A New Model of Care Emerging from Kita-Yoshima, Fukushima

Akihiko Ozaki, M.D., Ph.D. Physician at the Medical Governance Research Institute

10 Years After the Disaster: A New Phase for Community Healthcare

Fourteen years have passed since the Great East Japan Earthquake. Iwaki City in Fukushima Prefecture, which felt the dual impact of the tsunami and the nuclear accident, has seen its population dwindle from over 350,000 to approximately 320,000 today—a continuous decline of about 4,500 people every year.

It has been seven years since I began working in Iwaki. At Tokiwa Hospital, often called the "Entrepreneurial Hospital," I have focused my efforts on "growth" as a keyword—striving to enhance breast cancer care and advance the education of young medical professionals.

However, the reality now facing local healthcare is not growth, but "contraction." We have entered a stage where we must consider how to manage a strategic withdrawal.

In the face of this turning point, what will sustain community healthcare?

The answer I have reached is found not in systems or technology, but in the "voices" and "expressions" of the people living there. Rather than healthcare shouldering the entire burden alone, I believe "care" can emerge from within local culture and human connections.

To realize this vision, I will launch a research project in November 2025, supported by a grant from the Toyota Foundation.

"The Third Form of Care": Beyond Medicine and Administration

The stage for this initiative is the Kita-Yoshima district of Iwaki City. Here, local women gather once a month for a luncheon called the "Kita-Niku Baba-no-Kai" (The Grandmothers' Club of the Second District). Since the COVID-19 pandemic, these women have been crafting sarubobo (amulets for warding off evil and ensuring health) and hanging peach-blossom dolls. At first glance, it looks like a simple handicraft circle, but a genuine form of "care" exists within that space. Someone calls out to another, roles are shared, and hands move amidst laughter. This time spent together prevents isolation and provides "lifestyle care" that supports the heart.

Furthermore, these activities have been supported by "Igoku," an Iwaki-based community project. This initiative, which connects people through art and expression, has garnered nationwide attention.

I believe that the efforts practiced by the residents and the members of Igoku in Kita-Yoshima hold the key to filling the "gaps" that medical and nursing care systems alone cannot bridge.

Redefining Care through "Narrative" and "Expression"

The themes of our research this time are "narrative" and "expression." For our study of narratives, we will utilize the "Fukushima Dialogue," a series of ongoing conversations between residents and experts since the disaster. These dialogues have recorded countless stories related to medical and nursing care, blending voices that speak of the limits of systems, anxieties regarding support, and hope.

By carefully analyzing these narratives—and incorporating interviews from Kita-Yoshima—we will illustrate how people have supported one another and survived. Furthermore, using these stories as raw material and themes, we envision a collaborative effort between residents, artists, and government officials to create various forms of "expression," including photography, handicrafts, video, and dialogue.

The ultimate goal is not necessarily to create a finished "artwork." It is the process itself that matters: through expression, people meet again, talk, and reclaim their relationships. This process, I believe, is the very essence of a new form of "care."

Toward a Society that Sustains Care as a "Culture"

Community healthcare in Japan, facing depopulation and increasing isolation, is reaching its systemic limits.

Instead of relying solely on systems and professionals, can we build a new "infrastructure of care" by embedding the power of mutual community support into the local culture?

I am committed to ensuring that this endeavor in Kita-Yoshima serves as a small but significant step toward a future where healthcare is sustained by the power of culture.

This article is a translation of Japanese MRIC published on Jan 7, 2026