This report presents a series of health intervention activities in the humanitarian assistance in Northern Iraq implemented during the Iraq war between March and May 2003 by Peace Winds Japan, with the fund from Japan Platform. Preparedness before the war included organization of mobile clinic teams, stocking of medical supplies and coordination between local health authorities and aid agencies. The initial rapid assessment effectively identified needs of massive number of displaced people with considerable health problems and those of disrupted local health service system. Maximum twelve mobile clinics covered a variety of sites in four areas in Northern Iraq including Kurdistan area and Mosul. Disease patterns in these areas are similar, showing acute respiratory infections are the most common. Neither large outbreak nor high incident severe malnutrition did occur though diarrhea was prevalent in some unsanitary areas. Disruption of local health service system prevented patients with chronic diseases and severe diseases such as cancer, and vulnerable groups such as disabled persons from receiving continuous or timely care and treatment. Co-ordination was successful in demarcation of NGO's activities and information sharing along with joint assessment.
Equitable and quality health care is a challenge of the future reconstruction phase.

The purpose of clarifying a foreign resident's in Japan healthy problem and a health care subject was carried out, and foreigner demographic statistics and vitalstatistics were analyzed. The following things became clear.
From the second half of the 1980 th generation, foreign-resident-in-Japan population and international marriage were increased rapidly, and many race-nization in Japan was progressing.
The people population from Brazil was concentrated on 30 years-old cost from 20 years-old cost, and the population of the less than 15-year-old child born in Japan was increasing every year. Moreover, ”the sickness and wound and the external cause of death” which are occupied to the total number of death were high.
The Korean resident in Japan formed 80 percent of the 65 or older-year foreigner registration person. The three major causes of death of Korean are malignant neoplasms (cancer), heart diseases and cerebrovascular diseases. It was similar with the Japanese death trend. Suicide of a persons-of-middle-or-advanced-age male was increasing like the Japanese male.
A foreign resident's in Japan healthy subject is roughly classified into three. There is a geriatric health problem about a Korean resident in Japan. In recent years, about the foreigner who immigrated to Japan, there is a problem of mother-and-child health and labor health. And to all foreigners, there is a problem of the mental health resulting from migration, foreign culture, and the minority.
The health care corresponding to internationalization is called for also in Japan.

 The opportunity for the community health nursing profession to engage in international cooperative activities is increasing in recent years. Many challenges are anticipated for developing the cooperative activities, since the basic situations in each country regarding the environment, the cultural background or the health system are quite different. However analysis of the challenges is not enough, we must also understand limitations based on individual personal experiences. The purpose of this report is to describe the challenges that interrupt the development of cooperative activities.
 The target group was sixteen public health nurses who were sent to developing countries as JOCV (Japan Overseas Cooperative Volunteers) from June1997 to March 1999. The research was conducted for two years. Data were collected from each participant using five semi-structured questionnaires and analyzed using qualitative methods for the following areas: (1) challenges, (2) changes in viewpoints about the language learning, and (3) changes in participants' health conditions.
 Fifteen participants returned the questionnaires. Results showed wide variation in the challenges described, and the challenges changed during the period of assignment. During the beginning period, there were many descriptions about difficulties based on daily life and cultural adaptation. Afterward, challenges based on the cooperative activities became the core of issues to resolve. Some challenges involved a lack of information for planning the cooperative activities, lack of funds, a too-short time frame, local staff's resistance to the out-reach activities. Also some issues were very difficult solely on the basis of the personal effort required
 When we carry out cooperative activities in developing countries, there will inevitably be various challenges. However, there are two types of challenges, challenges able to be resolved by personal effort and challenges in need of system responsiveness. To develop effective cooperative activities in a limited period, it is necessary to understand the possible challenges that will happen and take measures to prevent avoidable situations.

 Between June 1998 and January 2000, "The Master Plan Study on Strengthening Primary Health Care Services (JICA PHC Study)" was executed in the Republic of Malawi. The purpose of the study was to formulate a central region master plan and a national master plan to improve the primary health care (PHC) system, and to transfer essential research, analytical skills, and methodologies to Malawian counterparts. The health investigations covered the referral system, human resources, health finance, policy and management, the health management information system, community participation, logistics systems and health facilities and supplies. As a result of the study, childhood malnutrition, maternal health, and the inappropriate role of informal drug-sellers, in the PHC system were found to be key health issues, and on the basis of these problems the national master plan was formulated with six prioritized proposed projects. In this report, the following challenges to the execution of effective and efficient study were discussed and recommended through the review of health development studies conducted in five developing countries including Malawi; 1) the study purpose and the concept of a master plan should be clarified, 2) the study outcome should be evaluated and utilized effectively, 3) terms of reference for the study should be reviewed and improved, 4) a better relationship with counterparts and donors should be developed, and 5) a capacity of participants in the study such as consultants should be built up.

 Health sector has increasingly played a critical role in global trends of development assistance toward focusing human-centered development and poverty reduction, sharing common goals such as `Millennium Development Goals', and expanding sector-wide approaches and donor harmonization. Japan has contributed to the developing world as the top or leading donor over a decade, and has extensively committed itself to health-sector assistance. In particular, Japan has announced commitments to fighting some of the global health issues through the Global Issues Initiative on Population and AIDS, the Global Parasite Control for the 21st Century known as Hashimoto Initiative, and the Okinawa Infectious Diseases Initiative. However, to increase efficiency and effectiveness, and world's proper appreciation of Japan's development assistance for health, some challenges should be tackled, including priority settings in issues and approaches, more strategic collaboration/coordination with overseas and Japanese development partners, and human resources development and retention in Japan.