In the battle of Okinawa between one third and one fourth of the Okinawan population was killed in the cross fire between Japanese and American forces. In the early years of the twenty-first century Okinawa is once again facing an acute shortage of medical personnel, particularly on the outer islands which are simultaneously facing aging and depopulation.

About 100 kilometers off the coast of the main island of Okinawa lies Kumejima, in the East China Sea. A 77 year old medical practitioner, known as an ikaiho (medical assistant or paramedic), is still practicing his craft on the island. For over half a century the lives of those living on the island have rested in his hands. With few medical facilities the people of Kumejima, and of the other outlying islands, face new difficulties as they look to their future.