2. Emergency Relief and Rebuilding of the Foundationin the Postwar Days : 1945-1954

(1) Overall Situation

Postwar Confusion

• World War II brought a devastating shock to Japan's economy and society. In addition to the direct damage caused by the war, an influx of repatriated soldiers and people returning from overseas added to the nation's problems. Because of this, there were many needy people, such as the unemployed, war-stricken orphans and other victims of the war disaster. In addition, a poor harvest of agricultural products immediately followed the end of the war causing an extremely serious shortage of foodstuffs. Nutrition and sanitation conditions were also at the worst level. The nation was compelled to deal with the spread of communicable diseases, partly due to the insufficient quantities of sanitary facilities and supplies. Under these circumstances, Japanese citizens were forced to live a marginal life.

Improvement of Nutritional Status, Prevention of Communicable Diseases and Relief for Daily Living

• Under these conditions, urgent measures were needed to improve nutritional status and prevent the spread of communicable diseases, both of which were the result of the severe foodstuff shortages and poor sanitary conditions. In addition, relief measures for daily living had to be offered to needy people including repatriates and the unemployed. Thus, social security policies in postwar Japan were first developed with an emphasis on the emergency measures mentioned above.

Establishing the Basic Principle of Social Security

• After World War II, under the leadership of the GHQ (General Headquarters of the Supreme Commander of the Allied Forces), such reforms as the democratization of the economy and liberalization of education were implemented. It was also decided that we should develop new principles of social security. The new Constitution of Japan explicitly noted that the Japanese people shall have "the right to maintain the minimum standards of wholesome and cultured living" and that the State "shall use its endeavors for the promotion and extension of social welfare and security, and of public health" for this purpose. In this way, the basic principles on our country's social security were established.

Nutrition Improvement and Rural Life Improvement

• As a result of the serious foodstuff shortages, the nutritional status of Japanese citizens was extremely poor. Therefore, the following measures were taken: a) To identify the nutritional status of the general public, the National Nutrition Survey began to be taken in 1945, and emergency food assistance was extended by the United States Government; and b) American private relief organizations offered assistance for food and clothing, which were called "Lara relief materials." In addition, c) nutritionists were assigned to health centers, and a system was set up to provide professional dietary guidance in local neighborhoods. Also, d) based on the Nutrition Improvement Law, nutritional guidance offered by nutrition counselors and the assignment of nutritionists to mass feeding facilities among other activities were promoted.
  The school lunch program which was resumed after receiving relief materials, such as skim milk powder, from the United States and other countries in order to offer relief primarily to school children under the postwar food shortage. Later, an implementation system for the school lunch program was expanded when this program was positioned as part of school education based on the School Lunch Law which was enacted in 1954.

• After the war, while the promotion of food production was urgently requested in rural areas,the farmers themselves remained poor. Thus, efforts were undertaken to overcome the delay in improving their living standards. The Rural Life Improvement Extension Services were provided through guidance provided by rural life improvement advisers who were equipped with the necessary expertise. The Extension Services included, for example, the improvement of traditional kitchens (especially ovens), the improvement of nutritional status, the development of preservable food products which were used during the peak agricultural season, and so on.
  Especially, activities related to the improvement of kitchen ovens contributed to the enhancement of young housewives' positions, the improvement of farmers' living standards, and the living environment in rural areas.

Prevention of Communicable Diseases

• In postwar Japan, massive outbreaks of acute communicable diseases, such as cholera, were experienced. For this reason, measures to prevent the spread of communicable diseases became an urgent task, and the following measures were taken:

a)

First of all, the notification, isolation and hospitalized treatment of patients based on the conventional Communicable Disease Prevention Law were in place. In addition, community residents organized vector control teams. Under the guidance and supervision of sanitation inspectors who were assigned to health centers, activities to exterminate vermin and rodents which serve as vectors for pathogens were carried out throughout the country.

b)

Later in 1948, the Preventive Vaccination Law was enacted. Six diseases, including smallpox,were specified as those for which the routine vaccination program would be offered, whereas another six diseases, including epidemic typhus, were specified as those which would be covered by a conditional vaccination program. More thorough implementation of vaccination was ensured through this law.

c)	Moreover, a quarantine system was being developed to primarily target repatriates returning from abroad in an effort to prevent epidemics at ports of entry.

d)	Public water supply development which was necessary to prevent epidemics was being promoted by various measures, including the provision of national subsidies to small scale public water supply projects undertaken by municipalities.

