Chief Editor Mitsuko Kojima

Mitsuko Kojima
Professor Emeritus, Nihon Fukushi University

“Living with Disabilities/ Medical Treatment and Welfare Service for Senior Citizens in the Community” [Translated from Japanese.], Minerva Shobo 

“An Introductory Book of Welfare” [Translated from Japanese.], Hitotsubashi-Shuppan

“Theory of the New Medical Social Worker -System Development-” [Translated from Japanese.] , Minerva Shobo

Date: March 25, 2009

Place: “Osa House”, Mitsuko Kojima’s residence, Nagoya, Japan

Interviewers: Tateo Ito and Shiori Nagamori

Translator: Shiori Nagamori


She’s a post, World War II pioneer to medical social workers


After World War II, I wanted to do something to improve the miserable and suffering situation in my home country, Japan.

There wasn’t enough food nor clothes, and many babies didn’t survive.

I graduated from a professional training college and became a dormitory superintendent at one of the munitions factories used during the war.

I also belonged to a social study club with Keio University students at the time.

This experience helped me to learn more about people and society.

During the first post-war election, thirty-nine female politicians were elected.

The women created a nonpartisan dairy committee to address malnutrition in babies.

I became a volunteer member on the committee and it represented a new beginning for me.

My father was a wholesaler of woolen textiles. That industry had a lot of ups and downs during that time.

He experienced three big catastrophes – the Great Kanto Earthquake (1923), the Great Depression (early 1930’s) and World War II (1939 – 1945).

Of course, we had our share of good times but mostly I remember the bad times.

We basically lived in abject poverty during those days.

My family members thought that my father was a good-for-nothing person.

We thought that our poverty was because he didn’t work hard enough.

I realized that the problem was not my father but the existing societal situation, so my respect for him was renewed.

During this period, the Kanto Food Democratic Association (Kanto Shokuryo Minshu Kyougikai), movement, was founded.

These people created the “Give Us Rice (Kome Yokose Toso) Movement”, “Food (Shokuryo) Mayday” and “Exposed other Malfeasance (Tekihatsu Tai)”.

Some patient groups participated in some of their activities.

I first encountered “patients’ movements” in 1946.

As mentioned earlier, when I was a volunteer on the dairy committee, I researched the supply and demand of dairy goods.

My research drew accolades from a manager of the dairy section within the Ministry of Agriculture and Forestry.

I consequently became a researcher at the Japan Political and Economical Research Center (Nihon Seiji Keizai Kenkyusho).

There was a lot of focus on the center and it attracted famous researchers.

Though I wasn’t as highly educated compared to my colleagues, I did have a good opportunity to be part of the agricultural reform team.

I learned that women living in rural farm communities were in a miserable situation, so I wanted to research the problem and develop solutions.

Unfortunately, due to my lack of practical farming experience, I was caught in a compromising situation.

During field research I was introduced as an agricultural expert, however upon visiting a farm, and not knowing what a “thresher” was, I realized that my so-called expertise was very limited. I resigned after two years.

At that time, one of my family members were admitted at Orimoto hospital in Tokyo due to tuberculosis.

I became a volunteer member of a patients’ group there.

Orimoto hospital specializes in thoracic surgery.

The hospital was located in Nakano which used to be the Geisha quarter.

They performed many appendectomies on Geishas at the time.

After WWII, they introduced a short-stay system which was a progressive idea as people usually stayed in the hospital for many years during those days.

They performed surgeries and many patients were back home within a month.

In this hospital there were many activists trying to improve human rights and/or social environments.

Orimoto hospital had a connection with the National Kiyose Hospital.

The son of the director of the Orimoto hospital was also a doctor and he practiced at the National Kiyose Hospital to learn thoracic surgery techniques.

The National Kiyose Hospital was a center of a labor, patient and other movements.

The director of the hospital was a communist and the hospital made the communist newspaper headlines occasionally.

The head nurse and other nurses at the National Kiyose Hospital were part of the “Red Purge” extracting communist sympathizers.

The hospital’s secretary-general graduated from the school of economy at Tokyo University and engaged in “Zenkanro”, a labor movement of the government offices.

Many patients had activist backgrounds.

Doctors of the Japan Federation of Democratic Medical Institutions “MIN-IREN” introduced many patients to the Orimoto hospital.

Therefore, the Orimoto hospital was greatly influenced by the labor movement.

Even though the patient’s admission times were shorter, they still wanted to be active in the patients’ movement, so I became a volunteer publisher for the newsletter “Shinro” which kept everyone up to date.

During those days, only a few hospitals including Orimoto did thoracic surgery therefore many patients traveled there from all over Japan.

After surgery, they returned to their hometown hospitals.

Some hometown hospitals couldn’t care for some patients’ specific needs therefore they were admitted into satellite hospitals throughout Japan, which at the time had many vacant beds.

The satellite hospitals were converted from traditional hospitals due to the aging of the directors and the void of their doctor sons inheriting their positions due to WWII combat attrition.

They welcomed out-patients from the hospitals that performed surgeries because they just required follow up treatment.

The satellite hospitals increased to over 15 in Tokyo during this time.

I also visited those hospitals to check on the patients.

In addition, these patients also organized patients’ groups.

They tried to improve the hospitals’ meal services.

By improving the menu, I was able to increase the overall meal standards at Orimoto hospital.

The patients really appreciated the improved meal service while recovering from surgery.

