Abstract
Abstract
Okinawa, a group of small islands between Japan and Taiwan and a formerly independent kingdom, has been the site of wars conducted by foreign armies for hundreds of years. Since World War II, the mainland of Okinawa has been the principal focus of the American military presence in Japan. The people of Okinawa experience a number of adverse health and environmental effects from U.S. military bases. Environmental effects include aircraft noise, asbestos exposure, and pollution of sea, land, and air along with disrupted biodiversity. Adverse health consequences have been identified as severe hearing loss, sleep disturbance, poor quality of life, and increased cancer risk in local Okinawan people, and impaired learning among Okinawan school children. Furthermore, the central government of Japan recently approved construction work on a new U.S. military base despite strong opposition by the local population. Healthcare professionals are in a position to recognize and understand the adverse health and environmental effects of the existing military bases. However, no medical professional societies in Japan or the United States has ever commented on this issue. We believe that healthcare professionals have a responsibility to educate citizens and politicians concerning the adverse health and environmental effects of military bases, and to advocate for a more peaceful world.
Introduction
I
The people of Okinawa strongly oppose the construction of a new U.S. base and the governor of Okinawa has declared that the central government's decision “tramples on the will of the Okinawan people.” 6 There are two major reasons Okinawan people oppose the new U.S. military base: further adverse environmental and health effects on Okinawa and Okinawan people, and the longstanding antiwar philosophy of Okinawans.
Environmental Findings
The people of Okinawa have already experienced a number of adverse health and environmental effects from existing military bases. Aircraft noise has long been a huge public health problem in Okinawa. 7 Local residents living near military bases have developed severe hearing loss, sleep disturbances, impaired learning among school children, and poor quality of life. Use of asbestos in the U.S. military buildings has led to numerous cases of lung cancer and malignant mesothelioma among local workers. 8
Military bases have caused serious air pollution, including carbon monoxide, nitrogen oxides, hydrocarbons, and sulfur dioxide. Furthermore, the island's sea, land, and air have been contaminated by the leaked high concentrations of polychlorinated biphenyls, Agent Orange dioxin (retrograde shipments from postwar Vietnam), and dichlorodiphenyl trichloroethane, arsenic, depleted uranium, and nerve gas from U.S. military storage.9,10,11 It is expected that there will be ongoing environmental damage and adverse health effects produced by any new military base, as well as the other already existing military bases. Other dangers include aircraft accidents and damage to the fragile agricultural and fishing environments upon which the Okinawan people depend for their livelihood. A detailed discussion of the environmental problems of U.S. military bases in Japan was published as a compendium of issues disseminated in 2004. 12 The health harms of military bases were also described by the U.S. government's own Department of Veterans Affairs about the many presumptive diseases from the many toxins used on U.S. military bases. 13
In addition to these issues, there are other serious environmental concerns about the construction of military base in a large bay area in Okinawa that need documentation. Destruction of forest and its habitat with its lost CO2 capture would increase global warming. Light pollution affects many flight-borne species. There would be a massive impact on marine life, especially to fragile coral reefs.
Justice Concerns
Another reason for opposing the new Henoko base is the prevalent antiwar philosophy among the Okinawan people. Early in historical times, Okinawans inhabited the Okinawan islands by multiple waves of migrants from continental Asia and Okinawa became an independent kingdom over the chain of the islands. 14 Their language, the Okinawan language, made up one of two major different branches of the Japonic language family, the other one being Japanese and its dialects. 15 However, in the early 17th century, the kingdom was invaded by the Japanese and ultimately absorbed into Japan as one of prefecture in 1879. 16 During this period of Japanese invasion into the islands, Okinawan people developed and used karate, a unique martial arts system with bare hands without use of swords based on an antiwar philosophy, against Japanese warriors with bayonets. 17
Okinawa has been the object of centuries of foreign military occupation by China, Japan, and the United States. Okinawa was the site of harsh battles between the United States and Japan near the end of World War II (WWII), which killed almost 100,000 Okinawan civilians. 18 Since WWII, the central government of Japan still continues to force Okinawa to host about 70% (more than 30 bases) of all U.S. military installations in Japan, occupying 20% of the main island of Okinawa. In addition, it should be noted that Okinawans, with a 1.4 million population, are the largest minority group of Japan.
Okinawa had been previously known to be ranked as one of global precious regions. Although the Okinawan people were known to have among the highest longevity in the world, the rank has recently decreased because of multiple causes. 19 Socioeconomic status among Okinawan people is lower than that of the people of mainland Japan. Okinawa has the worst unemployment and child poverty rates throughout Japan. 20 Adoption of Western habits, such as fried and other “junk” food and a sedentary lifestyle near the U.S. military bases, has also adversely impacted traditional healthy lifestyles among Okinawans. 21 Thus, in addition to environmental effects, social and medical determinants of health in Okinawa have become worse, and life expectancy has plummeted. Furthermore, tourism, which is the major industry in the islands, currently faces serious challenges posed by limited land available for tourism, polluted beaches, and the nuisance of massive aircraft noise from the presence of multiple U.S. military bases.
Fortunately, several U.S. communities have taken the initiative of supporting the Okinawan position. On December 21, 2015, the City Council of Cambridge, Massachusetts, passed a resolution opposing the construction of the new base in Henoko, after the resolution by the Berkeley, California City Council in September, 2015, which opposed the new base and pledged solidarity with Okinawa. 22 The City Council of Honolulu, Hawaii, also proposed a resolution opposing the construction of the base in January 2016. These thoughtful councils of U.S. communities believe that it is their responsibility to support Okinawan people because the construction of the new base is mandated by the Japanese government in defiance of local opinion and is likely to cause further ill effects to local people.
Healthcare professionals have in the past played a key role in warning governments and the public about the danger of war, and this role is still needed. 23 We also believe that healthcare professionals have a role for protecting health of local populations, because they have a unique opportunity to assess clinical cases associated with effects of military bases. Politicians, the media, and ordinary citizens do not usually recognize, much less publicly acknowledge, real people with “hidden” problems, such as hearing loss or mesothelioma. Core principles of medical ethics such as justice, beneficence, and nonmaleficence lead us to advocate for disadvantaged minority people, and, indeed, all people, by protecting their rights for health and safety. Thus, healthcare professionals have the opportunity to accurately assess and communicate the adverse health and environmental effects of existing and new military bases in Okinawa. However, no medical societies in Japan or in the United States has so far provided comment about this issue. Healthcare professionals of Japan and the United States have the social and medical responsibility to educate the citizens and members of both governments to protect the Okinawan people from the ill effects of military bases, and to advocate for promoting a more peaceful and just world.
Footnotes
Author Disclosure Statement
No competing financial interests exist.
