In 1996 Japan repealed a draconian law confining leprosy patients to institutions even after their disease had been cured. According to Ryuichi Kitano, the failure to do so sooner reflects the pervasive intolerance and conservatism of Japanese society.

Ryuichi Kitano, a reporter for the Asahi Shimbun in Tokyo, is currently an associate at the Program on U.S.-Japan Relations at Harvard University. He is the co-author of several books on social minority issues in Japan, including buraku people (also known as burakumin), and Koreans. He has covered Hansen’s disease (leprosy) issue for the Asahi Shinbun since 1995.

On the evening of May 23, 2001, Japanese Prime Minister Koizumi Junichiro announced his government’s decision not to appeal a Kumamoto District Court ruling holding it responsible for the needless quarantine of thousands of leprosy patients. One of the plaintiffs present was Hino Koki, a resident of the Hoshizuka Keiai-en (“Respect Love Garden”) national leprosarium in Kagoshima Prefecture. Upon hearing the news, he shouted, “I have finally become a human being!”

At a press conference in Tokyo held immediately after the Prime Minister’s announcement, Hino read the following poem that he had written: “The sun is shining/ For 90 years, we lived in a long, long darkness/ A single flash of light shone/ It became brighter/ And crushed a hard boulder/ Light shone/ I no longer have to look down/ Together with citizens in the light/ I can walk with my head held high/ I no longer have to look down/ The sun is shining.”

I have often reflected on Hino’s exclamation that he had “finally become a human being.” Despite the importance of last year’s legal resolution, many questions raised in the case remain unanswered. Were Hino and others like him not human beings before the Prime Minister’s announcement on May 23? Why did the Japanese government, together with Japanese society, effectively conspire to revoke the humanity of thousands of citizens for nearly a century? The following pages attempt to explain how the humanity of Japanese leprosy patients was revoked, as well as the long process through which it was regained.

The Case Against the Government

There are currently 15 leprosaria throughout Japan, of which 13 are national and two are private. These leprosaria house and provide medical care to 4,300 residents who once suffered from Hansen’s disease – otherwise known as leprosy – and are usually located in rural areas, particularly on small islands or deep in the mountains. In 1900, the number of leprosy patients was estimated to be 30,000, and in 1919, the official number was 16,000. By 1950, the government estimated that there were 15,000, of whom 10,000 were confined in leprosaria. Today there are about 700 leprosy patients requiring drug treatment. Ninety percent of Japan’s 4,300 leprosaria residents – whose average age is 74 – have recovered from the disease and are not contagious, but most of them remain institutionalized due to a combination of old age, disability and fear of prejudice in the outside world. The Leprosy Prevention Law, established in 1907, reinforced in 1953 to stipulate compulsory isolation of patients, and only repealed in 1996, had not provided for the discharge of patients under any circumstances.

The patients’ lawsuit was initially filed in July 1998 by 13 residents from various national leprosaria. It alleged that the government, through its isolation policy as established in the Leprosy Prevention Law, had infringed on leprosy patients’ human rights as stipulated in the Japanese Constitution. The plaintiffs sought ¥115 million (about US$1 million) each in damages from the government. By the autumn of 2001, more than 2,000 individuals had joined the litigation as plaintiffs. Over half of them joined after the victory of the first plaintiffs was upheld by a higher court. The 2,000 plaintiffs were not only residents of leprosaria, but also former patients who had been informally discharged by medical officers at leprosaria, as well as family members of deceased patients.

On May 11, 2001, the Kumamoto District Court handed down a judgment ordering the government to apologize and to pay a total of ¥1.82 billion (US$15 million) in compensation to a first group of plaintiffs consisting of 127 leprosaria residents. The verdict held the Ministry of Health and Welfare (MHW) – which has been in charge of implementing public health policy towards Hansen’s disease – responsible for failing to seek an early reversal of the Leprosy Prevention Law. In an unusual move, the court also held the Diet responsible for its inaction on the issue, ordering compensation and apology by the government as a whole.1  It further declared that the isolation policy had violated Articles 13 and 22 of the Constitution pertaining to the dignity of the individual and freedom of movement, respectively.

