Overview: Yoshio Koya, Jackson, State Capitol Building, in Tengoku Amerika, Jigoku Amerika (Heaven America/Hell America) (Tokyo: Deido Shuppansha, 1951), 85. This essay revisits Japanese public health official Yoshio Koya’s trip to the U.S. South in 1950, arranged by the U.S Occupation Army in postwar Japan, to study birth control services for African Americans. It examines Koya’s observation of the relationship between racial politics, population control, and "democracy." It uncovers the process in which eugenically-inspired, state-sponsored “public health” services in the U.S. South came to inform Koya’s birth control experiments in rural Japan. Koya’s experiences were eventually applied to other population control programs in several locations of the world, particularly among racially and economically disenfranchised groups.

"The Color of Democracy: A Japanese Public Health Official's Reconnaissance Trip to the U.S. South" was selected for the 2010 Southern Spaces series "Migration, Mobility, Exchange, and the U.S. South," a collection of innovative, interdisciplinary scholarship about how the movements of individuals, populations, goods, and ideas shape dynamic spaces, cultures, and identities within or in circulation with the U.S. South.

Introduction:

Map of Yoshio Koya's destinations, 2011.

From February to April 1950, the head of the Institute of Public Health in Tokyo, Yoshio Koya, was sent by the U.S.-led Occupation Army to the U.S. South to study public health, specifically birth control services. U.S. officials were alarmed at the rapid increase in population in postwar Japan. They feared that population pressure and economic instability could once again push the nation into aggressive expansionism, possibly resulting in another war. Advancing communist forces in Asia further aggravated such concern. The southern states were the first in the United States to incorporate birth control as part of public health programs targeting the poor and racial minorities before the war. Koya’s mission was to learn how to launch effective and mass-scale, state-sponsored birth control programs in remote, low-income locales in Japan.

Drawing from his travel accounts and memoirs, this essay follows Koya’s trip to several states in the U.S. South—Louisiana, Mississippi, Tennessee, Kentucky, Georgia, and North Carolina—and explores his observations of race relations in the United States with regard to public health. Koya linked the relative increase of black population to the white Americans’ eugenic and economic fears about differential fertility, interracial mixture, and job competition, which ultimately led to the southern states’ efforts to disseminate birth control practices among the rural blacks. Koya applied what he learned in the South to his own birth control experiments in rural Japan: specifically, the field-trial method to disseminate easy, simple, and free contraceptives; the use of nurses as social case workers to directly visit “needy” women for birth control consultation; and the operation of governmental offices to effectively provide these services to the poor. This essay reveals the process through which discriminatory and semi-coercive "public health" practices in the U.S. South were transplanted into birth control programs in postwar Japan and other “overpopulated” areas in the world. By using Japan as a model for global population control, U.S. leaders sought to establish the legitimacy of birth control programs both at home and abroad. I show the reach of eugenic and racist philosophy at work in these "scientific" field experiments and "public health" activities before and after World War II, as well as the spread of these ideas beyond national borders.

I also analyze images and illustrations associated with Koya’s travel accounts, which include drawings, photographs, and maps of the towns and areas he visited. I argue that these images, along with his texts, reveal Koya’s idealized view of American democracy, modernity, and pragmatism. They indicate that Koya indentified with white (male) leaders and public health officials rather than with African American women and the rural poor targeted for birth control.

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Background:

U.S. intellectuals and the general public had been debating the increasing Japanese population since the early-twentieth century. Japan's population increased steadily during the late-nineteenth century as the nation embraced policies influenced by modernization and Westernization. However, Japanese population growth alarmed many Americans only after military expansion entered the equation. After winning the first modern war against China in 1895, Japan shocked the international powers with its victory over a Western nation, Russia, in 1905. Meanwhile, the increasing flow of non-Western immigrants, particularly those from China and Japan, heightened anti-immigration sentiments among the residents on the U.S. West Coast. Popular books written by eugenicists such as Madison Grant’s 1916 The Passing of the Great Race and Lothrop Stoddard’s 1920 The Rising Tide of Color Against White World-Supremacy incited anxiety among white Americans that the United States was deteriorating from within—through immigration from Southern Europe and from Asia. Stoddard alarmingly declared: “the introduction of even a small group of prolific and adaptable but racially undesirable aliens may result in their subsequent prodigious multiplication, thereby either replacing better native stocks or degrading these by the injection of inferior blood.” These fears provoked by eugenicists, coupled with anti-immigration sentiments among residents on the East and West Coasts, contributed to the passage of the Immigration Act of 1924. The law banned further Japanese immigration and was a culmination of previous laws and campaigns targeting Asian immigrants.

Underwood & Underwood Photography, Margaret Sanger, 1922. Courtesy of the Library of Congress.

