Friday, December 31, 2010

In Japan, Mark Yamazaki pioneers importing wide variety of wheelchairs

From The Japan Times:

"You can't keep a good man down" is the darkly applicable phrase that springs to mind when listening to Yasuhiro "Mark" Yamazaki (pictured). The energy, conviction, sense of mission and utter absence of self-pity in this soft-spoken man is humbling.

In 1979, the Tokyo-born Yamazaki, now 50, was attending high school in Massachusetts. It was about a year into his studies, and the students had opened the dorm windows to let some air into the building after curfew on an unseasonably warm February night.

Yamazaki was sitting on the low ledge of the hallway windows, a place students often gathered. But when he leaned back against the window grate, it broke and he fell three stories to the ground, breaking his back, fracturing his skull and severing his spinal cord. Unconscious for 10 days, Yamazaki awakened to find himself paralyzed from the waist down.

At a time when such an accident in Japan would have likely meant a three- to seven-year hospital stay, he was out and about in just four months. Unbowed by fate's blow and determined to live as full a life as he could, Yamazaki remained in the U.S. and went on to complete high school and college before returning to Japan.

It wasn't until his return in 1985 that Yamazaki realized how different the years following his accident would have been had he spent them in Japan instead of the U.S. "When I came back from the United States after college, I was surprised to find that such an advanced country as Japan had such poor wheelchairs. There was no assistive technology, no pressure-relieving cushions, seating devices, nothing," he said.

The counseling he had received soon after his accident had helped him maintain a positive outlook and focus on what he could do, not what he couldn't.

An avid swimmer, Yamazaki had immediately asked if he would ever be able to swim again. "They told me, 'Sure!' and told me that many paralyzed people lead very active lives," he said. Such counseling, or even an honest briefing on one's condition, was virtually nonexistent in Japan at the time.

Realizing the need to help others with similar conditions, Yamazaki in 1990 started Access International Corp. Today, the company mainly imports and sells a wide variety of wheelchairs, from simple manual models to lightweight, sports chairs, state-of-the-art power models and standing chairs, as well as other seating goods and assistive technology products.

In the early days, with his business slow to take off, Yamazaki made full use of his double major from Boston College in marketing and computer science and produced and sold computer software.

"I couldn't profit just from selling wheelchairs. No one would buy them at first so we had to concentrate on educating people," he said.

That education focused on what was, at the time, a severe lack of understanding of how seating and positioning could greatly affect a wheelchair user's health and mobility.

Today, Access International is considered the pioneer of seating in Japan, and thanks to it many people have realized huge improvements in their lives. A simple diagnosis and minor adjustment are often all that is needed for a person to avoid undue suffering and expense and significantly raise the quality of life.

Yamazaki was familiar with the pain from his personal experience. After six operations for pressure sores, he went to the U.S. for surgery. "The surgery itself wasn't much different from in Japan," he said. "But what was different was that after surgery there was a person called a 'seating specialist' who checked my pelvis, said it was tilted and that was the reason I was getting the pressure sores.

"They changed the balance of the cushion and also the back support and cured it."

Since then, Yamazaki has been free of such problems, and now travels regularly to the United States to learn the latest in seating and import the knowledge to Japan, where he holds seminars and seating clinics and gives seating trials and consultations nationwide.

Surprisingly, Yamazaki's work was often met — and is still met — with animosity, largely from hospitals and doctors. The reasons for this are manifold, one being the "close relationships" he says often exist between hospitals, wheelchair companies, dealers and local governments. Long-term ties are given priority and outsiders are shunned.

"In the beginning, some local governments outright refused to use imported products," Yamazaki said. "Some people are also simply afraid to use new products or just don't want to change."

Sadly, the resistance to change, for whatever reason, comes at the expense of those who need help the most. "The history of my company has been one of fighting this resistance," he said.