But after relocating to the satellite hospitals they were disappointed with the meal standards there.

So, they organized patients’ groups to improve the situation.

Orimoto hospital considered closing due to a malpractice case.

The patients’ families lobbied the Tokyo Metropolitan Government against the closure.

And thanks to their efforts, the hospital didn’t close.

The hospital administrators wanted to show their appreciation for the patients’ efforts, so they changed my status from volunteer to full-time medical social worker.

We organized a patients’ group there and it became the largest in Tokyo with more than a thousand members.

We also published a newsletter.

As well as patients, orderlies, nurses and doctors contributed to the publication.

Rehabilitation, physical and occupational therapists were not yet intrenched.

A small area in the hospital was created for rehabilitation at the time.

Patients who were recovering went to this area in preparation for discharge.

The patients’ group “Shinwa-kai(親和会)” was a peer organization that shared useful care and daily life information.

They supported each other while trying to secure employment.

Some recovered patients were hired at the hospital.

Patients that recovered from tuberculosis found it difficult to socialize and possibly marry due to social prejudices at the time.

We needed better social awareness of this dilemma.

In order to help the victims, we organized joint wedding parties and broadcast them on the radio.

Furthermore, in the 1950’s, I was in charge of the “Asahi Human Rights Lawsuit”.

The lawsuit was launched on behalf of Mr. Asahi, a tuberculosis sufferer.

As well as fund-raising for the lawsuit I also gave testimony at the trial.

My testimony was based on patients’ interviews regarding their daily necessities.

Valuable and relevant data was compiled that contributed to the success of the trial.

The interviews were carried out at my hospital, (Kiyose) and the “Sanyoso” support facility in Yamaguchi.

We won the first trial, and my data was quoted often during the judgement announcement.

Also, at that time, activists were able to secure employment and housing for recovering tuberculosis patients.

It was called the “Colony Activity”.

One day I was contacted by a lawyer who was also a TB patient at the sanatorium in Saga.

He suggested I join an upcoming Colony Conference there.

The overall situation for TB patients needed drastic improvement.

Even though post-surgery results were promising for many, others however didn’t fare so well.

The latter, unable to fulfill their dreams, often became quarrelsome and engaged-in prohibited activities such as smoking, drinking and gambling at their extended care facilities.

I was worried about them, so I attended the Colony Conference in Saga.

After the conference, on the way back to Tokyo, I visited a patient leader, Mr. Kazuoki Shirabe in Yamaguchi.

I only knew that he lived in Ube, Yamaguchi but not where.

He had retired from working due to severe complications following TB surgery and decided to write a novel in his hometown of Ube, Yamaguchi.

After a while, I finally located his apartment.

I provided a beef steak dinner for him and his wife and we discussed, possibly where recovering patients could secure employment.

I asked him to organize a “Colony” in Tokyo.

He eventually agreed and moved to Tokyo with his wife.

They rented a small apartment and organized the “Tokyo Colony” starting with a few TB recovering patients.

A peer organization “Shinwa-kai” did fund-raising and collected 430,000 yen for the Colony.

Mr. Shirabe and others did a great job and then organized a national organization called “Zen-Colo”.

I became a social worker at the “Tokyo Colony” and also a secretary general of “Zen-Colo”.

Soon after, Nihon Fukushi University in Nagoya hired me as a professor.

I moved to Nagoya therefore leaving the “Tokyo Colony” and “Zen-Colo” positions.

Prior to 1980, Mr. Shirabe had successfully helped to organize about 100 groups for people with disabilities.

The United Nations declared 1981 the International Year of Disabled Persons (IYDP).

At this time, many organizations cooperated together leading to social welfare reform in Japan that progressed through the next decade.

Next, I’d like to compare the patients’ movements history in Japan versus oversea countries.

While at Nihon Fukushi University, I visited the U.K., (United Kingdom).

My first question to my English colleagues was “Are there patients’ group’s movements in England?”

The answer was no.

European countries have bottom-up welfare systems, not top-down.

Consequently, there weren’t patients’ movements in the U.K. at that time.

However, there was a TB prevention group.

I was so disappointed.

I thought maybe that patients’ movements were only in Japan.

Later, I visited Sweden and stayed there for about a month.

At a research institute I discovered a thesis regarding Swedish disability movements.

It noted patients’ movements from World War II.

I was surprised that it documented heart disease and TB patients’ groups, so I found out where they were located and visited them.

While there, I met with the secretary-generals and read some of their literature.

After which, I wrote a thesis that the origin of Swedish welfare was based on the patients and disability movements.

In Sweden, social, co-op (cooperative) and grass-roots movements are very popular.

The Swedish welfare system began from patients’ movements.

Patients negotiated with city governments regarding the cost of daily necessities however, their efforts were futile.

In order to create a more viable action plan, they organized study groups that met at national high schools which symbolically is important in Sweden.

At the study groups, they invited knowledgeable speakers including members of the municipal assembly, scholars and politicians.

They negotiated again, and this time they succeeded.

The study groups developed into bigger and diversified organizations and associations that continued the efforts to improve the quality of life for those in need.

I therefore concluded that the origin of Swedish welfare was the movements of patients’ and people with disabilities.

Upon my return to Japan, I lectured extensively about my findings in Sweden.

Consequently, we started international exchanges with Scandinavian patients’ movements.

In Japan, I went on to further engage myself in patients’ movements and also began focusing on disability movements which I continue to do to this day.