The immigration law did not quell American concerns about the “swarming” people, as the Japanese government appeared to resort to even more violent means to acquire outside territory and resources to sustain their growing domestic population. By the 1930s, population studies emerged as an “objective” scientific field, replacing the “value-ridden” approaches of previous eugenic research. In reality the two fields shared much in common, including their primary interest in differential fertility between classes, races, and nations. Sociologist Warren Thompson’s 1929 book, The Danger Spots in World Population, for example, prominently featured the overpopulation problem in Japan as a primary threat to world peace. These male scholars provided scientific credibility to political campaigns such as immigration restriction and anti-expansionism, while stigmatizing female fertility as a cause of chaos and war. As international relations deteriorated, even feminist activists such as Margaret Sanger, who initially envisioned birth control as a means of female liberation across national borders, started to use the same language of population control in the name of world peace under U.S. leadership. Citing Thompson’s work that named Japan, along with Germany and Italy, as a major "danger spot" of the world, she denounced these fertile nations as "destroyers of our civilization through their ruthless method of waging arrogant warfare against innocent, peaceful peoples."

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The U.S. Occupation and the Population Problem in Postwar Japan:

The United States' preoccupation with Japan's population growth continued after World War II, when the war-torn country faced renewed problems with the return of soldiers from overseas, increasing birth rates, and food shortages. In reality, actual birth rates had started to fall after 1947, and many U.S. officials were aware of those numbers. Nonetheless, U.S. leaders who visited postwar Japan retained the impression that masses of people who were poorly dressed and homeless, including orphans and starving children, roamed about in destroyed towns and cities. This impression led Americans to intervene in solving the “big question” of population growth. Moreover, in the context of the Cold War Japan represented an important foothold for the United States' further political influence in Asia. Social and economic instability caused by overpopulation, the Americans warned, could leave Japan and the rest of Asia vulnerable to communism, which in turn would threaten a reduced "free world." Communist China became an embodiment of this threat. The leader of Planned Parenthood Federation of America, William Vogt, warned that the loss of Japan and India to communism would indeed be a “serious breach in western defense.”

Japan Today. Newsreel by Ed Herlihy, 1946.

The U.S.-led Occupation government (the Supreme Command for the Allied Powers, or SCAP) was in a complicated situation in dealing with population growth abroad. After giving a statement to the press endorsing birth control—along with industrialization and urbanization—as a key solution to Japan’s population problem, Crawford F. Sams, head of the Public Health and Welfare Section (PHW) of SCAP, received a series of protests from U.S. Catholics. In addition, Sams feared that a conspicuous population reduction policy by a military conqueror could invite criticism from communist countries as conducting genocide against other races. Consequently, SCAP decided to assume an official position of “benevolent neutrality” regarding population policy in Japan, meaning that they would neither endorse nor oppose efforts made by the Japanese.

Despite this outward position, U.S. officials maintained an active interest in controlling birth rates in Japan and used less visible methods to guide the Japanese toward effective population policies. To give at least a semblance of Japanese initiative, SCAP members searched for an appropriate Japanese leader to carry out population reduction policies on their behalf. The Institute of Public Health in Tokyo (IPH), established in 1939 with the assistance of the Rockefeller Foundation, was working alongside the PHW to carry out health reforms in postwar Japan. After expelling the IPH’s wartime leader, SCAP appointed Yoshio Koya as its new director. Through Koya, Sams and his consultant from the Rockefeller Foundation, Oliver R. McCoy, ensured that concrete provisions on birth control instruction were included in the Eugenic Protection Law, a law that legalized therapeutic abortion in 1948. Sams further ordered the IPH to carry out training programs for doctors and medical officers on the use of contraceptive methods.

Yoshio Koya was a leading medical scientist in Japan, working closely with the government on racial hygiene and population policies since the prewar years. After graduating from the prestigious Medical School of the Tokyo Imperial University, he spent a year studying at the Kaiser Wilhelm Institute in Berlin-Darlem, Germany in 1926. During his professorship at the Kanazawa Medical University in Japan, he focused on biostatistics and anthropometry: specifically, research on tuberculosis among the rural Japanese and the racial composition of the Ainu people in northern Japan. Together with his colleagues, he started the periodical Minzoku Eiseigaku Kenkyū (Racial Hygeine Research) in 1936. He was also vice president of the Japanese Association of Racial Hygiene (Nihon Minzoku Eisei Kyōkai), established in 1930. Koya's reputation for tuberculosis research earned him a position in the Ministry of Health and Welfare (MHW) in 1939. While maintaining this position, he also began working in the IPH in 1941, and was appointed head of the Division of Welfare Science the following year. Investigating population statistics and the health and hygiene of Japanese subjects were the major tasks of the IPH, which was taken over by the military government during the war. These studies became particularly important after the Manchurian invasion in 1931, as the military government demanded research into the practical matters of colonial ruling, namely the matter of race relations between the Japanese and the colonial subjects.

Notwithstanding his wartime research supporting the government’s pronatalist policies, Koya found a smooth transition to a new advocacy for population restriction after the war. Koya’s core position had not changed at all: he consistently aimed to protect the quality of the Japanese population, and the issue of quantity was only a secondary concern. Koya’s wartime endorsement of pronatalism stemmed from his concern about the declining birth rates and physical condition of urban and “educated” people, as his own research demonstrated. This trend, he argued, was causing a “reverse selection” in Japan, in which the lower socio-economic classes were outnumbering the higher ones. After the war, Koya merely changed his emphasis from encouraging “educated” people to have more children to discouraging the rural poor from having as many.

