Disability in the Far East: JapanÕs Social Transformation in Perceptions of People with Disabilities Miho Iwakuma, Ph.D. Kyoto University Graduate School of Medicine Abstract: The phenomenon of disability is socially constructed; therefore, it is not free from norms, rules, shared understandings or value systemsÑin short, culture. This paper examines the universal presence of disability in the Japanese context, which is affected by a myriad of ever-changing influences, including political, cultural, and social forces. Key Words: Japan, culture, disability EditorÕs note: This article was anonymously peer reviewed. Introduction The phenomenon of disability is socially constructed; therefore, it is not free from norms, rules, shared understandings or value systems--in short, culture. Cultural anthropologists thus argue that Òall human societies have and have always had disabled members. While the presence of such individuals is constant, culturally shared responses to them vary greatly across time and social contextÓ (Scheer & Groce, 1988, p. 23). This paper examines the universal presence of disability in a Japanese context, which is affected by a myriad of ever-changing influences, such as political, cultural, and social forces. Given that some readers of this article may not be familiar with Japanese culture, it seems appropriate to describe the cultural characteristics and political inclinations of Japan and their implications for disability. Culture and Disability The ethnic homogeneity of Japan appears to trickle down to interactions with and perceptions toward disability. It is well known in communication studies that the more homogeneous a society, the more culturally ÒtightÓ and collectivistic the members become (Triandis, 1994). This has many ramifications for how and why people interact as they do with each other. In a culturally tight society, which tends to develop in a highly populated and isolated geographic region like Japan, strict rules, norms, or ideas of proper behavior are imposed. In other words, a slight deviation from the norms is quickly noticed and criticized in a tight society. In such a culture, the force of conformity is stronger than in a loose one, and people are inclined to become more collectivistic, longing for ÒsamenessÓ and loathing anything ambiguous, contradictory, or different (Triandis, 2003). Disability, however, is nothing but ambiguous,1 contradictory,2 and different. The sense of being tight and collectivistic has been an undercurrent in Japanese society, and communication regarding disability is rigid and tense. Despite this undercurrent, Japan has experienced critical events concerning disability and people with disabilities (PWDs). The present paper contextualizes the social transformation of Japan through its policies, the media, and current demographic challenges, all of which have interacted within the environment surrounding PWDs. Policy Making Equality of Access and Equality of Results Heyer (1999) suggests that the notion of ÒequalityÓ is interpreted quite differently in different countries, and these differences are deeply embedded in disability-related policies and legislation. According to Heyer, Japan employs an Òequality of resultÓ doctrine, which acknowledges differences (and often disadvantages) resulting from impairments, and provides special treatments as compensation. Other nations such as the United States, interpret ÒequalityÓ as securing the same access and treatment regardless of physical differences, as exemplified by the Americans with Disability Act. Ò[W]hen does treating people differently emphasize their differences and stigmatize or hinder them on that basis? And when does treating people the same become insensitive to their difference and likely to stigmatize or hinder them on that basis?Ó (Minow, 1990; cited in Heyer [1999]; emphasis in original) In answering these questions about the Òdilemma of difference,Ó Japan has created difference-based disability policies from a welfare perspective, exemplified by disability employment quota, special schools, or taxi discount tickets. With the goal of special treatment and consideration, the Japanese welfare model of disability has created different spheres of living, especially in educational environments, which render disability invisible in society (Heyer, 1999; Iwakuma, 2005; Nakajima, 2006). Thus, the disability movement in Japan began with a counteraction against the conventional notion of disability (i.e., to be subdued or separated from the rest of society). The following section outlines Japanese disability movements, which began in the 1960s. A Brief History of the Disability Movements: The 1960s, 1970s, and 1980s It is generally accepted that the modern disability movement in Japan intensified and came into maturity in the late 1960s,3 propelled by a group of people with cerebral palsy whose disabilities were most severe and who were deprived of social