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Dr. Etsuko Kita doesn’t hesitate to respond when asked what is lacking in Japan’s assistance to the Third World — understanding and confidence.

Kita, 63, a pediatrician and public health specialist, has worked to help Afghan refugees as part of UNICEF.

Avon Products Co. is giving her this year’s Avon Award to Women for her decades of helping refugees worldwide, paving the way for Japanese to follow a career in international development and humanitarian aid.

The Tokyo affiliate of the New York-based cosmetic maker singled out Kita’s efforts to provide better sanitary conditions, inoculations and pregnancy testing for Afghan refugees in Pakistan in the late 1980s and early 1990s.

Avon said that in a world marked by threats and violence, as highlighted by Sept. 11, 2001, and its aftermath, Kita’s respect for human rights and efforts to improve health conditions in war zones should be highly regarded.

The award is to be presented to her Thursday in Tokyo.

Kita began her pediatric career at a hospital and university in western Japan. She was dispatched in 1986 to a hospital in Beijing by the Japan International Cooperation Agency as part of a development aid program.

When Kita later returned to Japan, she joined the former Health Ministry, working in the Cross-national Cooperation Section. At age 50, she became involved with a UNICEF task force and found herself working on behalf of 3.5 million refugees after the Soviet invasion of Afghanistan in 1979.

“There was nothing I was able to do at first but observe children and women encountering violence in ruined Afghan villages or refugee camps in neighboring Pakistan,” she recalled. “I felt pure anger for everything, even myself, for all the trouble in handling a situation that was beyond my expectations and capability.”

In Japan, she said, doctors are educated on the premise that they will work at well-equipped hospitals, handling a manageable number of patients coming from relatively high living standards.

Aware that such a background may be of limited use in a war-torn society, Kita, now a professor at the Japanese Red Cross Kyushu International University of Nursing in Munakata, Fukuoka Prefecture, is leading an academic push for sound official development assistance and cooperation from Japan.

Her classes center on the study of international health and humanitarianism, teaching how to assess health conditions, both mental and physical, and how to organize — with other developed countries if possible — aid that works within the limitations of the recipient area’s medical and sanitary conditions.

Aid needs vary from one region to another, Kita said.

In this regard, she said, aid assessments should not only take into consideration an area’s level of devastation, but also such factors as geography, the refugee situation, the nature of the conflict or disaster, and which cultures or religions may or may not be coexisting.

Kita grew up in Takarazuka, Hyogo Prefecture. At 17, she read a book written by a U.S. Army surgeon who had served during the Indochina upheaval in the 1950s and decided early on that a doctor must serve the people.

When Kita left Afghanistan in 1990, she chose not to practice again at a Japanese hospital and instead worked for five years managing ODA at the health ministry, following eight months of work at the Johns Hopkins School of Public Health in the U.S.

A later move to the World Health Organization headquarters in Geneva then fueled her anger toward the conditions faced by civil war refugees. She headed a team that provided health and medical aid in war zones, including in Angola, Burundi, Cambodia, East Timor, Sudan and Zaire.

She also worked on an interagency medical task force dealing with the humanitarian crisis in Kosovo.

Kita recalls seeing wounded women and small children outside hospitals. “Those were horrible scenes that really upset me,” she said. “Of course in hindsight, I made many mistakes.”

She noted that her priority now is to teach her students about the nature of her mistakes and how they might have been avoided.

Kita believes aid must be dispersed on the basis of principles that can be academically conveyed.

“I haven’t regretted getting involved in refugee relief,” she said. “Most Japanese are probably aware that there are serious problems in the world and that they should do something about them. They are not very good, however, at knowing how to get involved.

“We Japanese have amazing sense and skill, and could improve the lives of refugees in a way that differs from the Western approach. I’m still not sure what way that is exactly.

“However, I feel we should have the confidence to make a radical, fresh change from the conventional world commitment.”

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