Koya’s reconnaissance mission to the United States, supported by the U.S. Government Appropriations for Relief in Occupied Areas (GARIOA) fund, represented a major step toward implementing a U.S.-designed population policy in Japan. Koya did not know where he would go until he was given a detailed schedule after landing in San Francisco. From there, he was told, he would head south via Los Angeles, change trains at New Orleans, stay in Mississippi (Jackson, Hattiesburg) for about a month, then in Georgia (Atlanta, Columbus) for a few weeks, and gradually head north through North Carolina (Chapel Hill, Raleigh), before joining the rest of the group in Washington D.C. Among the eleven Japanese officials representing the MHW, Koya and another official were the only ones taking the “southern route” into the Deep South.

Koya offered a couple of reasons why he was excited to travel the to South. He was aware that the southern states were the first in the United States to include birth control services in state-sponsored public health programs. Having studied the relationship between the Japanese and such neighboring Asian ethnic groups as the Koreans during the war, he was interested in U.S. race relations, where the two most “distinct” races—blacks and whites—cohabited on the same continent. Finally, he wished to learn about the “American spirit” that he associated with the frontier in the West and the South. Having visited Berlin, Paris, Vienna, and Rome before the war, Koya wanted a different experience. He had expressed his feelings to Rockefeller Foundation's McCoy and believed that SCAP officials had taken them into consideration. Whether or not that was actually the case, Koya’s desires coincided with SCAP’s active—albeit implicit—role in promoting birth control through state-initiated public health services in Japan.

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Public Health and Birth Control in the South:

In the prewar decades, birth control was a controversial subject in the United States, associated with sexual radicalism and political propaganda as represented by Margaret Sanger’s activism. In the 1920s and 1930s, however, medical professionals, eugenicists, and other birth control advocates—including Sanger—sought to establish birth control as a legitimate medical issue. Clarence J. Gamble, heir of the industrial giant Proctor & Gamble, played a key role in efforts to incorporate contraceptive services into public health programs targeting poor and “needy” women, especially in the South.

At Princeton Graduate School, Gamble worked under Edwin Grant Conklin, a leading biologist and eugenicist, who “laid the intellectual foundation for [his] interest in the quality and quantity problems of human life.” After graduating from Harvard Medical School in 1920, Gamble continued his medical research at the University of Pennsylvania. In 1924, he met physician Robert Dickenson, who urged him to “take up the work” of establishing birth control as a legitimate medical practice. While working in health clinics in Philadelphia and Cincinnati, Gamble became convinced that it was more effective to give money to prevent babies than to care for them through relief programs once they were born. He also speculated that the diaphragm, which had a relatively high success rate of preventing pregnancies, was not suitable for poor women, since it depended on correct use, foresight, initiative, and will power, habits that Gamble felt they lacked. Based on his experience in hospitals, Gamble initiated programs to test cheap and easy methods of contraception, such as spermicidal jelly and foam powder, among women in remote areas in West Virginia, Kentucky, and Tennessee in the 1930s. In these experiments, he sent public health nurses to visit women’s houses and provide birth control instruction. Gamble’s birth control crusade saw a major breakthrough in 1937, when he gave financial support to George M. Cooper, an assistant director of North Carolina’s state board of health, making it the first state to officially incorporate birth control into public health services. South Carolina, Virginia, Georgia, Mississippi, and Alabama soon followed. Both Gamble and Cooper strongly influenced Koya’s birth control programs in Japan in the 1950s.

Economic and eugenic factors attracted many white birth control advocates and health officials to promote birth control among southern blacks. Birth control, these authorities believed, would reduce the number of those on relief and/or those deemed inferior and undesirable. The so-called “Negro Project” of the Birth Control Federation of America (BCFA), launched in 1938 by Margaret Sanger and Clarence Gamble, specifically aimed to reduce the birth rates of blacks in the rural South. To avoid being “misunderstood by Negroes” as a white conspiracy to trigger black “race suicide,” Gamble assured that the program should “appear to be of, by and especially for the colored race.” Jessie Rodrique demonstrates that black communities actively took part in the BCFA’s Division of Negro Services in Tennessee and South Carolina with their own agenda and concerns in mind. Nonetheless, as Johanna Schoen argues, the “Negro Project” resembled a kind of “social science laboratory,” as they accepted Gamble’s advice to focus on establishing “demonstration clinics” over Sanger’s suggestion for a grassroots educational campaign. State-supported birth control programs in the South undeniably had in mind the presumed high birth rates of African Americans, often disregarding the fact the birth rates of southerners in general, including whites, were quite high and that infant mortality rates were significantly higher among blacks than whites. Regardless of the actual demographic trends of southern blacks, the preconceived idea of white southerners being overwhelmed by fertile blacks was enough for George Cooper and his supporters to successfully persuade reluctant county health officials in North Carolina to establish birth control clinics.

Along with the discovery of the germ theory and other scientific knowledge, medical experts and eugenicists pathologized the African American body by linking race to susceptibility to certain diseases. Under the name of “public health,” ordinances and programs backed by these new “scientific” theories helped justify Jim Crow segregation and racial discrimination in the southern states. In particular, campaigns against tuberculosis and syphilis established a powerful model for eugenically-informed public health initiatives in the Deep South during the 1920s and 1930s. These prewar public health programs served to solidify the image of the black body as carrier of disease and agent of contamination, thereby instigating social fears about differential fertility and racial mixture between blacks and whites.

