Human rights activist Dr. Masaki Tada leads a double life. He has just returned from Peshawar, Pakistan, where he struggled to save the lives of Afghan refugees with the meager resources at his disposal. In Japan, he plays a very different role — as president of Josai Hospital, a modern, fully equipped hospital in Ibaraki Prefecture.

Here, he lectures about the gravity of what he has just witnessed in Peshawar. His message raises an important question: What does it mean to be human? Can we shut our eyes to others’ suffering or should we try to do something about it?

For Tada, the only option is the latter. With more than 20 years of experience in the refugee camps of war-torn countries, including Cambodia, Ethiopia and, for the last 14 years, Pakistani camps teeming with Afghan refugees, he brings to his work a medical mission.

He also, by taking photographs of what he sees, shoulders the more personal responsibility of moving the Japanese public to take action.

“I take pictures to let people know what’s really happening there,” says Tada, who is also president of the nongovernmental organization, the Japan International Friendship and Welfare Foundation.

Having recently returned from JIFF’s Malnutrition Project in Peshawar, where he spent nearly six weeks from late October to early December, Tada’s most recent photos testify to the disease and starvation of the Afghan refugees. There are babies with rickets, children with severe skin infections — all with the same glassy stare. One photo shows a child with seven fingers on each hand. Another, a mother with severe gout. And yet another shows a child suffering the effects of a genetic defect. His feet are mere stumps.

“These children are often very sick,” Tada says. “Some have birth defects. If we had an intensive-care unit, such babies would have a chance of surviving, but we don’t have an ICU facility in Peshawar.”

Of the 500 children that pass through JIFF’s Malnutrition Project every day, about 25 percent are severely malnourished. “One-year-old children can weigh as little as 3 kg and be nothing but bones, severely impairing their ability to walk,” explains Tada. If they live at all.

For 14 years, JIFF has provided free food, medical assistance, X-rays, physiotherapy, pharmaceuticals, education and training to the thousands of fleeing civilians who have taken refuge in Peshawar over the desperate years of war in Afghanistan. The number of refugees dramatically rose after the Sept. 11 terrorist attacks. The seven JIFF doctors and nurses in Peshawar now see more than 1,200 people per day. JIFF finds itself severely short-handed, with a staff that has shrunk from 20 to just seven after the terrorist attacks.

JIFF’s staff includes the four Ahmadyar brothers, who are native Afghans. Three of them are doctors, who worked in Tada’s private 319-bed hospital in Ibaraki. They made headlines in Japan this year in September and October for their decision to ignore the government’s Level-5 danger warnings and to go to Peshawar for refugee relief work.

Tada gave them his full support. After all, their relationship goes back a long way — to 1988, when the oldest of the brothers, Kazem, began his affiliation with JIFF. Following the attacks, three of the four went to Peshawar. Only the youngest, Jafar, remained behind in Ibaraki to support his brothers’ families and to coordinate JIFF activities in Japan and Pakistan.

Avesta Ahmadyar, eldest son of Akbar Ahmadyar, a surgeon, follows what his father does in Pakistan with understanding well beyond his nine years. “I want my father to help the refugees as much as possible,” he said in a television interview. It was an expression of hope and faith about his father’s mission, a hope that is echoed in the refugee camps of Peshawar and captured by Tada’s camera.

Some of his photos depict the courtyard of the Malnutrition Project, with mothers and children sitting together in the shade of the trees. They pass the daylight hours waiting for their turn to be called. Beautiful women wear their blue burka loosely to expose surprisingly young faces. Children in colorful, embroidered clothing are seen doing ordinary things. They play ball, sit and chat, or carry newly acquired sacks of food back to the camps.

After a long wait comes the examination. The difference between the fairly healthy children and the severely sick and malnourished ones is clear. But for Tada, every child deserves a treat.

“They have such long faces when they meet me and this makes me so sad,” Tada says. “So to build trust and open the lines of communication, I put a caramel candy in each child’s hand before I examine them. Their faces light up. Then they start to think of me as a nice ojisan.”

Other photos capture the educative efforts of relief workers, who use simple illustrations to teach mothers to make powdered milk, or to sterilize water by boiling it. Some pictures show a striking contrast between the hunger of the camps and the abundance in the crowded markets of Peshawar, where food, medicine, clothes, blankets and other basic necessities are available for anyone with the money to pay for them.

The 10 million yen that JIFF receives annually from the Postal Services Agency, supplemented by 20 million yen it raises in donations, is barely enough to keep the Malnutrition Project center running. Tada’s photographs are part of a traveling exhibition, available for loan and on the Internet. JIFF hopes that it will raise awareness about the magnitude of the human tragedy among Afghan refugees — and make visitors realize the difference that a donation can make to a refugee child’s life.

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