What do we want to accomplish through this project in Sri Lanka?

After long discussions in many days and months, we came up with four core goals for this project as follows:

1. Developing the culturally appropriate architectural design and care program

2. Applying the concept of aging in community

- Developed countries : creating intentional community

- Developing countries : maintain and strengthen the existing community to care for elders

3. Learning about the social value of elder care in Sri Lanka

4. Application of the lessons learned from the past experience of long term care for elders

First, as a group of young researchers in the field of Architecture, we felt the social responsibility of developing culturally appropriate design scheme for Sri Lankan. This is actually so much more complex than one may think. It requires strong understanding of not only the local architecture, but also lifestyle, demographical and social situation, and most importantly economical capability. I am sure that this learning process will never end....

Second, I personally wanted to explore the potential application of concept of "aging in community" which is an emerging idea to care for elders in developped countries. To transfer this idea in different countries, we made adjustment and defined the concept to fit with Sri Lanka. In the USA or Japan, aging in community is considered to be an "intentional community" where people would create. However, we thought it was very important to harvest the strong culture of inter-dependent lifestyle in the existing Sri Lankan community, and maintain and even strengthen the positive aspect with the appropriate housing support.

Third, we should learn the social value of elder care from Sri Lanka. This action will be essential to this project, however, more importantly it would be a valuable investment that we can learn and bring back to developed part of world.

The last goal was that we wanted to avoid making the same mistakes that developed part of world already experienced, such as hospital like long term care environment, neglect, isolation, or other negative histories of elderly care. We believe that it is our responsibility to inform our mistakes for them to avoid, so that elders in Sri Lanka will be treated with respect.

I will report the current aging situation in Sri Lanka in the next post.

Objective of Sri Lanka Project

Since I was not able to upload our presentation about the Sri Lanka, I decided to introduce the process and the current situation of our project in this blog in next several weeks. I hope you will enjoy getting to know our ideas and give us your feedback!

First, I would like to share the purpose of our project. There are two main goals that we would like to achive through this project.


1. Exploring the possibility of creating the age valued community in rural village in Sri Lanka

2. Exploring the mutual benefits through Information exchange

- developed countries: knowledge of long term care for elderly

- developing countries: social value of elder care

Our world established the paternalistic dynamics/attitude that developped part of world would help developping part of world by providing financial, technical, or other support, and slowly loosing the humble attitude of gratitude toward what we are given. Moreover, we are overlooking the wealth of wisdom and social value that have been sustained for centuries in cultually rich countries. When we try to help developing countries, we should be careful not to impose our idea but sincerely listen to what they really need and how we can be helpful to honor their cultual heritage.

Through studying elder care situation in Japan and the United States, I have learned that what elders are seeking is not "things or money," but much more simple things like happiness, relationship, meaning, or legacy, which cannot be measured by monetary value. I strongly believe that it is the time for us to re-visit traditional way of life that people informally help each other in a community. Since our society has lost the sense of community during the shift to capitalistic society, the developing part of the world can teach us social value of community and the meaning of elder care.

This project aim to explore the concept of "inter-dependency," and attempt to maintain the existing community in developing countries, and also examine what part of traditional community lifestyle can be transfered back to developed part of world, such as Japan and the USA. Most importantly, we would like to carefully think about how we as citizens in developed countries can be helpful to improve life of elders in the world.

Presentation in Montreal

My colleague and I presented the Sri Lanka project in the Interantional conference of aging and design in Montreal last week. Our presentation was well received and generated interesting questions from the audiences. I tried to upload the powerpoint presentation in this blog but I was not successful. Since the presentation will be available in the conference website, I will make a link to the site to make it available for viewers.

I have noticed that the sessions organized by developing part of world attracted less people than the ones done by developed countries in the conference. I do believe that design should be emerged from the cultural value and lifestyle, rather than copying the physical environment from other countries. In order to come up with innovative idea of elder care settings, it does worth for us to look into the developing part of the world to learn about the strong social value and community to care for elders, which may give us better design idea to enable elders to have normalized and enjoyable life style within their community.

Encouraging Words by A Wise Elder

I encountered the quote of Mother Teresa the other day. Every single word of this short description touched my heart and gave me such a great encouragement for what I believe. I felt that this quote perfectly captured the importance of "aging in community" concept. I think it is the time for us to realize that "we must find each other..."