Measures to address the sources of infection, infection routes, and susceptibility of the people, of communicable diseases, were taken in a comprehensive manner through the efforts mentioned above. Thus, we were able to see a prospect of controlling most of the major communicable diseases.

• Additionally, during this period, parasitic diseases, such as those caused by ascarid and Ancylostoma duodenale, also spread widely. Though regular mass screening and vector control were performed, they did not work as decisive countermeasures. In the next period described below, infection opportunities of parasites via night soil decreased dramatically thanks to increased use of chemical fertilizers in place of human excreta and the development of sewage treatment systems. Furthermore, municipalities and other organizations took the initiative in fully implementing regular stool testing and the use of vermicides, sharply reducing parasitic diseases thereafter.

Developing Basic Laws on Medical Care Delivery

• We were in a situation in which it was difficult to deliver sufficient medical care, because many medical care facilities were destroyed and closed due to damage caused by the war, while medical personnel and supplies were in shortage. It was under such circumstances that the building of a foundation for medical care was in progress. In this context, the Medical Service Law which set forth the requirements for medical care facilities was enacted in 1947 with the purpose of providing scientific and appropriate medical care. The new Medical Practitioners Law which defined the qualifications and status of medical personnel was also established in 1948 with the purpose of developing high-quality medical personnel.

• In this period, former military-related medical care facilities were made available to the general public as national hospitals and sanatoria, playing an important role in the delivery of medical care, while, on the other hand, the development of private medical care facilities was being promoted. The Medical Service Law formalized a system, as the basic one, to allow physicians to open their own practice, a system which had been maintained since the Meiji era (19681912).
  Along with this came the creation of a non-profit medical corporation system which facilitated the accumulation of funds by private-sector medical service businesses, and at the same time, offered continuity in terms of business management.

Measures on Relief for Daily Living

• Immediately after the end of World War II, an overwhelming majority of Japanese citizens,including those affected by the war and repatriates from abroad, were compelled to live in circumstances in which they were not able to locate food each day. Under these circumstances, in order to provide help to these needy people, temporary and emergency relief measures for daily living were extended to secure a minimum level of living to all citizens if they were in need regardless of the reasons. The focus of this effort was to provide needy people, those affected by the war, families whose members were abroad, etc. with lodging, meals, beddings and other daily necessities, and supplementary provision of foods among other things. In 1946, people receiving such relief numbered about 3.17 million, or as much as 4.2% of the total population.

• Following these activities, the old Public Assistance Law was enacted in the same year to establish, in some respects, a public assistance system which was based on the three principles of non-discrimination/equality, government responsibility and securing a minimum level of living.
  Later on, in 1950, the new Public Assistance Law was enacted under the new Constitution, thus offering relief for daily living based on the principles set forth in the Constitution. The size of the public assistance budget for fiscal 1951 was approximately 20 billion yen or a share of about 2.7% of the general account budget of the national government, and people under public assistance reached about 2 million. While the national experience was one of extreme poverty, the public assistance program played a key role in securing minimum standards of living for the general public.

Child Welfare and Welfare for People With Disabilities

• In the period immediately following the end of World War II, the protection of street children,including those made orphans as a result of the war, became an important issue. In 1948, orphans without parents were estimated to number 124,000, and there were many children who were living on the streets. Many of these orphans engaged in work in a live-in style. For orphans who had the most urgent need for protection, sending them to host families, adopting them and accommodating them in institutions were the measures taken. In addition, street children were placed into child protection facilities as part of protective guidance efforts.

