After the quake

Weekender, The Star
Story and photos by LOH FOON FONG

Japan is still recovering from the earthquake and tsunami in March, but the people are unbowed and continue to exude warmth and generosity.

THE crowd at the Universal Studio in Osaka was only a quarter of what I had expected. The numbers had not returned to “normal” since the earthquake in Sendai on March 11.

Business was still slow three months after the tsunami.

Not one to thrive on crazy rides, I hesitated at a roller coaster ride but then thought I should experience it now before I was too old to do it anymore. I shut my eyes the moment the coaster moved high up and started plunging downwards and side-ways, speeding up and down mercilessly.

I dared not open my eyes, and just when I could not bear it any longer, the ride ended. Phew! Feeling like a nervous wreck, I shuddered at the thought of another ride. But then after lunch, the Spiderman 3-D adventure beckoned, and we couldn’t resist. Hopping on board, we saw Spiderman swinging and fighting the bad guys high in the air as our jeep escaped the attacks of strange huge creatures and from falling from midair.

Standing tall: The Statue of Liberty and the Rainbow bridge in Odaiba snapped from the Aqua City Mall.

The ride, filled with special effects including fire and water targeted at us, made us feel like we were in the thick of action.

We had landed in Osaka on June 5 for a tour organised by Apple Vacations & Conventions and immediately commenced our tour of this river city with many bridges before we ended up at Universal Studio. Come dinner, we had fugu (puffer fish) – raw, fried, as well as syabu-syabu style (steamboat) – at the Zuboraya on Dotonburi Road.

I liked the fried version best. Raw puffer fish is chewy and without much flavour. However, the porridge was what surprised me the most. Watching the waitress adding overcooked rice and raw eggs into the steamboat soup with fugu and vegetables in it did not impress me, but I took a scoop anyway. It was surprisingly delicious, and I ended up eating two bowls despite being full.

We took a walk after dinner and came across live puffer fish in an aquarium at the Genpin Fugu restaurant. The restaurant has apparently been around for 30 years and has more than 100 outlets throughout Japan.

Genpin uses Tora fugu (Tiger puffer), reportedly the best puffer fish there is. We were taking pictures of the fish when an employee came out and started speaking to our guides in Japanese. Wary, I stopped taking the pictures but then he scooped out a fish to show us.

“The bigger fish can blow up to as big as a basketball,” said Shinya Nakamura, 30, the restaurant manager.

When I asked for permission to take a picture of him, Nakamura ran into the restaurant and came out with a gift bag containing a few stalks of carnations, a bottle of Japanese sauce and sparkling drink.

Genpin Fugu restaurant manager, Shinya Nakamura, with a puffed-up fugu.

Stunned, I refused but he insisted. His appreciative gesture and business skills floored us. The difficult economic situation had not hampered the Japanese generosity – I saw this throughout my six-day stay here.

We put up the night at Cross Hotel Osaka, a combination of modern furniture and zen-like atmosphere. It served the best breakfast of the trip – extremely fresh and crisp salad, and sausages and bacon that were top-notch.

The following day, we headed for Kyoto, 50km away, stopping first at Kiyomizo Temple, a Unesco Heritage site with a lovely view. Founded in 798 and rebuilt in 1633 by the third Tokugawa shogun, Iemitsu, the temple occupies a high point on Mt Otowa, with its main hall constructed over a cliff.

We then made our way to Gion, an ancient district in Kyoto famed for its traditional hut-like structures and the geisha who we could occasionally glimpse on the street. After that, we hopped on the Shinkansen (bullet train) from Kyoto to Hamamatsu.

The journey took us one hour, instead of three by bus. At the Hamamatsu train station, we stepped into Tonkatsu Wako for dinner. The food served looked like over-fried meat but we were told it was good. Indeed, I was surprised by how the pork cutlet coated with breadcrumbs was so delicious and crispy. It was succulent on the inside, with excellent meat flavour and texture.

Their tonkatsu sets came with the standard rice, miso soup, pickles, and tea, and were priced between 1,100 yen (RM42) and 1,600 yen (RM60).

At the Okura Act City Hotel in Hamamatsu, rooms department manager, Hideki Matsuura, said we were the first Malaysian tour group he had encountered after the earthquake. He said the hotel had only recovered 10% of their customers since the tragedy.

“All 50 tour groups from Malaysia that were supposed to turn up for the cherry blossom season in May and June cancelled,” he said, adding that Malaysians made up 18% of the tourists at the 45-storey hotel.

As the hotel catered to many local businessmen travelling between Osaka and Tokyo, Matsuura said he had not expected business to be very bad, but he was wrong.

