Introduction to our Clinic

It would be impossible to describe our aims and ambitions for our clinic without taking a look at the history of Minamata disease, Minamata Clinic, and Minamata Kyouritsu Hospital.
Even after the official recognition of Minamata disease, mercury contaminated wastewater continued to be released into the sea for another 12 years. In 1968, the point in time when the mercurial discharge was stopped, those recognized as Minamata disease victims numbered just over a hundred. At this point, large numbers of people, including people who suffered from very serious cases of Minamata disease, were not being certified as Minamata disease sufferers, and as a result where ignored and received no medical care.

When this situation became known, a number of doctors volunteered their services and in January 1970 began to examine patients and victims in the area. In 1971, these volunteer activities led the forming of “The Association of Doctors against Environmental Pollution of Kumamoto Prefecture,” and activities continued to discover more latent patients. As a result, more than 4,000 people had applied for official certification by 1974.

In April 1972, Dr. Fujino Tadashi, who was a member of Kumamoto University’s Second Minamata Disease Study Group, formed in June 1971, started examining patients at Minamata Hoyouin Hospital (today’s Mizuho Hospital). There, he saw for himself how victims with the symptoms of Minamata disease, were receiving neither medical treatment nor compensation, and were struggling to make a living. In January 1974, as a direct result of Dr. Fujino’s observations, the Minamata Clinic was established in a building in front of Minamata Station, to treat victims of Minamata disease. At the beginning, in addition to a full-time staff of 8 (1 doctor, 4 nurses and 3 office workers), there was also 1 part-time doctor. Soon an in-patient facility was needed, so the clinic was upgraded to a hospital (Minamata Kyoritsu Hospital) in March, 1978.

In those days it was difficult to borrow enough money from the banks to finance the hospital, and there was a shortage of doctors. Therefore, we had to raise money to cover expenses through donations and loans from patients and local inhabitants. In addition we sought support from doctors from all over Japan.

As a result of our efforts the numbers of patients applying to become officially certified increased rapidly. The Government responded to this by rejecting the majority of applications.
In those days, Dr. Fujino, together with the Association of Doctors against Environmental Pollution of Kumamoto Prefecture, using information from the Katsurajima Report, established the diagnostic criteria that the consumption of seafood polluted by methylmercury and four-limb’s sensory disorder were indications of Minamata disease.
Using the new criteria, more than 10,000 latent patients were detected, to the north in Kumamoto City, to the south in Takaono Town (Kagoshima Prefecture), and to the west in the Amakusa Islands. Many inhabitants of Minamata had moved to those areas during the years following the outbreak of the disease. By 1995, 17,000 people, in Kumamoto and Kagoshima Prefectures, had applied for official certification.

In April 1990, the Minamata Kyouritsu Physiotherapy Clinic (Rehabilitation and Psychiatry sections) was established on a plot of land adjoining the Minamata Kyoritsu Hospital.
In April 2002, Dr. Takaoka, the present director, was appointed to the post after the departure of Dr. Fujino, and in June of the same year the clinic was renamed the Kyoritsu Neurology and Rehabilitation Clinic.
By the end of 2010, after the Supreme Court judgment in the Minamata disease Kansai Suit of October 2004, the Association of Doctors against Environmental Pollution of Kumamoto Prefecture, which includes our clinic and Minamata Kyouritsu Hospital, had performed health checks on more than 5,000 patients and inhabitants.

A health survey, with director Takaoka as the organizing doctor, was planned to be carried out around the coastal areas of the Shiranui Sea on 20th and 21st September, 2009. More than 1,000 inhabitants were checked, and even though 89% of the examinees were being checked for Minamata disease for the first time, more than 90% of them were found to have abnormal neurological symptoms that were specific to Minamata disease. A similar phenomenon had been observed in a health survey carried out among the inhabitants a generation previously, in 1987. For 22 years many victims of Minamata disease had been undetected and left to suffer without anything being done for them.