At the end of life we will not be judged by how many diplomas we have received, how much money we have made, how many great things we have done. We will be judged by 'I was hungry and you gave me to eat, I was naked and you clothed me, I was homeless and you took me in.' Hungry not only for bread - but hungry for love. Naked not only for clothing - but naked for human dignity and respect. Homeless not only for want of a room of bricks - but homeless because of rejection.

Being unwanted, unloved, uncared for, forgotten by everybody, I think that is a much greater hunger, a much greater poverty than the person who has nothing to eat . . . We must find each other.

Mother Teresa

Is Elder Care a Social or Individual Responsibility?

Through working on the Sri Lanka project, I encounter a question that "Is taking care of elder a social responsibility or Individual responsibility?"

Since I have been living in developed countries such as Japan or USA, I tend to look at everything through "my own lens" which is based on what I have known through my life experiences. Talking with people who live and work in developing world, I was often embarrassed myself how narrow minded I became. For example, I was challenged by some people when I indicated that "developed world might fail to provide a quality of life for elders because we created an institution with medical model mindset." They said that "it sounds like an argument from the countries where they can spend time and abundant resources to discuss about the issue. In the places like Sri Lanka, people have to manage with what they can afford, and do not have a time and resources to so." When I heard these comments, I realized that my argument was constructed based on "what we have already have in the developed world where basic social system is put in place to look after elders, such as pension, social security, affordable housings, or residential care."

In the USA, Japan, or European countries, we tried to establish a social system to ensure that elders would be looked after as societal responsibility. In developing countries, however, elder care has been treated as individual/family responsibility because 1) traditional societal value of family care still remain as strong ethical responsibility, 2) their countries/society cannot afford providing elder care in the level that developed countries can offer.

I personally believe that we should always try to find a culturally appropriate balance between the two: Social and Individual responsibility. We should not forget that society consists of individuals, and individuals are part of society, and these two parts are inter-connected.

How can we find the balance between the two to provide a care that elders can live with dignity and happiness? I found it difficult to see "from users' point of views" because we have been unconsiously seeing our surroundings with "our lens." I would like to think further about this issue....

People first or Design first?

I have spoken to my friend who is an industrial designer about designing a chair. During the conversation, he stressed the importance of "knowing how people sit in a chair." Learning about how people sit.... it is much more complex than one can imagine. It requires so much knowledge about people, material, art, culture, or lifestyle to create a simple "comfortable chair" for users. The height of chair and armrest, softness of seating, durability of material, coating of surface, and etc... When we start listing up all the possible considerations to design a "comfortable" chair, it may take countless number of pages to fill. It becomes even more complex when designing "a comfortable chair for general public," because nobody has the same body shape, preferences, and lifestyle.

"Understanding how we sit in a chair is the basic and most important skill to design a comfortable chair for people. The comfortable chairs can also be beautiful"

Through the conversation with my friend, I have learned that industrial designers aim to create products with the approach of "people first." How about designing long term care facilities? How much do we know about the life of elders, staff members, and visitors? Are we putting people first or design first?

Interview with a wise man

I have visited an elder care home located in the beautiful site in Galle Sri Lanka. It was located on the top of the hill, and overlooks gorgeous ocean. I loved the feeling of fresh air, comfortable breeze, and peacefulness of the place. I would like to share the images of this home, and the interview with the person who operates this place.

Magnificent view of ocean from the elder home:



Building of this home:



Interview(1)-7:14min
I asked my driver to video tape our interview. Although he had a good intention to capture some interesting views, it just gave me a bit of dizziness... (you can still listen to our conversation which was quite intriguing.)



Interview(2)-9:42min

Power of Plastic Movable Chair

I discovered the magical power of "cheap plastic chairs" in long term care facilities in Sri Lanka. Most of the elder care homes had a front porch with several light weight plastic chairs. It seemed to be the most frequently utilized space by elders, staff members, and visitors.

Normally, chairs were neatly placed along the wall. When people came out to the front porch, they slightly adjust the location of the chairs and sat. I have observed that people were constantly adjusting their chairs to maintain their comfortable distance among others. The distance and configuration were also adjusted in different social functions. Because these chairs were light enough for elders with limited strength to move easily, everybody was able to find their most comfortable location in the area.

William Whyte found that providing movable chairs increases the peoples' usage of public open space in NYC. This time, I have witnessed that simple movable chairs gave a magical power to draw people into gathering space in rural Sri Lanka. It was quite amazing to learn that simple and inexpensive furniture like plastic chairs could help elders to make their own place.