• The need to take measures to help street children triggered the enactment of the Child Welfare Law in 1947. This law was to enforce not only measures for street children, but principles for child welfare in general, and ensure the welfare of children through public responsibility.

• In 1949, measures for disabled veterans prompted the establishment of the Law for the Welfare of People With Physical Disabilities. This law set forth a structure of helping people with physical disabilities to restore their vocational capabilities. Through the process outlined above, a system of the three welfare laws was established: the Public Assistance Law which generally secures a minimum level of living, the Child Welfare Law and the Law for the Welfare of People With Physical Disabilities.
  In addition, because the conventional laws became obsolete due to the establishment of these basic welfare laws, the Social Welfare Service Law was enacted in 1951 in order to develop a structure of social welfare services. This law institutionalized the administrative organization for social welfare services, such as welfare offices, and social welfare non-profit corporations which have a more public nature than ordinary non-profit corporations under the Civil Code, thus reinforcing the foundation for social welfare services.

Unemployment Measures and the Enactment of the Labor Standards Law

• Immediately after the war, many people were jobless in Japan partly due to the influx of repatriated people returning from abroad. For this reason, in 1946, urgent employment measures,such as the promotion of civil engineering projects, were taken and the public works system was created, in an attempt to absorb the unemployed and increase production.

• In 1947, the Labor Standards Law was established. This law not only incorporated prewar labor protection statutes, but also included such basic philosophies as: a) Labor standards are necessary for workers to maintain the minimum standards of wholesome and cultured living; b) The residual feudalistic relationships in social status in labor relations should be eliminated; and c)International standards on minimum working conditions should be adopted. The law set forth requirements regarding the sure payment of wages to workers, minimum wages (Currently minimum wages are set forth by the Minimum Wage Law.) and statutory working hours among other requirements.

Workmen's Accident Compensation Insurance and Unemployment Insurance

• Before the war, employers' assistance related to workers' occupational accidents was considered to be benevolent measures for workers. However, in enacting the Labor Standards Law in 1947,the Workmen's Accident Compensation Insurance Law was established in order to ensure compensation by employers indicated in the Labor Standards Law. Moreover, while uncertainties about employment increased after the war, extreme inflation progressed and the unemployment issue became focused. Thus, in 1947, the Unemployment Insurance system under which benefits would be provided when workers lost their jobs was created.

Fundamental Law of Education and the School Education Law

• The modern school system had been already established in Japan since the prewar period.
  However, in the period discussed in this section, a variety of educational reforms took place under the guidance of the GHQ. In 1947, the Fundamental Law of Education which advocated the democratization of education and was called the "constitution of education," was enacted. In addition, the School Education Law was established. This law took steps, among other things, to: a) secure equal opportunities for education; b) widely and thoroughly spread general education; c) implement the so-called 63 school system under which the compulsory education period was extended from the previous six years to nine years; and d) implement coeducation. These efforts substantially reformed the school system in our country. The development of the school education system greatly contributed to improving the knowledge and educational levels of the general public. It is fair to say that this effort served as one of the factors for the social security system to become so widely accepted in subsequent years.

Discussion on Social Security Policies

(1) Developing Health/Medical Care and Sanitation Administration

• In terms of health/medical care and sanitation administration during this period, it was necessary to rapidly improve the health and sanitation problems which existed during the chaotic postwar period. It is fair to say that for this purpose, concerted, nationwide efforts towards service development under the strong leadership mainly exerted by the national government were effective in achieving the objectives of the time (improved nutrition and communicable disease prevention).

1. One concrete achievement in this regard was the establishment of an administrative organization. Along with the development of health-related bureaus in the Ministry of Health and Welfare, the founding of health departments in each prefecture, and the appointment of doctors and other professionals for administrative organizations, health centers were positioned as specialized technical agencies for public health, and established throughout the country (675 health centers as of 1948) with an enhanced allocation of human resources, including public health nurses, nutritionists and food sanitation inspectors, forming regional public health networks. The establishment of a basic organization and human resources was highly significant for the purpose of advancing various policies. In particular, defining health centers, which had been the bases of activity of technical specialists, as front-line facilities for public health in the community for vigorous implementation of various measures for personal health and sanitation, were evidently effective countermeasures during this period. In conjunction with this, another very significant measure was the stationing of rural life improvement advisers in rural areas, where conditions were particularly bad, to energetically promote voluntary activities of life improvement, particularly among housewives.
   
