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NATIONAL REHABILITATION CENTER FOR DISABLED CHILDREN

Seishi-Ryougoen Institute for physically disabled children

Murasaki-Aiikuen Institute for severely and multiply disabled children

Gairai-Ryouikubu

Outpatient Clinics and Day care center for disabled children

1-1-10 Komone Itabashi-ku Tokyo 173-0037 Japan


Tel: 81-3-5995-4511 Fax:81-3-5995-4515



FUNCTION AND SERVICES

Our center is a very comprehensive institute for children who have various types of disabilities. We provide our patients with diagnosis assessment and
medical care. We are one of the largest centers for orthopedic and neurlogic care in Japan. The main plans for this center are determind by the the
Ministry of Health, Labor and Welfare. The Japanes Society for Disabled Children has the responsibility for general operations.

Our center is consists of the following sections;

1. Seishi-Ryougoen:
This institute is for children with physical disabilities. The section consists of three "blocks". The first is for orthopedic surgery and post operative
training (about
thirty-six beds). The second is for nursing and rehabilitation care for children with impairments of the brain (about thirty-six beds). The last block is for
Mothers and their severely mentally disabled children (about twelve pairs of beds).We also have a medical and social emergency unit stationed in this
last block (about fifteen beds).

2.Muasaki-Ai ikuen:
This institute is for children who have both severe mental and physical disabilities. We, Rather than their families, provide the care for these children.
Although this center is primarily for children, many patients will stay for long periods of time, often until the end of their lives. Currently we have
children and adults living in this section.
The average age of these patients is around thirty.

3. Gairai-ryouikubu:
This section has various types of clinics including day care and support for community care systems. The clinics we provide are pediatric,
neuropediatric, dental, urologic, otolaryngo, and psychiatric.
For day care we provide rehabilitation training, play training, and other services are also provided. We have a huge network of supporting functions for
community care systems including hospitals, community health centers, community day care centers and medical-social-caseworkers in all areas of
Japan, especially around Tokyo Met. Area. We send our staff to these places to assist them, they refer children to our center. In recent years about
1,600 new children are referred to us whilst annually.

4. Ryouiku-Kenshusho:
At this section we hold various postgraduate educational courses for staff working for handicapped children. They come from all areas of Japan.

Although there are two kinds of special school for disabled children. One of them, it belongs to the neighbor special school and Tukuba University. It is
called "Kirigaoka yougo gakkou." The other belongs to Tokyo Met. It is called "Keyaki Gakkyu."


Staff: To maintain the running of the center, we have over 300 regular staff and a lot of non-regular staff.
Main regular staff:
Doctors; 6 orthopaedic, 8 neuropediatrics, 1 dentist.
Rehabilitation staff; 19 physiotherapists (PT), 14 occupational therapists (OT), 5 speech therapists (ST.)
Care staff; about 100 registrated nurses, 30 nursery teachers and nearly 50 other care staff.
Others; 5 clinical psychologists, 3 medical-social-workers, 4 pharmacists, 2 x-ray technicians, 4 laboratory technicians


PAST AND PRESENT

"Rehabilitation" is not a new concept in this country. The late Dr.Kenji Takagi, emeritus professor of orthopaedics, Tokyo University School of
Medicine, realized that medical science was not enough to meet the needs of disabled children -- physical, mental, social, and vocational. Led by this
belief, he started a campaign to establish a rehabilitation program in 1914.
Unfortunately, people did not understand him at that time; to make the matter worse, he was suspected as a socialist and secretly put under the
supervision of the police authorities in his daily conducts. His long-standing and untiring efforts, however, survived all these hardships and difficulties
and he finally succeeded in organizing an association which is called today "The Japanese Society for Disabled Children."
The hospital and rehabilitation center "Seishi Ryougoen" was founded for the disabled in 1942 (A limited number of patients had been treated before
this time). It was a magnificent community center of rehabilitation for physically handicapped children and adults with 105 beds, but tragically was
ruined by the war during 1945. Almost all the facilities were destroyed.
However, it did not result in a total retreat of the rehabilitation work which had been demonstrated by the great pioneer, and the program for physically
handicapped children was incorporated into the Child Welfare Law, which was inaugurated soon after the end of the war. (The law for the handicapped
adults was enacted separately a few years later ) According to the Child Welfare Law, the Ministry of Health and Welfare began to subsidize prefectual
governments for constructing the institutions (hospital and home) for physically handicapped children, and the same time the Ministry of Health and
Welfare started to reconstruct the center with national governments funding in 1950.
Since then, this institution has undergone reconstruction work by the national government, and its operation was assigned to the Japanese Society for
Disabled Children. In 1967 when the Child Welfare Law was modified, a special institution for the severely and multiply handicapped children
"Murasaki-Aiikuenn" was established in the compound of the hospital. It now has about 130 beds for long term care.
In 1980, an out- patient clinic was expanded to a total care service center for handicapped children called "Gairai-ryouikubu" and the name of the whole
center become "The National Rehabilitation Center for Disabled Children." (This institution is run on a semi-government basis as a rehabilitation
center.)