If universities and research institutes in the northeast were the epicenter of knowledge production, the southern and western states were the testing grounds to apply these “scientific” theories. The eugenics and disease eradication campaigns in the U.S. South and West were also informed by colonial experiences in tropical medicine and disease control abroad, namely the Philippines, Cuba, Puerto Rico, Hawaii, and the Panama Canal. In many ways, the southern states followed the Californian example, as white leaders of both regions shared the racial anxieties about job competition as well as miscegenation. The delayed introduction of public health services in the southern states, particularly those targeting African Americans, meant that most of the eugenic programs in the South were not as organized and institutionalized as their Californian counterparts. It was after most other states in the U.S. had abandoned these discriminatory programs after World War II that the southern states rigorously adopted eugenic programs of disease and population control that disproportionally targeted African Americans.

Harris and Ewing, Travelling syphilis laboratory, Washington, D.C., 1937. Courtesy of the Library of Congress.

The development of public health programs in the South remained rudimentary until the first half of the twentieth century. Early endeavors, such as the Rockefeller Sanitary Commission for the Eradication of Hookworm Disease (1909–1914), failed to actually eradicate diseases, although they did stimulate a “public-health awakening” in the South. Linda Gordon argues that the absence of large Catholic constituencies combined with racism accounted for the pioneering roles of southern states in birth control services despite the general lag of other social-service programs. Nonetheless, before the nationwide anti-poverty campaigns of the 1960s, public health services for African Americans were severely limited as funds were scarce and the primary concern for most southerners was to uplift poor whites. Most health officials did not dare to dabble in the controversial subject of birth control and found it unnecessary to provide any services to African Americans. White professionals who sponsored birth control services for blacks repeatedly changed their minds and terminated financial support without any continuous follow-up programs. Gamble and Cooper’s programs failed to consistently provide contraceptive advice to poor women and to measure the effectiveness of contraceptive methods offered. Although North Carolina established clinics in more than sixty counties over three years, after Gamble ended his financial support in 1940 many county health officials struggled to secure funds to continue the program.

The development of birth control programs and other public health endeavors in the Deep South before the war had powerful effects even if they were not implemented immediately. The scientific rhetoric supporting racial boundaries and social hierarchies, regardless of the actual etiology or statistical data, influenced many other programs beyond national borders and changes in social and political contexts. What Koya observed in the U.S. South included these sporadic birth control programs targeting African Americans. Oblivious to the fact that blacks were underserved in public health programs, Koya would reach an opposite conclusion about the white officials’ treatment of blacks—that they had “thoroughly taken good care of” this population—based on a trip to the South carefully arranged by the U.S. government.

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Louisiana – Mississippi: An "Exhibition of Races"

As a governmental researcher during the war, Koya wrote prolifically on race relations between the Japanese and neighboring ethnic groups in the Japanese-led empire, the so-called Greater East Asia Co-Prosperity Sphere (Dai Tōa Kyōeiken). To back up the wartime government’s pronatalist position, Koya insisted that the Japanese needed to increase their population in order to effectively rule their Korean colony. He warned that the birth rate of Japanese women in Korea was “far below” that of local women and reiterated the common eugenic argument that “lower” races typically outnumbered the “advanced” ones, as the latter adopted modern practices of birth control. Koya argued that a misguided interpretation of Western individualism and liberalism had led the Japanese to a “hedonistic” lifestyle, in which personal pleasure took precedence over their social duty to produce future citizens. To illustrate this point, one of his studies showed that the birth rate of Japanese in Korea declined upon emigration as a result of their elevated status as colonizers and increased material wealth. Koya also expressed concern about the flow of Koreans as laborers into mainland Japan and its effect on the survival of the Japanese race. Considering the problem of wartime labor shortages, Koya insisted that foreign laborers should be introduced with caution, after “elevating” the cultural practice and living standards of these foreigners to a level similar to those of the Japanese.

In addition to differential birth rates, the prospects of racial mixture between the Japanese and other Asian ethnic groups worried Koya and eugenicists in the Ministry of Health and Welfare during the war. Because of their warnings about the harmful effects of race crossing, the colonial government’s assimilation policy in Asia remained largely ineffective in practice. These scholars considered the Japanese to be a distinct race—separate from other Asian races—despite its “hybrid” origin. Koya's beliefs represented typical thought among Japanese intellectuals concerning race, in which they simultaneously affirmed and ignored the dynamic process of racial formation. Even as they conceded that different ethnic groups contributed to the original formation of the “Japanese race,” they either dismissed or rejected further racial mixture once the Japanese had achieved a “superior patriarchal race.”

This was a convenient ideology to support the idea of Japan’s inherent leadership role in the Greater East Asia Co-Prosperity Sphere. “Even though we love the peninsular Japanese [i.e. Koreans] as brothers,” Koya recommended, “Japanese intermarriage with Koreans should proceed gradually,” accompanied with deliberate research on the long-term effects of intermixture. He insisted that some Asians with strong “assimilating power,” such as the Chinese Kan race, should be avoided altogether.

