Dr. Tetsu Nakamura's achievement
The 24th Fukuoka Prize Grand Prize laureate
Dr. Tetsu Nakamura, the Grand Prize laureate of the 24th Fukuoka
Prize in 2013, has sadly passed away on the 4th December 2019.
For a long time he had delivered international aid work throughproviding medical treatment, land reclamation in Pakistan and
Afghanistan.
He was born in Fukuoka City and spent his time in Fukuoka citywhile he was in junior high school to university. He had a strong
connection with the city.
In the occasion of receipt of his Grand Prize in 2013, he engaged
with many people in Fukuoka in the events such as the Award
ceremony, public lectures and school visits.
The special panel exhibition will be held to remember Dr. Tetsu
Nakamura's achievement.

Grand Prize 2013
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5HSUHVHQWDWLYHof Peshawar-kai in Pakistan and Afghanistan）%RUQ6HSWHPEHU DJHGFor 30 years, Dr. Tetsu Nakamura has been taking the lead in medical services, land
reclamation and social welfare for the sick, the poor and the vulnerable in Pakistan and
Afghanistan. His profound thoughts, speeches and written work, built upon first-handexperience, have been highly praised worldwide as an intellectual means to create true
peace, by seeking for cross-cultural understanding and mutual respect.
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For 30 years, Dr. Tetsu Nakamura has devoted himself to the medical treatment, land reclamation and local welfare of poor andvulnerable people in Pakistan and Afghanistan. His thoughts, speeches and written work based on his first-hand experiences inthose countries aim at enhancing cross-cultural understanding and respecting different cultures. His work has been highly praisedinternationally as providing an intellectual basis for building genuine peace.
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Dr. Nakamura has never limited his work to his commitment to providing medical services and taking initiatives in international
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through his experiences, and he makes endless efforts to address people about the necessity of social reform by way of non-violent
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more than ten books which are well-written and easily readable, and present a comparative cultural theory based on the situationin Afghanistan. These books persuade readers to view the world from a different angle and to put themselves on the same side as
the local people when thinking about it.
A sustained intellectual endeavor to create a better society, on the basis of profound understanding of different cultures, achieved
through comparing one’s own culture to others and so reconsidering it, is a fundamental principle of international cooperation. In
his work, Dr. Nakamura has made it his highest priority to respect local residents and their culture, which is indeed the original
and true essence of cross-cultural understanding and international cooperation. For 30 years, Dr. Tetsu Nakamura has exemplified
the very spirit of the Fukuoka Prize which was founded in order to contribute to the promotion of culture, mutual understandingOverseas activities

Visiting Pakistan as a doctor
Visiting Pakistan as a doctor— his time supporting through medical aid
Dr. Tetsu Nakamura was born in 1976 in Fukuoka City, and spent his childhood in the Wakamatsu ward, Kitakyushu City, and Koga City. After graduatingfrom the medical department in Kyushu University, he worked as a physician in several Japanese hospitals. He was later appointed to work in the Mission
Hospital in Peshawar, the state capital of Pakistan, located in the Northwest Frontier Province.
The turning point in his life came in 1978 when he was still working in a Japanese hospital. Dr. Nakamura served as a physician for a mountaineering teamtraversing the Hindu Kush mountain range between Pakistan and Afghanistan. He originally joined as he had an interest in the rare species of butterflies
that inhabited the region, however, what he witnessed was the harsh reality that the local people faced there.
The locals came to see Dr. Nakamura after hearing the rumor of a visit by a physician. However, he felt powerless as he could not provide support to thepeople seeking his help. Six years later, he heard about a post for a dispatch physician in Pakistan in 1984. He had a wife and a small child then, but hemade his decision to work as a doctor in Peshawar.
After being appointed as a dispatch physician, he treated Afghan refugees in both refugee camps and mountainous regions while providing treatment for thepatients with Hansen's disease and enteric infections, which were prevalent in the poor. He started providing regular medical treatment for Afghan refugees
from 1986 onwards.
In 1991, Dr. Nakamura established the first general practice in Dara-e-Noor, the eastern mountainous area in Afghanistan. The Peace Medical Service(PMS) Clinic was built as the base hospital in Peshawar. From then on, he provided medical treatment at three satellite clinics in doctorless villages in theeastern mountains.
Afghanistan was troubled with armed uprisings against the government, military interventions by foreign countries and civil war when Dr. Nakamura was
appointed to work there. Of course, it was the normal citizens living there who suffered most from these hardships. The only choice they had was toevacuate to refugee camps and other mountainous areas as they lost their lands
because of the conflict.
Dr. Nakamura had worked and provided medical treatment from the viewpoint of
those civilians, however, his journey was interrupted by a series of hardships
including the Pakistan government demanding the closure of his clinics, the lossof medical specialists due to the increasing need which was unrelated to medical
expertise such as irrigation work, and so on.
Despite being forced to close his clinics due to the conflict, Dr. Nakamura
continued to examine 73,000 people in his clinics. He then moved his focus frommedical treatment to irrigation work. However, even now his clinics have beentreating many patients and supporting local staff, including female workers with
their emphasis on medical education.

