Sweet Bean Paste

Author: Durian Sukegawa
Publisher: A One World Book 2022

I have been to all inhabited islands of Hawaii except Molokai. The reason I could not go was due to the objections of my traveling companions. There was a leprosy colony on Molokai. Since leprosy is known as an infectious disease, nobody wanted to risk exposure. This was in the late 1990s.

Leprosy is caused by a bacillus (a rod-like bacterium), Mycobacterium leprae (M. leprae). The microorganism was discovered by a Norwegian physician, Gerhard Armauer Hansen, in 1874, and the disease has been known as "Hansen’s disease" since then.

Hansen’s disease is ancient. The term "Arun Kushta" (අරුන් කුෂ්ඨ) was used in ancient Indian literature to refer to leprosy. Indian physicians used the oil of Tuvarks seeds to treat the disease.

(Ref: "Mycobacterium leprae: A historical study of the origins of leprosy and its social stigma" by Luigi Santacroce et al. Infez Med. 2021; 29(4): 623-632.)

Leprosy is not highly contagious. However, people who are exposed to a person with leprosy are 5-8 times more likely to develop the disease. Symptoms include light-colored or red skin patches with reduced sensation, numbness, and weakness in hands and feet.

Promin was one of the effective drugs for leprosy developed in the 1940s. Leprosy can be cured with 6-12 months of multi-drug therapy. The currently recommended treatment regimen consists of three drugs: dapsone, rifampicin, and clofazimine. Early treatment avoids disability.

This is a story about a Japanese woman who contracted leprosy as a young girl and was then restricted to a leprosy colony in Tokyo in the 1940s. Even though she was fully cured of the disease, she was not allowed to leave the colony until the late 1990s.

Under the 1953 Leprosy Prevention Act, most people affected by leprosy were isolated and forced to move into sanatoria. The act was abolished on April 1, 1996. The Japanese parliament enacted a new law to compensate family members of former Hansen’s disease patients in November 2019.

As a novel, this book is an abject failure. The characters were chosen haphazardly, and there is no rhyme or reason for their actions. The ultimate goal of the story is to expose the stigma associated with Hansen’s disease, but the author has done a very poor job of achieving this.

The author should have written a non-fiction book instead. However, I am not sure he has the skills to succeed in writing such a work. A more skilled writer could have produced a better fiction or non-fiction book about Hansen’s disease. For example, Gina Kolata wrote an excellent non-fiction book about the flu virus of 1918, titled "Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus That Caused It."

However, the book is popular among its readers. One World first published it in 2017. Since then, it was reprinted in 2018 (twice), 2020, 2021 (three times), and 2022 (twice). Perhaps someone else should read the book and write a review.