participation (Kuramoto, 1999; Tateiwa, 1997). Their group Aoi Shiba (ÒGreen GrassÓ) formed officially in 1957, initially for recreation, but its purpose changed drastically through several critical events that were considered by some to be antisocial or antagonistic (Hayashi, 2001; Kuramoto, 1999). One of these incidents was triggered in 1970 when a child with a severe disability was killed by her own mother. Subsequently, petitions were circulated to reduce the motherÕs sentence, pleading that the mother was in such desperate circumstances in raising the pitiful child that the killing was done out of mercy and was thus understandable (Hayashi, 2001; Tateiwa, 1997). Aoi Shiba reacted angrily toward this Òcommon senseÓ opinion that life with disability was worthless and was better ended, and they ran a counter-petition campaign against the mother. Another famous turning point was the so-called ÒKawasaki Bus TosoÓ (the Kawasaki Bus Strife). In 1977, members of Aoi Shiba stopped 78 city buses in Kawasaki that had refused to transport passengers using wheelchairs. Aoi Shiba members occupied and lay on the ground in front of buses to protest the denial of transportation of PWDs. Their antagonistic protest was disdained, both by non-disabled people and PWDs themselves, because Aoi Shiba members refused to apologize or plead (Tateiwa, 1997), as the ÒtightÓ and collectivistic society expected of them (Iwakuma, 2005). Japanese culture prefers rigid and predictable social roles to avoid embarrassing scenes that can arise from unscripted interactions. Society expects PWDs, who are protected and supported by the state, to be conscious of the burden they impose on society and try to reduce it (Iwakuma, 2005). The cost of people with disabilities to society is generally thought to outweigh their contributions (Nakajima, 2006). During the Kawasaki Bus Strife, protesters decided to become an annoyance and burden by bringing bus transportation to a halt. Their defiance of an expectation imposed on PWDs was an eye-opener for others with disabilities; PWDs began to think outside of an inflexible frame, thereby changing the course of the disability movement in Japan (Kuramoto, 1999). This incident was symbolic, because the issue of accessibility has played a central role in disability movements in Japan (and elsewhere in the world); securing accessible transportation directly translates into social participation for PWDs. In Japan, accessibility for people with physical disabilities in the 1970s was incomparable to the current situation. For example, the number of passengers with wheelchairs at Tokyo Station in all of 1973 (the busiest train/subway station in the nation) was only 249 (Baba, 2004).4 This low number illustrates that mobility for a person with a disability was quite limited in the 1970s and was met with many obstacles.5 In 1973, two stations, in Sendai and in Ueno, were remodeled for wheelchair accessibility for the first time in Japan; a ticket gate was widened and two bathrooms were made accessible (Baba, 2004). However, most stations remained inaccessible due to steps, a large difference in elevation between the platform and the carrier, or absence of accessible bathrooms. When Aoi Shiba members demanded accessibility at stations, officials were caught off-guard; they had never imagined that people with mobility impairments might even consider riding on trains (Nakajima, 2006). Thus, ÒobstaclesÓ include not only physical barriers, but also societyÕs perceptions. Imrie (2001) contends that Òthe socio-spatial patterns of ableist values are etched across the city in numerous ways, forming a type of architectural apartheidÓ (p. 232; emphasis in original). The ableism, according to Imrie (1996), is crystallized in the Òdenial of bodily diversity and differences and the projection of normalcyÓ (p. 83), and will be revisited later in this paper. A structure of spacialities eloquently reveals the position of Japanese PWDs in the 1970s who were isolated and marginalized due to a different living sphere created by inaccessible environments. The 1980s brought about many changes, including The United NationsÕ International Year of Disabled Persons in 1981 and A Decade of Disabled Persons, both of which facilitated disability movements that had arisen earlier (Tanaka, 1998). Yukiko Nakanishi, who has long been a part of the Japanese disability movement and travels throughout the world, commented to me at a recent meeting that she first started noticing Òa shift in the windÓ in the disability context during the 1980s. She further suggested that tenacious protests organized by groups of PWDs have had a lasting impact on policy and environmental changes. For example, members of Disabled Peoples International (DPI) have staged demonstrations, and in one such instance, more than 2,000 PWDs gathered at 20 different ÒinaccessibleÓ train stations on the same day to use trains (Nakanishi, 2004). The