"Place making..." can be a meaningful concept only when users are fully involved, which has been over-done by designers so far.

We have a lot more to learn...

Beautiful People

I am so blessed to encounter such wonderful people in my life. Through this project, I had an opportunity to meet with Japanese persons with beautiful heart in Sri Lanka.

Mr. Ono works at IOM as an architect to design housings for the Sri Lankan who were displaced by the Tsunami incident. When I met him, he patiently listened to my idea about the elder care and provided me his insight based on his experience working in this country. When I shared my idea that “I strongly believe that we have so much to learn about social value of elder care from Sri Lanka”, he showed his interest and thoughtfully listen to my point view. Without his kind encouragement, I might have withdrawn from my passion to change the ways in which elders should be treated in Sri Lanka. Talking with him taught me how powerful it would be to "genuinely interested and carefully listen to one's story."

He arranged to have a dinner with his friends from JICA who provide services to elders in Sri Lanka. Ms. Kato coordinates various programs to improve the life of elders in Sri Lanka. She had such a wealth of knowledge about the elder care in this country, and generously shared her experience and valuable information with me. Her colleagues, who were volunteers from Japan, came all the way from Japan to provide their skills and knowledge to improve elder care homes. They go around elder care homes and work directly with elders and staff members on site. They had such positive attitude toward their work and elders they serve. Their professionalism and passion for their volunteer effort in developing country made me proud of being Japanese.

Coming to Sri Lanka reminded me how difficult it is to live in unfamiliar countries where language, custom, food, and hygiene condition are different from what we have been used to. It can be especially challenging to live in developing countries. However, these Japanese people have chosen to live in this condition to follow their passion and belief to change the lives of people in Sri Lanka. I cannot stop admiring their generosity.

Their genuineness touched my heart, and made this trip even more worthwhile for me.

Dragon Food2

Whenever I spoken to the people who were involved in the elder care in Sri Lanka, I have always heard the words such as "inmates", "sick room", "institution", or "sick people" from their mouths. In the beginning, I tried to repeat their sentences with using different terminologies to implicitly correct the offensive language. However, I quickly realized that my approach was not effective at all. Although it was a bit sensitive thing to challenge the language use in different cultural context, I decided to express my feeling about the power of language to the people who were using those offensive words.

As you can imagine, I was criticized by my action being "too picky" about the language. I was told that "we use inmates, but it does not mean we treat them without respect. This is the common term that we use in the institution." I was also told that "when we call each individual, we call them aunt or uncle. We treat them with respect."

When I asked some staff members that "how do you call prisoners in prison?" They said "inmates". Then, I said "don't you think that it is a bit strange to use the same terminology for elders in a care home and prisoners in prison?" Most of them seemed to understand my point at that moment. However, I found them calling "our 10 inmates...." to describe elders in five minutes later.

The battle of "changing language" will be quite a challenging one, because most of the people do not even realize how offensive some words sound. Because language controls our perception and behaviors in unconscious level, we should carefully monitor the ways in which we choose our language in our society.

We should not allow us to feed institutional mindset with offensive language...

Update from the Sri Lanka Project

I have been learning the difficulties in coordinating a project with individuals from different cultural background. It is so easy to have serious miscommunications among us because each culture have different ways in which things are handled for certain situation. Since I have been raised in Japan where rules and regulations are seriously respected, I seem to be appeared as “rigid person” who are not open-minded to other culture. Moreover, understanding the different mentality about the international collaboration has been also challenging for me. We wanted to purely collaborate to create the place where “elders can aging in community.” We expected that we constantly discuss and try to figure out the ways in which we can work together to make this project happen. However, we were told many times that funding should come from Japan, and generating money to complete this project is a part of the jobs that Japanese team members should do. When I was told by other team members, I was a bit shocked to learn this situation. I almost wonder “do people from other parts of the world view me as a Japanese people who can bring money to the project?”

While I was discussing with other Japanese team members about the future aspect of this project, some shared their feeling that they were a bit discouraged. We are the group of individuals who would were interested in sharing our knowledge together to make some positive changes happen in the world, however, we sometimes felt that people were more interested in how much money we can bring than what knowledge and skills we can contribute to this project. Through this process in an unfamiliar environment, I spent few days without much sleep. Then, I finally found my answer that “we should be distracted by the politics around this project. We should focus on the elders who are deserved to have a better living environment.” I embarrassingly realized that I was also part of this power game and dealing with my ego and control problems in this process… When I shared by honest opinion with other team members from Japan, they mentioned that they would fully support my idea. I am sure that this is just a little problem compare to what future will bring to complete this whole project, but I am glad that I was able to find my answer and passion from the stories that I learned from the individuals from the culture change movement over years.