Dr. Tetsu Nakamura on the left in the front row

The fight against drought
One irrigation channel worth more than 100 medical clinics
Dr. Nakamura continuously worked to provide medical aid in Afghanistan for many years. His idea that you could not save people’s lives there only by
medical support grew stronger gradually.
The great drought of 2000 in Afghanistan was the trigger of this idea.
Afghanistan has a strong image of conflict. However, originally more than 80% of the national population were farmers. It is a traditionally agriculturalcountry. Due to the great drought, Afghanistan’s rich crop lands were entirely turned into desert, causing famine on a massive scale. Many people havesuffered from starvation, and tens of millions have fled these lands. It has been reported that several million people have died due to starvation.
People could not grow grain without water and did not have anything to eat. Therefore, they deserted land for a better place. Entire villages just vanished.
Many people were suffering from malnutrition, and died from dysentery due to the contaminated drinking water. The doctors could do nothing to save thoseyoung children dying because of what the great drought had caused.
They were overwhelmed with the thought that they could have saved
many people from dying if they had only had clean water and food.
Even though they had medicine, they couldn’t give it to everyone.
Needless to say, the medicine could not relieve their thirst. Dr.
Nakamura thus started a new project focusing on digging a well near
the PMS clinics after reaching to the idea that rather than medical
treatment, the most important thing was to secure clean water andfood.

Dr. Nakamura driving a power shovel‘One irrigation channel worth more than 100 medical clinics’
They took on the challenge of digging a well for the first time in May 2005. It apparently took one month to hit the first water source. In the beginning, they
dug around 1,600 wells for drinking water, as well as 13 wells that were 5 meters in diameter for irrigation. They then restored the Karez, the traditional
underground water channels, in 38 different locations. They referred to the idea of the Iranian Qunat, a method of using spring water, for this project.
Secondly, they focused on the water coming from the mountains. In 2003, everyone in the project, including Dr. Nakamura, started to work on building the
Marwarid irrigation channel in order to draw water from the abundant Kunar River for agricultural use. Despite not being construction experts, they
watched and learned from others to construct a channel that was 25.5 kilometers long.

This irrigation channel, which was completed in seven years, restored
a 3,000-hectare area of farmland. Around 150,000 people’s lives were
saved as a result. As the construction of the irrigation required
approximately 500 people a day to work, it created around 70,000 jobs
during those seven years. The construction of the irrigation channel
contributed not only to securing a stable source of water, but also to
the settlement of the local people and their public security.
Dr. Nakamura used the Yamada Weir from Asakura City in Fukuoka
Prefecture as inspiration for the design of the irrigation channel, as
they were facing difficulties in obtaining heavy machinery as well asbuilding materials such as concrete. The Yamada Weir is an irrigation
channel from the Chikugo River built in the Edo era in Japan, and it
has been continuously providing water to the surrounding land.
The reason why he borrowed the design of the Yamada Weir was
because it was not constructed as a temporary flood control measure.
In Afghanistan you could not easily find heavy machinery, so theychoose to apply the gabion and wickerwork methods, which were bothtraditional Japanese flood control techniques, rather than relying on
modern construction methods using concrete and steel. By doing so,
the local people could repair the system themselves and could evenbuild other irrigation channels in other areas by copying the design.

The gabion method

The land has been transformed intoa place full of water and vegetation!

ˢ

July 2009ˢ
August 2009

April 2012

-DOLEDEDLQ

7KH-DOLEDEDLUULJDWLRQFKDQQHO The Green Ground Project
The village restoration project coming to close.
Agricultural projects are one area that the Peshawar Kai, Dr. Nakamura’s NGO group, focuses on after medical and irrigation projects.
The project to construct a 25.5 kilometer-long irrigation channel created employment; water has returned to the area and the ground sprouted vegetation
with the completion of the irrigation project. The next major projects were helping the locals become self-sufficient and building a hometown where
farmers could live peacefully.
In 2002, The Peace Medical Service launched the Green Ground Project as a long term village restoration plan in parallel with the irrigation project. Basedon this project, they started practical aid work with the aim of restoring villages so people could be self-sufficient. The plan included constructing buildingsthat would form the core of the community, such as schools, mosques and homes, which were all essential to the local people.
Dr. Nakamura said; ‘We can only start living peacefully after having a homeland. When your family can eat well, then you can live in your hometown
safely. That is what we call peace.’
Now children in the village study at school, and people harvest crops such as carrots, potatoes, Chinese radishes, turnips and spinach in their fields.
The water flows through the irrigation system that Dr. Nakamura took many years to build. The land is permeated with water, people returned to themountain and their villages were restored. By the time a new village was completed at the terminating point of the irrigation channel, Afghanistan could becovered in vegetation.

