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[The history of Yunosawa village and the policy of leprosy of Japan. I].

There was a village which was called Yunosawa, lots of leprosy patients lived, existed from 1887 to 1941, Kusatu town, Gunma Prefecture, Japan. It was the only place continued securing self-government to the last as area was free from the isolation policy of State in prewar days there. The aim of this study will make clear the dynamism of "The protection from the tension of the society of leprosy patient currently persecuted" to "The defense of the society from the leprosy patient who is a source of infection". In this study, it outlined what community of Yunosawa village. This seen here was not an image called the illness person's group but the advanced community, and was equipped fully with an autonomous system, institution, etc.

Balneology↗

[The history of Yunosawa village and the policy of leprosy of Japan III].

There was a village which was called Yunosawa, lots of leprosy patients lived, existed from 1887 to 1941, Kusatu town, Gunnma Prefecture, Japan. It was the only place continued securing self-government to the last as area was free from the isolation policy of State in prewar days there. The aim of this study will make clear the dynamism of "The protection from the tension of the society of leprosy patient currently persecuted" to "The defense of the society from the leprosy patient who is a source of infection". In this study, explained the history of the Yunosawa village and the shift of the policy of leprosy by State had relation to the village. In addition, showed worth of free medical-treatment area here.

Health Policy↗

[A case of Hansen's disease seen in an Indonesian resident, and tracing of the patient after coming back to Indonesia].

A 26-year-old Indonesian male living in Japan consulted our hospital with complaint of fever, general malaise and infiltrative erythematous plaques associated with lymph node swelling. Physical examination revealed a sensation disorder in the distal portion of the extremities and hypertrophy of peripheral nerves. Histopathology of the skin lesion showed the multifocal granulomatous inflammation containing many acid-fast bacilli associated with infiltration of foam cells and neutrophils. Under the diagnosis of leprosy (LL type) accompanied by erythema nodosum leprosum, the combined chemotherapy (clofazimine, rifampicin, and diphenyl sulfone) was started. For the leprosy reaction, short-term administration of the systemic steroid was added. The general condition was carried out soon, and the sensation disorder has also been gradually improved. The patient came back to Indonesia after 6 months treatment because of the time limit of visa. We traced the patient's condition through personal networks, and knew that the patient could not have continual treatment for the disease, and that he is suffering from disability of hands and feet. In this case, several medical facilities were consulted before the final diagnosis of leprosy. The Japanese medical doctors should also remember this disease when they examine persons with infiltrative skin eruptions and sensation disorders.

Adult↗

[The history of Yunosawa village and the policy of leprosy of Japan. II].

There was a village which was called Yunosawa, lots of leprosy patients lived, existed from 1887 to 1941, Kusatu town, Gunma Prefecture, Japan. It was the only place continued securing self-government to the last as area was free from the isolation policy of State in prewar days there. The aim of this study will make clear the dynamism of "The protection from the tension of the society of leprosy patient currently persecuted" to "The defense of the society from the leprosy patient who is a source of infection". In this study, explained the history of the Yunosawa village and the shift of the policy of leprosy by State had relation to the village. In addition, the effort of residents and Christianity persons' activity are drawn in this paper. Moreover also drew what is desired how it is going to live under adverse circumstances, and showed worth of free medical-treatment area here.

Charities↗

[Case report revisited: review of the 6 cases].

Out of the cases we experienced in our 11-year service in sanatorium, 6 cases were selected to review the medical care and social environment that each patient was involved. Two cases were the residents in a sanatorium and 4 cases were in the community, including 2 cases having foreign nationality. The review of these cases drew the following conclusions. 1. We must be aware of our responsibility for early diagnosis and treatment of leprosy to prevent tragic disability. 2. The fixed duration of MDT/MB may not be enough for LL cases having high bacterial load before treatment. Enough duration of chemotherapy and follow-up is desired to prevent avoidable disability. 3. Basically, the treatment of leprosy should be carried on in outpatient clinic. The duration of hospitalization, if necessary, should be shortest to enhance patient's motive for treatment. 4. Intermittent administration of RFP must be done under direct observation. 5. For foreign patients not accustomed to the life in Japan or elderly patient living by oneself, various supports from community are greatly helpful to achieve the long course of leprosy treatment. Through these supports, we can expect community enlightening that may promote rehabilitation of the people once suffered from leprosy.

Adult↗

[Hansen's disease control in Miyakojima, Okinawa].

A brief history was reviewed of Hansen's disease control in Miyakojima, Okinawa. National Sanatorium Miyako Nanseien played a leading role, while Miyako Skin Clinic, an outpatient clinic present between February 21, 1970 and April 1, 1987 played an important role in finding new cases and in the treatment of some cases. A schoolchildren survey was conducted by a team of specialists in 1967.

Ambulatory Care Facilities↗

[The history of Yunosawa village and the policy of leprosy of Japan. IV].

There was a village which was called Yunosawa, lots of leprosy patients lived, existed from 1887 to 1941, Kusatu town, Gunnma Prefecture, Japan. It was the only place continued securing self-government to the last as area was free from the isolation policy of State in prewar days there. The aim of this study will make clear the dynamism of "The protection from the tension of the society of leprosy patient currently persecuted" to "The defense of the society from the leprosy patient who is a source of infection". In this study, explained the factor of confusion to a National Leprosarium Kuryu Rakusen-en during World War II and considered relation between patient movement and residents of Yunosawa village at the postwar period.

History, 19th Century↗

[Survey on the present conditions of the residents regarding aging, aftereffects and subsequent complication].

A survey of present conditions of the residents regarding aging, aftereffects and subsequent complication was conducted and its data were analyzed in the National Leprosarium Osima Seisho-en; located on an isolated island of the Seto Inland Sea. The results showed that they have become older with a various type of disease and most of them suffered from aftereffects caused leprosy, although after therapy. This survey also suggests that future problems in the management of our leprosarium will no doubt be to cope with the aging and to reducing our scale.

Age Factors↗

[Effect of physician shortage on today's Hansen's disease management].

In recent years, the total patient population of Hansen's disease has been rapid declining throughout Japan by as many as 200 - 250 each year. This decline is due to the aging of existing patients, and scarcity of new cases. Less patients are a welcome phenomenon. However, existing treatment facilities are now confronted with problems. The most serious problem is shortage of treating physicians. The causes of the shortage are (1) the aging of the existing patient population that creates mounting need for medical-surgical care and (2) the nation-wide shortage of physician in national sanatoria all over Japan. Let me present a sketch of the current situation at Amamiwakouen Hospital as an illustration. Amamiwakouen is a government-run sanatorium. It is responsible to take care of inpatient as well as out patients. Currently, there are 70 long term inpatients, who are handicapped by Hansen's disease sequela of various degrees. 11 minimally former inpatients are followed at the outpatient clinic. The clinic is also open to all community citizens. The number of annual clinic visitors averages 6,500 - 7,000. They come with wide range of problems requiring a dermatologist. While the total number of full-time staff is 100, only two are licensed physicians at present. This is indeed a disastrous situation. Therefore a number of contract physicians are recruited from nearby medical institutes to meat the demand.

Allied Health Personnel↗

Leprosy in Korea.

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Adult↗