The judgment concluded that “since 1960, Hansen’s disease has not been one that requires patients to be forced to live in isolation, and quarantine was therefore unnecessary after this time.” According to the Kumamoto decision, the Ministry of Health and Welfare should have changed its quarantine policy in 1960 when the World Health Organization issued a report denouncing the isolation of Hansen’s disease patients, yet it failed to do so until the Leprosy Prevention Law was abolished in 1996.

The government initially intended to appeal this decision to a higher court, but the plaintiffs launched a counter-movement, which included a sit-in at the front gate of the Prime Minister’s Official Residence in Tokyo. Some of them spoke out on live television programs and were interviewed about their experiences by well-known news anchors. On May 23, Prime Minister Koizumi announced that the government would abandon its appeal, stating that “we seriously accept the court ruling and, although it is extremely unusual, we have decided not to appeal.” Koizumi had only assumed office one month before, and was very conscious of the need for favorable public opinion. Immediately after his decision, support for Koizumi’s cabinet rose to 80 percent according to public opinion polls.

Although the government’s decision to abandon its appeal was due in part to political considerations, the patients’ success also owed much to unprecedented public support. The plaintiffs’ appeal to the public – unlike their failed protests against the strengthening of the Leprosy Prevention Law in 1953 – aroused widespread sympathy that the government was unable to ignore. Yet why was the public sympathetic to the plaintiffs in the 1990s, but not before? One likely reason has to do with media coverage of the issue. During the patients’ 1953 struggle, the Japanese media largely ignored patients’ activism against the Leprosy Prevention Law. It was not until the late 1970s that newspapers began to criticize the isolation of Hansen’s disease patients, and by the 1990s the plaintiffs’ movement had become front page news.

Origins of Isolation

Raija, or lepers, had been regarded as “unclean” and shunned as outcasts in Japan since the 12th century. They were ostracized by their families and communities, and often became vagrants who gathered in and around Buddhist temples and Shinto shrines. Attitudes toward leprosy were closely associated with the Buddhist notion of tenkei-byo (divine punishment for sins committed in one’s previous life) as well as the traditional Japanese concept of kegare (pollution). Neither the Japanese term raibyo, nor the illness today referred to as Hansen’s disease, corresponds precisely to the Western biblical term “leprosy”.

In the late nineteenth century, Japan’s increasing interaction with the West brought changes in the way that leprosy was conceived of and treated. The practice of isolating victims of “epidemics” was introduced from the West into parts of the Asia-Pacific such as Japan, Hawaii, and the Philippines as a component of modern public health policy. By the early part of the twentieth century, Meiji government officials, like their counterparts in the United States, began considering the establishment of leprosaria for the confinement of leprosy patients. They were urged to do so by European Christian missionaries such as the British evangelist Hannah Riddell, who cared for leprosy patients in the streets of several Japanese cities in the late nineteenth century. Another influence on governments to establish isolation policies was a resolution at the first World Leprosy Conference in Berlin in 1897, which stated that “every leper is a danger to his surroundings,” and “isolation is the best means of preventing the spread of the disease.”

In 1902, speaking in the Lower House of the 16th Imperial Diet, Representative Saito Hisao argued: “It has become an established theory in the international academic world that leprosy is infectious. Most civilized nations have regulated leprosy to prevent contagion. In our nation, however, only a few foreigners provide relief for leprosy patients. The government pays no attention to the regulation of leprosy. This behavior causes extreme loss of face for our nation even as we are trying to maintain equal relationships with other civilized nations.” To save face, the government decided to bring its treatment of leprosy patients in line with the “civilized” world. In 1907, the first leprosy-related law was enacted as Law No. 11 for Leprosy Prevention. Article 3 of this law stipulated that “the authorities shall provide accommodation in sanitaria and medical treatment to leprosy patients who have been abandoned without any treatment or care.” The original law was therefore intended to provide relief for homeless patients rather than to prevent the spread of the disease.

“Racial Purity” in Japan

Although the law was intended as a form of social welfare for leprosy patients, leprosaria increasingly came to serve as places for quarantine rather than treatment. In 1916, the law was amended to permit the detention of patients for disciplinary action, and the government built patients’ prisons in each leprosarium to hold those who organized patients’ associations and protested against maltreatment. One of these “special wards” (tokubetsu byoshitsu) in Gunma Prefecture’s Kuryu Rakusen-en (Happy Fountain Garden) leprosarium served as a prison for at least 92 patients from several leprosaria. Twenty-two of these patients died from hypothermia, suicide and other causes before a public outcry in 1947 led to the closing of the “special ward”.

