Foreword by author: this research series centers around the history of U.S.-Japan medical exchange and collaboration in the twentieth century. It explores how key agencies, in both the medical and diplomatic worlds, pursued cooperative efforts to develop public health throughout shifting domestic and global political landscapes. Continuing from “When Medicine Met Diplomacy Part I and Part II,” this article turns to the launch of the “Tokyo project”—a joint initiative by both Japanese government and Rockefeller Foundation, to improve public health work in modern Japan.
Set in the quiet, tree-lined neighborhood of Shirokanedai, the Minato City Local History Museum provides a calm retreat from the intensity of central Tokyo. Closely located near the Institute of Medical Science of the University Tokyo with an “Uchida Gothic” style building, the site subtly signals that it has long been more than an ordinary residential quarter. Formerly occupied by the National Institute of Public Health until 2002, the hazelnut-colored structure had its glorious past of standing at the forefront of Japan’s 20th-century public health reforms. Constructed in the 1930s with support from the Rockefeller Foundation, it unfolds a complex history of U.S.-Japan medical collaboration marked by dramatic ups and downs.
After Japan’s first official medical commission to the United States returned in May 1923, the delegation’s observation of America’s advanced public health system intrigued both young Japanese physicians, as well as the government. Immediately after the catastrophic Great Kantō Earthquake in early September 1923, the newly-established Yamamoto Gonbē (山本権兵衛) Cabinet appointed Gotō Shinpei (後藤新平) as both Minister of Home Affairs and President of the Imperial Capital Reconstruction Board (帝都復興院). Trained in medicine and seasoned through military and colonial sanitary projects in his early career, Gotō understood the significance of public health. When serving as the mayor of Tokyo in 1922, he had already reached out to the Rockefeller Foundation, via Dr. Charles A. Beard, about potential cooperation to launch a large public health program in the city.[1] Now at the helm of the Ministry of Home Affairs, Gotō sought to advance public health in a larger national scale.
Gotō’s ambition closely aligned with that of the American medical professionals who endeavored to promote “American medicine” in Japan with a focus on public health. For both sides, post-earthquake reconstruction provided a timely opening. In September 1923, the Rockefeller Foundation expressed willingness to support Japan’s public health work during reconstruction, upon an official request from the Japanese government and an invitation for Foundation representatives for further discussion. The message quickly reached Gotō via Dr. Teusler and Dr. Beard. In early November, an official invitation from Gotō reached Dr. George E. Vincent, urging a visit “as speedily as possible” to confer on medical education and public health reconstruction.[2]
Like a stone hitting calm water, this quick mutual approach between Japanese government and the Rockefeller Foundation set off a wave of reactions in Japan. Public press and medical magazines were curious about the Rockefeller Foundation’s detailed plan in Tokyo. Medical professionals wondered whether they could secure support to rebuild research institutes devastated by the earthquake. But the response was not uniformly welcoming. At cabinet meetings, Gotō’s plan unsettled the Ministry of Education, Okano Keijirō (岡野敬次郎). He sensed “a good deal of anxiety” over the possibility of the Foundation’s proposed work “seriously disturbing the already-established program of medical education planned on the German system.”[3]
On January 7, 1924, the short-lived Yamamoto Cabinet was replaced by Kiyoura Keigō Cabinet, which survived only five months until June 11, 1924. Even so, the regime change did not halt the emerging collaboration with Rockefeller Foundation. While awaiting an official invitation from the Japanese government, in February, the Foundation had already drafted a detailed survey plan to obtain an overview of public health in Japan. Consisting of Dr. Victor G. Heiser, Dr. John B. Grant, and Dr. Frederick F. Russell, the Foundation commission was to survey public health laboratory works, facilities of medical education, public health inspectors and nurses training, situation of vaccine use, diet, and to collect mortality and disease statistics in Japan.[4] In late April, through Japanese Ambassador Hanihara in Washington, the new Minister of Home Affairs Mizuno Rentarō (水野錬太郎) conveyed his readiness to confer with Foundation representatives.[5]
Quickly prepared, the three Foundation representatives sailed for Japan and arrived in early June. In the midst of another cabinet transition, three doctors were welcomed by a letter from the director of the Central Sanitary Bureau of the Ministry of Home Affairs, Yamada Junjirō (山田準次郎). Expressing regret over Japanese population’s higher death rate “than that of any other great nation” and reflecting on the “greatest defect of Japan’s health machinery,” Yamada asked for the Foundation’s aid to establish “an institution for training of public health officers and nurses, and the other facilities for public education.”[6]
Contrary to the brisk pace of communication despite considerable political volatility in the early 1920s, it took fourteen years for Yamada’s proposal to materialize. Officially established in 1938 as the Institute of Public Health, the new institution embodied how public health cooperation between Japan and the United States navigated global crises, worsening bilaterial relations, and domestic political changes. The dramatic story, in many ways, was only beginning.
(To be continued)
Picture
“Tokyo Institute of Public Health,” 1932, Folder 2807, Box 147, Series 609L Japan, Photographs, Rockefeller Foundation Records, Rockefeller Archive Center.
References
[1] Letter from Charles A. Beard to Raymond B. Fosdick, December 29, 1922, Folder 353, Box 56, Series 2 Special reports, Sub-series 609 Japan, International Health Board Division Records, Rockefeller Foundation Records, Rockefeller Archive Center.
[2] Letter from George E. Vincent to R. B. Teusler, September 11, 1923; Letter from Viscount S. Goto to George E. Vincent, November 13, 1923, Folder 353, Box 56, Series 2 Special reports, Sub-series 609 Japan, International Health Board Division Records, Rockefeller Foundation Records, Rockefeller Archive Center.
[3] Letter from R. B. Teusler to George E. Vincent, December 19, 1923, Folder 353, Box 56, Series 2 Special reports, Sub-series 609 Japan, International Health Board Division Records, Rockefeller Foundation Records, Rockefeller Archive Center.
[4] Memorandom for Japanese Health Survey, February 4, 1924, Folder 353, Box 56, Series 2 Special reports, Sub-series 609 Japan, International Health Board Division Records, Rockefeller Foundation Records, Rockefeller Archive Center.
[5] Letter from M. Hanihara to George E. Vincent, April 22, 1924, Folder 353, Box 56, Series 2 Special reports, Sub-series 609 Japan, International Health Board Division Records, Rockefeller Foundation Records, Rockefeller Archive Center.
[6] Letter from Junjirō Yamada to Victor G. Heiser, June 11, 1924, Folder 353, Box 56, Series 2 Special reports, Sub-series 609 Japan, International Health Board Division Records, Rockefeller Foundation Records, Rockefeller Archive Center.
