My Views of the ‘Medical Care System’ Reform Issues. Recent Article in JBPress

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I am originally a medical doctor and have spent more than 10 years both in Japan and the United States practicing medicine. So naturally I am quite familiar with the health care system, think much about it, and am very concerned about the issue in Japan.

I am confident that I have been faithfully doing my job pointing out where the problems exist on this web site as well as in other forums, despite various complaints and criticisms thrown at me from authorities in Japan.  The effects of these discussions may not be easy to see, but I think they are starting to show.  A system reform is above all the development of human asset capable of adapting to a global era.

If you just search my web site by related key words, you will find many postings, and I have also published many books for common readers such as ‘University Hospital Reform (Daigaku Byoin Kakumei)’, ‘A Challenge to Japanese Healthcare Culture (Nihon no Iryo Fudo e no Chosen’, ‘Lessons for Medical Students (Igakusei no Obenkyo)’  (all books are in Japanese), to  name just a few, and I have introduced some more in my web site  (in Japanese).

The world has gone through a drastic change since the beginning of the 21st century.  Major issues of healthcare system today are: an aging society; increased chronic diseases, especially those related to lifestyle or adult diseases; expansion of the inequality of wealth particularly in the past 20 years due to the globalization of market and economy; and the rapid increase of country debt after the Lehman Shock.

What about Japan?  As the most rapidly aging society amongst the developed nations, we have many problems.

Although I intend to continue my effort to help promote the reforms of healthcare systems through activities and recommendations of our Health Policy Institute  or WHO there are lots of power politics occurring at the same time.  The many stakeholders (i.e. opposition powers) involved make reform a major political issue and this complicates how we address reform in developed countries.
 
Besides  reports and comments on my web site, my recent views are also presented in a book ‘E-Health Reform: IT to Change the Future of Japan’s Health and Healthcare (e-Health Kakumei:IT de Kawaru Nihon no Kenko to Iryo no Mirai)’ (in Japanese), an interview, and on-line publications such as JBPress.

Please take a look when you have time.

In this context, I think the Twelve Ideas developed at the Symposium by Swedish Medical Center (SMC) in Seattle in October are worth noting.

How do we implement these political process is the next question. The book I introduced to you before would be a good guide.

Unless we rename “Medical care system” (Japanese word for “Healthcare system”) by adopting something that more accurately describes the problem like, “Health and Healthcare policy” (Ref.1), I think executing good reform that addresses the actual needs of our society will be really difficult.

The naming of policies is important.

Recommendation for Taking a Leave of Absence from School, AIESEC: An International Internship Support Organization, Support from a High Official of the Ministry of Education

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Japan’s insularity or closed mindset is now becoming so evident that we can no longer wait for social structure reform to resolve this problem.   Many media reports as well as opinions from various fields in the society continuously point out the seriousness of the Japanese closed, insular mindset.  This problem, however, is not new at all.

This way of seeing refers not only to the youths, but as well as to the adults.  While many intellectuals point to the students as being inwardly focused, I believe that parents have a strong influence, and therefore should be held accountable for passing on these unprogressive mindsets.

As Japan grew in economic strength and prosperity combined with the publication of  'Japan as Number One' , National pride also grew. The baby boomer and subsequent generations accustomed to this status had to adjust their attitudes into a more defensive stance as the Cold War ended in 1991 followed by the Japanese economic bubble bursting in 1999.  Not to mention the advent of the internet, globalization, a dynamic restructuring of 14 city banks, the bankruptcy of Yamaichi Securities, a skyrocketing national deficit and stagnating GDP.

Therefore, I suppose, current college students grew up without being given any sense about a positive economy. (in Japanese)

All of the things I’ve said so far are the same as what I have written here so many times.

For a change, let me introduce you to some examples of the wonderful activities of college students who took leave of absences from school (Ref.1,2,3,4,5). 

And here is my small report on AIESC, an international internship network run by college students.

However, I regret to say that there are millions of obstacles that must be overcome in order for these kinds of activities to flourish.  For example, in many private universities, they charge various fees of students even on leave.  From my point of view such conduct is deplorable.  Being supported while traveling and experiencing the world is taken for granted in other parts of the world. Such attitude makes Japan’s unwillingness to encourage international experience that much more evident. I ask all university related persons to be quick in crafting ways to stop these kind of disgraceful procedures.

