Abstract
It has not often been reported that there were active internal patient organizations in institutions under fully controlled system. However, such was the case in a forced isolation sanatorium for Hansen's Disease in Japan in the 1940's. In 1941 a self-managed patient organization was founded in Tama National Sanatorium in Japan. The patients took up a wide range of paid work within the institution, making certain that everyone benefited in a fair way. This communal lifestyle occurred under some unique conditions. In the 1940's the number of residents increased dramatically. However, there was no increase in resources due to wartime shortages, and mutual help in all aspects of daily life became literally a matter of life and death. Additionally patients admitted did not wish to face the stigma outside the institution. The administration did not have any concern about patients escaping, so they did not restrict their self-managed production and distribution of the farm produce. Eventually the patients established economic independence and managerial control over all aspects of their work and developed their own identities empowering themselves beyond being helpless patients