An old trade in Kyoto.

“Now, we don’t know when they are coming back,” he said, explaining that local business travellers now did day-trips instead of staying overnight because business was bad.

At Owakudani, a volcanic valley with active sulphur vents and hot springs in Hakone, Kanagawa Prefecture, we enjoyed the scenic site despite the sewage-like odour. We had eggs boiled in the hot springs. The eggs had turned black and smelled slightly sulphuric.Apparently, eating them increases longevity.

Lake Ashi was our next stop, and it was rather deserted. At the Izu Hakone Railway station, sales and marketing manager Uematsu Kazuo said his area usually received 70% of the annual two million visitors to Mt Fuji, but for a month after the earthquake, no visitors came.

“It was a big loss for us,” he said. Fortunately, locals started to return a month after that and foreigners two months later.

“There’s no point for our government to say Japan is safe. People are not coming back, but foreigners who have come and seen for themselves and told others make a big difference,” said Kazuo, who generously treated us to lunch, refusing payment and even packing gifts for us.

Later in the evening, our bus stopped at the Factory Outlet in Gotemba for us to do a bit of shopping. After that, we made for the Fuji Mihana Hotel, where rooms were designed à la ryokan with futon on a tatamimat.

The highlight of our dinner was the huge Tarabagani crab (Alaska crab), which cost RM800 per crustacean, and assorted sashimi.

After dinner, we ran into a Malaysian tourist at the hotel.

It was the first trip to Japan for Raymond Gan, 47, and his family. Gan said he was impressed with the cleanliness, efficiency and friendliness of the Japanese. He said he did not worry about coming to Japan after the earthquake, but was concerned about food contamination.

A Japanese-style barbecue with fresh mushrooms and chillies, and crab brain (right).

“There are so many people here and they are not worried about the food, so I thought, why should I worry?” Gan said, adding that he then decided to snap up the deals on offer.

Malaysia Airlines (MAS) is among those that are offering attractive deals to Japan. It’s currently offering promotional fares starting from RM899 to support Malaysian tour operators, said regional vice president for Malaysia, Azman Ahmad.

Azman said prior to the tragedy, MAS flights to Japan were at 80% full or more, but after the tsunami, this went down to 20%.

“Currently, it is still low, and that is why we are offering the promotions,” he explained.

At the Fuji Mihana Hotel, owner Setsu Shintou said the number of lodgers from March to June were only 10% the number from the year before. He said 30% of Taiwanese, who made up half of the visitors to the hotel, had started to return, followed by the Thais and Malaysians.

Shintou, a former professional baseball player from Taiwan and a naturalised Japanese, said his two hotels and a restaurant were closed for one-and-a-half months after the quake, with huge losses incurred.

The following day, we headed towards Tokyo. The tour took us to Asakusa Temple and later, a walk around Ginza, where those with deep pockets could shop for premium items and the nicest things money could buy. In the evening, we had a train-ride from Shinjuku to Okubo station where we savoured seafood barbecue at the Fresh Seafood BBQ Restaurant.

Huge clams and crab brain (Kanimiso Kola) were certainly new to me. The crab brain has a creamy cheese texture and was tasty, but a bit too sweet for my liking. My favourites were the tuna, mildly baked in black pepper, butter and garlic, and the simple but tasty grilled mushroom and green chillies.

Restaurant owner Takeda Mitsuhiro said 30% of Taiwanese tourists had returned to his restaurant, and Thais and Malaysians had begun to return, too. He said he lost 20,000 tourists for a whole month after the earthquake.

Mitsuhiro, who is of Vietnamese ancestry, said the Japanese were very thorough when it came to food safety. They would not feed people food that was not safe.

After dinner, I decided to meet up with two Japanese friends.

Yuko Ito said they had so many aftershocks that many people felt dizzy and nauseous.

“A lot of Japanese are avoiding the beaches in Tokyo, Kanagawa, Shizuoka and Chiba this summer for fear of a tsunami,” she said.

Asahi Shimbun staff writer Daisuke Igarashi said the streets in Tokyo were quite deserted after the tragedy.

“There were hardly any foreigners for a whole month after the earthquake,” he recalled.

At Tokyo Disneyland the following day, we could see that the turnout was not great.

Tsutomo Takeuchi, from Tokyo Disneyland’s marketing department, said the March quake was the worst he had experienced.

“We could not even keep standing,” he remembered.

Tokyo Disneyland is hopeful that the summer promotion from mid-July to August would see a return of the crowds.

