The Return of Obstetrics to the Island and the Arrival of a Brazilian Youth in the Housing Complex

Delivering people to places where no one is—how difficult can that be?

In Etajima City, Hiroshima Prefecture, obstetric services have returned for the first time in decades. Those wishing to give birth on the island will no longer have to travel to hospitals on the mainland by ferry and car. Meanwhile, in a housing complex in Kure City, which is experiencing an aging population, a young man from Brazil who speaks Hiroshima dialect has begun living there, bringing subtle changes to the daily lives of the residents. Additionally, in the same Kure City, local volunteers have initiated a program to support summer homework for children with foreign roots.

These three stories differ in location and subject. Yet, they all share a fundamental question: how do we deliver people to ‘places where no one is’? Goodwill alone cannot sustain this effort. Without a system in place, delivery is impossible. Let’s take a closer look at the components of that system.

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The End of “Pregnancy Checkups by Ferry”

Etajima City has a population of about 20,000. This island, floating in the Seto Inland Sea, has long lacked a permanent obstetric service. Pregnant women have had to take a ferry for about 30 minutes to hospitals in Kure City or Hiroshima City for checkups. If the weather is rough, ferries may be canceled. Since it is not feasible to board a ferry once labor begins, some women would stay on the mainland as their due date approached. The reality of “living on the island but not being able to give birth there” has persisted for years.

The establishment of obstetric services this time was made possible through collaboration between local government and medical institutions. An annual budget of approximately 30 million yen is anticipated for its operation. For a municipality with a population of 20,000, this figure is significant. However, the decision was made against the backdrop of the “invisible costs” brought about by unequal access to healthcare. Transportation costs for hospital visits, days off work, mental burdens, and the judgment that “we cannot have children here” have all contributed to population outflow—an impact that is difficult to quantify but steadily erodes the community.

Residents’ voices were simple: “Now we can feel secure.” Behind that one phrase lies years of anxiety. The existence of an obstetric service is not merely about increasing medical services; it is a quiet affirmation from the community that “it is okay to raise children here.”

However, challenges remain. Securing obstetricians is a nationwide issue, and the number of doctors willing to work on remote islands is limited. The establishment is not the goal; the real question is how to design a sustainable system. The continuity of the budget, the rotation system for doctors, and the integration of online consultations—structures that ensure the delivery of services must be questioned to maintain what has been established.

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The “Neighbor Across the Way” Who Speaks Hiroshima Dialect

In a housing complex in Kure City, residential buildings constructed during the period of rapid economic growth were once filled with young families. Now, many residents are elderly. Vacant rooms have increased, and fewer people pass each other in the hallways.

Into this environment, a young man from Brazil has moved in. One reason he was naturally accepted among the residents is that he speaks Hiroshima dialect fluently. Initially surprised by his cheerful “jakee ne” (a Hiroshima dialect expression), residents quickly began to treat him as “the neighbor across the way.”

What is noteworthy is that his presence functions not as a grand banner of “international exchange” but as a part of everyday neighborly relations. Confirming garbage collection days, passing around notices, chatting about the weather in the elevator—these small interactions are cumulatively creating a renewed sense of “human presence” within the housing complex.

The issues faced by the aging housing complex extend beyond healthcare and nursing care. Days without talking to anyone, feeling that one’s existence is unrecognized—this sense of isolation is more palpable in silence than in numbers. What he brings is not an exaggerated notion of “revitalization” but rather the simple fact that “today, I spoke with someone.” Just how much can that fact change a single elderly person’s day?

Of course, we must not place the burden of community issues solely on the goodwill of one young man. Here too, the question is about the system. Support for foreign residents to integrate into the community, language assistance, and securing housing—these structures are necessary to ensure that his presence does not end with a simple stroke of luck.

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The Walls Behind Homework

In the same Kure City, another initiative has begun. The “Summer Homework Support Project” targets children with foreign roots, where local volunteers assist children facing language barriers in their studies.

At first glance, it may seem like just helping with homework. However, there are structural issues folded within this effort. In households where Japanese is not sufficiently understood, parents may be unable to read materials distributed by schools. They may not understand the intent behind the homework. The Japanese in textbooks can be difficult. Moreover, there may be no one to whom they can express their confusion. Summer homework is a time when these everyday difficulties become most visible.

Volunteers must be high school students or older, which is an interesting design that involves the younger generation in the community. Those providing support also become aware of the diversity of their own community by interacting with children from different cultural backgrounds. This initiative functions not as a one-way street of teaching and learning but as a space where both worlds gradually overlap.

Last year, about 50 volunteers participated, assisting around 100 children. While the numbers may seem small, the fact that 100 children’s summer vacations changed means that the anxieties of 100 families have been alleviated by one measure.

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Common Structures in the Three Cases

The obstetrics service on the island, the Brazilian youth in the housing complex, and the homework support for children—when we line up these three stories, a common structure emerges.

All of them are stories about delivering people to “places where no one is.” And for those who have been delivered to remain in those places, individual will alone is insufficient. Budget, systems, and community acceptance structures—these systems support people, and people provide warmth to those systems. Without that cycle, none of these efforts will last.

Another commonality is that what is born at the destination is not a “service” but a “relationship.” The obstetrician and the pregnant woman, the young man and the elderly residents, the volunteers and the children—what exists is not a one-directional arrow of provider and beneficiary but a bidirectional relationship where each existence transforms the other.

When we talk about depopulation and aging, we tend to count the “missing elements”: the lack of doctors, the lack of young people, the lack of budget. While this is true, merely counting what is lacking will not deliver anything.

Creating a system for delivery. Preparing the soil for those who have been delivered to form relationships. And ensuring that the system itself is sustainable—these three cases are on that path.

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What to Watch Going Forward

Will the obstetrics service in Etajima continue to operate in five or ten years? Will the presence of individuals like the young man in the housing complex become replicable as a system? Will the volunteer homework support evolve into year-round educational assistance rather than just during summer vacation?

None of these questions will be answered overnight. That is precisely why it is meaningful to continue to pursue them.

People have reached “places where no one is”—what lies ahead is the time when those who have arrived and those who were already there create a life together. The system exists to protect that time.