Through his wartime investigation into the relationship between the core “Japanese race” and other Asians in a multi-ethnic Japanese empire, Koya was keen to learn how another multi-racial country, the United States, handled its differential birth rates between races and interracial mixture. Koya struggled between the official ideal of brotherhood with other Asian groups and the emotional repulsion toward living with them. Aware of racial discrimination toward blacks in the United States, he wondered how white Americans were still able to maintain an ideal of "democracy."

Koya first encountered the living experience of race relations in New Orleans, where he changed trains on his way to Mississippi. As his guide gave him a quick tour across town, he immediately noticed the strict residential segregation. The group first walked through the “Creole district,” where he saw many people with “typical Mediterranean features.” Then, gradually as they exited the area, he saw more “northern European types” with blond hair and blue eyes. It was not until Koya got on the bus and crossed the outskirts of the city that he came across a black residential area. Once the group came back to the city center, they went to a Mardi Gras parade. More than the parade itself, Koya was keen to observe the racial composition of the performers. He noticed many “Latin types” with dark skin, and a fewer number of “northern European types.” What struck him was that, according to his observation, there were very few performers who appeared to be a mix of both types. The city of New Orleans, which seemed to him “like an exhibition of races,” showed him the intolerance of people against the “mixture of different blood” even as they lived side by side. His impression of race relations there conformed to his wartime recommendation against intermarriage between the Japanese and the Koreans.

Arriving at his first major destination, Jackson, Mississippi, Koya probed further into race relations. He spent the first week in the reference room of the city hall studying demographic material and statistics, particularly those that concerned the black population. The data indicating the gap in birth rates between blacks and whites captured his attention. Koya wondered, “What is the U.S. government’s response to this problem?” He found his answer in the budgetary records, in which an “unusually high budget,” according to his judgment, was allocated to housing and public health projects. Because African Americans lived in poor, rural areas which required social development and the improvement of health services, he assumed, the state must have created this “large budget” to deal with the “black problem” of population growth. Koya's was fallacious reasoning, as the U.S. government spared minimal money for public health and welfare services for African Americans before the 1960s.

Koya built upon his assumption through his experience in the “field.” He spent a week researching health and sanitation services by following white public health nurses visiting black communities surrounding Hattiesburg, Mississippi, a booming small city near Jackson. Koya was impressed by the subtle way in which the nurses offered guidance on family planning to black mothers without evoking the larger population question. After general health instruction, a nurse would ask “How many children do you have?” “Are your children all in healthy condition?” “Are they going to school?”—all of which led to: “Do you want more children?” If the mother answered in the negative, the nurse would promptly schedule an appointment at the health center, telling the mother that she would receive free contraceptives.

In one memorable moment at the clinic in Hattiesburg, Koya saw a black mother in the waiting room with a white baby. The woman was breastfeeding the baby, which suggested to him that the child was biologically hers. Surprised by the scene, he talked about it to the director of the clinic. The doctor answered uncomfortably, “I don’t know how that happened, either. But I see these things sometimes in this area.” “But even more disturbing,” he added, “is the opposite case: when a white lady bears a black child. That indeed is a big problem, and can cause a lot of tragedy.” While Koya believed that these stories of race crossing were rare, he perceived the emotional aversion among whites to biologically mixing with blacks. He recalled the words of a white scholar he respected [name unknown]: “We can tolerate intermarriage with American Indians, but we cannot stomach the idea of marrying a Negro. Every white person would choose to marry an enemy, rather than a slave.” This experience confirmed Koya’s impression that birth control programs in the South were partly driven by eugenic concerns among whites about interracial mixture with blacks.

Koya explained that white efforts to control the black population were also linked to pressing economic problems, including job competition between the races. During his research in Mississippi, he came across information on black migration presented by Thomas Jackson Woofter, a scholar on race relations in the South. Woofter's work showed that the percentage of black farmers in the southern “cotton belt” had decreased from 71.3 % in 1860 to 39.7 % in 1930, while the number of cotton farmers increased from around a million to more than two million. This was not an indication of the net decrease of black population, but instead suggested the large-scale black migration to the North and West.

To visualize the “threat” of black migration, Koya carried a map of the “Black Belt,” indicated by a concentration of “black dots”—representing the black population—in the Mississippi Delta region. He added a comment to the map that the “Black Belt” was gradually moving northward every year. Koya also found from Woofter’s study that many of the blacks who stayed in the South had shifted job types, indicated by the decrease of day laborers (29%) and the increase of black sharecroppers (58%) and landholders (13%). “All of these black landowners and sharecroppers are descendents of slaves,” Koya wrote, then mistakenly added, “while the ancestors of the present-day white sharecroppers and day laborers were slave owners.” Koya used these numbers to support his supposition about the pressing need for white Americans to control the fertility of blacks.

Through his experience and research, Koya detected the fundamental dilemma motivating birth control initiatives in the United States—between an ideal of democracy versus the reality of racial discrimination. Behind any ideal of a “color-blind” society, Koya had perceived the “strong objection among whites to mixture of different blood,” which he justified as a natural biological reaction. White efforts to control the growing black population, he concluded, were a reflection of their negative emotions about living in close physical contact with African Americans.