In the early years, when Yamazaki found so many doors shut, he decided to start approaching only those who were receptive to the help he offered. With no advocate to speak for him and no media coverage of the industry, the going was rough. But with time, satisfied clients whose lives had been drastically improved by his assistance and products helped to spread the word. Eventually, more and more hospitals opened their doors to him and an ever-increasing number of doctors and therapists stepped forward to learn. This, he points out, is happening just in time.

"Everyone is worrying now that in about 10 years, the number of caretakers needed in Japan is going to double. This is crazy!" Yamazaki emphasizes that the right products and proper seating can enable people to comfortably stay in wheelchairs the entire day, not just a few hours. "Too much time and manpower is still spent carrying people back and forth from their wheelchairs," he said.

Today, Yamazaki works not only on a one-on-one basis with clients but also as an adviser, committee member and consultant for universal design. The author of two books, this year he will act as a consultant in the construction of two buildings to make them more accessible to the physically disabled. "For the past 25 years I've been working to bring the level in Japan up to at least what it was in North America," he said.

"I want to tell people, 'Come out, get out of your home more.' If there's something you can't do, because of the wheelchair or the environment, we can change that."

Another of Yamazaki's projects is the promotion of parking permits for the disabled. Though designated areas exist in Japan, they are often taken by able-bodied drivers. Starting in Saga Prefecture, Yamazaki set out to establish permit systems and has now succeeded in implementing them in 16 prefectures and two other cities. "It's great!" he exclaimed.

Yamazaki is also eager to see Japanese permits recognized in the U.S., which would enable Japanese to take advantage of the wide choice of rental cars abroad that are equipped with hand controls. "When I drive in the U.S., I just reserve such a car on the Internet, but I still don't have a handicapped parking permit because they are only available to people living in the U.S.," he said.

Yamazaki is also approaching domestic rental car companies to try to increase the number of vehicles available for disabled drivers.

In 1995, Yamazaki started Active Japan, the country's first magazine for disabled athletes. He himself competed in the Barcelona Paralympics as a swimmer, and although he failed to win a medal, he made the finals in the 100-meter breaststroke.

During that time, Yamazaki was struck by the fact that there was no Japanese media coverage of the games. "There were maybe three lines in the newspaper," he said.

After Barcelona, his magazine and numerous television and radio interviews helped change that for the 1998 Nagano Paralympics, which received a lot of attention from Japanese media. "I didn't start the magazine just to print sports notices. I wanted to really change disabled people and the people around them," Yamazaki said.

Unfortunately, the now-defunct magazine ultimately became a source of disappointment for Yamazaki. He did not want to see it used to sing the praises of people who, he thought, did not serve as appropriate role models of living well-rounded lives and continuing to do so long after their competitive career.

"Some (former Japanese athletes) have no vocational skills and are living in nursing homes on a pension." A lack of income means they can't afford good wheelchairs and are at the mercy of the "kaigo hoken," or long-term care insurance, which Yamazaki said can lead to a further deterioration in their health.

Yamazaki himself continues to compete in swimming events and, at the end of November, he competed against 20- and 30-year-olds in the national swimming championships for the disabled in Tokyo, winning the 50- and 100-meter breaststroke and setting meet records in both events.

He also goes scuba diving, which he took up while in college. Even losing his bladder and a kidney to cancer recently has failed to keep him down.

"For four years I didn't scuba dive because of the cancer, but now that it's good, I am back scuba diving. Now I can show people who don't have a bladder that you can still do all these things," he said smiling.

"In my years in the United States," he said, "I later realized I never thought of myself as a disabled person. But when I came back to Japan I suddenly felt that I was disabled.

"When I was in a wheelchair in the U.S, people would look at me and say, 'Oh, you're a college student.' Here, when I came back and was a businessman, people would look at me and say, 'Oh, you're a disabled person.' Always the disabled part came first."

Though he believes things are changing: "In Japan, different is bad. I'm telling people, 'Different is not bad, it's just different.' "