Staggering economy is bad enough, but with high education fees combined, I must say that Japan is a nation that neglects future human assets.  We cannot expect any positive future for a nation like this.  Not only university administrations but Japanese government will also have to do a better job .

Just recently, I had an opportunity to see Japanese students from AIESEC Japan (sadly, this site is only in Japanese…), a Japanese branch of AIESEC the world wide student run organization working to promote international internships.  Now, we are trying to find how to empower their activities, make this organization known to people, to gain support.  Of course it goes without saying, companies will also gain a variety of great merits by providing support to such students’ activities.

If the website of AIESEC Japan is written in English as well as in Japanese, their activities will contain broader perspectives.  For instance, not only can they send students abroad, but they will also be able to offer international students internship opportunities at Japanese companies.  The problem is that the current system fails to take into account the needs of the counterparts.  We discussed this issue also in specific manners.

Recently a high official at the Ministry of Education (I won’t say the specific name) who I have once worked with started a blog (in Japanese).  From his blog I could see how he supported my ideas, or is helping students in his own way (Ref.1) ( both links are in Japanese).  I was thrilled to discover this.  He also gave a wonderful lecture (in English) at a recent meeting (in Japanese) that included much of his own thoughts. I was told that the lecture was well received by the audience for its originality and strong message, all very unlike typical government officials.  I would like to express my sincere gratitude to this official for supporting my views.

I am aware that there are many more people who understand and support my ideas besides people in the Ministry of Education, but on a whole, it seems that making policy takes more than understanding.  I do understand that there are many reasons and conditions particular to the posts they are in.

It must also be understood that another problem lies in the fact that educators in junior high schools, high schools, or universities are far from doing their best in nurturing talents for the global age(Ref.1,2, 3 in Japanese), (Ref.4,5 in English).  We must not forget that the trends of the world moves rapidly.

As for the argument on whether it is good or not that active officials write a blog, I think there is nothing wrong with it because the blog is a tool to express personal views.  It’s a way to interact with a diverse community, and besides, what they write on the blog is far from being a secret.

Keio SFC Class, Welcoming Two OGs

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For our Shonan Fujisawa Campus (SFC) class on November 17th, we welcomed as our guests two OGs of SFC: Ms. Maria Yogo and Ms. Naoko Tajima.

Ms. Yogo is working at Khalifa University in Abu Dhabi where I also serve as one of the board members.  She just arrived to Japan yesterday evening.

Ms. Naoko Tajima  is a young director whose current works are mainly TV commercials.

At the start of class, we played her portfolio reel, a short film that summarized her works. Watching her work created a nice atmosphere in class. .

Their self introductions impressed us by their very unique, difficult to imagine, careers.  With their aggressive, animated spirits and talents to make things happen, Ms. Yogo and Tajima are moving forward very steadily.

I am certain that their exciting narratives provided every student with inspiration and something to think about.

Good responses were also sent via twitter during the class.  Such a simultaneous, live, class makes it possible to share a good time together.
 
Because these two female guests followed last week’s SFC seniors, their stories appealed that much more to the students’ sense of reality.

Please enjoy their full stories on this video
 

The Power of Words, A Leader’s Power to Sense, Judge, Understand, and Reason

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Since seeing Mr. Kurihara of the Harvard Kennedy School this May I’ve written several columns about him.

Since then I try to see Mr. Kurihara every time he comes back to Japan.  He is a wonderful person of broad topics, and global thinking with a sophistication based on broad readings including history, philosophy, and literature.  He is also a rare person (a true human asset) who is capable of seeing Japan from the outside, thus has the ability to see the fundamental principles of our country.  Talking with him is thrilling because he introduces me to many perspectives that are seen from fields which are not mine.  

So, when he came to my office again the other day, time flew by and we could not help but talk for nearly two hours.  As you may know from my posting, he issues a periodical titled the Cambridge Gazzette (in Japanese). He kindly commented on our meeting in this yeat's final edition that features  power of insight and words.

His writing was again surprisingly dynamic, telling stories accompanied with rich references from books and articles about his friendships, human networks, historical views, and about how Japan has truly talented individuals on the one hand, and has fickle, intelligent idiots who mislead this nation on the other.