Leprosy patients had been rounded up and quarantined since the 1920s, and their confinement was reinforced in 1931 – the year of the Manchurian Incident – with the renewal of the Leprosy Prevention Law. As Japan fell increasingly under the influence of the military and the government strengthened its grip on society as a whole, isolation policy gained force. The spread of ultra-nationalism and imperialistic militarism in prewar Japan was accompanied by such Nazi-inspired ideologies as minzoku-joka (racial purification) and joketsu-kenmin (clean-blooded healthy people). Infectious diseases such as tuberculosis and leprosy were regarded as obstacles to the attainment of these ideals. In a 1926 article entitled “For Racial Purification - the Future of Leprosy Prevention Policy,” the physician Takano Rokuro, chief of the Prevention Section of the Public Health Department in the Home Ministry, wrote that “everybody must strive to eliminate such diseases, and this must be given first priority for the purification of our racial blood.”

In the 1930s, the government encouraged prefectural governments to promote Muraiken-Undo (“Campaign to clean up leprosy in every prefecture”). Medical officials traveled to villages and towns accompanied by sanitary policemen to find people afflicted with the disease. Once these people were found, they were forcibly incarcerated. Their families were also ostracized, since it was believed that the disease was hereditary. In 1931, Mitsuda Kensuke, a leading leprologist in Japan, explained the significance of the Muraiken-Undo campaign as follows: “We in the leprosaria have a great mission to rid the nation of leprosy. Those who are unfortunately afflicted by leprosy must sacrifice themselves by leaving their families and entering leprosaria. Those who are not afflicted must devote themselves to saving the victims in order to establish a Japan without leprosy.”

Isolation policy was also supported by contemporary theories of eugenics, which used an extreme version of Social Darwinism to advocate the production of superior offspring through the application of biological science and government policy. This theory manifested itself in the United States, Nazi Germany and Imperial Japan in the sterilization of “inferior” individuals afflicted with mental disabilities, mental illness, and various hereditary diseases. In Japan, Mitsuda started sterilizing Hansen’s disease patients at the Zensho Byoin (Complete Life Hospital) public leprosarium in 1915 without any legal authorization to do so. He knew that leprosy was not genetic but infectious, and he was also aware that sterilization was illegal. Nevertheless, he apparently believed that susceptibility to leprosy was hereditary. Sterilization of Hansen’s disease patients was later legalized under the Eugenic Protection Law of 1948.

Historian Fujino Yutaka has described the government’s policy as follows: “We should consider that sterilization and isolation were the most important elements in the eradication policy aimed at Hansen’s disease patients. The governmental authorities and medical officials at national leprosaria concerned themselves not with the eradication of Hansen’s disease itself, but with the eradication of patients. Since there was no cure, it was easier for them to exterminate patients than to eliminate the disease.”2 

The Failure in 1953

In prewar Japan, Hansen’s disease was believed to be incurable and contagious. With the development of sulfone drugs at Louisiana’s Carville national leprosarium in 1941, the disease became curable. Patients who were injected with the drug – commonly known by its brand name Promin – showed improvement, and some of them tested negative for the presence of the Hansen’s disease bacillus (Mycobacterium leprae) after a year or two of treatment.3 

Patients’ awareness of their human rights was stimulated by the importation of Promin and the spread of constitutional democracy, both of which were brought to Japan by the United States after World War II. Promin was first introduced into Japan from the United States in 1946, and medical officials began experimental therapy on several patients. Soon afterwards, its effectiveness soon became known in every leprosarium. In October 1948, patients organized the Puromin Kakutoku Iinkai (Committee for the Acquisition of Promin) and petitioned the government to purchase sufficient quantities of the drug.4  The Promin campaign encouraged patients not only to hope for recovery from the disease, but also to organize a national association to fight for their rights and dignity. In January 1951, the Zenkoku Kokuritsu Rai Ryoyosho Kanja Kyogikai (Zenraikankyo), or All-Japan National Leprosaria Patients’ Association, was formed (in 1953 it abbreviated its name to Zenkankyo).

