戦後沖縄の保健医療行政の推移とその展開-2-疾病・死因構造の変遷を中心として
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概要
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We have tried to classify the health/medical services administration in Okinawa after World War II into five periods and to describe the trends of major communicable diseases and causes of death for each period. First period (1945-49, the period under the administration of the U.S. Military Government (USMG)): In those days, the major activities of health/medical services for Okinawa Civilians were first, supplying food and second, controlling acute communicable diseases; especially, malaria which was very prevalent. USMG executed an aggressive sanitation program which included DDT spraying. Second period (1950-51, the period during which the USMG administration turned control over to a civil administration): Acute communicable diseases were eradicated by the aggressive sanitation control, but chronic communicable diseases - leprosy, tuberculosis, venereal disease and others became more prevalent. USMG issued many ordinances to affect "control of communicable diseases". USMG especially showed deep concern for controlling venereal disease and established district health centers and began free treatment for venereal disease in these centers. Third period (1952-64, the period of full-scale construction of U.S. Military bases): Markets, crowded houses, slums, so-called red-light districts and other similarly difficult living situations developed around U.S. Military bases with the full-scale construction of the bases, and chronic communicable diseases, especially, tuberculosis were very prevalent in the 1950's and 1960's. However in the 1960's the death rate due to tuberculosis decreased gradually as did the rates for gastroenteritis and pneumonia or bronchitis. On the other hand, the death rate due to adult diseases such as cerebrovascular disease, cancer, heart disease and others increased year by year. Fourth period (1965-71, the period of a great increase in financial and technological aid from the Government of Japan to Okinawa): The period started from the time when the late Prime Minister Mr. Sato made a speech on his visit to Okinawa in 1965 that a medical school should be established in University of the Ryukyus. From that time the financial and technological aid from the Government of Japan to Okinawa was substantial. A vaccination program to fight tuberculosis for health personnel, families of tuberculosis patients, students of the first and second year of junior high school was established in 1966, and consequently the morbidity rate due to tuberculosis decreased year after year. Fifth period (1972-, the period after Japanese laws were applied). After the application of Japanese laws, the condition of health/medical services in Okinawa improved considerably. The mortality and morbidity rates due to adult diseases increased significantly as the rates for communicable diseases declined.