   
2. In the area of local administration, there was a rapid surge in health and sanitation activities,backed by the strong guidance/supervision and assistance measures of the national government. These nationally-directed administrative measures were necessary in order to weather the chaotic period immediately after the war when the present system of municipalities was not yet well established, but it could be said that their autonomy of municipalities was delayed as a result.
   
   
3. In addition to these administrative efforts, it should be mentioned that community members were also active in efforts to improve the living environment. For example, voluntary local efforts to exterminate vermin and rodents were started around 1950 and later became serious. The national government then recognized the effectiveness of these activities and cooperated with local authorities to develop a national "Campaign to Achieve a Mosquito-free and Fly-free Environment."

• Amidst the economic and social devastation after the war, livelihood relief for the needy was one of the most urgent tasks, and later efforts were made to establish a system and to enact fundamental laws as a basis for the development of measures in this area.
  Livelihood relief for the needy was extremely inefficient because it was distributed among various systems, and emergency measures were taken to remedy these legislative deficiencies. Based on directions from the GHQ, these measures followed the three basic principles of: a) national responsibility for providing aid (the principle of national responsibility); b) non-discriminatory or non-preferential treatment in relief efforts (the principle of non-discrimination and equality); and c) providing the funds necessary for preventing poverty (the principle of securing minimum standards of living). These three principles later became the basic principles of Japan's public assistance.
  Because basic goods were in extremely short supply at the time, an essential issue was how to secure them for distribution. In this context, it must be mentioned that the vital significance of the large volume of former army provisions released under directions from the GHQ, and the donated supplies provided by foreign relief organizations.

• In addition to public measures, private welfare activities also played an important role in the development of Japan's welfare system.

1. Welfare Volunteers
   
   Welfare volunteers are private servants who work to improve the welfare of community residents and cooperate with administrative agencies. About 200,000 of them are currently active throughout the country. In the old public assistance system that existed immediately after the war, the front-line duties of welfare administration were mainly performed by welfare volunteers. They played the role of community case workers in providing support to heads of municipalities. Also, when the Child Welfare Law and the Law for the Welfare of People With Physical Disabilities were enacted, relevant duties were also assigned to welfare volunteers. Subsequently, as a system was developed for implementing welfare administration, the job of welfare volunteers became one of cooperation with the relevant administrative bodies, as it still is today. Currently, they regularly visit households with elderly members or members with disabilities, to check on their safety and give advice on daily living. They also recommend a variety of in-home welfare services and give advice on such services as well as clerical work for verification.
   Thus, they are expected to continue to be active in maintaining close contact with community residents in the future.
   
   
2. Social Welfare Councils
   
   Social Welfare Councils are private organizations, made up of local citizens and welfare related agencies, with the purpose of improving the welfare of communityresidents.
   In the devastation after the war, as the country moved towards democratization, it was deemed desirable that the scattered private social welfare organizations were to be reorganized and unified at the national, prefectural and municipal levels.
   As of 1996, 3,430 social welfare councils are active throughout Japan, in the light of the situations in each communities, researching and planning about social welfare, lending livelihood welfare funds, financially supporting volunteer activities and providing in-home welfare services among other activities.
   
   
3. Community Chest System
   
   Motivated by the need to make up for the shortage of financial resources for private social welfare activities after the war, the Community Chest was started with the aim of distributing private donations in a centralized manner and contributing to the better development of private social welfare operations. Community Chest Societies are established at the prefectural level, and collect donations widely in each prefecture.
   The collected donations are distributed to the social welfare activities which are the most in need in that area.