Kawaguchi City, Saitama Prefecture

　Good news! Kawaguchi City of Saitama Prefecture has started a “Rapport Collection” system, by which the garbage from elderly citizens and disabled persons’ households are collected at their doorstep. This was the result of the two-year campaign carried out by the caretakers of Medical Co-op Saitama, who knew very well about the difficulties of solitary old people. Garbage disposal was one of them.

Putting garbage out for collection may put old people’s life in danger
　At the home of Ms. K (Age 68), the author waited for the garbage recovery vehicle to come to her doorstep for the first time. Ms. K may be too young to be called elderly, but she has lost her eyesight after many years of suffering from diabetes. Both her husband and sister, who used to help her out in time of need have already passed away, and she has no one to turn to among her relatives.
　She can manage everyday household duties at her home. Food delivery service is available for meals, and she can also turn to a guide arranged by the city for her outing, including hospital visits. But one thing she was unable to do by herself was to bring her garbage out to the collection point.
　The garbage collection point is only a few steps away from her doorstep, but it is located across the street with heavy traffic. She tried to take her garbage out there a number of times, but every time she lost her direction after she dropped the garbage bag, and had to ask passers-by for help. After several failed attempts, she gave up.
　“I know someday I would be run over by a car, and I would feel sorry for an unfortunate driver”, she said. So she consulted with her care manager and rearranged the visits by caretaker on the mornings of the combustible and noncombustible garbage collections.
　“The scope of the services available through the nursing care insurance was limited. But now that I don’t have to worry about the garbage, I can ask for other kind of assistance”, Ms. K said.
　Through the “Rapport Collection”, general garbage and recyclable garbage from ordinary homes are collected. Those who want to avail themselves of this service need to submit to the city an application form distributed at the city hall or other public facilities, or directly call the city office. Later, the city staff in charge will visit the applicant’s home to confirm the necessity, and make decision on the garbage collection service. If the applicants so request, city workers would actually visit their homes at the time of the garbage collection to confirm if they are OK.

One problem has now disappeared
　The garbage will be picked up at the applicants’ doorstep once a week on the same day. Ms. K says, “It is very helpful for me as I don’t have to sort out different kinds of garbage for specific days.” And “I was finally able to abandon old clothes, which I have been unable to get rid of, due to the irregular collection days.”
　A little after 10:00 a.m., a truck from the city’s environmental department arrived, and the staff workers picked up several kinds of garbage bags placed in front of the front door. “Here they come!” Ms. K smiled, as she listened carefully to the sound of their work. “It is a big load off my shoulder, since I have to deal with the garbage as long as I live.”

Caretakers requests met with city’s positive response
　This special garbage collection system was set up as the result of the voice raised by caretakers, who heard from one solitary client that she felt sorry for her daughter who would come to her place from afar every week to get her garbage out for collection. Other caretakers were also aware of similar problems among their elderly clients.
　Ms. Chubachi Yu, Director of Medical Co-op Saitama’s Care Center Kagayaki says, “In the nursing care insurance system, you cannot request for ‘placing garbage at collection point” as a single category of service. So we used to arrange our caretakers to include that service on the garbage collection day when they visit the client’s home for cleaning or cooking. But the garbage collection is usually done first thing in the morning and we often found it difficult to combine other service, such as taking a bath, with disposing of the garbage. Some clients even paid to their neighbors or agencies for garbage disposal out of their meager pension income.”
　Garbage collection at the doorstep of elderly or disabled people is a service now taken up by a growing number of local governments across the country. In Saitama City, next to Kawaguchi, it had already been started. The caretakers’ proposal of setting up this service was taken up by the regional social security council in its regular consultation with the Kawaguchi City authority.
　During the negotiations with Kawaguchi City officials, Ms. Chubachi spoke about the difficulty of elderly households to dispose of their garbage. She also provided information on other local authorities over the cost for the service, arguing that it would not affect the finance of the city.
　As a result, the service was introduced, by arranging existing collection vehicles and staffs, without incurring additional cost on the part of the city. Kawaguchi City estimates that among the 11,000 solitary old people in the city, several hundred households would use this service.
　Altogether it took two years before the service was finally adopted by the city. Ms. Chubachi says, “Other care centers in the city must have noticed the problems of garbage disposal that their clients had, but they did not know how to solve the problem, such as lobbying the city authority. I believe only our organization had such expertise and experience for achieving this result through campaigning.”

(Report & Photos: Kinoshita Naoko)