No.2 Dr. Hideki Kobayashi : 20th Anniversary

Relay Messages from Japanese Peacekeepers

Relay Messages from Japanese Peacekeepers_No.2  Dr. Hideki Kobayashi(img)

<Photo> Medical treatment in Rwanda


Dr. Hideki Kobayashi(img)

Dr. Hideki Kobayashi

Commander of the SDF Central Hospital

Born in 1949 in Tokyo, and graduated from Tokyo Medical and Dental Univ. in 1976, Dr. Kobayashi joined the Ground Self-Defense Force as Lt. Colonel in 1990.
After serving as Surgeon and Chief of 3rd Dept. of Surgery of the SDF Central Hospital, he participated in the International Peace Cooperation Assignment for Rwandan Refugees as a medical officer in 1994.
Returning to Japan, he served as Chief of 3rd and 4th Depts. of Surgery of the SDF Central Hospital. In 1999, he was transferred to the Northern Army as Army Surgeon. He became Chief of Plans & Admin. Office of the Medical Dept. in the GSO in 2001 and was promoted to Major General and became Commander of the SDF Kumamoto Hospital in 2002. In 2003 he became Chief of the Medical Dept. of the GSO and Commander of the SDF Sapporo Hospital. In 2006 he was promoted to Lt. General and served as Vice Commander of the SDF Central Hospital. In 2010, he became Commander of the SDF Central Hospital. He is also a supervisory doctor for the Japan Surgical Society and the Japanese Society of Gastroenterological Surgery.
His hobby is collecting moths, and he is a member of the Japan Heterocerists' Society. He discovered a number of new kinds of moths, and some of them were named after his family members. As a moths doctor, he is travelling around Japan. He is a co-author of “Nihon garui hyoujun zukan” ( “Moth Standards in Japan” ) , published by Gakken.

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In 1994, as a medical officer of the Ground Self Defense Force, you (Dr. Kobayashi) participated in the International Peace Cooperation Corps in Rwanda, which was the first International Humanitarian Relief Operation under the International Peace Cooperation Law (Act on Cooperation for United Nations Peacekeeping Operations and Other Operations). In those days, more than 1.4 million refugees fled the neighboring country of Rwanda into Zaire (the erstwhile name of the present Democratic Republic of Congo), and you worked in Zaire. What did you feel about this assignment?

It was estimated that about 2,000 Rwandan refugees who fled into Zaire died daily. At the request of the then UN High Commissioner for Refugees Sadako Ogata, our Self Defense Force ( SDF ) unit was dispatched. But because it was the first experience for us to provide medical assistance abroad, we didn't know how to begin. We imagined that our tasks would be similar to that of an NGO or international organizations. However, we found out later that something much bigger was expected for us in the field, as we were the government entity. The World Health Organization ( WHO ) was also working in Goma (a city in eastern Zaire near the national border of Rwanda, where the SDF unit worked). Some WHO officers told us that expectations for government organizations were totally different. Unlike NGO s, we received various requests such as surgical operations, x-ray exams, and bacteria tests.

Arriving at Goma(img)

Arriving at Goma

I heard that many people died of cholera and dysentery. However, through our bacterial tests, only one or two persons were confirmed with cholera. Dysentery infection was very rare. The fact is that the local WHO office diagnosed those who died of watery diarrhea as cholera, and those died of bloody stool as dysentery. However, many of those people were actually infected with E. coli bacteria. Advanced medical assistance, which NGO s could not provide, was expected of our unit.

Although the Goma Hospital to which we provided our assistance had a building, it was almost empty inside. Nothing was equipped in the operating rooms and patient rooms. We provided items including anesthetic kits, medicines, blankets and beds, and employed local nurses and offered trainings. Also, for the sanitary survey, we donated various devices to the inspection stations so that sanitary engineers and clinical laboratory technicians could detect diseases like malaria by themselves.

Negotiating with the Goma Hospital staff(img)

Negotiating with the Goma Hospital staff

You worked in an environment completely different from that of Japan. What do you think were especially difficult and memorable in terms of health control of the unit members?

As I expected, AIDS was becoming an epidemic. In those days, AIDS was a fatal disease. The infection risk was very high; a local WHO office asked us to help them in this problem, and we made a manual to show how to deal with HIV infection.

One day, there was an exchange of fire, and a man with penetrated femoral artery was left in front of our camp in Goma. He was bleeding, and one of the medical officers stopped the flow of blood with his bare hand. By sewing the femoral artery in the camp, the blood flow was stopped and then the patient was sent to the Goma Hospital at night by the armed truck.

Under normal circumstances, blood is the easiest channel to get infected with HIV ; standard precautions should be taken and gloves should be put on. However, in this emergency case, we were not able to take such measures. Fortunately he did not get infected with it, but I felt regret.

Medical treatment at the Goma Hospital(img)

Medical treatment at the Goma Hospital

I guess that the things you could use in the field were limited. Were there any difficulties in this regard?

We considered the medical standards of Zaire before giving medicines there; we harmonized our medical service with that of Zaire. For example, we did not use powerful antibiotics which were not available there, because they could not provide the same sort of medical service after we left. Also, it was important to coordinate with Official Development Assistance ( ODA ) and Japan International Cooperation Agency ( JICA ) to ensure that the financial and medical assistance given by the private sector would be provided before we left the country.

