Tama Zenshōen Sanatorium

Tama Zenshōen Sanatorium, also known as National Sanatorium Tama Zenshōen, is a government-run medical and residential institution in Higashimurayama, Tokyo, Japan. It was established in 1909 as the first sanatorium serving the area assigned to Tokyo under Japan's early national leprosy-control system. Although its original institutional purpose was the isolation and treatment of people with leprosy, its history is inseparable from the long-term social consequences of Japan's segregation policy, including the continued residence of many former patients after effective medical treatments became available and after the legal framework for compulsory segregation had ended. The institution was created after Japan enacted its first national leprosy-prevention law in 1907. The law became effective in 1909, when Japan divided the country into administrative areas and designated facilities for people regarded by the authorities as requiring isolation. Tokyo was selected as the site for the first-area facility, which also served residents from a broad group of surrounding prefectures. The Prefectural Tama Zensho Hospital was formally established on September 28, 1909. In its early decades, the sanatorium functioned not only as a hospital but also as a self-contained community, with housing, work, internal administration and other services shaped by the restrictions imposed on its residents. Tama Zenshōen became associated with important developments in Japanese leprosy medicine. Kensuke Mitsuda served as chief doctor from 1909 and later became director. In 1919 he reported the skin-reaction test that subsequently became known internationally as the Mitsuda reaction, an important tool in leprosy research and diagnosis. The institution also developed distinctive internal practices, including special money known as enken, which began circulating within the sanatorium in 1919. Such arrangements reflected the practical consequences of institutional segregation and the limited freedom of movement available to residents. The sanatorium was also a site of patient activism, cultural production and debate over the meaning of institutional life. In 1931, 81 patients left Tama Zenshōen to follow Mitsuda to National Sanatorium Nagashima Aiseien, where they hoped to help create an exemplary institution. Literature produced by or about residents contributed to the record of leprosy in Japan. Tamio Hōjō's 1936 work The First Night of Life became an important example of leprosy literature and was recommended by Yasunari Kawabata. The postwar period did not immediately end segregation. Japan's 1953 Leprosy Prevention Law maintained a system that restricted patients and encouraged long-term institutionalization, even as effective treatments reduced the medical justification for compulsory isolation. The law was abolished in April 1996. Former patients and their supporters subsequently pursued legal compensation, arguing that the state's continuation of the segregation system had violated constitutional rights. In 2001, the Kumamoto District Court found the former policy unconstitutional, and the judgment became final later that year. Compensation awards varied according to the length of time affected and other factors. Today, Tama Zenshōen remains part of Japan's national sanatorium network and serves residents who are living with the consequences of past disease, treatment and social exclusion. Its surrounding area also contains institutions central to the historical interpretation of leprosy in Japan, including the National Hansen's Disease Museum and the Leprosy Research Center of the National Institute of Infectious Diseases. The sanatorium is therefore both a healthcare institution and a significant site of medical, legal, social and cultural history.