The Llanpur Plain: an endless desolate desert (in 2003)“The Llanpur Valley in the Kunar River Basin”
Willow, mulberry and olive trees spread across the valley.
The water flows on across the dried land, and the plants grow at the river sides.
People returned to the fertile land, then the farming was restarted. Villages are being
restored one by one.
A cauliflower farm

The Llanpur Plain after regrowth of plants and flowing water (in 2012)

Local farmers working in their fields

Public Lecture
Securing Water of Life in Afghanistan
Thirty Years of International Medical Aid
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Ŷ3DUWLFLSDQWVGlobal warming is not somebody else’s problem.
Re-thinking the relationship between nature and humans
There is a common saying in Afghanistan that “We can live without
money, but we cannot live without snow”. In this agricultural country,
water from melted snow brought blessing to the people in the past
centuries. Afghanistan is a multi-ethnic nation where tribal autonomy andsense of territory prevail. The geographic factors also obstruct central
government control, and there is a huge divide between the rich and thepoor. In 1984, Peshawar-kai started medical treatment for Hansen’sdisease patients in Pakistan. It was not easy to understand the feelings ofpatients who spoke a different language, different religion, and different
lifestyles. We foreigners tend to make superior-inferior or right-wrong
judgment for things with which we are not familiar. It is a mistake that wetend to fall into without realizing it is merely due to the cultural difference.
To avoid falling into this mistake, we made sure that everyone in ourorganization accepts the local culture and customs, including religion, as
they are.
After the withdrawal of the Soviet military that invaded in 1979 during theAfghan War, the Gulf War broke out in 1991, which pulled out allinternational organizations from Afghanistan. Fifteen years had passed
since the launch of our activities, during which we established theorganization, built and maintained our own hospital, as well as a system capable of continuing the medical practice as long as we
received resupplies from Japan. After the Taliban regime came back, the public security improved dramatically, making unarmed
travel possible. However, the area was devastated by the drought of the century in the spring of 2000. Twelve million people wereYLFWLPL]HGSXWWLQJPLOOLRQSHRSOHRQWKHYHUJHRIVWDUYDWLRQDQGPLOOLRQSHRSOHWRWKHYHUJHRIGHDWKIURPVWDUYDWLRQ:HIHOW
a great sense of helplessness because the medical technology can heal neither thirst nor hunger. So we started digging wells andcontinued until we secured 1,600 wells to ensure sources of drinking water.
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Afghanistan. We distributed 1,800 tons of flour and cooking oil for more than two hundred thousand evacuees in the capital city.
These activities would not have been possible without the support of the courageous Afghans who were willing to sacrifice theirlives for the sake of their fellow citizens. After the Taliban regime collapsed and the country was occupied by the US military, thepoppy cultivation was resumed to an extensive scale, and in the next few years Afghanistan became a drugoriented nation
producing 93% of the drugs in the world.
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water, we prioritized the building of irrigation channels for the clinic, but they needed to be sustainable without the local people
having to spend money. When I realized that the Afghan water intake technology is similar to the Japanese technology, we
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method of bamboo bags packed with rocks used as seawalls. These efforts led to a recovery of the agricultural field in the next few\HDUV7KHRQO\WZRZLVKHVRIWKHORFDOIDUPHUVEHLQJDEOHWRKDYHWKUHHPHDOVDGD\DQGOLYLQJSHDFHIXOO\ZLWKWKHLUIDPLO\LQ
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will fall apart. Now we need to ask ourselves again, “What is the relationship between humans and nature”?

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Fukuoka Prefectural High School Gymnasium