If you closely look at the current situation of “Sad Japan” you would inevitably notice that it basically has not changed, or rather, was incapable of changing, at all.  I am truly impressed with the huge volume of Mr. Kurihara’s readings not to mention his rich connections with people as an independent individual. His talent to assimilate a large body of information into one piece of writing and his huge knowledge from many layers of culture coupled with his eagerness for investigating different topics are most impressive. The process in which he thinks about the things is admirable.

At any rate, I have to say that the comments made by leading Japanese are the strangest of all.  Admitting that they have any extent of knowledge or information, they still do not have the ability to seize upon the principles and essences of things. Instead, their words sound uninspired and do not connect to the hearts of the people. I am quite concerned and saddened by this notion recently.  These leaders always have scripts in their hands when speaking, and they fail to convey their own will or thoughts by looking directly into the eyes of their audience. What is probably true is that they hold no confidence or genuine belief in what they are conveying. They do not have a good grasp of history or for any other topic for that matter, though I assume they made decent efforts for high scores at the university entrance examinations.  I feel obliged to say that everything from their policies to their discussions and work is shallowly conceived, despite the volume of knowledge they have.  These greatly respected individuals, don’t recognize how tragic they are; they only make excuses for their inabilities to step outside of their comfort zones and truly inspire the people who look to them for solutions. 

I also agree very much with Mr. Kurihara’s citation regarding Hirofumi Ito’s English ability.  However, I tire of persistently hearing the worn out discussions on policies for English education in Japan in this global age.

Today, facial and other expressions are clearly depicted on high resolution television. So I am even more convinced when I say that I cannot recall hearing insightful words that are spoken from the bottom of one’s heart, either from legislators questioning at Congress, ministers, high officials, distinguished professors, executives of companies, or so called journalists.

I think people of Japan share this feeling with me, too.  I am truly concerned and sad about the disgracing television programs, newspaper articles that originate from kisha club, and the meaningless words uttered by television people (all in Japanese language….)
 
Words are indicators of mental power and intelligence (not knowledge).  Since we cannot see inside people’s hearts we have to depend on words to judge the depths and broadness of one’s character, and their personality.

Mr. Kurihara is one of those people who has the sort of intelligence and heart that is lacking in Japanese intellectuals today.  He doesn’t let this show to many.  So, I am looking forward to seeing him again to partake in an enjoyable intellectual battle.

 

Exciting ORF2010

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Keio University’s Shonan Fujisawa Campus (SFC) presented the Open Research Forum (ORF) 2010 on November 22nd and 23rd at the Academy Hills in Roppongi during the Mita Festival, the Festival at Keio Mita Campus.  I participated in ORF2009 last year as well.  In comparison to last year’s this year’s atmosphere and student participation in displays and performance was much better and larger.  I enjoyed interacting with the displays and listening to the student-creator’s explanations for their projects.

Coincidentally, a book by Dr. Shigeru Nakanishi, Genealogy of Heresy (in Japanese) was published, and I was inspired to read how Keio SFC produces so many unique talents, entrepreneurs, and the like.  Equally wonderful is that professors spend such a large amount of time with and for the students that they’ve structured a system for students to teach each other.  The speech by the first Dean, Dr. Hiroshi Kato, at the first commencement ceremony was stirring, with words full of love and encouragement.  I was awed to read both about the devoted faculties and the active students.

It was a privilege to see Dr. Hiroshi Kato, the leading figure in the foundation of SFC, again after a long time

At the ORF2010 I participated in the last panel on November 23rd, ‘Considering the Future of KEIO and SFC’s Direction’ with Dr. Rakutaro Kitashiro, Hiroshi Fujiwara, and hosted by Ms. Maria Yogo, a graduate of the first class of SFC currently working in Abu Dhabi.

People expressed various opinions(in Japanese), but I think we agreed to wrap up the session with the recognition of necessity for SFC to expand its international exchange with overseas students and faculties.  My point was, as always, to recommend students take a leave of absence from school in order to see, hear, and sense the outside world first hand.

At the reception after the event, I had the impression that our session was well received by many.  The challenge now is to establish and cultivate action based on our opinions. 

A Meeting With Dr. Margaret Chan, Director General of the World Health Organization (WHO)

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Dr. Margaret Chan (Ref.1) visited Tokyo after attending a meeting at the WHO Kobe Center.

