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Providence Was with Us

Providence Was with Us

How a Japanese Doctor Turned the Afghan Desert Green

Nakamura Tetsu
Translated by Carl Freire

Published Titles / Social Sciences


Published by JPIC | ISBN 978-4-86658-147-7 (Hardcover) | 240 pages | 210mm (h) x 148mm (w) | December 2020

About the Book

Starting in 1984 and continuing until his untimely passing in 2019, Dr. Nakamura Tetsu carried out relief work in Pakistan and Afghanistan both as a physician and as a humanitarian trying to improve living conditions for the people he met. With nature and the bonds of fate that link humans together setting the tone, this unique memoir recounts the travails and triumphs of Nakamura’s three and half decades in those two countries. How did this Japanese doctor who traveled to the region to provide medical care end up digging more than 1,600 wells and building a 25.5 kilometer-long canal? In a foreign land struck by civil war, bombings, and drought, miracles could still happen.

“Dr Nakamura did understand Afghanistan. He established a clinic in the country’s Nangarhar province during the 1990s after a spell in Pakistan. Supported by Japanese non-governmental organisations, he saw that the illnesses he treated mostly could be traced to malnourishment and lack of sufficient water. . . . His response was to become an engineer. In the early 2000s, he began supervising the construction of a network of irrigation canals that restored life to vast tracts of desert. He borrowed the design from centuries-old canal systems in Japan. The network could be built without complicated machinery and, critically, it could be maintained by local Afghans. The water supply has transformed hundreds of thousands of lives.”

Philip Stephens, "A Japanese saint among the sinners of the Afghan war"

Financial Times, January 2, 2020.

About the Author


Nakamura Tetsu was born in 1946 in Fukuoka Prefecture and served as the physician and general director of Peace Japan Medical Services (PMS). He was a graduate of Kyushu University School of Medicine. Following work at medical facilities in Japan, he took a position in Peshawar, Pakistan, in 1984, and was involved thereafter in providing medical care to the impoverished, focusing on treating Hansen’s disease. In 1986, he formed a team to provide medical care to Afghan refugees and also began providing care to mountain communities that lacked physicians. He opened three clinics in Afghanistan’s mountainous eastern regions from 1991 onward, and opened PMS’s base hospital in 1998. In 2000, in parallel with his medical services, he began digging and repairing wells to secure sources of water around Afghanistan, which was suffering from a massive drought. Between 2003 and 2009 he led the construction of a 25-kilometer-long irrigation canal. Dr. Nakamura continued to work at opening desert lands to farming in spite of having to contend with sandstorms and floods. He won numerous awards, including the Peace and International Understanding Citation from the Philippines’ Ramon Magsaysay Award Foundation and the Fukuoka Prize. His written works include Peshawāru nite (At Peshawar), I wa kokkyō o koete (Medicine knows no borders), Isha ido o horu (A doctor digs wells), and Isha, yōsuiro o hiraku (A doctor builds a canal), all published by Sekifūsha.

Dr. Nakamura was killed by unknown assailants in Jalalabad, Afghanistan, in December 2019.


"Providence Was With Us provides an unvarnished view of an aid organization that has been on the ground for the long term, and has operated through two foreign invasions, massive drought, and the aftermath of such crises. Other NGOs came and went, but Nakamura’s Peace Japan Medical Services, aka the Peshawar-kai, stayed."

Chad Kohalyk, May 12, 2021

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