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One-man bridge: ConnectingEthiopia and Japan
Nagato Natsume (Prof.)

One-man bridge: ConnectingEthiopia and Japan

NagatoNatsume (Prof.)is a well-acknowledged dentist and specialized surgeon of cleft lips and palates. Currently, he is the director of Japanese Cleft Palate Foundation. In fact, he leads several medical establishments in his capacity both in Japan and abroad. For his years ofmedical service, many countries have bestowed on him their trust to serve them as an honorary consulate in their foreign missions. Ethiopia is the only African country to join Asians to officially appointNatsume as an Honorary Consulate of Ethiopia in the city of Nagoya, Japan. Besides, he is alsoan honorary professor atthe Addis Ababa University (AAU). Apart from Japan and Ethiopia, Natsume is well recognized in Vietnam, Mongolia, Laos, and Canada, where he extends his medical endeavors. He is either a visiting professor or advisor if not both in most of these countries. Outside of his medical profession, Natsume is currently working toestablish business ties between Mitsubishi Aircraft Corporation and Ethiopian Airlines. This week, he was in town meeting high officials and he had a brief moment to talk to BirhanuFikadeof The Reporter,regarding the challenges of the disease that left some 14 million children in the world to struggle with cleft lips or palates. Some 20,000 children in Ethiopia are believed to have received medical attentions for cleft lips or palates in the past 10 years. Excerpts:

The Reporter: For more than ten years, you have been actively involved in treating children suffering from cleft lips and cleft palates in Ethiopia. How many operations and post operation treatments have you provided in Ethiopia, so far?

NagatoNatume (Prof.):Before that, let me say a few things about Ethio-Japan diplomatic relation. Their official relationdates backto since before 1675. During that time, an Ethiopian king, I don’t recall his name, gifted two Zebras to a Japanese king. Since Japan didn’t have these animals, our king was very happy with gift and was motivated to formally launched diplomatic relations. Until the First World War (WWI), the two countries had enjoyed a positive diplomatic relations. My 96 years old mother, who still is in a very good health, always says that both Ethiopia and Japan had good relations. Both countries use to have imperial regimes. Both have more than 2700 years of history. Before WWII, an imperial arranged marital relation was about to happen between the royal families of the two countries. An Ethiopian king at that time sent delegates to Japan and the arrangements were progressing until the war came. During the war, the two countries had joined two different blocks [Ethiopia sided with the Triple Alliance and Japan was with the Triple Axis forces of Germany and Italy]. Fortunately, after the end of WWII, His Imperial Majesty HaileSelassie I, visited Japan and gave donations for the rehabilitation effort. The 1962 Tokyo Olympic was also very monumental; Athlete AbebeBikila, who still is very famous in Japan, won a gold medal in marathon. These are some of the essentialities that paved the long historical relations of the two countries. Talking about what I do, I am a medical doctor among other things, mostly specialized in the cleft palate treatment. Ten years ago, I was invited to come to Ethiopia to give lecture about the cleft lips and cleft palate treatments. From then on, I carried on operations with a team that campaigned annually. My foundation, Japanese Cleft Palate Association, is not only engaged in providing treatments,but also provides technical trainings and invite Ethiopian medical professionals to Japan to have more exposures about the treatment science.

Havingworked in this treatment sector regularly, what can you say about the disease and its preventive mechanism?

I have published a book in Amharic language in a view that it could help to communicate to both the medical professionals and communities about the disease that causes cleft lips and cleft palates. I am also thinking ofuploading the book to the internet so that it can reach more people. In fact, I wrote the book in English first and Ethiopian doctors helped me in translating it to Amharic. It is interesting that all the drawings are made by my wife and daughter. I have prepared some posters as well that could help to create awareness about the disease and how affected children could be treated at home. In rural areas, there is a huge gap in understanding the cause and impacts of cleft lips and cleft palates on children. More than 90 percent of children born with this complication couldn’t properly feed on their mothers’breast milk. The death rate is quite high.

How severe it is in Ethiopia,say compared to countries in Asia where you are working in?

More or less it is the same in most of the countries that I have worked in. Many of the countries have been challenged by the disease because of lack of awareness and partly because of shortages of facilities and medical personnel.

Can you give us a glimpse of how the impact of the disease isevolving over the years?Is there any observable declinein prevalence over the past 10 years? 

Ten years ago, many people didn’t have mobile phones, and now many have computers and other gadgets. That is a very good thing for us. You see we can easily spread the information about the causes, impacts and the treatments of the disease.