For about thirty minutes 4 staff members of our Health Policy Institute who specialize in Global Health  joined me in exchanging opinions about Global Health with Dr. Chan. I’ve had many chances to see her in the past (Ref.1,2), but I was particularly thrilled to see her this time because it had been such a long while since the last time we had met. Dr. Nakatani, one of the Assistant Directors of WHO, accompanied by an official from the Ministry of Health, also joined us.

The topics of our discussion covered issues such as Global Health, the meeting at the Chatham House, the number of increasing patients suffering from chronic diseases, social determinants of health, the Davos Meeting that will be held next January, and so on.

I think this meeting with Dr. Chan, the top female leader of WHO, was an exciting experience for our young staff.
 
Providing opportunities for young professionals to interface with the leaders of the world in person is very important and meaningful.  It is a very stimulating experience, one that will encourage our young generation to set higher goals for themselves.
Asking questions such as ‘What’s the point in trying to become the best?’ is irrelevant here.  People work harder when they see higher goals.

These important interactions serve as the seeds of ASPIRATION within the hearts of youth. 

Welcoming Mr. Ryoji Noritake to My Keio SFC Class

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My Keio SFC class.:  On October 27th we welcomed Mr. Ryoji Noritake, a wonderful individual doing a great job at the Health Policy Institute, an NPO in which I serve as Chairman.
 
Mr. Noritake is an alumni of SFC, class of 2007.  After graduating, he joined our Health Policy Institute Think Tank and has since been working actively in fields like, measures for cancer, cancer and brain stroke patient support ,  programs to nurture leaders of patients, and so on.  These programs have produced many results that will positively affect the health care industry.  As he persists in leading these diverse activities, he is gaining invaluable experience as a great leader.  He has become one of the most indispensable members of our institute.

Because he is an SFC alumi, I think Mr. Noritake was able to connect with the students even better. The students related with him more because he was their senior and because of his sharing of many moving stories.  

Among those stories, I was impressed especially by the one regarding the World Trade Center terrorist attack on September 11, 2001.  He was studying at Oklahoma University at the time.  He spoke about the reactions he observed of the people around him, and how he was moved to witness for the first time the power of words beyond his imagination.

In this course I aim to have students understand the importance of moving towards the global age, and to provide them opportunities to listen to the real world stories of people who are qualified enough to be their role models.  Such inspirational narratives, because they are true experiences, have power to move youth, to make them want to emulate or pursue similar careers .

Jiro Shirasu (in Japanese), is one of my favorite historical characters. He was a politician, whose career covered the early Showa era.  I wrote several articles (Ref.1,2,3,4 in Japanese) (Ref.5,6 in English) on him on this web site.   

Mr. Shirasu’s post-World War II work in Japan is just remarkable.  He studied at Cambridge University, and became a true ‘English Gentlemen’.  There are several books about Mr. Shirasu published, but he is more generally known for his philosophy of Principle (the fundamentals, essence, of things…) as well as for his countless piquant episodes.  I haven’t seen many true gentlemen like him around recently …
 
There is one collection of the essays by Jiro Shirasu titled,  ‘Japan: A Nation Without Principle’.  I purchased it at ‘Buaiso’ (in Japanese), his former residence.  In this book, there is a line that says something like ‘Education is about whether the teachers are practicing in real life what they teach…’  This is, in my view, an important ‘Principle’, especially in higher educations.  I remember nodding here and there as I went on reading.

Similarly, the stories that Mr. Noritake told in class clearly illustrated the importance of experiencing the world at an early stage in one’s life.

Thank you, Mr. Noritake, for giving us such an inspirational lecture.  I am confident that many of your juniors learned and sensed something important from your stories.

GEW2010@GRIPS, Communications in Broken English

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I reported about the Global Entrepreneurship Week (GEW) several times last year (Ref.1).   This year, the event is being held from November 15th to 20th and 100 countries from all over the world participateA variety of GEW events will be held in Japan, too.

My home institution, GRIPS, collaborated with Nikkei Newspaper to focus on Design Thinking. On Tuesday, November 16th we invited young professionals with the entrepreneural spirit who were working actively at places  such as TEDxTokyo, D-Lab Japan (in Japanese) , See-D, Soket, and Kopernik (in Japanese) to gather at GRIPS in the for a practical Workshop.  The event started at 7pm and all participants quite enjoyed it for 3 hours.