In the evening, we stopped by Aqua City Mall in Odaiba to capture a picture of the Statue of Liberty replica with the Rainbow Bridge in the background. Business at the mall had clearly not been spared. The prices of clothes prices had been slashed, and so for the first time in five visits, I bought clothes from Tokyo. Fancy that.

On this visit, although some of the sites were already familiar to me, I found the variety of Japanese food to be a pleasant surprise. However, what stood out the most was the warmth and generosity of the Japanese people in the midst a national tragedy.

Battling diseases on all fronts

Sunday Star, April 17, 2011

By LOH FOON FONG

foonfong@thestar.com.my

There is a need for a multi-pronged strategy to make Malaysians take their health more seriously.

SEAH Boo Hee, 42, was diagnosed with insulin-dependent diabetes when he was 16. His kidneys failed three years ago and he now suffers bleeding in the eye due to his diabetic condition. “If I had known the severe consequences of diabetes, I would have tried harder to change my diet,” he says.

Seah admits that as a teenager, he did not know much about good diet. “My normal diet,' like most teenagers, was fast food and sometimes mamak food at night.” He also did not realise he would lose his kidneys when a doctor told him about protein leakage in his urine five years ago, he adds.

“The doctor didn't explain to me what it meant and I thought nothing was wrong because I felt fine. If I was told that it was an early sign of kidney failure, I would have done everything I could to save my kidneys.” Being saddled with many health problems, Seah who is 185cm tall and weighs 94kg is finding it hard to get a job.

Dr Ikram: ‘If they live until 65 but get diabetes at 25, that’s 40 years of diabetes. A lot of complications can set in’

“If employers know that you need dialysis and have to be away from work three days a week, your chances of getting of a job is zero,” he says. Currently jobless, this graduate used to play tennis and squash and travelled a lot. He has had to give all this up because he is not allowed to drink too much water due to his failed kidneys.

Seah's mother died of diabetic coma and one of his older sisters is also diabetic. Many patients, like Seah, do not fully understand the severe consequences of diabetic complications until one of their organs fail or when traged y strikes. Nephrologist Dr S.S. Gill says many Malaysians think they are immune to these diseases. “They don't realise that it takes 20 to 30 years before they suffer from the effects,” he says.

Some even say they do not have chronic diseases although they are overweight. But as one ages, the risk of incidence will increase, he warns. “Our life span may now be longer, but it lacks quality.” According to endocrinologist Datuk Prof Dr Ikram Shah Ismail, one in five Malaysians is diabetic and three quarters of deaths related to diabetes are the result of heart attack.

“This is alarming,” says Dr Ikram, who is also dean of Universiti Malaya's Faculty of Medicine. In 1996, Health Ministry data showed that 8.9% of the population were diabetic and it was predicted to reach 10% in 2020. But by 2006, the figures had shot up to 14.9% and two years ago, it reached a high of 20%.

»My ‘normal diet’, like most teenagers, was fast food and sometimes mamak food at night« SEAH BOO HEE

Health Minister Datuk Seri Liow Tiong Laihas said the rise in chronic diseases is worrying. “Those getting chronic diseases are no longer in their 50s or older. Now, people as young as 30 or 40 are getting hypertension, heart attacks, diabetes and kidney failure. Many of these illnesses ca n be prevented,” he stresses.

He points out that the number of chronic kidney patients in the country has increased from 79 per million population in 2000 to 146 per million in 2009. The National Renal Registry reveals that the total number of patients on dialysis increased from 6,689 in 2000 to 21,159 in 2009, putting a serious strain on Malaysia's health resources.

Of these, 58% have diabetes. This puts Malaysia in the unenviable position of probably having the highest percentage of patients in the world with diabetes as the cause of end-stage kidney failure, according to Liow. Seah's case reflects three things. First, the need for doctors to talk to patients in layman's terms and help them understand the implications of their actions and their medical condition.

Secondly, parents and schools must introduce healthy diets and exercise to children from a young age; and thirdly, the whole machinery of society needs to be mobilised to support every individual in fighting chronic diseases.

Seah points out an important misconception diabetic patients tend to think that when they take medicine, everything will be all right. “They don't realise that if they don't take care of their diet and lifestyle, no medicine can prevent their organs from being damaged.”

Dr Ikram explains that although diabetes is an inherited disease, it does not mean it is unavoidable. “In the past, incidence of diabetes was low because people worked in the fields and they walked or cycled. Those with diabetic genes didn't become diabetic until much later in life, or totally avoided it.

“If they were supposed to get diabetes at 70, but died at 60, the diabetes did not appear in their lifetime.”