The Features of our Clinic

Our aim is to become a clinic which can treat both physical and mental problems through specialization in areas such as neurology, psychiatry, Oriental medicine and rehabilitation. We diagnose and treat not only Minamata disease but also mobility function disorders, sensory function disorders, mental function disorders and other similar illnesses causing pain. Patients suffering from mental disorders and/or dementia as well as patients needing rehabilitation are treated mainly by this clinic.

The Minamata Kyoritsu Hospital and Kyoritsu Care Centre provide home medical care, such as home visits by doctors and home nursing calls.

For physical disorders we perform medical treatment for :

• Neurological diseases such as Minamata disease
• Painful illnesses which do not require surgical procedures
• Occupation related diseases like vibration disease
• Disorders that can be treated by oriental medical techniques.

If a patient requests it, we provide, wherever possible, diagnostic tests and treatment for internal medical diseases such as high blood pressure, diabetes, medical diseases of the digestive and circulatory organs. Our physiotherapists can do good disorders provide rehabilitation therapy here in the clinic or in the patient’s home.

We provide diagnosis and medical treatment for mental diseases, including schizophrenia, depression, neurosis, personality disorder, panic disorder, insomnia, and dementia. We do not have in-patient facilities at this clinic but we belong to the Association of Kumamoto Psychiatric Hospitals and the Kumamoto Association of Neuropsychiatric Clinics, and we cooperate with psychiatry hospitals in Minamata, Izumi City, Kumamoto, and Kagoshima prefectures. Our clinic is a member of the Minamata Ashikita Society for Dementia.
In addition, we share mental health care in the community, cooperating with local vocational aid centers, work places for disabilities, livelihood support centers, and administrative offices including public health centers.
We also provide ambulatory rehabilitation for persons with physical or mental disorders, do various procedures based on the Services and Supports for Persons with Disabilities Act and the Long-Term Care Insurance Act, and make medical certificates for physical or mental disability certificates, and entitlement of disability pension.
The nurses at this clinic and the caseworkers of Minamata Kyouritsu Hospital are in charge of the examinations and the above procedures as well as the life support measures.

Tests and Examinations

Urinalysis and the blood tests are taken in our clinic and then sent to Minamata Kyoritsu Hospital or another external institution for analysis. We measure the total mercury concentration in hair in our clinic, but we commission the National Institute for Minamata disease to carry out the measurement of methylmercury in the umbilical cord.

We are also equipped to carry out the following tests and examinations in our clinic:

• Echography of the abdomen, heart and carotid artery
• Electrocardiogram
• Respiratory function inspection
• Electromyography (EMG)
• Electroencephalography (EEG)
• Visual field test
• Hearing test
• Treadmill test
• Neurometer
• X-rays

Then, using the results of the tests together with the patient’s clinical records, we make a diagnosis and decide on a suitable medical treatment.

For endoscopy (upper gastrointestinal, lower gastrointestinal, ERCP), CAT test and contrast x-ray examinations we refer the patient to the Minamata Kyoritsu Hospital and then make a diagnosis and decide on the patient’s medical treatment based on the results of their examination.
In the cases where we need an MRI inspection, which neither our clinic nor the Minamata Kyoritsu Hospital can perform, we refer patients to neighboring hospitals or hospitals in Kumamoto City depending on the patient’s wish.
We can perform psychological examinations by giving intellectual function tests such as WAIS-III, dementia scales and personality tests.

Overview

• Name
  The Houwakai Medical Corporation’s Kyouritsu Neurology and Rehabilitation Clinic
• Location
  2-2-12, Sakurai-cho, Minamata City, Kumamoto zip 867-0045
• TEL/FAX
  TEL：0966-63-6835　FAX：0966-63-1560
• Departments
  Medical care/ Internal medicine / Neurology / Rehabilitation / Psychiatry / Psychosomatic medicine

Brief History

• 1974
  The Minamata Clinic was established
• 1978
  The Minamata Kyouritsu Hospital was established and the Minamata Clinic closed
• 1990
  The Minamata Kyouritsu Physiotherapy Clinic was established
• 2002
  The clinic was renamed - the Kyoritsu Neurology and Rehabilitation Clinic