However, medical officials at the Ministry of Health and Welfare took countermeasures against the patients’ movement. In November 1951, the medical directors of three national leprosaria testified in the Parliamentary Upper House Committee for Health and Welfare. One of the witnesses was Mitsuda Kensuke, who had just been awarded the Order of Cultural Merit for his anti-leprosy activities. He stated: “It is necessary to have laws that make it possible to force leprosy patients to be contained in sanatoria even if it is against their will. Sterilization is a good way to ensure that the disease is not transmitted among family members. Escape from sanatoria should be made a crime for patients and, as such, should be punished.” In a book published in 1996, Otani Fujio, a retired MHW medical official and the main proponent of the Leprosy Prevention Law’s abolition in the 1990s, criticized the statements by Mitsuda and his colleagues: “The testimony of the three directors clearly indicated that those who represented the sanatoria refused to accept the new principles of the times and were determined to persist in their pre-war opinion.”5 

In May 1952, the Zenraikankyo resolved to fight for the revision of the Leprosy Prevention Law of 1931. The 1931 law stipulated that physicians must report leprosy patients to police or public health authorities upon diagnosis, and that local governments must confine the patients to national leprosaria. Patients demanded that the government use the term “Hansen’s disease” (Hansen-byo) instead of the stigmatizing word “leprosy” (raibyo); enact measures to ensure the livelihood of patients and their families; abolish punitive action and compulsory confinement; and discharge cured or non-infectious patients.

While the government did introduce a bill in March 1953 to revise the old Leprosy Prevention Law, it largely ignored the patients’ demands. The new version, far from reflecting the Zenkankyo proposal, hardly contained any improvement over the old law. Zenkankyo subsequently started a campaign to oppose the bill. Some members held a sit-in strike in front of the Diet and the headquarters of MHW during the Diet discussion of the bill in July and August 1953. In each leprosarium, dozens of patients went on hunger strikes. Although labor unions and intellectuals supported their struggle, the general public did not take as much interest in their movement as they did in 2001 because the public’s prejudice against Hansen’s disease patients remained strong. The bill was passed on August 6 without major modifications, except for a supplementary resolution by the Upper House that “it is expected the law will be revised in the near future.” Yet the Leprosy Prevention Law of 1953 was not revised for more than 40 years.

Many years later, Otani reflected on the failure of the patients’ movement: “I believe that the prewar contempt and feeling that Hansen’s disease patients were somehow lesser humans were still widely accepted by our government leaders and the mass media. It was this attitude that permitted both the stereotyping of patients and the prejudice against them to prevail. This attitude is what prevented the position and demands of the Zenkankyo from being taken seriously. It was most probably this attitude that led them to turn a deaf ear to the desperate pleas of the Zenkankyo and those few who supported them. I would imagine they were unable to comprehend what it was about … This is a truly horrible mistake and we, as human beings, should not be allowed to overlook this.”

Why Did Japan Delay?

In 1960, the World Health Organization (WHO) declared that there was no longer any reasonable basis for the isolation of leprosy patients. Its Second Report of the Expert Committee on Leprosy stated: “The committee strongly endorses the opinions of recent conferences that leprosy should be placed in the same category as other communicable diseases and dealt with as such by the public health authorities. Special legislation not in conformity with these principles should be abolished.”

Accordingly, many countries including the United States, Korea, and Taiwan abolished Hansen’s disease isolation policies by the end of the 1960s. Japan alone persisted with its isolation policy. Until 1996, when the government enacted the Law to Repeal the Leprosy Prevention Law, leprosaria residents were not legally allowed to leave their places of confinement, even after they were cured.

Why did it take so long for Japan to abolish this law? First, the influence of the medical “authorities” on leprosy – especially that of Mitsuda, who continued to insist on the necessity of isolation – remained strong. Second, the bureaucrats in charge of health policy were reluctant to revise established policy, both for fear of undermining their predecessors’ “accomplishments” and due to the lack of initiative that characterizes Japanese policymaking. Third, after their protests failed in 1953, residents of leprosaria shifted their focus from revision of the Leprosy Prevention Law to improvement of their living conditions in confinement.

