Monday, 2 July 2018

A Japanese Leprosy Patient Survivor’s tale


Japan put thousands of leprosy patients in compulsory detention in sanatoria because of their disease. One of these survivors, Edo told me his story in 2016 and how he became a leprosy patient champion. I visited the sanatoria with a human rights activist, Kay Yamaguchi, a 70 year old social scientist who has campaigned for human rights for Japanese leprosy patients.  She is petite woman who speaks fluent English and was an impassioned guide to the sanatorium and museum. She knew the patients in the sanatorium well from her visits over the years. The Japanese government put newly diagnosed leprosy patients in sanatoria from 1905 onwards.  There were searches to find patients with leprosy who were then put in the sanatoria compulsorily. The numbers of patients going into the sanatoria peaked in the 1930’s but continued until the 1970’s. They were not allowed to leave despite having an infectious disease that became treatable in 1948 with the antibiotic Dapsone.

Edo is 85 and has been badly affected by the disease and sits in a wheelchair. His nose had collapsed and his eyes were rheumy. He had lost several fingers and he wears heavy protective boots on his feet. He lived in a village and had developed single red patch of leprosy on his face when he was 20 in 1948.  Leprosy was diagnosed because he had no feeling in the skin patch. He was then sent to National Sanatorium Tama Zensho-en in Tokyo. He joined 900 other patients who lived in bungalows. He was treated with the new antibiotic drug Dapsone in 1950, although this cured the infection he still developed damage to his nerves. He later developed facial changes and severe deformities after treatment because he lost sensation in his hands and feet. He did not feel injuries and burnt himself on bowls. He had to weave bamboo and so cut his hands and he was unaware of the injuries.  These then developed into bone infections and his fingers became short and deformed.  He rebelled against the strict regime which included wearing uniforms. Disobedient patients were put in a prison inside the sanatorium; the incarceration was determined by the sanatorium head.  He still looked angry when telling me that when he married in 1954 he was sterilised so that he and his wife could not have children. This was even though leprosy is an infectious, not a hereditary disease.  In the 1960’s he became a patient leader and challenged the medical and government authorities on their treatment of leprosy patients.   His eyes lit up as he described meeting other human rights activists in Switzerland and seeing the mountains there. In the 1970’s the Japanese government stopped detaining leprosy patients.

The Japanese government acknowledged in 1998 that the leprosy patients should not have been in the leprosaria, they apologised for their actions and agreed that patients would have life long provision there. This was important because some had left the leprosaria and were now finding it difficult to manage when they were elderly and infirm.  Another patient Zen had returned to the leprosarium a few years ago. He had married and worked outside the sanatorium but when his wife died he was not able to look after himself. Because of the prohibitions on having children they had no children to care for them.  He now lived in two rooms, in the living area there were tatami floor mats and low sitting stools. On the mantelpiece were clay figures representing the harmonica band he used to play in.  He told us how the arts helped people survive their loss of liberty.  People produced beautiful ceramics, others wrote poetry. There was a sanatorium magazine which inmates contributed to. I met a third patient Sumi who was bedbound and frail in a geriatric ward where he was being well cared for by the nurses.

The sanatorium comprised a large pleasant wooded area. Most patients lived in bungalows with verandahs and a small garden.  There is a small Shinto shrine where the ashes of past patients are kept.  Here we sat and reflected on the lives of the former inmates.

The government established a modern museum in the sanatorium to record the experiences of the patients. Inside are the 10 different sections chronicling different aspects of life in the leprosaria. This includes photos of the things that Edo had described. The themes of the survival were explored. The museum was beautifully put together with nice photos and material objects but very little translation into English and the curator does not speak English. Kay was an enthusiastic translator. It was a fascinating exploration of the loss of human rights and the fight to document their struggle.  I felt that I was touching history by seeing the leprosarium and meeting the last patients, Edo and Zen. There are still 1239 patients in leprosaria across Japan. There are other leprosaria in Brazil, America and India.

The challenge of how to care for these patients and how to preserve their history is very live and discussed from the local to the global level. In the UK a novel about a similar colony in Greece in the 1940’s became a best seller in 2005 (The Island by Victoria Hislop). This book has helped to destigmatise leprosy and raise awareness of the human rights of the inmates. We need more books and activities like this to keep the issue alive.

Tuesday, 19 June 2018

Costa Rica – happy ecotourist haven


I spent 4 days fabulous biking and experiencing Costa Rica in Feb 2018. Costa Ricans have good government with a free health service and education and no Army. The citizens are proud of their country and its unique flora and fauna.

We biked in from Nicaragua. Costa Rica has rolling hillsides and abundant rainforest. On 2 hours rafting on the river Tenorio we saw many birds, egrets, ospreys, kingfishers. Iguanas basked in the sunlight on the bank. Crocodiles lurked on the banks and patrolled the depths. So I was careful to remain aboard. A coyote glanced down at from the bank briefly before trotting off.

I biked 60 km around lake Arenal. We started at a coffee farm and the road wound up and down with small bridges crossing the streams. Many different trees grew along the route. We stopped in a fine cafe with a lovely mural outside and a high balcony with views over the lake. Birds pecked at fruit hanging above the forest. At the roadside we saw beautiful white nosed coatis (raccoon cousins) asking for food.

I had bikefree day in La Fortuna. I visited the cataracts Rio Fortuna, and with steps down to the big waterfalls and thick forest. A heavy tropical downpour made it humid.  Toucans hopped around the forest whilst I lunched in the cafe. I walked the orchid trail, seeing 100’s of orchids labelled and some in flower.

