"Castration", the HIV Scandaland the Japanese Bureaucracy
MASAO MIYAMOTO, M.D.
PAPER PRESENTED ATMASSACHUSETTS INSTITUTE OF TECHNOLOGYAPRIL 10TH, 1996Cambridge Massachusetts
[From the Annals of Anthro Culture: http://www.nancho.net/anthcult/castrhiv.html]
Bracketed notes by WilliamBanzai7 Good evening ladies and gentlemen. I am delighted to be able to speak about the Japanese bureaucracy and the system of Japan here at MIT tonight. I find that Japan, the bureaucracy in particular, faces many problems. One could say that Japan's protectionism, led by the bureaucrats, leads to trade disputes with other industrialized nations. Furthermore, this protectionism does not benefit the Japanese people. If both Japanese and Americans recognize the grave problems of the Japanese system, it would mean further pressure on the system from both within and without, leading to a greater insistence on deregulation and downsizing. This change in Japanese society will not only benefit the Japanese, but will also benefit Americans as well as the world economy. In tonight's speech I will focus on the HIV scandal and the goal of the Japanese educational system, which I hope will shed some light on the bureaucracy and its protectionism. I feel some nostalgia for the Boston/Cambridge area as 22 years ago, when I first arrived in America, I lived in Waterbury, Connecticut. Since this town was so small, on weekends I often drove to the Boston area. I distinctly remember the wonderful
taste of the seafood in Boston. In Waterbury I started my residency in internal medicine at a hospital that was affiliated with Yale Medical School. Although Waterbury was a small town, everything to me was new so I had to struggle with a now environment. But I have a strong lingering impression that people were eager to help me become familiar with the community. After living in America for over 10 years, I went back to Japan and joined the Ministry of Health and Welfare. 10 years is along time and this caused me a certain uneasiness since a lot had changed in the intervening period. What perplexed me was the attitude of my colleagues who expected me to know all of the changes that had taken place. Instead of trying to help me become familiar with what was essentially a now environment, I was baptized by bullying or "ijime". When you compare my first year in America with the first year after I returned to Japan, I am convinced that coming back to Japan was far more stressful. Since I am Japanese it should have been easier, but this was not the case. [WB7: This is a very well known social phenomena in Japan, the stigma of those who return home. You are treated as a nail that has to be hammered down.] Americans were kind to me, but upon returning to Japan I found that bringing back foreign ways, for example, clarity in speech or an individual style of dress, was rejected. Many Japanese who have been abroad try to erase any acquired foreign habits because of their fear of ostracism through "ijime". I resisted this pressure to conform. In fact, I more or less preferred to be isolated from my colleagues, because by being ostracized I no longer had to dine or sing together with them at a karaoke bar, which meant my evenings were my own, to spend as I wanted. However, I was not happy with the way the Japanese bureaucracy functioned, and this is why I wrote a book called "Straitjacket Society," which is a clinical analysis of the psychology of the Japanese bureaucracy and society. [WB7: The English version of the book is out of print but was a best seller in Japan and is considered a must read for those who want to understand the iron triangle of business, politics and beureacrats. It is available used on Amazon.] I have no regrets about writing this book. In fact, through writing this book my world has expanded. For me to give a speech in front of you today is a good example. Being able to give speeches about the bureaucracy reminds me of the opening
remarks of a famous cardiology professor whose lecture I went to hear when I lived in Waterbury. He said to the audience, "I am very happy to talk to you about heart disease. Since Americans have become very concerned about heart disease, I receive more and more requests to speak. Not only physicians, but other health professionals, and even the man on the street are interested in what I have to say. But if I were a specialist in a rare disease with only 10 cases in the world, I do not think I would have an opportunity to speak to you today, nor would many people come to hear me speak. But since I chose such an ordinary subject, I have been asked to lecture around the world. The choice of field can certainly expand one's world. I could not agree with him more. If I were a researcher on snails, I do not think I would have been invited to speak to you today. But the Japanese bureaucracy is like a snail. It seems to me that people around the world wonder why the pace of change is so slow, and how Japan's economy became so successful. I think I can provide a partial answer to this question in today's speech. The bureaucracy is proud of having a history of over 1,000 years, and in the last 400 years this bureaucratic system has become so entrenched in society that it may take far longer than 20 years to downsize the system if they continue at the same pace. What this means is that I will continue to have the opportunity to speak about the bureaucracy. As many of you may be aware, over the last four months the Ministry of Health and Welfare has come under fire over the scandal of HIV-tainted blood being used to treat hemophiliacs. Because of their negligence, 400 people have already died and over 3,000 people have been infected with the HIV-virus. On March 29 the ministry acknowledged their negligence and agreed to pay compensation to the victims. This is a positive first step in investigating this tragedy. For those of you not aware of the background of this scandal, let me give you a brief summary. [WB7: Sadly Dr Miyamoto passed away in 1999. But his message has reached its critical moment in Fukushima.] In March of 1983 the Centers for Disease Control in Atlanta issued a warning in the U.S. that blood products might be tainted with the HIV virus. Soon afterwards the F.D.A. approved the use of heated blood products. As a matter of course, this information would have been reported to the Ministry of Health and Welfare by the Japanese embassy in Washington, D.C.