The inherited epidemic: a history of tuberculosis in occupied Japan

Scholarship on Japan’s Occupation Period (1945-1952) has focused on the ways in which Japan was transformed from an imperial power to a democratic nation. While such work provides valuable information about how the Supreme Commanders for the Allied Powers (SCAP) affected Japan’s political climate following the end of the Asia-Pacific War, they gloss over other ways in which the SCAP government came in contact with the Japanese people. The topic of health is one that has seldom been explored within the context of the Allied Occupation of Japan, despite the fact that the task of restoring and maintaining health brought SCAP personnel and policies into daily contact with both the Japanese government and people. By focusing on the disease tuberculosis, which boasted the highest mortality rate not only during the Occupation Period, but also for most of the first-half of the twentieth century, this paper hopes to illuminate the ways in which health brought the Allied Powers and Japanese into constant contact. The managing of tuberculosis in the Occupation Period represented a major success for SCAP’s Public Health and Welfare (PH&W) section. The new medical findings, medicines, and management and education systems that the PH&W incorporated into the Japanese health systems played a large role in the PH&W’s success in controlling tuberculosis within Japan. The PH&W’s expertise in dealing with tuberculosis reconnected Japan with the international medical community it had forfeited during the Asia-Pacific War. In doing so the PH&W also helped dispel the social stigma that surrounded tuberculosis and hindered earlier attempts to halt the disease’s spread. The management of tuberculosis was a major success for the Japanese government as well. While the PH&W section was quick to point out that their introduction of modern science into Japan lead to the defeat of tuberculosis, many of the methods used to combat the disease were familiar to the Japanese government and medical community. While SCAP may have provided new drugs like streptomycin, Japanese medical professionals were already well versed in the production and distribution of vaccines. Japanese citizens had also previously been exposed to many of the practices, such as regular tuberculosis screenings that the PH&W section mandated. The Japanese governments ample supply of manpower was also a crucial, though often overlooked, component of tuberculosis control in the Occupation period. Tuberculosis control was achieved during the Occupation Period through the cooperation of both SCAP and the Japanese government and medical community. After explaining why tuberculosis remained a problem in the early twentieth century, despite Japanese medical communities efforts to dispel the social stigma surrounding tuberculosis and to manage the disease, this paper examines why tuberculosis rates grew at their fastest pace ever following the end of the Asia-Pacific War. The early years of the Occupation brought both immediate changes instituted by the PH&W section and practices that had prewar precedents within Japan. Finally, this paper turns to the PH&W’s push to control tuberculosis. Building on the changes instituted in the early Occupation Period, the PH&W section introduced new findings concerning tuberculosis and strictly reinstated familiar practices including mandatory vaccine drives, in order to finally overcome tuberculosis