I learn that it is hard to keep our mind pure and clear when we deal with a project that attached to “status and money.” To keep our mind clear, we should always focus on the fundamental idea of “improving the life of elders.” It is easy to say but it can be hard thing to do to maintain as a group mission.

I will update the info. from the meeting with HelpAge Sri Lanka next!

Dragon food

We organized a participatory design review session this afternoon. Local villagers were invited for this meeting, and approximately 20 adults and 10 children has shown up. We explained three different architectural plans as well as models to them, and then asked any inputs or thoughts that they wanted to give us. Surprisingly, many villagers (especially women) spoke up and asked so many questions. After the review session, we asked villagers to design the layout of the residents’ rooms. We prepared a white board with floor plan, models of bed with magnet attached, and markers to draw any walls, partitions, furniture, or other household items. We had a quite successful and interesting session with them.



During the layout experiment, I found a “dragon food” in Sri Lanka (I hope Cheryl George is reading this post!) Villagers placed average of 10-12 beds side by side in a room as their suggestions. Many said that “since we have a large space, we have to maximize the people who would be benefited by this place.” or “people socialize more if we have many people in a same room.” Of course, it is so hard to interpret this result with cultural aspect; however, I still thought that 10-12 people in a room would certainly create a “medical model institution” from the pre-culture change movement. Most of the participants mentioned about the TV as an entertainment, and wanted to have a TV in a large living room area. Moreover, they suggested a large dining room area for all the “inmates in this institution.” (everybody referred elders as “inmates” and place as “institution”) Although we have worked so hard to come up with “non-institutional living environment with aging in community concept,” villagers’ mindsets were still no where near the “home” concept but a typical county hospital environment. I found that the results were such a scary size of “dragon food-institutional thinking” that takes over normalcy of elders’ lives in a community.

After seeing these reactions from the participants, a partner of this project who wanted to have 20 beds in two rooms said, “look Emi, you thought you knew what was right, but you really did not know what would be right for the local people here. This is what community decided so we should accommodate as many beds as we can fit in these rooms. We are not like Japanese, they don’t need the privacy like you.” Her comment gave me vivid image of “warehousing people on the belt conveyer.” I do agree that we should take culture into consideration for the spatial planning, but it is certain that this approach will create a “total institution” in Sri Lanka. I explained that “these participants are re-creating the hospital environment that they were used to see in the past. We should go beyond that and create a community where elders are fully integrated into the surrounding community.” The reaction was “you are imposing your idea and not respecting the reactions from the local villagers. Your attitude may make me and villagers distrust you as a person.”

……….. my tears came out when I heard this comment.

Dragon food made me cry, however, it did not discourage me to focus on “doing a right thing for elders.” It made me cry once, but it will not happen again. As a Japanese woman, I have such a difficult time standing up for myself in many situations. However, I am certain that this issue is worth fighting for me. I should stand firmly and keep fighting to get rid of dragon foods one by one.

I was also told that this project should be named after the property owner’s last name, which I did not feel comfortable at all. When I said about my feeling toward naming, I was told that “the problem is more to do with you who have issue with this decision. This is what community decided, so you just have to respect the property owner.” I believe we should all focus on the “life of elders” first, and not be distracted by satisfying the owner who seeks family legacy.

The day like today, thinking about Bill Thomas, Cheryl George, Carol Ende, or Christa Monkhouse heals my soul….

Again, Dragon Food was found in the place where a half way across the world.

I guess my battle continues….

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Day 2 in Sri Lanka

My day started very early this morning due to my jetlag. I got up around 4 a.m. and could not go back to sleep, so I decided to read until my Sri Lankan friend, Kapila, would come to pick up my colleagues from Japan at the Colombo Airport. Upon Kapila’s arrival, we had a breakfast together. When I walked into the restaurant in the hotel, I was immediately overwhelmed by the smell of curry. (I am not used to eating spicy meals in the morning….) I ordered a nice cup of milk tea, and serve a little bit of typical Sri Lankan breakfast for me. Although it was a bit strange feeling to eat the real meal in the early morning, I actually quite enjoyed it. (without knowing what would come next….)