We had a decadent evening in bathing in Ecothermales hot springs and drinking the best pina coladas in CR. My skin felt good after the soak. 

Costa RIcan food is Caribbean style. The staple dish is casado comprising rice and beans with fish and fresh vegetables, spiced with salsa and chilli. Costa Rican coffee is the best I have tasted and their chocolates are excellent.  We enjoyed Costa Rican gold pineapple and sweet tasty watermelon on our bike rides.

I left the group early and travelled home via San Jose.  I enjoyed an interesting ride with the driver and his wife. We drove across farmland seeing many vegetables plots. We had coffee in a little cafe in the mountains with home made cheese for sale.  I talked more Spanish to this couple than I had talked in the previous 10 days.

I stayed in a boutique hotel in albujera with small individual rooms in a lovely garden and loud bird dawn Chorus. The local cafe where I enjoyed ceviche and salad was full of families having Sunday lunch.

The museums in San Jose opened up Costa Rican history to me, through jade, money, gold and art.  The jade museum is in a new huge rectangular building made of thin pieces of slate. Jade was polished in the pre Columbian era and the museum explored life and rituals with jade pieces in war, death and shamanism. Daily life, cooking, eating and weaving were explored through pots. The numismatic museum had silver coins used in leprosaria and TB Sanatorium to supposedly reduce the risk of infection. The gold museum is a gem of pre Columbian gold and captures past life. The gold artefacts were beautiful and captured the different aspects of life, decoration for status, and armadillos, frogs, jaguars, turtles and their place in the spirit life.  We experienced some existential angst in the applied art section.

My hotel in Albujera was an archetypal cheap hotel with people staying pre-departure. So I enjoyed wandering the town instead. There was a pleasant square with a museum and a cathedral. I enjoyed exploring a restored arts centre full of kids learning music, a junior orchestra, a guitar lesson and a tiny boy practised drumming.  There was a small theatre and modern outdoor sculpture. I had supper of casado pescado in a small bar opposite my hotel.

I left Costa Rica early because my friend Iain died rapidly at the start of my holiday and I wanted to attend his funeral in Amsterdam.  So I left this lovely country early. I shall definitely come back and enjoy the birdlife and trees more.

Thursday, 7 June 2018

Nicaragua – volcano islands and undemocratic poverty


On a 4 day bike ride in Nicaragua I explored an island volcano and biked to the Pacific.

I had an 8 day holiday in Nicaragua and Costa Rica biking through the two countries. The holiday was organised by Exodus. There were 9 of us biking (age range 50-72). We had an excellent guide Guilermo Sanchez who was very keen for us to have a memorable central American experience. The route was well thought out and we ate at small cafes for lunch. I had an extra day in Granada before the biking started. 
Granada is a beautiful old colonial town with houses arranged around central courtyards. There is a central plaza and a huge cathedral, with large modern, unattractive frescoes. The old convent was more atmospheric. The convent museum had an extensive collection about the many local Catholic traditions, and also pieces of the pre columbian rock carvings and the local primitivist art. We explored the city and walked down to lake Nicaragua. We lunched in a cafe and explored shops, including leather shops with high quality work. We had fresh fish supper in the Garden cafe with a lovely tree filled courtyard.

We drove up to a tourist viewpoint, Mirador Catarina with fine views over the lake. The many shops sold colourful tourist tat, including pottery hens and hammocks. At night the Masaya volcano mouth has red larva glowing and smoke rising, it felt v alive with bats swooping around.

We spent a night on the isla Ometepe with its two beautiful volcanoes rising above the lake and covered in cloud. The ferry from San Jorg to the island was crowded with people and tourists and I watched Nicaraguan daytime TV. We had a hot strenuous post midday ride across the island up 5 steep slopes with a lovely fruit stop at the top of the hill, big chunks of pineapple and water melon to nibble.  We descended to Ojo de Agua resort to a fabulous outdoor swimming pool surrounded by trees and with large rocks on the bottom. I got a lift to the top of the hill and then biked down to our hotel, a lakeside resort with palm trees around the huts. I enjoyed the sunset with Geoffrey and Geena followed by an excellent supper of grilled fish and jalapeño sauce.

I started the day with yoga on a stone platform overlooking the lake, the most beautiful setting for stretching and thinking. We biked across the island to the ferry port and I enjoyed seeing the countryside. I  enjoyed the ferry trip back to San Jorge. From the top deck and appreciated the islands double volcanoes much better, though there was again mist on both of them. A brief rain squall drove me inside for the last 10 mins of the crossing. We had a lovely afternoon ride across rolling countryside. Many homes had pigs and chickens and someone resting on the verandah.  We saw a bike being carried on a horse. We climbed up and had a fruit stop at the top, We had a beautiful descent to San Juan del sur. We biked across a river and onto the beach just in time for sunset. It was a wonderful way to end the day and we had a beer there. We had supper in a beach hotel I savoured octopus with garlic sauce. I walked round the town quickly, I was tired after our exertions.

People are quite poor and still doing some harvesting by hand.  The animals are quite thin, there are crops of sugar canes.   Nicaragua is visibly poor and the gdp    (5.755) is much lower than Costa Rica gdp (48.2).  Ortega has just won his third consecutive term of office. Democracy is not as developed here as it is in Costa Rica where they have enjoyed uninterrupted democracy since 1948.

Nicaragua was wonderful to explore by bike.  The volcanoes were unforgettable.  It was interesting to then be in Costa Rica which has a much stronger democracy and social systems with free health care for all citizens.

Feb 2018