentality and cultural norms surrounding waste. The capitalistic nature of America contributes to constant consumption, which leads to overconsumption of goods and subsequently wasteful practices. Whereas in Japan, reducing waste and utilizing resources as needed are both emphasized during early education in schools. In sum, both countries are developed, but differences in values between United States and Japan are: convenience versus efficiency (many public trash cans, and less prevalent public trash cans), environmental awareness on a societal level, and community responsibility to take care of public spaces (individualistic, versus community based society). On a side note, I did not know Tokyo was the number one most populous city in the world at 37 million, followed by New Dehli India at 32 million (World Population Review). After I learned this fact, it is even more amazing how clean the streets are of the most populous city in the world! This is a picture of when we were walking in Shibuya, Tokyo and one I like the green spaces in the city and two, the streets are clean!