Hiroaki Shiihara, M.D.PhD.

Tokyo Metropolitan Tobu Medical Center for Persons with Developmental/multiple Disabilities (TMTMC) was established by the Tokyo Metropolitan Government in 2005. It has been administered by Social Welfare Cooperation, National Association for Children (Adults) with Severe Motor and Intellectual Disabilities (NAC for SMID). The objective of our center is to provide intensive medical care and the best “Ryoiku” (therapeutic education and rehabilitation) to promote fruitful lives for children and former children with SMID.

Our philosophy is to support the weakest people without exception, which is the basic concept of the NAC with SMID. We accept the severest SMID cases who require intensive medical and nursing care. We provide them not only with specialized intensive medical care but also with pleasant experiences inside and outside of our center. We support their lives safely and comfortably. We do want them feel their lives are/were so nice.

We run day care facilities for children (infants and toddlers) and adults with SMID separately for people who live in the communities. We also accept people with SMID in order to treat acute diseases and to provide respite services in our wards. Our target is mainly the people who live in the eastern part of the Tokyo Metropolitan area.

Our outpatient clinic is specialized mainly in child neurology. Many children visited our clinic because of various kinds of developmental and neurological concerns such as delayed or deviated development in speech, motor abilities, or social communication. Patients with convulsive events also visit the clinic.

Considering the brief history of SMID, there was almost no medical or social care for people with this condition from ancient times until the end of World War II. Medicine had no power to save infants and children with such severe disabilities. Neonatal death rates and rates of child death due to infection/dehydration were very high, even for children without any handicaps. In the defeat of World War II, many parents died from the war or if they could survive, they could not choose but abandon their children.

Dr. Teijyu Kobayashi, who was a pediatrician and a real revolutionary in providing for the medical treatment, social welfare, and care of SMID patients, was director of the Department of Pediatrics at the Red Cross Hospital in Tokyo. Since 1946, he had many abandoned children with handicaps especially with SMID in his wards. He could not discharge them from the hospital. Many children did not have home to go back. Even if they have home to go back, their handicaps were too severe to care at home in the ashes of defeat of World War II.

Dr. Kobayashi encouraged the mothers who visited his outpatient clinic for their children to work together cohesively to secure the lives of their children and to establish a parents’ organization in 1955. This was the beginning of NAC for SMID which was established in 1964. Along with the efforts of its members including Mrs. Masako Kitaura (honorary president of NAC for SMID) to improve their children’s lives and overall social welfare, important achievements were made by their predecessors in this field such as Dr. Kobayashi, Mr. Kumakichi Kusano (the founder of Akitsu Ryouikuen established in 1958) and Mr. Kazuo Itoga (the founder of Biwako Gakuen established in 1963).

Mr. Itoga is famous for his proposal to “make these children to be the light of the world” and not to “give these children the light of the world.” His noble and lofty philosophy regarding children with disabilities has continued to be transmitted for generations.

Prior to these pioneers, children with severe handicaps often could not survive infancy, and if they did, they were often impounded in a confined and restricted area in their house, secretly abandoned, or otherwise neglected. A social welfare system for people with SMID has developed over the past 50 years. We would like to continue to take care of people with SMID.

In the Japanese community, the numbers of survivors with SMID at the Neonatal Intensive Care Unit and the severity of their conditions have increased because of progress made in neonatal medicine, in the quality of medical care, and in nursing techniques. Most people with SMID are now able to live considerably long. Thus, as they grow older, their families also become older. Under these circumstances, parents want their children to be cared for at comfortable and safe facilities. At the same time, the number of people with SMID and their families who want to continue to stay at home, even if their disability is very severe will increase.
Thus, we provide a day care center, beds for respite, and a consultation office for Ryoiku and social welfare through cooperative relationships with public/private facilities and local governments.