Gabon, a country located in the West Central Africa, relying on abundant natural resources for revenues, is diversifying its industries for sustainable economic growth. This economic transition is bringing about substantial social changes, such as widening income gaps, growing new urban population, and raising the number of nuclear families. In this social situation, elderly care issues have become serious particularly in urban areas, where more than a few cases of neglect have been observed.

To improve this situation, the Government of Gabon reorganized Estuaire-Mélen Regional Hospital, a national hospital located in the suburbs of the capital city of Libreville, and established an elderly division $ ^{*} $ there. However, due to insufficient equipment and poor know-how of the staff, it was rather impossible to provide adequate care to the incoming elderly patients. Therefore, upon

Ms. Morishima giving a piano lesson to Jean who has impaired vision (Source: Ms. Morishima)

the request by Gabon, Japan has been dispatching Japan Overseas Cooperation Volunteers (JOCV) for nursing care to this hospital since 2005. One such volunteer is Ms. Mizue Morishima, who started working for the Elderly Division at the hospital in January 2008. Ms. Morishima studied nursing care at a vocational college, then acquired professional experience in this field as a careworker for five years in Kagoshima city. Wishing to make full use of her expertise in developing countries, she applied for the JOCV program.

At the beginning, for Ms. Morishima, the elderly did not seem very lively at the hospital. Applying her techniques and know-how that she had learned in Japan, she took various initiatives to make their lives more enjoyable. While teaching the staff how to assist the inmates in meals and other activities, Ms. Morishima tried to encourage them to join various recreational activities such as coloring, quoits, and piano. Although initially her colleagues just stood by watching her doing these activities, they, as time went by, began to follow her example; they started understanding her ways of thinking towards care taking. Eventually, her colleagues absorbed the essence of nursing skills and ingenuity that Ms. Morishima brought from Japan.

One example of Ms. Morishima's performance can be illustrated when she assisted one of the inmates, Jean, who has difficulty in sight, to enjoy playing the piano. For his convenience, she put stickers on "C" keys, taking a hint from the method used in Japanese nursing homes. Knowing the position of the proper keys, Jean gradually improved his skills and now enjoys playing it every day. "I enjoy singing to music I play by myself. I want to learn more new songs," said Jean. Another inmate, Lembé, who used to shut herself away from others, gradually started talking with Ms. Morishima, after she began to carry matches with her to light a cigar for Lembé any time she wants. She began to enjoy coloring that she had initially hesitated to join in, and stopped wandering out of the hospital as frequently as she used to, which had been of great concern among the careworkers.

Ms. Morishima takes care that all inmates can look forward to their life by always keeping in touch with them. Moreover, she never forgets kindness. "In general, compared to Japanese, Gabonese tend to express themselves more frankly, which perhaps explains why both inmates and careworkers seem to have relatively lower stress. We, however, tend to overlook the fact that

Ms. Morishima (far right) and the staff at L'Hopital de Mélen (Source: Ms. Morishima)

elderly inmates can be in vulnerable position. I think we can provide better service by balancing kindness with frankness." Ms. Morishima is striving to realize better nursing care, by sharing what she has learned in Japan and Gabon with her colleagues.

$ ^{*} $ Japan also provided Grant Assistance for Grassroots and Human Security Projects for newly establishing the Elderly Division within the hospital.