However, the life span is now longer and an unhealthy lifestyle has led those in their 20s or 30s to become diabetic, says Dr Ikram who believes that parents need to set good examples in their diet and also that schools should also provide healthier food options to children.

“You can imagine if they live until 65 but get diabetes at 25, that's 40 years of diabetes. A lot of complications can set in, like eye damage or kidney damage, and the quality of life will be poor.” Dr Ikram says people like to blame their parents for bad genes, but their lifestyle can determine whether they develop diabetes at the age of 30 or 70.

“For instance, many people say they cannot live without added sugar even when we tell them they are getting enough sugar from other food sources. People survived well without sugar in the past,” he says, adding that misplaced perception has also led many to see smoking as dangerous but do not consider their unhealthy diet as a problem. Losing weight and keeping oneself healthy, as many would attest, is a discipline in life that is almost unattainable for many.

“I try to bring down my weight but it's a struggle,” Seah, who is 16kg overweight, confesses. National Kidney Foundation chief executive officer Chua Hong Wee says even though Malaysians are now more affluent, their lifestyles have become worse and many are indulging in high-sugar and high-carbohydrate drinks and food, and eating late into the night.

“People are overeating, especially with easy access to food 24 hours a day. This poses a burden on kidneys because the organs have to work extra hard to remove waste,” he says. People must make it a life-long practice to reduce intake of sugar and salt, eat more healthy and balanced meals, and exercise but not many have the stamina to do the right thing continuously, he points out.

The dire situation needs to be tackled with drastic measures, and the Health Ministry has rightly adopted a multi-pronged approach. It adopted an “all-of-government” and “allof- society” approach against non-communicable diseases (NCD) this year, which called for the collaboration of 11 ministries, the local authorities, the media, professional bodies, private sectors, communities and NGOs. As Malaysians eat out a lot, the quality of food at food outlets has to be given top-most attention.

This is where the Health Promotion Board has to step up efforts to make food manufacturers and operators offer healthier options. As pointed out in a conference in Kuala Lumpur recently, the Singapore Health Promotion Board, for instance, had encouraged a manufacturer to produce whole grain noodles that incorporate 10% of whole grain, half the recommended daily requirement.

Dr Ikram also feels the authorities should restrict the opening of food outlets to 10pm. “People should go home and sleep,” he says, adding that 24-hour food outlets are a relatively new phenomenon and which we managed to live without in the past.

Liow points out that Malaysians are consuming too much oil (2.1kg per person per month) and the Ministry is studying its impact on their health. Dr Gill says awareness must be created continuously.

Finland, for instance, had one of the highest rate of heart diseases but managed to bring down the numbers after 30 years, he says. Efforts have to start with the young, he stresses. “It's tough getting people to change but we have to keep trying.”

Most Malaysians lack exercise, which can easily solve half of our health problems. In Australia, the local council provides gymnasiums for the public to use for free, he adds Dr Ikram has called on local councils to provide clean and safe parks to attract people to go there. Companies too can motivate their staff members to exercise together and promote better work relations, he says.

Understanding human behaviour or attitude why people tend to be addicted to eating bad food and not healthy food is a mind boggling matter.

Universiti Malaya Centre of Addiction Sciences director Professor Dr Mohd Hussain Habil says the Government should give more grants for such studies and on whether excessive eating habits should be treated as a form of addiction or psychological issue. “This is a relatively new concept that should be explored since obesity is an important public health issue,” he says.

The American Journal of Psychiatry points out in one of its issues that standard interventions based on promoting lifestyle changes to reduce excessive food consumption and increase physical activity are effective but people could not sustain the efforts.

One in three Americans is obese, and this increases risk for cardiovascular disease, diabetes, cancer, and other diseases, resulting in annual healthcare costs conservatively estimated for the US at $70bil to $100bil ((RM218bil to RM302bil) a year as well as reductions in life expectancy by five to 20 years.

In South Korea, naturally-derived sugar from fruit sources are often used instead of processed sugar and much of their meals, snacks and desserts contain little salt and sugar and are free of artificial colourings or additives.

The Koreans, who are very nationalistic about their food that is mostly made up of kimchi, vegetables, seaweed and fish, really take their health into their own hands.

Malaysians should emulate the Koreans as the battle against chronic diseases must be fought by the whole nation. Only when all citizens begin to take charge of their health and moti vate others to do likewise will they be healed of self-inflicted diseases.

Source: http://thestar.com.my/news/story.asp?file=/2011/4/17/nation/20110417072313&sec=nation