Although an ocean and several time zones separate them, both Jefferson County, Washington, and the Ishikawa Prefecture in Japan are home to rural residents whose distance from big cities can limit the medical resources readily available to them.

A delegation from the Ishikawa Prefectural Nursing University made the trip to Jefferson County on March 24 to see how the South County Medical Clinic in Quilcene ensures that local country dwellers can receive quality health care.

Merrily Mount serves as the nurse practitioner for the clinic, a position that doesn’t even exist in Japan, so her visitors expect it will take at least a half-dozen years to properly emulate her practice.

Tomoe Makino serves as dean of the university, while fellow registered nurse Noboru Hasegawa is a professor of biochemical pharmacology at its department of health and medical sciences.

With Yumiko Osawa translating for them, as well as for associate professor and public health nurse Hisae Tsukada, all three faculty members agreed that many of the health problems most commonly faced by rural South County residents – high cholesterol, diabetes, cancer and nicotine use – are also prevalent in Ishikawa villagers.

COMMUTING TO CARE

“They have to commute to the nearest larger towns to receive treatment for major medical conditions,” Makino said. “Some villages have tiny clinics, that can deal with minor ailments like diabetes, but serious illnesses can only be treated by big hospitals.”

Makino explained that the nurse practitioner status is such a new concept to her country than she anticipates that a number of discussions will have to take place within the Japanese government before schools like hers can even begin to draw up curricula to train their own nurse practitioners.

“That they can have an independent practice that is actually supported by the government is amazing,” Makino said.

“We can write our own prescriptions,” Mount said. “We can make diagnoses and treat patients. We can staple together lacerations, deliver babies and even assist in surgery. We can run lab tests without assistance. And we can run our own businesses.”

Mount admitted that she has no business background, which is why she’s so grateful to lead a satellite clinic of the Jefferson Healthcare hospital in Port Townsend. She credited the hospital with paying the bills and keeping the power on, so she can focus on getting to know her patients.

“Nurse practitioners treat the total person,” Mount said. “It’s not just about giving them medicine. It’s asking them about their meals, and how well they’ve been sleeping. They say 70 is the new 50, but what you do in your 30s and 40s will affect how healthy you are in your 50s and 60s.”

Mount works with patients to curb them of habits such as smoking, excessive soda or alcohol consumption, and sedentary lifestyles.

“We need to keep moving, or our bodily fluids will pool in our lower extremities, causing diseases,” Mount said. “Simple steps like drinking more water, walking 20 minutes a day and eating real food can make so much difference.”

LOCAL RESOURCES

Mount also noted a number of resources she has available to her in Quilcene, from the fire and rescue station directly across the street from her clinic, to the massage therapist just down the street.

“If one of my patients goes to see a pharmacist and forgets to tell me, I can pull up the records on my computer,” Mount said. “If I have a patient here who needs to be sent to Seattle, I can have a helicopter land outside my door, and that patient on an operating room table, in 20 minutes.”

The Japanese delegation were treated to a taste of the local culture, quite literally, when Garry Stebbins, principal of the K-12 school at Quilcene, escorted two of his sixth-graders, Barron Williams and Riley Benek, as they presented the visitors with gifts of Pacific oysters and Fuji apples, both of which originated in Japan and have thrived in Washington state.

Jefferson County Commissioner Kathleen Kler, a Quilcene native, likewise greeted the Japanese delegation by noting that many of Washington pioneer farming families were Japanese.

“When an oyster is irritated, it develops a pearl,” Kler said, alluding to Quilcene’s nickname as “the Pearl of the Peninsula.” “Our isolation as a community is a problem, but from it, we’ve developed a pearl of a clinic.”