In addition to these three reasons, there is another, even more important cause for the persistence of isolation policy in Japan: the prejudice and indifference of most Japanese people towards the problem of Hansen’s disease. Although over 90% of leprosaria residents had been cured by the 1950s and 1960s, most were convinced that they would not be welcomed by society and therefore gave up hope of ever returning to their families and communities.

Even after its defeat in 1953, Zenkankyo did not abandon its opposition to the Leprosy Prevention Law. In 1963 it presented the Minister of Health and Welfare with a “Request for the Revision of the Leprosy Prevention Law”. At first, the bureaucrats in charge responded positively. In October 1963, for example, Konishi Hiroshi, Director of the MHW Tuberculosis Prevention Division, who was also in charge of Hansen’s Disease prevention policy, replied to Zenkankyo: “We will organize a committee for research into leprosy prevention policy within fiscal year 1964 and revise the law in fiscal year 1965.” By August 1964, however, Konishi had encountered some roadblocks. MHW’s National Sanatoria Division, which was in charge of leprosaria administration, opposed any change. Konishi noted at the time that “it is difficult for us to implement revision because no one in the Ministry would support us. Prejudice against the disease exists in the Ministry as well as in society in general. It takes time to persuade them.”

Zenkankyo therefore changed its strategy and, until the 1970s, focused its efforts on the improvement of patients’ living conditions. It demanded that MHW raise the patients’ allowances and supply better medical care. Yet they were cautious when making their demands, for fear of losing the modest benefits they had gained in the course of their struggle. Goto Etsuko of Osaka City University described the leprosaria residents’ position: “They feared that, if the law were carelessly revised, they might lose their current living conditions and vested interests, which had been acquired after a long period of struggle. They were very careful because they had been forced to endure terrible hardships; therefore, they were quite suspicious of the government and Japanese society, even if attitudes changed to support abolition of the law.”6 

A Retired Bureaucrat’s Effort

The eventual decision to abolish the law owed much to Otani Fujio, a retired medical official from the Ministry of Health and Welfare. In 1972, Otani was appointed Director of the National Sanatoria Division. He was in charge of the administration and management of 145 national sanitaria, including 13 leprosaria and dozens of sanitaria for tuberculosis. Otani soon became convinced that the Leprosy Prevention Law was no longer valid, yet he also realized that the leprosaria could not easily be abolished. He later wrote: “Patients felt that there was nowhere that they could go other than the sanatoria without being subjected to discrimination. Some had made friends and some had gotten married inside. The sanatorium was really their home … quite a number of physicians and government officials were vehement in their opposition to any talk of repealing the law. The question was whether it would be good to work towards a repealing of the Leprosy Prevention Law or better to work towards liberation by improving the conditions while keeping the law intact.”

Faced with this dilemma, Otani chose to improve patients’ conditions without revising the law, and his efforts resulted in considerable enhancement of the residents’ standard of living. However, Otani reflected afterward that “as long as the law continued to exist, I could not say that what I had done was for the liberation of the patients.” It was only after his retirement in 1983 that Otani began to tackle the problem of the law itself. In 1988, he was appointed Chair of the Study Committee on Hansen’s Disease Prevention Policy.

In the 1980s, Zenkankyo made yet another push for the revision of the Leprosy Prevention Law. Zenkankyo Chairman Sogano Kazumi visited every leprosarium in the country and discussed the Prevention Law issue with the residents. In April 1991, seven years after Sogano began the campaign, Zenkankyo presented another “Request for Revision of the Leprosy Prevention Law” to the Minister of Health and Welfare. Encouraged by Zenkankyo’s campaign, Otani proposed at the 1994 meeting of Japanese Leprosy Association that the Leprosy Prevention Law be repealed, and a new law guaranteeing the welfare of current leprosaria residents be enacted to fill the vacuum.

Otani managed to convince leprologists and medical officials, as well as the National Sanatoria Directors’ Association and the Japanese Leprosy Association, to follow his lead. The Japanese Leprosy Association, for example, stated that “any and all justifications for the current law have been lost, and therefore it is only natural that the law is something which, from a medical perspective, should be repealed… The reason why the Japanese Leprosy Association has not taken a lead in the efforts to have the Leprosy Prevention Law repealed and has failed to admit to the errors of the policies regarding Hansen’s disease lies in the fact that the Association’s core consisted of those involved in the sanatoria… The Association deeply regrets that it has ignored the realities and permitted the existence of the Leprosy Prevention Law for so long.”