Chikushi Jogakuen

Fukuoka Prefectural High School Gymnasium

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standardization, and emphasized the importance of willingness to acknowledge diversity. While presenting the drought situationin Afghanistan, the Grand Prize winner pointed out that the water problem emerges from the people’s involvement in nature, andthat what is happening in Afghanistan could well happen in Japan. He also shared an episode of one occasion when the farmers
rejoiced in the hope of life when all the irrigation channels were opened. Dr. Nakamura also put the following question to the
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people seem to look more depressed. Perhaps the more people have money, status, jobs, and entertainment, the more they get
depressed. The urban space gives people an illusion of power to do anything at will. Isn't now the time to think about the
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In response to the question asked by one of the students in Chikushi Jogakuen High School, “What is necessary for achieving
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able to forgive, to accept, and to love”.
In Seinan Gakuin High School, where Dr. Nakamura was asked a question, “What difficulties did you have in communicating withthe local people”, he answered firmly, “We had misunderstandings all the time because of differences in language, customs, andUHOLJLRQ%XW,DOZD\VEHOLHYHGWKDWZHZLOOEHDEOHWRILQGVRPHWKLQJWRVKDUHZLWKHDFKRWKHUDVORQJDVZHZRUNHGWRJHWKHU´
In Fukuoka Prefectural High School, where Dr. Nakamura himself is a member of the 17th class of graduating students, somestudents asked for some advice about their career options.
When asked, “What is important for someone who wants to become a medical doctor?” Dr. Nakamura’s answer was, “A medical
doctor should not be merely a technician. You also needto learn about things that may seem unrelated to medical practice”.
Dr. Nakamura’s lecture was a great opportunity for the youth, who will be the leaders of the next generation, to expand their worldview.

Acceptance Speech

Grand Prize NAKAMURA Tetsu
Human beings are a part of Mother Nature.
We must find ways to live in harmony,
between nature andhumans, and among peoples
I am thankful and delighted to receive this honor and to become one of the recipients of the Fukuoka Prize. Afghanistan, for the last\HDUVKDVVXIIHUHGIURPFRQIOLFWVDQGLQWHUYHQWLRQVIURPIRUHLJQFRXQWULHVDORQJVLGHODUJHVFDOHGURXJKWVDQGIORRGVWKDWKDYH
lead to a gradual loss of habitable environments. The impact of climate change and global warming is overwhelming. The once
agricultural nation is now suffering from starvation, and their sufficiency rate has decreased by half. Since international aid
agencies did not prioritize the water shortage, we as a medical organization, had no choice but to secure drinking water sources
ourselves, building water facilities and water intake works. We are now about to develop an exemplar model of rehabilitation by
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The aggression dominating the international community allows little room for diversity, and the Asian world is suffering frompoverty. Not only are the people deprived of food, but also of their unique traditions, their land, their dignity, and their harmony.
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live in harmony, both between nature and humans, and among peoples, in every element of our activities.
I was deeply encouraged by what the other laureates have said in the past – and realized I was not alone on this path. Although thevoices may be small now, I pray that they will one day become a roaring tide.

What is the Fukuoka Prize?
〜 Background of the Fukuoka Prize 〜Asia is home to a diversity of ethnic groups, languages, and cultures, which coexist with and depend on each other. These diverse cultures have served not only as guardians of the priceless legacy of our long history and tradition, but also as sources of inspiration.
However, in the current era of globalization, there is a danger that Asian cultures may lose their distinctive features due to the encroaching homogenization of culture. It is therefore vital to preserve, develop, and promote the harmonious coexistence of the diverse
Asian cultures.
As Japan's cultural gateway, Fukuoka City has since antiquity played a significant role in promoting exchanges with other regionsof Asia. This history, and a determination to promote and understand the distinctive cultures of Asia, and to further peace, inspired theinauguration of the Fukuoka Prize (formerly known as the Fukuoka Asian Culture Prize) in 1990 through collaboration between academia, businesses, and the city authorities. Since then, there have been many prize recipients from almost every region of Asia.
Since cultural exchange looks to the future, it is not enough merely to preserve cultures with long histories and ancient traditions.
New things emerge from the midst of change: it is necessary to observe them, respect them, learn from them, and build upon them.
This is the aspiration of Fukuoka City and its citizens, as we strive to become a center for cultural exchange in Asia.
The Fukuoka Prize will continue to be a means of showing respect to those who have made outstanding contributions to academia,arts, and culture in Asia. We intend, together with the people of Fukuoka, to advertise to the world through our city, the diversity and thedistinctiveness of Asian culture.

Objective

Prize Categories
Grand Prize
To be presented to an individual or group who has made outstanding contributions to the preservation and creation of Asian culture, and has demonstrated the significance of Asian culture to the world through the internationality, universality, popularity, and/or
creativity of their work.

Academic Prize
To be presented to an individual or group who has made outstanding achievements in the field of Asian studies, contributing to theworld’ s understanding of Asia. It covers various social sciences, such as history, archaeology, cultural anthropology, economics, andpolitical science.

Arts and Culture Prize
To be presented to an individual or group who has made outstanding contributions to the cultivation and/or advancement of theunique and diverse arts and culture of Asia. It covers fields such as fine arts, literature, music, drama, dance, film, architecture, andtraditional and ethnic culture.

Management
Secretariat of the Fukuoka Prize Committee c/o Asian Partnership Section International Affairs Dept.,

Organizing Bodies
Fukuoka City, Fukuoka City International Foundation

Fukuoka Prize website
http://fukuoka-prize.org/en/

This document is based on the 24th Fukuoka Prize report and the article on the Fukuoka Prize website.