Physician Tetsu Nakamura, 67, tries to take a different route to work each day and varies his departure times because that is the safest way to live in Taliban-troubled eastern Afghanistan.

His Peshawar-kai aid group has conducted medical and agricultural work there for the past three decades.

Nakamura also said it is essential to maintain close contact with the local police to keep abreast of the changing security situation.

But above all, he has bonded with residents and relies on that for his work in the remote villages of eastern Afghanistan to succeed, he said.

“I’ve tried to make no enemies. . . . The best way is to befriend everyone, even if that makes people think I lack principles. Because the people are the only thing I can depend on there,” he said.

“And that’s surprisingly more effective than carrying a gun,” he added.

In an interview with The Japan Times in Tokyo during a temporary break from Afghanistan, Nakamura said he opposes moves by Prime Minister Shinzo Abe’s administration to reinterpret the war-renouncing Constitution and expand the role of the Self-Defense Forces — including his bid to reinterpret the Constitution to allow the use of collective self-defense, or aiding allies under armed attack.

Allowing the SDF to have a presence in Afghanistan would jeopardize the safety of Japanese aid workers, he said. In a situation like that, he would have to shut down the aid group and leave, he said.

“If Japan exercises the right to collective self-defense, the way Afghans see Japanese will certainly change,” he said. “Japan will be seen as one with Western countries, and that would greatly increase the risk we face.”

As the front line against Islamist extremism, parts of the Afghan population harbor considerable anti-Western sentiment. He said the hostility has grown ever since the U.S. began attacking Taliban positions in October 2001 and the North Atlantic Treaty Organization invoked the right to collective self-defense, creating a multinational security presence across Afghanistan.

In 2013, civilian casualties in armed conflicts there rose 14 percent from the previous year to 8,615, with 2,959 dead and 5,656 injured, according to a report by the United Nations Assistance Mission in Afghanistan. Of the casualties, 1,756 were children.

The report attributed 74 percent of the casualties to anti-government elements, such as the Taliban, 8 percent to Afghan national security forces, 3 percent to international forces, and 10 percent to fighting between government troops and insurgents.

The Maritime Self-Defense Force contributed to the multinational mission by providing free fuel and water from the Indian Ocean between 2001 and 2010, but the mission was invisible to many Afghans and they still view Japan favorably, Nakamura said. He credited this to the fact that there were no troops on the ground, and to the general perception that Japan is a peaceful country that does not use force.

While Abe has argued that an SDF unit engaged in a U.N.-led peacekeeping operation should be allowed to defend Japanese NGOs with arms — which is prohibited under the current interpretation of the Constitution — Nakamura said such a scenario would bring trouble to Japanese aid workers.

“It would be seen as incursion within a sovereignty country . . . I might even become a target for attacks from our local staff,” he said.

Nakamura started working in Pakistan in 1984, initially to treat patients with leprosy, also known as Hansen’s disease, because there was a shortage of specialists who could diagnose it. In 1986, the group also began treating Afghans at refugee camps in Pakistan. It later expanded to mountain villages in eastern Afghanistan that lacked medical staff and facilities, opening one clinic in Dara-e-Nur and two nearby.

He expanded the group’s activities to the construction of wells and irrigation canals to revive farmland that had dried out after a severe drought in 2000. He said many children died because they had no clean water.

The war on terror brought further turmoil, he said, noting the population was already on the brink of life and death.

Since the drought is still spreading and continuous assistance is needed, Nakamura said he views the government’s move with bitterness.

Abe has repeatedly said Japan will not send troops into foreign countries to use force even if he succeeds in reinterpreting the Constitution. He even pledged to limit the use of force to a minimum.

Nakamura suspects the reality will be different.

“There is no such thing as ‘minimum’ use of power on the battlefield,” Nakamura said. “What he’s saying is a fantasy. Such a ‘limit’ won’t apply in reality.”