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Mississippi – Tennessee – Kentucky: American Democracy and the Southern Pioneers

Koya was not critical about white U.S. leaders’ attitudes toward black citizens. On the contrary, he was impressed by their “democratic spirit” that led them to provide various public health services and education to this poorest part of the population despite their discriminatory feelings. He was surprised to find that the death rate of blacks in Mississippi (9.1% in 1946), a state known for its low living standards was still below that of Japan (11.9% in 1949). Koya believed that the relatively low death rate was a reflection of the southern states’ efforts in public health. He praised white southerners for taking good care of blacks, even defending them against the criticism from northern liberals about racial segregation in the South. He argued that black population growth occurred by and large as a result of white efforts’ to improve the living standards of blacks. He thought the southern states had gracefully handled the population problem by educating blacks about family planning and providing them with modern contraceptive methods. He concluded that the resulting birth rate of blacks in Mississippi (28.2% in 1946) was lower than that of the Japanese (33.9% in 1949). What Koya did not mention, however, was that the birth rate in Japan in 1946 was actually 23.6%, lower than the number he cited for blacks in Mississippi the same year, and that the numbers were already starting to fall after peaking at 34.6% in 1947.

Koya further speculated that the generosity of white Americans was reflected in the “happy and complacent” attitude that he perceived in the lives of blacks. He believed that blacks were innately “a racial group content to live an easy life despite their poverty.” Of course there were exceptions, he noted, but those blacks had moved to the North or the West, some of them even becoming professionals. He felt that the majority of blacks who stayed in the South were enjoying “a very primitive life” that many of those living a modern life had lost in the process of civilization. As he crossed the cotton fields and wheat fields, he saw many small shacks lived in by blacks. “Even though they know they could live in better houses if they worked harder,” Koya commented, “it seems that they do not find it worth the trouble.” As part of his research on “race biology” during the war years, Koya had investigated the scientific studies on race by Western eugenicists, including the notorious American Charles Davenport. In accepting racist and biologically-determinist theories about the “nature” of African Americans, Koya concluded that white Americans provided the black population with more than they actually desired. He contended that it was their own choice, not the perpetuation of social injustice, that accounted for their low status.

Koya’s identification with white American leaders is evident in the images carried during his travel accounts. Most of them were distant, bird’s-eye views of cities and buildings, illustrating American modernity and orderliness: a photograph of downtown New Orleans and his drawing of downtown Jackson.

Koya’s drawing of a Mardi Gras parade in New Orleans showed the event and the crowd from a window of a building. Despite his description of the diversity of races in the parade, he reduced the people in the picture to indistinguishable dots.The only image with “real” people that Koya carried was a photograph taken at a Kiwanis Club gathering among white local elites in Los Angeles, before heading to the southern states.

These illustrations and photographs together indicate Koya’s own relationship to U.S. society and his approach to social issues as a public health leader; he represented a view of a national leader interested in bringing order and modernity to society. While Koya confessed that the uniformity of the buildings’ architecture was confusing—and even boring—for a traveler, because it made all the cities he visited appear the same, he certainly saw it as a measurement of modernity and progress. When one of his hosts took Koya in front of the building where the state’s health department was located, the host proudly asked him, “Isn’t this a magnificent building? Does Japan have anything like this?” Koya was surprised by the man’s “ignorance about [the progress of] Japan.” In other words, he felt pride that the state of Japanese science and technology was not as backward as Americans assumed, if not more advanced than the level of the United States at the time.

The images suggest how Koya's top-down approach to social problems reduced ordinary citizens to indistinguishable “subjects” and data. Despite spending weeks in rural Mississippi, Koya provides few details of his experience among the black population, except for his descriptions of public health activities in Hattiesburg. There are no descriptions of any interactions with blacks; he seems to have merely observed them from a distance and interpreted them from the perspectives of white officials and scholars. Most of his observations came from the window of a vehicle that carried him between his primary white destinations.

Koya’s description of his rural experience was devoted almost exclusively to his admiration for the hospitality and generosity of his white hosts. He excitedly imagined himself among a modern-day version of rustic life in the “frontiers.” As a Christian, he was deeply impressed by their professions of democracy and Christian love. He found that his main destination, Mississippi—whose capital Jackson was named for Andrew Jackson—was an ideal place to learn this “American spirit.” The rural America he saw with yearning eyes was not that of of blacks or poor whites; it was his own imaginary world inhabited by wealthy white southerners.

One major character portrayed quite sympathetically in Koya's accounts was the old director of the health center in Hattiesburg, referred to as “Mr. Blackwelder” and described as a man with “fortitude and a beautiful personality—unique qualities of the descendents of the southern frontier people.” Koya stayed at Blackwelder’s place for a week while he visited black communities in the area. One day, as they rested in a field, Blackwelder told Koya: “I have been doing this for thirty years. I know I’d be able to earn a lot of money if I quit this job and start my own practice. But I cannot do that because I realize how important my work at the health center is for our community.” When he examined a skinny white boy at a local school, Blackwelder joked, “We should take good care of him, too. You never know; he might become our future president.”

Koya was also moved by the “frontier spirit” in Tennessee and Kentucky. The opportunity to visit these states came unexpectedly when he had trouble finding a hotel room for the last few nights in Jackson. After returning from rural sites in Mississippi, Koya found the hotel fully booked. He decided to take a short trip to Nashville to see an acquaintance, Robert Nail, a church elder and school principal. Nail took Koya to his hometown of Allensville in Kentucky, where his family welcomed the special guest from Japan. Koya felt “at home” sharing this visit with his friend's family, landowners, whom he compared to “the wealthy farmers in Tsarist Russia that [he] often read in novels.” Such families, Koya wrote, represented the “backbone of America.”