The guests included many young, hot ‘role models’ of entrepreneurs such as Mr. Kota Matsuda (in Japanese), current member of the House of Councilors and the founder of Tully’s Coffee, Japan (in Japanese), Mr. Kohei Nishiyama of Imaginative Life (cuusoo seikatsu) and Elephant Design, and Mr. Magnus Jonson. 

Other events for this weak are planned and organized by the initiatives of Impact Japan.

These activities are part of an ongoing process ? a 24hours a day, 365days a year of effort -  of connecting the activities of young innovators, of people who’s creative thoughts and actions drive society into new directions. This conference introduces them to worlds beyond Japan or their native land, expanding their networks and perspectives. Although the internet is a strong connective tool, it is just as important, if not more, to share time and space with others who pursue common values and dreams. The internet in combination with these conferences expand possibility of expanding in multiple orders, not just additional ones.

I ask you to support them.  I ask that you help to cultivate future paths for youths. They are the fundamental structure and basis for the future of our Nation.

By the way, the communication tool during this event was broken English. There were no interpreters.  Everyone did a splendid job in making themselves understood.  Yes, you can do it!  You were all truly wonderful.

As Serbian IT entrepreneur, Sinisa Rudan put it: "We are taught to take business rationally, to focus on profit. However, I suggest that if you feel a particular project is good for you ? even a non-commercial one ? take it, because it will advance your skills or expand your network, possibly bringing you other, more-profitable projects. Choose projects you love. Do your business from the heart, and business comes to you!" (Quote from GEW website, http://www.unleashingideas.org/)
 

 

 

Dr. Muto’s Challenge: Building Ageing Community Healthcare

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In Japan and other developed countries, the conventional healthcare system is facing its limit because of continuing expansion of the aging society, chronic diseases, and the limited public funding for healthcare(ref.1). 

I have been speaking on this issue for some time (the most recent articles  (ref.1:in Japanese)include), I’ve made policy recommendations, urging people to take action, but things are not moving as I hoped, because, I suspect, of oppositions from the conventional interest groups.

However, there are some people who are starting to take action in their own way to make change.  One example is Dr. Yu Muto.

Dr. Muto spent 10 years or so as an established medical doctor. But he left his career in hopes of achieving higher goals. During this departure, he worked outside medical practice for a couple years.
After this experience, he launched an innovative, urban-style community medical practice.

I was deeply impressed to hear Dr. Muto after he started this clinic.  He said, “I left medical practice to search and explore my life work.  As I resumed my work as a doctor in this city of an aging population, I now feel from the bottom of my heart that this is truly what I have wanted to do.” 

Dr. Muto and I had a dialogue (in Japanese) recently, and it is on his website. 

His words reflect his truest feelings. He is following his dream. This is the beginning of something wonderful.  I congratulate him wholeheartedly and will support him in anyway possible.

Learning by Taking a Leave of Absence and Going Abroad: An E-mail From Ghana

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Do you remember a student I introduced on this site some time ago who took a leave of absence from school and went to Ghana?(ref.1).  The purpose of his visit was to participate in an AIESEC program in Ghana. AEISEC (Japan Office) is a student-run organization from more than 100 countries that focuses on creating youth leadership development, offering young people opportunities to be global citizens.  This particular student sent me an e-mail from Ghana. After staying in the capital, Accra, for about 10 days he described what he saw, felt, and learned as being much more than he expected.

After sending me this message, he traveled to the northern parts of Ghana and stayed there for about 3 weeks. He returned to Accra and sent me another e-mail.  I could sympathize with his long silence, since I too, while traveling in Ghana(ref.1,2), had a difficult time finding internet access, even in first-rate hotels.

His e-mail was as below:
●I spent some time at a rural village located in the northern part of Ghana and am now back to Accra.  I chose to go to this village because I wanted to learn more about Ghana, and a farming village seemed to be a good place to see the poorest part of this country.  There, I started to observe distant affects from our development aids which I would not have known had I not gone to this place in person.

