On June 3rd, 2023, we had the honor of visiting the Tottori University School of Medicine, located in the city of Yonago in Tottori prefecture. We came for the purpose of linking up with the medical students and staff, to learn firsthand about the activities they are involved in and the goals they have regarding global and local health.

When we first arrived at the medical school facility, we were greeted by the Hakuna Matata team - a student organization from Tottori University. We instantly felt the warm welcome as we were ushered into a small auditorium filled with a few other students and staff.

After exchanging greetings, Dr. Anavaj Sakuntabhai gave a brief introduction on himself and Institut Pasteur, conveying the relevance of Louis Pasteur’s work and explaining his desire to create an Institut Pasteur facility in Japan. He also shared some of his aspirations for the future, such as supporting the youth of Japan in global health and science; he resonated with Hakuna Matata’s motto to “think globally, act locally”, sharing how he wanted to give the Japanese youth an opportunity to travel abroad and develop an all-inclusive, forward-thinking mindset but also encourage them to use the knowledge and expertise they gain to help their local communities.

There was a brief Q&A session after Dr. Sakuntabhai’s presentation, where many great questions were asked by the students. For example, one student asked about how to best incorporate people of different fields/expertise into global health. Calling back to the themes of cooperativity among people of different backgrounds, Dr. Sakuntabhai expressed the importance of not only listening to others but also of making the effort to know where they come from; in the case of people from different fields, this could take the form of learning the terminology associated with their field to make communication smoother. In addition, another student posed a question regarding life goals, and Dr. Sakuntabhai elaborated on how he focuses on short-term rather than long-term life goals. If the short-term goal is achieved, it will open doors to many great opportunities to choose from. He further explains that one should take advantage of the opportunities using intuition and passion, even though the option may be challenging; if one does this, it could lead to a better life and can inadvertently lead to the fulfillment of long-term goals. For example, for his Ph.D. program at the University of Oxford in the UK, Dr. Sakuntabhai’s research project was on finding a gene responsible for an inherited skin disease disorder. It was his short-term goal to find the gene and after much focus and hard work, he finally discovered the gene. This achievement opened up many opportunities in the form of research offers but he chose to work at Institut Pasteur in Paris on infectious diseases. This position, although challenging, led him to where he is now, which is much more than any long-term life goal he could have ever planned. From this experience, Dr. Sakuntabhai concluded that a life goal should focus on short-term actions and not long-term goals such as a job position or a financial goal, as the latter will come after the former.

After Dr. Sakuntabhai’s presentation, the Hakuna Matata team introduced themselves. Hakuna Matata was founded in 2001 and is comprised entirely of Tottori University students who are interested in global and public health. There are three main activities that the circle partakes in: meetings, overseas activities, and Komachi visits. The meetings take place once a week, where various international and public health topics such as HIV vaccinations and contraception are discussed. The overseas activities involve Hakuna Matata going abroad to countries such as Vietnam and visiting hospitals or NGO’s to experience firsthand the healthcare of other countries. The last activity, Komachi visits, is when the Hakuna Matata team visits a rural town with a population of 49 people called Komachi which is close to Yonago. The students told us they visit Komachi around 3-4 times a month to help with everyday tasks such as cooking and cleaning, develop personal connections with the residents, and spread awareness of local medicine within the community.

The Hakuna Matata team then presented their fieldwork in Vietnam. The team focused on the spread of drug-resistant bacteria, and the main objective of the trip was to hypothesize how this sort of bacteria spreads in Vietnam. They found that markets were very crowded and sanitary conditions were not enforced; there were dishes on the floor and previously used water in buckets that were to be used again for washing, and various meats, vegetables, and fish were sold outside in the heat with no covering at room temperature. There were also drug stores where antibiotics could be purchased without a prescription, which can lead to the overuse of drugs and the spread of antibiotic resistance. The team noticed that hygiene standards in Vietnam differed greatly from those in Japan, and they later confirmed that food safety management is enforced at a local level and not at a national level. Some questions they posed for further discussion included “how are unsold items stored?” and “where is food waste usually discarded?”

Dr. Sakuntabhai gave his own thoughts regarding the presentation topic, noting that Japan has an extremely high standard of food hygiene compared to countries all over the world; he speculated that perhaps the strict hygiene standards are taught and enforced in Japanese public schools, and the practices taught during childhood carry over into adulthood. He encouraged the team to explore why Japan has such high food hygiene standards and present the data/information they gather to Liaison in the future.

After listening to the two presentations, we set off for Komachi to participate firsthand in the Komachi visits activity. When we arrived, we were given a tour of the town, including a farm where cows are raised. Many farms raise cows for the purpose of consumption, but the farm in Komachi raises cows for breeding purposes, where calves are raised for 9-10 months before being sent off to other parts of Japan.

We then had an interesting conversation with Endo-san, a resident of Komachi who runs a farming business with his son. Endo-san told us about the farm work he does throughout the year, alternating between growing rice in the summer and leaks in the winter. Endo-san also raised concerns about the population issue of Komachi, as it has been halved within the last 30 years. The elderly population is increasing at a fast rate so the younger generations must work harder to support the elderly, but the increased time and energy spent working takes time away from having children and raising a family which further decreases the population, bringing about a vicious cycle of population decline. Although this issue is also happening in many other parts of Japan, he explains to us that Komachi also deals with the problem of its young residents moving out to find jobs or following friends who have also moved out, leading to a further decrease in the population. Although this issue cannot be fixed overnight, it is important to address for the sake of preserving small towns like Komachi in the future.

 

We ended the day with a large barbeque that included grilled chicken, vegetables, river fishes and even wild boar. We sat around the grill for hours, continuing to get to know the Tottori students and the Komachi residents; we could truly feel the strong sense of compassion and care for one another, and it was a great reminder to never neglect any community no matter how small.

All in all, our visit to Tottori was an unforgettable one, and we thank the students and staff of Tottori University School of Medicine and the residents of Komachi for hosting us! We plan on continuing to work closely with the students of Hakuna Matata and ensure they have the opportunities to travel within Japan and internationally for global health-related events.