¹ Usami uses several terms here—kanja and moto kanja (patients/former patients), nyūshosha (“residents”/admittees), and byōyū (friends in illness)—while rejecting the word raisha as dehumanizing as its English equivalent leper. Likewise, since the 1950s, the term Hansen-byō (Hansen's Disease) has replaced raibyō in general and scientific discourse, with the latter considered far more stigmatizing than the English leprosy, which remains common in many parts of the world. Usami also uses the term shūyōjo (incarceration/concentration facility) which is often used to translate both Nazi concentration camps, a comparison Usami himself made in the pages of Time magazine in 1996 following the repeal of the Leprosy Prevention Law, and Pacific War-era U.S. and Canadian “relocation centers”/internment camps for their citizens and residents of Japanese ancestry.

² See here and here.

³ A month after Usami's death, the two leprosaria located on Nagashima Island—Aiseien which was opened in 1931 as the flagship of a new system of national institutions replacing local and missionary hospitals and Oku Kōmyōen which was relocated from Osaka Bay following the Muroto Typhoon of 1934—celebrated the 30^th anniversary of the “Bridge of Restored Humanity” which connects the island across a narrow strait to Honshū. At that time it was reported that the combined population of the institutions was down to 261—nearly 7,000 having died there—with an average age of well over 85. A move is underway to register the two institutions, as well as Ōshima Seishōen on another Inland Sea island, as UNESCO World Heritage Sites. Perhaps Usami would have agreed. See here.

⁴ The first effective treatment for Hansen's Disease, the sulfone antibiotic Promin was developed at the United States Public Health Service Hospital in Carville, Louisiana, in the early 1940s and was introduced into Japan during the Occupation.

⁵ Ogawa Masako was a doctor at Aiseien in the late 1930s. Her 1938 memoir Kojima no Haru was made into a popular film in 1940.

⁶ Following the lawsuit, a professionally-curated museum was established in the former administration building and many of the artifacts Usami collected are now displayed there.

⁷ Although the jūkanbyō at Aiseien is only a ruin with a historical marker, the one at Kiryu Rakusenen at Kusatsu, where numerous patients froze to death, has been reconstructed as a museum. That work was led by Usami's comrade Kodama Yūji (1932-2014)

⁸ Prior to the development of antibiotics, oil extracted from the fruit of the tropical Chaulmoogra tree was the only medical treatment available. There is some debate as to whether it was at all effective.

⁹ As Usami indicates here, Shima Hiroshi (1918-2003) was among the leading and most forward thinking Hansen's Disease patient-activists. A novelist and editor as well as political activist, he spoke out about the parallels between the Hansen's Disease experience and how Japanese infected with HIV were being treated in the 1990s and called for the repeal of the hated law. After making a life at one leprosarium in Kagoshima Prefecture, Hoshizuka Keiaien, for fifty years, he exercised his hard-fought right to “return to society” for the last several years of his life.

¹⁰ Usami is referring to a major cause of unease among the remaining residents of Aiseien and the other national sanatoria: the question of whether, as their numbers decrease and their need for care compounds, the Ministry of Health, Labor, and Welfare may decide to break its oral promise and forcibly relocate them once again as a consolidating and cost-saving measure.