Japan's first national leprosy-prevention law was promulgated on March 19, 1907, but financial constraints delayed its implementation until April 1, 1909. The country was divided into five administrative areas for the purposes of the system. Tokyo was chosen as the facility location for the first area, which included Tokyo and a large group of neighboring and surrounding prefectures. The policy was influenced both by official concern over visible wandering patients and by anxieties about the number of people identified with leprosy during military draft examinations. Tama Zensho Hospital was established on September 28, 1909. Tokutaro Ohno served as acting director during the establishment period, while Kensuke Mitsuda became chief doctor. Saijiro Ikeuchi became the first director in 1910, and Mitsuda later assumed the directorship in 1914. Mitsuda's work at the institution had lasting international significance: in June 1919 he reported the reaction that came to bear his name. In September of the same year, the sanatorium introduced enken, a form of money intended for internal circulation. The institution's history also includes movements by patients and staff to shape the model of leprosy care. In March 1931, 81 patients moved to National Sanatorium Nagashima Aiseien after Mitsuda, seeking to help establish an idealized sanatorium community. During the same broad period, residents and writers contributed to a body of Japanese leprosy literature. Tamio Hōjō's The First Night of Life, published in Bungakukai in February 1936, is remembered as an important work in that literary history and was recommended by Yasunari Kawabata. The postwar legal framework continued compulsory segregation for decades. The 1953 Leprosy Prevention Law remained in force until April 1996, even though medical advances had changed the clinical management of leprosy and weakened the justification for institutional isolation. The long duration of the policy contributed to stigma, disrupted family and community relationships, and made social reintegration difficult for many former patients. A compensation trial began in July 1998. On May 11, 2001, the court ruled that the former prevention policy was unconstitutional. The decision was confirmed on May 25, 2001, and awards reportedly ranged from 8 million to 14 million yen depending on the duration of the unconstitutional period and the circumstances of individual patients. Tama Zenshōen's later history is consequently connected not only with clinical care but also with redress, public memory and the reassessment of state-controlled medical segregation. The sanatorium remains in Higashimurayama and is situated near the National Hansen's Disease Museum and the Leprosy Research Center of the National Institute of Infectious Diseases. These neighboring institutions reinforce the area's role as a center for care, research, documentation and education concerning Hansen's disease in Japan.

• 2001

  Former segregation policy ruled unconstitutional

  [1]Tama Zenshōen Sanatoriumen.wikipedia.org

  A compensation judgment found the former policy unconstitutional, and the ruling was confirmed later that month.

• 1996

  Leprosy Prevention Law is abolished

  [1]Tama Zenshōen Sanatoriumen.wikipedia.org

  Japan repealed the 1953 law that had maintained the legal basis for long-term segregation.

• 1936

  A landmark work of leprosy literature is published

  [1]Tama Zenshōen Sanatoriumen.wikipedia.org

  Tamio Hōjō's The First Night of Life appeared in Bungakukai and became associated with the literary history of Japanese leprosy institutions.

• 1931

  A group of patients transfers to Nagashima Aiseien

  [1]Tama Zenshōen Sanatoriumen.wikipedia.org

  Eighty-one patients followed Mitsuda to National Sanatorium Nagashima Aiseien in an effort to help create an ideal sanatorium.

• 1919

  Mitsuda reaction reported

  [1]Tama Zenshōen Sanatoriumen.wikipedia.org

  Kensuke Mitsuda reported the reaction later used as an important tool in leprosy diagnosis and research.

• 1909

  Tama Zensho Hospital opens

  [1]Tama Zenshōen Sanatoriumen.wikipedia.org

  The institution was established in Tokyo on September 28 as the sanatorium for Japan's first administrative area.

• 1907

  Japan promulgates its first leprosy-prevention law

  [1]Tama Zenshōen Sanatoriumen.wikipedia.org

  The government enacted the legal foundation for a national system of leprosy control and institutional isolation.

A national public-care institution whose identity is rooted in long-term medical care, resident support, Hansen's disease research history and the preservation of memory about Japan's former segregation policy.

• 2001

  Compensation ruling against the former policyOther

  Background

  Former patients brought a compensation case challenging the constitutionality of Japan's prolonged leprosy segregation system.

  Action taken

  The court ruled on May 11 that the former prevention policy was unconstitutional; the decision was confirmed on May 25.

  Aftermath

  Eligible patients received compensation, with reported awards ranging from 8 million to 14 million yen according to the duration of the affected period and individual circumstances.

  Reported compensation awards. 8,000,000–14,000,000 yen per eligible patient (2001 ruling)

  Source

• 1996

  End of the statutory segregation frameworkStrategy

  Background

  The 1953 Leprosy Prevention Law had continued institutional segregation after effective medical treatments were available and had shaped the lives of residents for decades.

  Action taken

  Japan abolished the law in April 1996, changing the legal environment in which national sanatoria operated.

  Aftermath

  Many former patients continued to live in sanatoria because of age, disability, stigma and the difficulty of returning to ordinary community life.

  Source

1. 1Tama Zenshōen Sanatoriumen.wikipedia.org
2. 2Tama Zenshōen Sanatorium official websitenhds.go.jp