In Nashville Koya recalled an incident in which he felt racial hatred directed toward the Japanese. Randomly entering a movie theater, he saw a Japanese soldier on the screen in a movie about World War II. The soldier was torturing an American POW. Koya was shocked, writing, “The American viewers must imagine the Japanese to be such a violent race.” He had left the theater and was wandering aimlessly in the dark when a man came up and asked whether he was Japanese. The man told him that he had been in Okinawa during the war and that he was happy to see a Japanese person again. Koya believed that while the war had created negative images between Japanese and Westerners, Japan's leaders had been treated with respect. As the historian Yukiko Koshiro observes, many postwar Japanese leaders entertained the idea of Japanese as “honorary whites”—racially Asian, but culturally closer to Westerners. The remainder of Koya's southern journey further confirms his identification with white leaders, especially those in state offices and universities.

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Georgia – North Carolina: State Initiatives in Public Health

Koya passed a week in Atlanta, Georgia, attending seminars at the Communicable Disease Center (CDC, now the Centers for Disease Control and Prevention) of the U.S. Public Health Service. While the topics of the lectures, such as pest control and cancer prevention campaigns, did not directly relate to his expertise, Koya was keen to learn about the organization and operation of state public health services. He was impressed by the CDC’s goal of “applying new scientific technologies and information to governmental services.” While much of Koya’s wartime research on how to improve Japanese racial fitness did not go beyond desk theory, in the postwar period, with the help of the U.S. Occupation officials and other birth control supporters, he would immediately apply the “new technologies” of contraception to field trials and programs. Koya appreciated the efficiency and practicality of these U.S. governmental services.

In North Carolina, his final destination in the South, Koya talked with scholars and officials specializing in population studies and public health. In Chapel Hill, Koya met with Harold J. Magnuson, a scientist famous for his syphilis experiments. Rupert B. Vance, regional geographer and authority on population demography, happened to be out of office during Koya’s visit. In Raleigh, Koya visited George Cooper, who with the help of Clarence Gamble, had incorporated an emphasis on black population control into the state’s public health services. Over the age of seventy, he was still working at the state’s public health department. Koya was excited to have an in-depth conversation about how to launch birth control programs in Japan. The two doctors talked about the training courses for medical professionals on contraception offered at the Institute of Public Health (IPH) in Tokyo. Assuming that most women did not voluntarily visit clinics for birth control instruction, Cooper advised that IPH initiatives should be followed by even more active measures such as deploying public health nurses as social case workers, a Gamble strategy. Cooper also suggested that Koya should—in the beginning--offer contraceptive devices and drugs for free. Koya was in complete agreement. Despite the inclusion of birth control instruction in the Eugenic Protection Law, few people—usually urban and educated—visited health clinics for birth control consultation in Japan; the most “needy” people in rural, working-class areas showed little interest. For Koya, these rural Japanese with high fertility rates corresponded to African Americans in the South.

Koya’s brief conversation with Cooper, whom he credited for “set[ting] up [his] mind about family planning,” had a crucial impact on population policies in postwar Japan. Koya would incorporate many of Cooper’s suggestions into legal reforms and birth control programs: specifically, the strategies of directly sending visiting nurses and providing easy and simple contraceptive devices for free to poor families. Cooper likewise counted on Koya to make these birth control reforms in Japan on a national level through official avenues, whereas in the United States, at least until the 1950s, birth control programs lacked uniformity, remained underfuned, and failed to expand beyond the South due to various political pressures and cultural opposition.

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"Pioneering in Family Planning":

Koya wasted no time carrying out what he learned in the U.S. South. While many Japanese leaders were alarmed at the growing population in a devastated postwar economy, there were others who continued to support the government’s wartime pronatalist position, which equated national power (military) to population size (number of soldiers). SCAP’s position of “benevolent neutrality” on population issues further deterred the Japanese government from allocating any significant budget for birth control programs. Major U.S. non-governmental organizations, such as the Rockefeller and the Ford Foundations, which later played vital roles in global population control, were hesitant to openly engage this controversial field.

Personal donations from Clarence Gamble first bankrolled Koya’s project. Gamble found the opportunity to extend his birth control cause to Japan in 1949 after his conversation with Frank W. Notestein, director of the Princeton University Office of Population Research. Notestein had headed the Rockefeller Foundation’s 1948 reconnaissance mission in Asia, starting with Japan, to assess population questions. Gamble contacted SCAP officials to find ways to finance birth control programs in Japan and was soon introduced to Koya. Venturing into population control in Japan was a continuation of Gamble’s prewar activities in the U.S. South, but (excepting Puerto Rico) it also represented his first project abroad.

In September 1950, with Gamble’s assistance, Koya started the “Three Village Study,” designating three model villages, where he offered free samples of different methods of contraception to find out which method was most effective and easiest to use. In late 1951 Koya assigned public health nurses and midwives to the role of case workers to disseminate birth control information and techniques in rural areas. The Three Village Study became the most successful birth control program organized among a rural population before the advent and spread of more “modern” methods of contraception such as the IUD and the pill. Koya published his studies in academic journals in the United States and Japan, including the Milbank Memorial Quarterly and Eugenical News. With the support of the Population Council, he compiled and published his findings in 1963 as Pioneering in Family Planning: A Collection of Papers on the Family Planning Programs and Research Conducted in Japan.

