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  • Reforming Public Health in Occupied Japan, 1945–52: Alien Prescriptions? by Christopher Aldous and Akihito Suzuki
  • Takakazu Yamagishi (bio)
Reforming Public Health in Occupied Japan, 1945–52: Alien Prescriptions? By Christopher Aldous and Akihito Suzuki. Routledge, London, 2012. xvii, 234 pages. $135.00, cloth; $125.00, E-book.

In Reforming Public Health in Occupied Japan, 1945–52, Christopher Aldous and Akihito Suzuki study the impact of the U.S.-led occupation on public health policy in Japan after World War II. Public health, by their definition, “operates at the national or local level and is concerned with protecting the health of communities” (p. 5). Compared with policies that deal with the economy, agriculture, labor, and constitution, public health policy has received insufficient attention from occupation studies scholars, especially those who publish in English. This is in spite of the fact that public health policy laid an important foundation for Japan’s recovery in [End Page 503] the postwar period. In addition to filling this gap, Aldous and Suzuki try to carefully situate public health policy in the broader historical context.

The authors’ main goal is to refute the near-dominant narrative that the Public Health and Welfare (PH&W) Section led by Crawford Sams dramatically improved public health by “alien prescriptions” (p. 8). This view was supported by the title of his memoir in Japanese, DDT kakumei (Iwanami, 1986). The term kakumei, which means revolution, symbolizes Sams’s claim that PH&W brought about an unprecedented reformation in public health policy. Aldous and Suzuki provide a critical perspective to this story.

To locate the occupation period in the long history of public health policy in Japan, they investigate three aspects of public health policy: capacity (manpower and financial resources), practices (programs), and outcomes (statistics of disease). By investigating these key public health measures, they conclude that major policies were more the legacy of prewar and wartime policy developments than a revolution brought by the occupation authority.

This book is composed of seven chapters. The first two describe the prewar and wartime development of public health policy and reveal that although Japan faced some difficulties in improving its public health, it made substantial progress in these years. Chapter 1 challenges Sams’s claim that Japan’s policy to control communicable diseases was “a blind following of the theories and system of Germany” (p. 19). With attention to the contributions of public health experts such as Nagayo Sensai and Kitasato Shibasaburō, who studied abroad and introduced what they learned into the Japanese context, this chapter demonstrates that Japan successfully modernized its public hygiene system to deal with epidemic problems. Chapter 2 shows that Japan also developed policies to address chronic diseases such as tuberculosis, syphilis, and trachoma. The policies included efforts to improve citizens’ diets, which was evidenced by the Imperial Government Institute for Nutrition, “one of the first of its kind in the world” (p. 47). Programs to fight chronic diseases, according to Aldous and Suzuki, were further advanced by the government to improve the health of the people in order to effectively fight the war with China and the Allies.

The following five chapters deal with the development of specific policy areas during the occupation. Chapter 4 demonstrates that in responding to the serious sanitary problem Japan faced after the war, occupation officials produced policies to deal with disease-bearing insects, water, and night soil. They also created sanitary teams for public education on environmental hygiene. Aldous and Suzuki argue that many policies were aimed at “reestablishing or reinstituting procedures and practices associated with Japan’s pre-war and wartime hygiene regime rather than introducing novel, innovative approaches” (p. 115). But they admit that introduction of the insecticide DDT was an exception because it was a U.S. product. However, [End Page 504] Aldous and Suzuki argue that Japan’s own pyrethrum industry was well established and DDT vied with this indigenous product.

Chapter 5 discusses policies to improve the Japanese people’s diet. Despite Sams’s “high-blown rhetoric about transforming nutrition,” Aldous and Suzuki claim that occupation policy was “re-establishing the pre-war dietary pattern that had been distorted by war and defeat” (p. 140...

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