continuous efforts made by the disabled have resulted in the establishment of guidelines for elevator and escalator installations at stations and the enactment of two laws: the Act on Buildings Accessible and Usable for the Elderly and Physically Disabled in 1994 and the Law for Promoting the Improvement of Public Transportation in 2000 (Nakanishi, 2004). Policy Making in the Disability Environment Although Òguidelines and outlinesÓ for developers and architects of environmental designs for PWDs were established in the 1970s and approved by the government, the standards of that era were viewed as too generous. Therefore, architects and developers did not to adhere to these governmental recommendations (Akiyama et al., 2001). In the 1980s, environments for PWDs were drastically transformed, especially in the areas of community living and policy making, largely due to the United Nations-implemented International Year of Disabled Persons in 1981, and later, A Decade of Disabled Persons, from 1983 to 1992 (Tateiwa, 1997; Hayashi, 2001).6 Many guidelines, projects, or plans were initiated concerning environments for PWDs such as housing, transportation, and employment (Tanaka, 1998). A paradigm shift from a mere ÒrecommendationÓ to ÒlawÓ occurred in the 1990s. During this decade, public awareness of the issue of accessibility had become apparent. For example, 51% of those surveyed acknowledged accessible transit facilities inside stations for PWDs, and more than 80% believed that access was not sufficient for individuals with disabilities (Date et al., 1999). This trend went hand in hand with a cultivated public awareness that an aging society like Japan, which has the highest average life expectancy in the world (79 years old for men and 85 years old for women in 2008), cannot survive unless it becomes disability-friendly (Higuchi, 1997). With this social background, two laws concerning accessibility were passed: the Act on Buildings Accessible and Usable for the Elderly and Physically Disabled (Accessible and Usable Building Law) in 1994; and the Law for Promoting the Improvement of Public Transportation (Transportation Accessibility Improvement Law) in 2000. Tanaka (1998) states that in the early 1980s, welfare laws predominantly targeted PWDs, but since the late 1980s, laws have been passed in response to concerns for the aging in Japan. This expansion or inclusiveness in the philosophy of accessibility, Òaccess made only for the disabledÓ to Òaccess for all,Ó was incorporated in the enactment of the New Barrier-free Law in 2006, which included the provision of accessible environments for all members of society. The Media and Disability Circumstances surrounding people with disabilities in Japan seem to have changed in unexpected ways in the 1990s. Ototake: The Gotai-Fumanzoku Phenomenon In 1998, Ototake (1998) published an autobiographical essay as a person born without limbs; the book became an overnight bestseller and has been translated into many languages.7 As more than five million copies of the book were sold, media coverage of Ototake was intense and he became a social phenomenon (Iwakuma, 2002). His media appearances were welcomed enthusiastically. Unlike other people with disabilities previously seen in the media, Ototake rarely complained about having a disability or nagged the unaccommodating society, which put people at ease (Sakurada & Kohama, 2001). Throughout his life, Ototake was educated in mainstream schools and he graduated from a prestigious university. He has lived as a member of the able-bodied society, and his humorous comments contrasted with the conventional depressing, pitiful, and/or too sensitive images of others with disabilities. Many also pointed out that his handsome, well-groomed appearance has helped him gain acceptance. Upon university graduation, he chose to be a sports writer, got married, and more recently, became an elementary school teacher in Tokyo. The disabled and non-disabled communities perceived Ototake very differently (Iwakuma, 2002), and coverage of his life seemed to diverge from the traditional depiction of disability that is confined to a welfare or medical context.8 I have heard from many individuals with disabilities who experienced social as well as interpersonal changes because of Ototake; for example, his book was often used as an icebreaker in conversations between people with and without disabilities. Talking about disability tends to be anxiety-filled, especially in conversations with a PWD (Iwakuma, 2002; Iwakuma, 2003); nevertheless, one of OtotakeÕs contributions has been to reduce the difficulty of these conversations. Nagano Paralympics Another significant event in 1998 was that the city of Nagano hosted the Winter Olympics and Paralympics. More than 500 athletes with disabilities from 32 different countries and regions flew into Japan. According to Takahashi (n.d.), who is an editorial writer for the Asahi