The significance of Koya’s experiments among leaders in family planning was not measured only by the lowered number of births; what mattered most were the people his programs targeted. Koya’s work received favorable responses from U.S. and British eugenicists and demographers, including C. P. Blacker, Irene Taeuber, and Dorothy Nortman. Nortman, in her review of Koya’s Pioneering in Family Planning, claimed that that his experiments proved that even “marginal people”—rural people, coal miner workers, and people on public relief—could be turned into “contraceptors” in a relatively short period of time through field trials of cheap, simple, and suitable methods of contraception. His results indicated that the “large masses of illiterate people” in the rest of Asia could “restore the balance between births and deaths before achieving Japan’s degree of literacy, economic development, urbanization, and modernization [emphasis added].” Nortman’s comments represented the general approach of U.S. leaders to global population control in Third World countries in the decades that followed: education, economic development, and the promotion of health were all secondary to the perceived urgency to bring down birth rates by disseminating cheap and easy contraceptives. The same eugenic and economic concerns that Koya perceived among white leaders in the South also motivated the U.S.-led population programs abroad. Koya’s travel accounts reveal the hypocrisy and racism behind birth control programs in the U.S. South, programs expressive of eugenic ideology that he reproduced in Japan.

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Conclusion:

Population control in Japan in the early post-World War II years, represented by Yoshio Koya’s activities, served as a testing ground for mass-scale, state-sponsored programs initiated by the United States in Third World countries in the following decades. Japan’s seeming success in bringing down birth rates and achieving peaceful recovery after the war helped establish the efficacy of such programs. The publicity about “successful” population control projects abroad, in turn, brought renewed attention to birth control programs in the U.S. South. In 1960, Charlotte, North Carolina inaugurated its birth control program under the state’s public welfare department; similar experiments followed across the country, but especially in the South, as part of the national “War on Poverty” campaign. The increased funding expanded poor women’s access to birth control services, but at the same time increased the potential for abuse and coercion. Some health officials took advantage of new funding sources and used them to test new, but often unapproved and dangerous, contraceptive devices. By focusing on battling poverty, birth control projects diverted public attention from issues of women’s health and rights.

Through its focus on Yoshio Koya, this essay has traced some of the ideological roots of these global population control projects—which neglected the needs and concerns of actual women—to public health programs in the U.S. southern states. Public officials, foundation executives, and birth control advocates frequently shared a eugenic logic that resulted in the transplanting of birth control experiments in the rural South to national- and international-scale population control projects in Japan and elsewhere. By testing the techniques and strategies of birth control abroad as a form of development aid, U.S. advocates of birth control and population control were able to evade the moral and political opposition at home. The consequent development of birth control methods and expansion of funding brought reproductive freedom to many, but often at the expense of the reproductive rights of others, especially economically and racially marginalized women.

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Recommended Resources:

Links:

Dolan DNA Learning Center, Cold Spring Harbor Laboratory. “Image Archive on the American Eugenics Movement.”

http://www.eugenicsarchive.org/eugenics

Library of Congress. Margaret Sanger Papers.

http://lccn.loc.gov/mm76038919

Sophia Smith Collections. Margaret Sanger Papers.

http://asteria.fivecolleges.edu/findaids/sophiasmith/mnsss43_main.html

The Institute of Twentieth Century Media. “The Database of Newspapers and Magazines Published during the Post-war Occupation Period from 1945 to 1949.”

http://m20thdb.jp

The Rockefeller Archive Center.

http://www.rockarch.org



Printed Materials:

Ettling, John. The Germ of Laziness: Rockefeller Philanthropy and Public Health in the New South. Cambridge, MA.: Harvard University Press, 1981.

Gordon, Linda. Woman's Body, Woman's Right: A Social History of Birth Control in America. New York: Grossman, 1976.

Larson, Edward J. Sex, Race, and Science: Eugenics in the Deep South. Baltimore: Johns Hopkins University Press, 1995.

Littlewood, Thomas B. The Politics of Population Control. Notre Dame, IN.: University of Notre Dame Press, 1977.

Oakley, Deborah. “The Development of Population Policy in Japan, 1945-1952, and American Participation.” Ph.D. dissertation, University of Michigan, 1977.

Reed, John. From Private Vice to Public Virtue: The Birth Control Movement and American Society Since 1830. New York: Basic Books, 1978.

Rodrique, Jessie M. “The Black Community and the Birth Control Movement.” In Passion and Power: Sexuality in History, edited by Kathy Peiss and Christina Simmons, 138-154. Philadelphia: Temple University Press, 1989.

Schoen, Johanna. Choice and Coercion: Birth Control, Sterilization, and Abortion in Public Health and Welfare. Chapel Hill: University of North Carolina Press, 2005.

Williams, Doone. Every Child A Wanted Child: Clarence James Gamble, M.D. and His Work in the Birth Control Movement. Boston: Harvard University Press, 1978.

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