In July 1995, MHW organized the Leprosy Prevention Law Review Committee, with Otani as its chairman. The committee presented its report in December 1995, recommending the abolition of the law. The resulting bill was passed by the Diet on March 26, 1996, and the Leprosy Prevention Law was at last repealed six days later on April 1, 89 years after the first prevention law had been enacted.

Why did it take so long to repeal the law? Otani places much of the blame on Japanese society’s stifling of individual action: “There was no one to take the initiative to change the policy so that the human rights of a minority would be protected… Among all of us involved, we lacked the intelligence, consciousness, and courage that are required in the citizens of a democratic society and are needed to change the mistaken system. This lack applies in particular to the Hansen’s disease specialists and the government bureaucrats who dealt with matters related to Hansen’s disease patients… Japanese society is such that it is very difficult to accomplish any real change when it is only one individual who brings a problem to the fore. There is a tendency among Japanese to try to evade responsibility, and this means that much time often elapses before anything gets done.”

Otani’s explanation provides insight into the government’s long delay, but the question remains: what changed in the 1990s to allow change after decades of inertia? One of the likely answers is the drastic change of political, economic, and social world in Japan. The early 1990s saw the burst of the bubble economy, the end of the Liberal Democratic Party’s domination of Japanese politics, and the end of the Cold War. As a result, Japanese policymakers realized that they could no longer follow precedents uncritically. Furthermore, the year 1995 witnessed three major events: the Hanshin-Awaji earthquake in January, the Aum-Shinrikyo cult’s poison gas attack on the Tokyo subway in March, and the 50th anniversary of the end of World War II in August. The coincidence of these events forced Japanese people to reflect more deeply than usual on their history as well as on the country’s contemporary politics and society. The repeal of the Leprosy Prevention Law was therefore one of several watershed events in a national re-evaluation of Japan’s postwar identity.

History of A Patient

The story of the Buddhist Priest Ina Kyosho, whom I interviewed shortly before his death in December 1995 at the age of 73, illustrates the human impact of the Leprosy Prevention Law. Ina was born in Nishio, Aichi Prefecture in 1922, and was diagnosed with leprosy in 1947 at the age of 25. He was carried in a freight car labeled “infectious disease cases only” to Nagashima Aisei-en (“Love Life Garden”), a national leprosarium in Okayama Prefecture located on an island separated from the mainland by a 30-meter wide strait. When he entered Aisei-en, Ina took the name “Fujii Zen” based on the story of Shinran, the 13th century founder of the Jodo-Shinshu school of Japanese Buddhism who renamed himself “Fujii Zenshin” after being banished to a remote island. At Aisei-en Ina married another patient, but they had no children since all married patients were sterilized by the leprosarium physicians.

Although Ina recovered in 1960 after receiving treatment with Promin, his family never asked him to return home. His father told him to “keep living there as ‘Fujii Zen’”, and later forbade Ina’s mother from telling her son of his death until after the funeral, in order to prevent his son from attending. Nor did Ina’s family call him to mother’s deathbed.

His treatment was not unique or even unusual. Some patients were divorced by their spouses upon their diagnosis and confinement. Others’ families held funeral services for the patients as if they had died. “What kind of society is it,” Ina asked me, “where people assume they cannot be happy unless the disgraced have been exiled?”7 

Patients in Japanese leprosaria frequently used aliases in order to protect their families, fearing that if neighbors knew of their condition their relatives would face difficulty in marriage and employment. According to a 1996 research report by the Kyushu Bar Association, 45.6% of the 1,199 residents at six national leprosaria in the western part of Japan had used aliases at one time, and 31.1% still did.

In 1989, Ina decided to use his real name again. “I have to because I am a person who preaches the teachings of Buddhism and human truth,” he told me. “I cannot talk about the humanity of others until I have recovered my own humanity.”

