September 1, 2025
TOKYO – Preservation of state-run leprosy sanatoriums across the nation has become a challenge as residents age and their numbers decline.
Residents in the National Sanatorium Tama Zensho-en, a leprosarium in Higashimurayama, Tokyo, and others compiled a future vision to preserve the facilities for future generations, aiming to convey the history of discrimination against Hansen’s disease patients who were forcibly segregated.
Though much is undecided for realizing the vision, residents of the sanatorium have spoken about it with a sense of urgency. One said, “We hope a decision will be made on the preservation of the sanatorium while it still has residents.”
Final home for patients
“For many people who came before me, Zensho-en has become a place like a hometown, so we can’t just let it fade away,” said Yoshio Yamaoka, 76, head of the residents’ association.
He made the remark in front of trees planted in the sanatorium grounds by residents.
Yamaoka is from Mie Prefecture. When he was a sixth-grade elementary school student, he was diagnosed with Hansen’s disease and taken to a leprosarium in Okayama Prefecture.
Upon graduating from high school at the leprosarium, he lived in Zensho-en for about two years. After that he left and began working as a company employee.
Yamaoka said, “I was afraid of being discriminated against, so I lied about my disease and background to the people around me.”
His Hansen’s disease was later cured, but he has continued to suffer aftereffects such as nerve paralysis.
He returned to Zensho-en in 2012. “I wanted to receive medical treatments with a sense of security,” he said.
There are 13 state-run leprosy sanatoriums across the nation, including Tama Zensho-en. According to the Health, Labor and Welfare Ministry, there were 639 residents across the 13 sanatoriums as of May 1 this year, or 40% of the level a decade ago.
Tama Zensho-en was preceded by Zensei Hospital, which opened in 1909, at around the time government policy forcibly segregating Hansen’s disease patients began.
More than 1,500 patients lived in Zensho-en at its peak in the 1940s. As of May 1 this year, there were 85 residents and their average age was 88.7.
There are many buildings in the roughly 35-hectare ground, such as a housing complex, a medical facility, a church and a temple where residents offer prayers, and a columbarium where the remains of deceased patients are stored.
There are also many trees, including cherry trees, which were planted in the precincts by residents.
Next to the state-owned leprosarium stands the National Hansen’s Disease Museum, which is meant to convey the history of patients’ hardships.
Yamaoka emphasized the significance of Zensho-en as a place where patients came to live. He said, “If there comes a time in the future when there are no residents, the land may be sold off in pieces. Preserving the sanatorium in its current form is important for conveying to future generations the history of discrimination against us.”
Practical steps not taken
A future vision committee comprising Tama Zensho-en, the Higashimurayama city government and the Zensho-en residents’ association announced the vision in March this year to outline plans for the sanatorium.
The vision for the facility was created so residents of Zensho-en will be able to continue living with a sense of security, and the leprosarium can become a base for raising awareness about Hansen’s disease.
It contains a plan to divide the sanatorium’s precincts into three areas: a zone for residents to live, a medical facility zone and a park which will be open to the public. By doing so, the future vision aims to preserve the sanatorium.
However, efforts to preserve the leprosarium have faced obstacles.
A facility formerly used for child residents built in 1953 was demolished in 2023 due to its age.
Residents used to reminisce as they faced the direction of their hometowns on a miniature hill, completed about 100 years ago, but the spot is currently off-limits because it is at risk of collapsing.
A health ministry expert panel decided in 2022 to preserve the hill and other parts of the facility to convey their significance to future generations.
But only the first steps have been taken, such as collecting the opinions of residents, while practical plans for construction and refurbishment have not been compiled.
For the churches and the temples, which residents hope to preserve, no actions have been decided partly because of the issue of separation of state and religion.
An official of the health ministry said, “While listening to the opinions of residents, we want to decide on the course of preservation in cooperation with the local government.”
Prof. Ai Kawasaki of Showa Women’s University, who is an expert on issues related to Hansen’s disease and social welfare studies, said, “Time for listening to the residents’ opinions is limited due to their advanced age. The central government and other authorities need to firmly understand the history residents want to pass down and take practical actions to realize a plan.”