In Japan there are now about 70 centers for the physically handicapped and about 130 institutes for the severely handicapped each supported by local
government.


CASES

The center accepts all handicapped children regardless of type or severity of disability. Formerly services were limited to the physically handicapped
only, such as poliomyelitis, scoliosis, CDH, several bone and joint diseases and limited cases of cerebral palsy. But recently due to advances in medical
science, many diseases have disappeared or markedly decreased, like poliomyelitis. For example instead however, the need for care for children with
various kinds of brain damage is increasing. Besides their motor handicap they can have a lot of other handicaps such as mental, psychological, verbal,
visual auditorium or feeding problems. So our services are many and varied. Some of the children need quite intensive medical therapy, so the center
also has high level medical equipment such as CT scanners, arterial O2 monitors and laboratory autoanalyzers.

In 1975 we started a program for the early detection and early treatment of children with cerebral palsy. Now this program has expanded to all kinds of
disabilities, and we can offer quite comprehensive care services from a very early age. Also recently the "Integration","Normalization" has been
spreading rapidly. Instead of residential care systems, or education in special schools, many handicapped children are now spending their daily life in
their homes and communities, and they are going to regular schools. So year by year the number of children who need residential care service is
decreasing. Things are now changing quite rapidly.

COST

For inpatient service: Medical care insurance schemes pay for 70 - 80% of the total cost during hospitalization including all kinds of treatment. National
and prefectural government pay the remainder according to the income of the family.

For outpatient services: 70 of the cost are paid from medical insurance schemes, Families should pay the remainder but there are a lot of supporting
systems based on national or prefectural government, so the costs are quite low.


CHIEF of Staff

Director Mamori Kimizuka, MD

Vice Director Kazuo Kodama, MD

Chief of Seishi-Ryougoen Mamori Kimizuka, MD

Chief of Murasaki-Aiikuen Kazuo Kodama, MD

Chief of administrative Dept. Kazumi Shibata

Chief of Medical Out-Pt. Dept. Eizi Kitazumi, MD

Chief of Medical In-Pt. Dept. Yasuo Yanagisako, MD

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Tuesday October 30,1979 The Japan Times

UNICEF Support Helps Handicapped Children

History of Seishi Ryogoen Hospital:Stigma Gives Way to Hope and Pride

( By JAN CORASH)

 

Although the stigma of having a handicapped child dies hard in Japan, feelings of shame are now at last giving way to hope, expectation, even pride. The history of Seishi Ryogoen Hospital in Tokyo is really the history of that change.

In the dark days of following the end of the second World War, when Japan was still at receiving end of assistance from the United Nations Children's Fund(UNICEF), part of UNICEF's help went to the still young Seishi Ryogoen, whitch had benn devastated in the fire bombings of Tokyo and was struggling to get on its feet again.

Today, government of Japan has singled Seishi Ryogoen out of further substantial expansion and improvement as one of its major projects for the International Year of the Child(IYC). The hospital, in Tokyo's Itabasi Ward, is to become more than ever the mainspring of Japan's efforts to give the disabled child a generous place in the sun.

 

Birth and Resurrection

One of the first leaders in the struggle to overcome attitudes of shame toward hadicapped children in Japan was the late Dr.Kenji Takagi, professor of orthopedics at Tokyo University of Medicine. As early as 1914 he campaingned for the establishment of a rehabilitation program for the handicapped. Misunderstood, suspected of propagating subversive views, he nevertheless persevered, and in 1935, succeeded in organaizing what is known today as the Japanese Society for Crippled Children. In 1942 the society established a 105-bed hospital and rehabilitation center for crippled children. This was Seishi Ryogoen.