His nephew, Nakamura Kaoru, an associate professor at Doho University and a priest in a Buddhist temple in Ichinomiya, Aichi Prefecture, heard that Ina had started to use his real name and to give lectures about his life. Although Nakamura already knew about Ina, he wondered why his uncle had started to speak out. Like many relatives of patients, Nakamura was afraid of what might happen to his family if it was revealed that his uncle had been afflicted with Hansen’s disease, but he finally unburdened himself to his wife Masako in 1991. She replied, “Go and meet your uncle. That’s what you should do.” Nakamura followed his wife’s advice, and in May of the same year he invited Ina to preach at a Buddhist memorial service in his temple. On this occasion, Ina visited his parents’ grave for the first time.

As a priest, Ina had been present at the deaths of 500 residents at Aisei-en. Almost all of these people were cremated in a charnel house, where the ashes of 3,200 patients have been laid to rest. “The ashes of fewer than 10 were received by their families,” Ina told me. “Many families were reluctant to even attend the funeral. Even after death, we are not given the opportunity to be rehabilitated in society.” During my interview with him, Ina told me that he had started to think about his impending death. Ina’s family had recommended placing his ashes in his parents’ tomb, but he instructed that they be put in the charnel house in Aisei-en with those of his 3,200 fellow patients. After his death, his family divided his ashes into different urns, placing one of them in the Aisei-en charnel house, and others in his parents’ tomb and in his nephew’s temple.

In January 2002, it was agreed that the government would pay from 5 million to 14 million yen (or US $40,000 to $100,000) to each of the 2,000 plaintiffs, including both leprosaria residents and their families. The total amount of compensation was estimated at more than US$100 million. In addition, in December 2001, the Minister of Health, Labor, and Welfare (MHLW) estimated that an additional ¥44.8 billion (about $300 million) would be needed for compensation and related projects in 2002.8  The Ministry is now planning the following projects: to promote the recovery of Hansen’s disease patients’ honor; to improve the quality of life of the remaining leprosaria residents; and to pay tribute to the patients who have died. For Japan, the high cost of compensation can be described as the “price of isolation”.

 1 In other lawsuits dealing with such issues as compensation for World War II, some district courts delivered similar rulings blaming the Diet for its inaction. However, these rulings seldom stand, since the government appeals them to higher courts which usually dismiss charges such as “legislative inaction.”

 2 Fujino Yutaka, “Inochi” no Kindaishi: “Minzoku Joka” no nano mononi Hakugai sareta Hansen-byo Kanja [A Modern History of “Life”: Hansen’s Disease Patients Persecuted In the Name of “Racial Purification”], Kyoto: Kamogawa Shuppan, 2001: 156.

 3 John Parascandola, “Miracle at Carville: The Introduction of the Sulfones for the Treatment of Leprosy,” Pharmacy in History, Vol. 40, No. 2 & No. 3, 1998: 63-64.

 4 Yamamoto Shun”ichi, Nihon Rai shi [History of Leprosy in Japan], Tokyo: University of Tokyo Press, 1993: 261-266. Zenkoku Hansen-shi-byo Kanja Kyougikai [National Hansen’s Disease Patients’ Association], ed., Zenkankyo Undo-shi: Hansen-shi-byo Kanja no Tatakai no Kiroku [The History of Movements by the National Hansen’s Disease Patients Association: Documents of Struggles of Hansen’s Disease Patients], Tokyo: Ikkou-sha, 1977: 34-35.

 5 Otani Fujio, The Walls Crumble: The Emancipation of Persons Affected by Hansen’s Disease in Japan, Tokyo: Tofu Kyokai Association, 1998: 107-108.

 6 Goto Etsuko, “Houteki Sabetsu no Teppai ni Mukete [Towards Elimination of Legal Discrimination],” Fujino Yutaka, ed., Rekishi no naka no “Raija” [The “Leper” in History], Tokyo: Yumiru Shuppan, 1996: 233-236.

 7 Ina Kyosho, ed., Hansen-byo Kakuzetsu 40 nen: Ningen Kaiho e no Messeji [Isolated for 40 Years by Hansen’s Disease: A Message for Human Liberation], Tokyo: Akashi Shoten, 1994: 118. Rongakusha Henshubu, ed., Yamisuterareta Hitobito – Nagashima Aisei-en Kimin Shuyosho [People Deserted Due To Disease], Kyoto: Rongakusha, 1996: 72-87.

 8 The Ministry of Health and Welfare and the Ministry of Labor were combined in December 2001 as part of the government’s administrative reform program.