ABSTRACT
Objective：The Nagasaki Prefectural Centre of Medicine and Welfare for Children was established in 1954 as a center for children with physical disabilities in Nagasaki prefecture. Medical education consultation in the local area of Nagasaki prefecture was started in the following year.Methods：We examined the number of patients and the area selected for this project over the recent 36 years. Documents from the center's library were examined, and orthopedic physicians who had previously participated in the project were interviewed.Results：The number of patients and visiting areas in the project continuously decreased. This patient tendency was caused by the declining birth rate in Japan and the satisfaction from human services in local areas. The decrease in the number of local areas visited was affected by the financial administration of our center and the development of a traffic network in the mainland of Nagasaki prefecture. Health visitors now working in the island continue to require visits to pediatric specialists from the mainland twice a year. The number of visits to four selected isolated islands has been maintained till date.Conclusion：Medical support from the mainland is necessary for isolated islands because of the absence of physicians, especially those for children with physical disabilities, and visiting the hospital in the mainland by airplane is difficult for these children.