●I assumed this village to be highly dependent on the aids from the NGO, since I was told that this village was poor, even by Ghana’s standards. However, they were apparently self-sufficient people.  They hunt chickens running around in the village, grow corns, yams, vegetables, beans.  They are not at all in hunger.  When they need cash, they get them by selling things to passengers on the buses that stop by their village occasionally.  Men do not seem to have particular jobs, they love to play board games, or just hang around all day.  Women, on the other hand, appeared to be busy farming, cooking, doing laundry…

●There is a primary school in this village, but since only two teachers are taking care of all 6 grades, their workload seems to be very heavy.  The fee for school seems low, but even so, some children were not attending.  Financial excuses were not so much the explanation for not attending school as the need of parents for domestic labor (mostly doing laundry).  As a foreign person, I worried about their lack of education, since I had been taught that, ‘if you don’t learn English, your perspective of the future will be very narrow, and you might end up staying in this village your whole life’. But this anxiety seemed to be pointless to them. For them, they probably figured understanding the local dialect would be sufficient for their long tradition in living a self-sustained, local life in their village.

●The most shocking of it all was to feel that the activities of the NGO that was so instrumental in my travel, was not so appreciated by the villagers. This NGO is run solely by the money of its founder.  The salaries of the local staff also come from the founder’s pocket money.

●This NGO is working to support developments through agriculture, and is currently focusing on rice planting.  Their plan is to get the villagers involved in this effort.  So, they are donating used tools, giving text books and providing uniforms to village school.

●I was impressed with the volume of the donation and support, but, strangely, no one in the village seemed to be truly thankful of the NGO.  Rather, their attitude implied a stance of ‘It is not because we are in need, but because they offer it us that we accept their aid’.  Maybe this lack of appreciation is due to the fact that this NGO is run by its owner’s pocket money and so the support is given according to the needs that he perceived from from an outsider’s viewpoint.  In other words, he gave what he wanted to give.  In a way, he did not try to understand the true needs of the villagers, or try to support them as one of the foreigners.  Actually, whenever I talked to local NGO staff or villagers and said ‘I think our NGO is doing a great thing!!!’, all I got in return were smiles, not agreement.

●Through this observation, I strongly felt the difficulty of giving support to the people with respect to the values they live with.  It is easy for us, people in developed countries, to point out the ‘needs’, as we see, of the developing countries.  The lesson I learned was that whenever we seek to build relationships with developing countries, we must always be careful not to become ‘preachy’.

●Another thing I noticed by staying in Ghana is that African people do not think ‘being different’ is a bad thing.  In Japan, if someone can not do things as you do, the most commonly heard comment is; ‘You can’t do even this?  What a shame.’  If someone is not capable of doing things that you can do, then you take it as their failure because you think they should also be good at what you do.  In short, we see what is different from ourselves as being not good. However, during my stay, the Africans were very kind to me.  They always tried to find cool tree shade for me, and cared much about my appetite.  ‘You are Japanese, you come from where food and climate are so different’, they said, and treated me, a foreigner, with respect to the differences that I hold.  They never made me feel bad because of I was different from them.

●So, as for the ability to accept different values, and the ability to build relationship with respect to those differences, I came to think that Japanese is far behind African people.

I was happy that this student sent me such a long e-mail to share his thoughts with me.  Although I trust that many ODAs are aware of such issues and they take them into considerations before putting their plans into actions, there is still much to be done in terms of understanding the value of local people, and the way they feel about our aid.

Regarding the activities of ODA, Dr. Toshiharu Yamamoto provides lots of good information and also points out many local issues in his blog.  Here, I found many observations similar to the student. In my mind, what really counts is whether or not you have been to the country, whether you have a sense of that place, and whether you will take actions.  It is by these measures that you will be judged in the future.

Going to the area and having first hand experience during early stages of your life, such as this student did, can be very helpful in the process of building your career.  Of course, you could choose to go through tons of research before you go and I wouldn’t deny the importance of ‘careful planning before taking actions’, but quite often, excessive prudence ends in inaction ? that is, with nothing being done.  It seems to me that the power of putting things into action, as this student demonstrated, is hopelessly lacking in Japan today.

There is more value than you think in lessons you gain through actions, and I recommend actions particularly to the young generation.  Understanding the local situation by being on the site and having your senses refined is not something you acquire overnight.  I am confident that this student will continue to grow, because through this experience the way he sees the world has changed, his point of view has become much broader, and without doubt this will work positively in his search for his dreams and in his efforts toward his goals.

A week after his return to Ghana, this student sent me an e-mail saying, “In just one week I came to feel that I became friends with so many people, that I am connected, and the world is going to change.  I am filled with so much wonder.”

With telecommunication technology ?e-mails, cell phones, and websites ? you can sense the powerful connectivity.  Indeed, today, this world is one world.