One difficult experience was that occasionally we had to conduct surgical operations using local devices, although we took with us as many things as possible from Japan. There was a case that the gas container we brought from Japan was not connected with a local anesthetic machine, and we had to travel all the way to Nairobi and Geneva to find a substitute container. We learned that we need to take different types of containers from Japan.

What do you think about cooperation with non-military organizations working in the field such as international organizations and NGO s? Do you have any stories to tell about this?

Well, the roles of the SDF and NGO s are certainly different. When we visited a field hospital operated by the International Red Cross to provide our assistance, we were requested to install a wire fence and guard the area.

Although the SDF could be considered as a military force abroad, the Japanese domestic laws do not allow it to engage in such activities. What the NGO s expected of us was things such as security, transportation, and provision of materials. Unfortunately, we were legally prohibited from providing security. As for transportation, our tasks were already fixed, and we were not able to modify them according to the local requests. Also, provision of materials did not always go well.

It is true that as a government organization, we had more man power and materials than the private sector did. NGO budgets for security were limited, and therefore they wanted to rely on us for their safety. It would be best if we could fully respond to their requests. We tried our best, but it was not so easy to respond. From these cases, I strongly realized that NGO s relied on the SDF and we were not treated like NGO s.

Dr. Hideki Kobayashi(img)

Also, our unit was dispatched in response to the request of the UN . However, our assignment was a part of the International Humanitarian Relief Operation(stipulated in the International Peace Cooperation Law), and therefore we did not work under the control of the UN . We established a health program for the region, and then we asked the local UNHCR and WHO offices to conduct it. It makes a big difference whether you work under the UN peacekeeping operations or not. In the cases of UN peacekeeping operations missions in places such as South Sudan and Haiti, those missions operate under the UN control, so I guess what each member can do in the mission is limited.

How did this International Peace Cooperation Assignment in Rwanda affect your future career?

I joined the SDF as a surgical officer; I worked in a hospital and did surgical operations for cancer treatment. One day, I was informed about this assignment. I had no experiences of medical assistance abroad, nor did I expect to have any.

In these days SDF personnel are dispatched to various countries such as Iraq and Haiti. The SDF also forms the Japan Disaster Relief Team. It is clear that working abroad is part of the SDF 's job, and know-how has been accumulated.

I learned that not only the medical service within the hospital but also these missions abroad were the duties of medical officers of the SDF and our medical administration was diverse. I think I understood more about the medical service of the SDF . I learned that my job is not limited to surgical operations for cancer patients.

At the Goma Hospital(img)

At the Goma Hospital

A local staff member(img)

A local staff member

“Only the SDF can do it.” Is this a big thing?

To conduct our assignment in Zaire, it was necessary to build facilities and deliver x-ray devices, as well as to hire x-ray operators, clinical laboratory technicians, and nurses. I think these kinds of big operations can only be done by large-scale organizations like the SDF unit. It's probably difficult for NGO s to do more than put up tents and administer medicine.

The SDF unit is an armed organization officially dispatched by the government, so it must perform properly. Because it represents Japan, we want to hear something like “Japan is cool” and definitely not, “Japan is no good”.

There was an NGO based in Goma that built orphanages. One day, a nurse from this NGO visited us to see if a child accompanied by her could avoid amputating his leg. Before visiting us, amputation had been advised by a military medical officer of another country. His leg was badly deteriorated, and I first thought cutting could not be avoided. However, we kept washing his leg and removed the rotten bones gradually. One month later, his leg was cured. He was very happy, and I felt very proud of it. Episodes like this show how useful, and even cool, Japan really is. By showing the considerate character of the Japanese people and by working properly, I think we can be trusted, and that will be the advantage of Japan in the future.

Finally, please give your message to members of the International Peace Cooperation Corps and to those young people who want to work for international peace cooperation.

When I go abroad, I am aware of my country and the national flag. I mean that through the activities of Japanese personnel, Japan is evaluated. So, if we work properly as a representative of Japan, Japan will be highly appreciated. On the other hand, if we behave badly, Japan's reputation will be damaged. So I am naturally aware that I work abroad with the Japanese national flag flying over me.

The most important things to work on in the field of the international peace cooperation are health and language. We need to control our health. Taking a walk is just one example. As for language, we can't rely solely on body language, so it is important to try to remember a lot of single words. It's my hope that young people will work energetically as a representative of Japan, while improving language skills and staying healthy.

Mission completed; going back home.(img)

Mission completed; going back home.

Interviewed on April 23 at the SDF Central Hospital
Interviewers:Takuro Horikawa, Kiwako Tanaka and Seiko Toyama, Secretariat of the International Peace Cooperation Headquarters
Photographer:Takuro Horikawa, Secretariat of the International Peace Cooperation Headquarters

Back number :

No.1  Mr. Yasushi AkashiNo.3  Mr. Shigeru YotoriyamaNo.4  Colonel Toru NamatameSpecial Edition  Mr. Lou Oshiba

In “Relay Messages from Japanese Peacekeepers”, we look back on the history of Japan's international peace cooperation through messages delivered by prominent figures who are well versed in international peace cooperation as well as former members of International Peace Cooperation Corps in commemoration of the 20 years since the enactment of the International Peace Cooperation Law.