Bridging medical borders with okigusuri in AfricaNPO 法人AfriMedico 代表理事の町井恵理さん

アフリカでの医療支援に取り組むNPO法人AfriMedico代表理事の町井恵理さん。江戸時代から続く日本発祥の「置き薬」の仕組みをアフリカで展開し、医療アクセスが限られる農村部にセルフケアの薬とノウハウを届けている。医療でアフリカと日本をつなぎ、健康と笑顔を広げている。

Eri Machii is the founder of AfriMedico, a nonprofit that brings Japan’s traditional okigusuri system to regions in Africa with limited access to medical care. “In Africa, I’ve seen people die due to a lack of basic medical necessities readily available in Japan. I wanted to rectify that situation by deploying an okigusuri system in Africa.”

In university, Machii majored in pharmacology before joining a foreign pharmaceutical company. She enjoyed the work, but aspired to do overseas aid. “While backpacking through Asia in university, I volunteered at a children’s home in India run by Mother Teresa and realized this was what I wanted to do. But I felt gaining solid work experience first was important.”

Machii says that in school, she wasn’t very good at English. “But I knew that aid work calls for language skills. Back when I was working for the pharmaceutical company, I attended an English conversation school and studied whenever I could spare the time.” At 27, she decided to get cracking on realizing her dream. “I applied to JICA (the Japan International Cooperation Agency) as a volunteer to help fight infectious diseases and was stationed in Niger.”

Her time there was tough and intense. However, as she gained experience in international aid work, she was assailed by the feeling that “my efforts weren’t fixing the root causes of poverty and illness. I learned the importance of educating people about diseases and self-medication, but even then, awareness didn’t lead to a change in behavior. For example, even if people knew mosquitoes caused malaria, they lacked the means or opportunity to buy a mosquito net. We needed to connect knowledge to behavior patterns.”

After two years, Machii returned to Japan and started studying at Globis University’s Graduate School of Management. “As I considered how to help people in Africa live healthier lives, I realized that the first challenge was my own lack of ability. I wanted to learn how to create sustainable systems and manage organizations, so I decided to study at Globis. I didn’t think I was the entrepreneurial type but eventually, I created the business model for AfriMedico and became the founder and president.”

AfriMedico is the only organization in Africa offering the okigusuri service. Machii also launched AfriMedico in Tanzania, where local members are now running the organization independently and sustainably. “One of the biggest merits of okigusuri is the ‘use the medication now and pay for it later’ system. Having a set of medicines right in the home is a game changer for everyone.”

Japan’s okigusuri service goes back about 300 years and it’s one of the things that has shaped this nation’s health care system. Okigusuri used to be in every home but these days, it’s distributed to residences in locales where doctors and hospitals are not always accessible. There’s no initial cost or paperwork – the box is brought right to your door and all you have to do is store it somewhere. The okigusuri box contains medicinal remedies like pain relievers, indigestion pills, hot and cold compresses, sterilizers, bandaids, surgical gauze and more. At intervals, a salesperson comes to your door to check up on the medications that have been used and replenish the supply, sending you the bill later. They will also take away the old pills and replace them with new, updated versions.

Machii’s AfriMedico replicates the Japanese okigusuri service, but also raises medical awareness and encourages self-medication. “In the okigusuri box, we include informative leaflets about the pills, what to do when someone is injured and other useful tips. It’s a great way to spread preventive medicine and endorse basic medical knowledge, which is empowering for everyone.” (Kaori Shoji)

Words to live by