When the war ended, only the nurses' domitory was still standing. It quickly became the new hospital. There, the treatment of some 25 children continued.

 

Assistance

UNICEF assistance to Japan began in 1949 with donations of powdered skim milk, and today many "UNICEF babies"are rising to positions of influence and responsibility in Japanese society. UNICEF also provided cotton and wool from whitch branket and clothing were manifauctured for the needy. Its assistance to Seishi Ryogoen can be linked to the early efforts of Dr. Fumihide Koike, present director of the hospital.

IN 1950 Dr. Koike traveled to the United States on a United Nations fellowship grant to study the most modern methods of orthopedic rehabilitation. The report he wrote on his return brought Dr.Mareia Hays, at that time California state director of social services, to Japan as a World Health Organization(WHO) consultant.

Next five doctors from Seishi Ryogoen went as WHO fellows to the United States for training, and UNICEF donated therapy equipment, modern medical textbooks and beds. As one nurse reminisces, the staff was overwhelmed by the large,well equipped beds complete with pulleys and rings for traction. The hospital had previously possessed only tatami mats and wooden beds. The shortage of materials was, indeed, so acute at that time that even from the wood from the packing crates was kept and used.

Later in the 1950's UNICEF also donated books and equipment to the fledgling prefectural rehabilitation centers.

 

Government Support

In 1947 the Japanese government first acknowleged the problem of the handicapped by including disabled children in the existing orthopedics and Law. This was an important event ,because it recognized not only existence of such children in Japan but also their right to be helped. It acknowledged that rehabilitation was possible. For that watershed development Seishi Ryogoen could legitimately claim some part of credit.

Equally important were the economic consequence of the new law, which empowered the Ministry of Health and Welfare to begin subsidizing the construction of new national and prefectural rehabilitation centers throughout Japan. Since then,Seishi Ryogoen -now recognized as the "National Center for the rehabilitation of the Handicapped"-has been put on a semi-governmental basis.

 

Effect of IYC

As part of its IYC commemoration,the government is -as one official put it -attempting to "open the door wider for the handicapped"

Seishi Ryogoen will become a General Medical Treatment Center for Handicapped Children. In addition to advice and treatment,it will conduct research and train personnel. As a first order of business,the operating theater will be completly overhauled at a cost of $1.5 million.Special appropriations have also been made to equip 20 major cities throughout Japan to become "welfare cities for the handicapped."

 

Seishi Ryogoen 1979

Seishi Ryogoen today is the friendliest hospital I have ever visited. Nowhere else have I seen doctors playing with their small patients the atmosphere throughout is warm, kind and cheerful. Doctors nurses,therapists, aides and trainees work as a team. The equipment is thoroughly modern ,and the diagnostic and medical techniques totally up to date. Seisi Ryogoen is a unique position to enlighten the public about the possibilities of the handicapped.

Take, for example,the mother and child class. From all over Japan they come, because, in the words of one mother, "There is nothing like this where I live. " Mothers and the children live together in the hospital throughout the three-month course. The mothers learn about their children's special needs and how to care for them.

Since its inception in 1953, the course has served to bring the parents of handicapped children out of their isolation. Because of lingering feelings of dishonor and disgrace many of these mothers have not previously been able to talk with mothers facing similar difficulties. It may be first experience for many of these children to interact with others.

Seishi Ryogoen has set out to educate the public about the crucial importance of early diagnosis. As a result it is not uncommon today to see treatment beginning at the age of 6 months.

A change of attitude also accounts for the enormous growth in the number of out-patients under treatment. Much of the impetus generated by IYC will, in fact, be directed toward the establishment of a comprehensive out-patient center at Seishi Ryogoen. As planned, that center will have even a dental facility - to compensate for a lingering reluctance on the part of dentisits in private practice to spend precious time on handicapped children. It will have other new facilities as well- eye, ear and nose, and urology. These in addition to the existing orthopedics and pediatrics.

In this time of changing attitudes, Seishi Ryogoen has no intention of resting on its laurels. On the contrary, its means to continue fighting for total rehabilitation. In the words of Dr. Koike: "We want to develop each child to his or her fullest potential so that as many children as possible can enter society and live useful lives." This emphasis on the need for the children to lead normal lives in their communites explains the upsurge in out-patient treatment.

Celebrations for children are being held all over the world this year in commemoration of IYC. But what greater cause of celebration can there be than a handicapped child confirmed in the love of his parents and assured of a place in the sun?

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