One particular statistics that I have seen about Ethiopia indicates that one out of every 672 live birth children are affected by the cleft lips or cleft palates diseases. How challenging is that to the country or for you?

In many occasions we depend on estimated data. We need to have the actual figures regarding how many babies are born and how many are really born with the disease. There should be a monitoring mechanism to actually find out the prevalence rate. Some 20 to 30 years ago, we thought that the prevalence of the disease was varying over the course of time. On yearly basis, it went up and down. And, 10 years later, we thought the incidences of the disease is not that high anymore. From the data we have collected from Hawassa University, it is quite clear that the disease is not affecting as many children as we anticipated before.

Including post operation treatments like speech therapy, how much does it costs to treat a child with cleft lips or cleft palate?

The costs depend on the type of procedure, treatment and medicines you provide for the patient. Let us say, you use chip medicine and chip materials, the cost perhaps will be around USD 200 to 300 per patient. But, since we bring in quality materials and treatment equipment and medicines from Japan, the cost is significantly higher: USD 1,000 to 1,500 per patient. 

How do those children, who couldn’t receive the medical treatment, survive? 

60 or so years ago, the story of these kids in Japan was so heartbreaking. After delivery, when the children found to be affected by the disease, their fate was as good as sealed;they die. The midwives when they knew the child was born with cleft lips or cleft palates, they would take a wet towel and put that on the mouth of the live birth child and it will certainly die. During that time, due to the cultural belief, children born with such diseases meant something against the norm and they were treated differently. That still is a challenge in many countries, especially in communities of least developed countries.In rural areas, children with such diseases face tremendous amount of life threatening encounters. I hope in the future children born with such diseasescould easily survive to live. You see, they all deserve the very basic human right:the right to life. It is very important that every rural community have the right information about the disease and its impact. When I started to visit Ethiopia, I started to communicate with the Addis Ababa University (AAU). We met with doctors focusing on the disease and we did many things together. We have worked on several treatments and we also collaborated on counseling services and post operation treatments as well.

Do you think there could be a possibility to eradicate the disease within the coming years?

That will be very difficult. I think that is unattainable. One difficult practice around this time is thatparents with children sufferingwith the disease try to abort the fetus when they learn that their unborn child have the complication. Previously, we have talked about how the affected live birth kids were struggling to survive. Some were simply killed. Now, thanks to the technology, some defects such as cleft lips could easily be detected even before the children are born. The trendis that when they realize that babies inside their wombs are with some form of defect, they tend to abort.

Let us talk about your other role as an honorary consulate. What do you with this title, representing Ethiopia in japan?

I have been engaged in activities that could help countries to have more cooperation. For last 15 years, I have done just that. I have been given honorary consolatory task which I have been performing in collaboration with my country’s stakeholders to create a platform for mutual cooperation;and also business ties. For instance, Ethiopian Airlines has a direct flight to Tokyo and that helps us a lot. Five million flower stems are exported from Ethiopia to Japan, annually. In the near future that could expand to six to eight million. We want to expand these kinds of business cooperations to other sectors as well.

We are in the era of astonishing scientific outcomes. One area we keep hearing about is the Gene editing field. We hear, these days, that children’s genes could be edited while they are still in their mothers’ wombs. Is that something helpful to the cleft lips and cleft palate treatment?

I have written many papers on gene editing. In the coming 20 years, we might say gene editing could help cancer treatments. However, it is still a work in the progress and this science is very difficult to be applied in the procedures of cleft lips or cleft palates. We would be able to decrease the rate of incidences of the disease. Currently, there are a number of treatments and medicines that help various health conditions during the prenatal and antenatal periods. The likes of folic acid are helping mothers deliver healthy babies, these days. We can’t eliminate the disease but we could reduce its incidences.

What could be said about the cultural and educational exchanges?

Currently, we have only 1,000 Ethiopians hosted in Japan. There is a need for more to come to Japan. There are many job opportunities there. We are a country of 124 million population; and yet fertility rates are seriously in decline. Hence, there might be the need for workforce and I think it is good that Ethiopian skilled youth explore opportunities in Japan. University students from Ethiopia will have a short term job opportunities while during their studies there. From their experiences in Japan, many students will acquire skills and language abilities and Japanese companies will be interested to offer them regular jobs. I am more interested to create that platform; and my strategy is that I want Ethiopian and Japanese universities to establish exchange programs so that many Ethiopian students could get job opportunities there. Apart from government of Japan, there are several companies and businesses interested to provide educational access and some sort of grants and scholarships. I am willing to work on that space.