On the way to the airport, we went through several security checks and saw quite a few young people in the military uniform. We were actually stopped couple of times, and I needed to show my passport… I was very surprised that Sri Lankans were patiently cooperating this inconvenience. For someone like me who was born and raised in Japan and currently living in the USA, it was very scary scene to see military solders with machine guns pointed toward the regular roads. After going through the heavy security process, we were finally able to get into the airport to welcome our team members.

As soon as our team members arrived at Sri Lanka, all of us got into a car for another 7 hours drive to the village where we are working on the project. I remember that it was about 30 min after we left the airport, I started having motion sickness caused by the multiple reasons, breakfast curry, incredibly bumpy road, rough driving, and chaotic traffic flow. I told Kapila that I needed to use a bathroom, and he called his professor’s home and asked if I could use their bathroom. Of course, they were so kind to let me use their bathroom and also prepared medicine for me. This was one the most embarrassing moments for me… I greeted and introduced myself for 2 seconds and went straight into their bathroom, and threw up…. Honestly, I developed a “breakfast curry forbia” symptom. (I do not think I can try curry for breakfast anymore….)

Our 7 hours trip was quite eventful. I started being sick first, then we encounter the Hindu ritual—some men had hock in their backs, and witnessed a traffic accident. The episode of the traffic accident was quite funny (of course, nobody gotten hurt). A man was running to cross a local dirt road, and a small track hit him slightly. The man stood up and complained to the driver. While they were talking, a police arrived and scold the man (pedestrian) that he was not careful enough to cross the road, then let the car go without any warning. If this happened in Japan or the USA, I am sure that pedestrian would be fully protected and the driver would be in trouble. However, it did not seem to be the case in Sri Lanka.



By the time we arrived at the hotel in Bandaravela after the 7 hours drive, we were quite exhausted. The great news is that we are staying at such a beautiful historical hotel. The colonial style architecture and garden are well kept, and it gives me a nice flavor of the life from 150 years ago in this area. We just finished the dinner and came back to my room, I do not think I can stay up more than 20 min….

Greeting from Sri Lanka

I have arrived safely at Colombo Airport after the very long flight from Washington DC (via London). It was such a relief to have my friend, Kapila, waiting for me at the exit. Since my flight arrived at 5:00a.m., we went to the near beach area to sit back and enjoy a nice breakfast together. After the relaxing breakfast, my friend took me to a local fish market where I saw the cobra for the first time. (I would die if I encounter cobra on a street… )We gave him about $1 for his performance which made him so pleased. I felt so sad to know that his income resource is limited by this unstable job.



After the fish market, I checked into my hotel and slept for several hours before the dinner party that we were invited. This party was organized by the chairman of the HelpAge Sri Lanka, and there were many people from various background enjoying the beautiful garden party. In that party, I spent most of my time talking with a lady from HelpAge International to learn about their work and social pension system. When I expressed the interest of elder care and shelter issues in developing countries, she immediately challenge my idea and said “I do not think that we should promote any type of elder care setting, because the elders in the aged care are not happy. We should come up with a system that helps family members to look after elders.” Although I agree on her point of view, I decided to ask question that “how about the elders who do not have family members, or who develop dementia or Parkinson?” She said “then, they have to move into elder care…”

I might just be too cynical about the current elder care situation, but her argument did not convince me because her approach does not fix the current elder care (especially frail elders) situation, it may even create the bigger gap between homecare and aged care. I asked her that “Is your organization addressing the issue of reducing the gap between the home-care and institutional care, such as diversifying the services?” She said that various services are available for the people who would like to stay at home, however, they would not like to encourage people to use the idea of “elder care homes.” When I heard her comment, I felt that her negative image about the long term care is so strong that she could not think of exploring the care option with “residential care.”

Yes, it is very important to have elders to stay at home with their family, yet we should not be too naïve to think that this type of living condition is sustainable in our current society where modernization and urbanization have strong impact on how we live our life. Although I do not quite agree on the current long term care living environment for elders, I still believe that the concept of “aging in community” will be a viable option for the society where sense of community and family care practice are still strongly exist.

I was told that what I am doing in Sri Lanka is a “development work.” However, I strongly disagree on that comment, because I have been learning such a fundamental value of elder care from the people in Sri Lanka. Developed countries have higher standard of infrastructure, yet we have so much to learn from Sri Lankan about how and why we care for elders in our society.

Please click here to read previous blog postings about this project.