cseas nl74 Fujisawa Michiko Visiting Associate Professor, CSEAS

My Fieldwork as a Medical Doctor

I write this essay with some trepidation and doubt that maybe I don’t deserve to comment on fieldwork. This is because I have always looked up to fieldworkers such as anthropologists who have mastered language and adapted to the people and cultures they are interested in. However, I do also work in the field. In fact, when I say that I am a Japanese medical doctor, it is relatively easy to be accepted at a field site. Yet as a woman, people seem to feel that I give off a soft impression. Sometimes people may take a threatening attitude toward me. Yet from the outset, I feel this soft impression has its advantages in allowing me to be accepted in the field. For health surveys, it is rather easy to collect data without speaking any language. If we stay for some days, we can see what people are eating and what activities they participate in. We can get data from blood samples and measuring blood pressure and so on. However, just from this we cannot know what they are thinking about their lives, health, and diseases. To communicate with people, we need language. Because of my age and because I am a doctor, people always treat me with some kind of respect and I have difficulty understanding their true intentions. In other words, what I want to say is that it is better to go out and do field research when you are young.

I specialize in geriatrics and conduct research on aging in various societies. Diseases are often only a part of aging for the elderly, therefore learning how to live side-by-side with diseases is often more important than receiving treatment. Even if physical functions decrease, an independent life would support the elderly to maintain their right to choose their own lifestyle and maintain their dignity. Based on this idea, we have done fieldwork in Kahoku, Japan which has intended to improve the independence of activities of daily living (ADL) even if the elderly have diseases or disabilities. I joined this activity as a medical student, thinking diseases must be treated completely. However, by participating in these activities my eyes were opened to another reality.

Subjective life satisfaction is higher among people independent in ADL, compared to people dependent in ADL (this is as expected). However, from field research we have conducted as a team, we noticed that the improvement of independency of ADL did not necessarily increase the quality of life of people in a community (Matsubayahi et al. 1997). I was awakened to the fact that health plays a big role in the lives of the elderly, however it is not health itself that is the most important thing in life. An independent life means we bear responsibility for our own individual lives. This is meaningful in the western world. Until a few decades ago, in Japan, several generations lived together and the family was nested in a kind of co-dependent relationship. I wonder then, if the aim of a dependent life doesn’t fit the values of traditional Japanese.

Excluding other depopulated aging areas in Japan, what about other places? Dr. Matsubayashi (Emeritus professor of CSEAS), my supervisor, started research in Asian countries where aging has rapidly progressed, and Dr. Okumiya (Visiting professor of CSEAS), my senior, started investigations in high altitude areas where people are living under extreme conditions of low oxygen to see how aging plays out in different environments. To look at issues from another perspective, I took an opportunity to research the aging of chimpanzees in their society as they are the most closely related animals to us and possess an advanced social structure.

Fig.1 Fanle, the right chimpanzee, is carrying her son ventrally, and Fana, next to Fanle, is carrying her grandson on her back. (Photographed by Kimbery J Hockings)

Generally, the elderly are regarded as people who have fulfilled their roles and retired from social and economic activities. The most important biological activity is reproduction and as with most other animals, survival rates fall with decreasing fertility. In general, in the animal kingdom, healthy individuals do not help disabled individuals. However, most human societies acknowledge the elderly as the recipients of care. Through participation in social activities such as child-rearing, the elderly contribute greatly to our prosperity (this is known as the Grandmother effect) (Lahdenperä et al. 2004). Chimpanzees create a paternal society and females move their birth groups to others at the age of sexual maturity. Chimpanzee females have to raise their children only by themselves for about five years until children become independent. There is no evidence of menopause in chimpanzees and their survivorship declines with their decline of fertility (Thompson et al. 2007). However, we have observed that there are some chimpanzees who have already reached menopause in their groups. The population of this group is aging and fertile females are extremely rare. Let me give an example of what I mean. I assume because of this reason, one very young female, named Fanle, got pregnant before she reached the age to leave the group. Fanle’s mother, named Fana, was at the end of her reproductive life, and we made many observations of her persuading or helping her daughter to care for the infant. In particular, when the second son was born before the first son matured and became independent, I observed that the first was taken care of by the grandmother, Fana, and the second son by his mother, Fanle (Fig. 1). This observation indicates that when there is an opportunity, old chimpanzees will take on the role of “grandmother.” We also noticed that old females who reached menopause play with children very frequently.

In the past, the elderly were respected for their wisdom and their experiences. In the chimpanzees group, there is also an old male, and he seems to be the most trusted among females. Is this because his experience is useful in stabilizing the group? Or is it due to the long length of time spent together creating affinities or feelings of reliance? Maybe it is reasonable to think that both play an important role in trusting the old male.

Fig.2 A young man who is using a mobile phone with traditional costume (Photographed by Ebashi Chihiro)

At present I am investigating how people’s health status changes and how this change influences their way of life and thinking. In the New Guinea highlands of Indonesia, people were still continuing their traditional lives on my first visit in 1999 in spite of a rise of many tourists visiting from the West. Yet, recent rapid urbanization and modernization of neighboring areas triggered by immigrants from other islands of Indonesia have disrupted traditional tribal societies (Fig. 2).

Industrialization first took root in the West before spreading to other countries including Japan. The Japanese have maintained their own relationship with those around them, however with modernization, a western way of being which we can call individualism, heavily influenced the nation. This may have led to a decrease in our confidence with our own way of being. This is by no means unique to Japan and the people I have met, such as New Guinea highlanders or forest people in Guinea who are also facing rapid changes to their lifestyles. What we are seeing is an intense period of transition in our values across the entire world.

We can learn about the different concepts of values from field research because we go to places and share our lives with people living there. Even if their worldview is very different from ours, we can understand it in the context that it fits the environment or might be based on historical events. The role of the researcher may be to encourage people to look at the world with an open mind to understand and respect others, even if we find it hard to share the same values.

We are social animals. Chimpanzees also greet and pay attention to issues or sometimes protest against others. They don’t use language but they carefully observe others in order to understand. Human prosperity is due to our collaborative relationships; thus it is important for us to think about ourselves vis-à-vis others. Subjective happiness of the elderly is also deeply related to a feeling of connection with others. From time immemorial, people have said “no man is an island.” Yet, in spite of this wisdom, I am appalled at how little we have learned from our ancestors and primate cousins.


Lahdenperä, M.; Lummaa,V.; Helle, S.; Tremblay, M.; and Russell, A. F. 2004. Fitness Benefits of Prolonged Postreproductive Lifespan in Women. Nature 428: 178–181.
Matsubayashi, K. et al. 1997. Quality of Life of Old People Living in the Community. Lancet 350: 1521–1522.
Thompson, M. E. et al. 2007. Aging and Fertility Patterns in Wild Chimpanzees Provide Insights into the Evolution of Menopause. Current Biology 17: 2150–2156.