Newspaper, this event was noteworthy in several aspects compared to previous Paralympics. Despite the relatively high cost of tickets, they were sold out within a week immediately following the opening ceremony (Nebashi & Inoue, 2005). The mass media enthusiastically reported not only game results but also personal stories of the athletes. The Asahi Newspaper, one of the major nationally-circulated papers in Japan, reported the four medals won by Mayumi Narita in color on the front page, but also published a feature article about her (http://www.yuki-enishi.com/media_shougai/media_shougai-04.html). Other articles about the Paralympics appeared in the sports section instead of the lifestyle or health sections of the newspaper (Nebashi & Inoue, 2005). More than 10,000 people per day visited the official Paralympics website during the games, and many people with disabilities were inspired and became interested in these sports (Nebashi & Inoue, 2005). In the Asahi Newspaper, two short articles about the Paralympics appeared in 1988, three in 1992, and only one in 1994; however, the number of articles about the Nagano Paralympics exceeded 100 in 1998. Furthermore, disabled athletesÕ names were given without any title, such as ÔMr.,Õ which is the same convention used for reporting the names of non-disabled athletes (Takahashi, n.d.). The Nagano Paralympics has left long-lasting effects on the perception of disability in Japan. During these games, people in Japan were exposed to new images of competitive and accomplished athletes with disabilities, in stark contrast to the conventional Òdepressive, frail, unathletic, and/or immobileÓ perceptions of PWDs (Iwakuma, 2004). At the same time, the media made it apparent how ablest the environments were for individuals with disabilities. The present author saw footage of a non-Japanese athlete in a wheelchair who visited a local Japanese souvenir store. To traverse the several steps at the entrance, which are typical for small stores, the athlete stepped off the chair and crawled up the stairs, before an astonished store owner came to rescue him. By watching Paralympics athletes with various kinds of disabilities, Japanese people came to the realization that there was a group of people, the so-called Òdisabled,Ó who were often forgotten and subdued due to different living spheres created by society (Takahagi, 2000). Changing Japanese Society in the 1990s and Beyond The Great Hanshin/Awaji Earthquake On January 17 1995, the Great Hanshin/Awaji Earthquake shook the nation. More than 5,000 lives were lost, many of them elderly people over 60 years old (Tanaka, 1998). Major infrastructures were cut off in the aftermath, and the nation, standing on shaky ground, witnessed how conditions normally taken for granted (e.g., water, electricity, roads) were changed. Many people regarded as Òable bodiedÓ under normal circumstances suddenly underwent experiences common to people with disabilities. For example, many disaster victims were isolated from the flow of information, could not use the toilet or bathe for days, or were unable to go to school or work (Kawauchi, 2001). In addition, temporary houses contained many barriers, and receiving food or water outside on the street in cold January added another difficulty for PWDs and the elderly. Removed from a familiar community network, many disaster victims died from despair and isolation, demonstrating the importance of a social network for survival. This experience has provided many valuable lessons for the rest of the country regarding city planning, transportation, and living environment (re)creation. As the revitalization of Hanshin proceeded in tandem with responses to needs of the aging, issues such as accessibility, barrier-free environments, and universal design became well known to the public. Following this earthquake, tangible changes took place throughout the nation due to the understanding that this could happen anywhere in Japan (Kose, 2002; Tanaka, 1998). For example, the rebuilt Itami station and its surrounding area were designed to be barrier-free. Many stakeholders comprised committees and provided ideas prior to the design phase and evaluated the newly built station areas afterwards. Another change was seen in housing. Prior to 1995, a step at the bathroom entrance was considered necessary in Japanese housing to prevent water from flowing outside the area.9 When a large number of people, many of whom were elderly, lost their houses and moved to public assisted apartments after the earthquake, the state put a great effort into creating step-free bathrooms (Kose, 2002). This action took place due to the provision that the residents would remain in the apartment for the rest of their lives and was based on concerns about future remodeling if the bathrooms were not made accessible initially (Kose, 2002). Mass production of step-free bathrooms has become a norm in Japan, even beyond earthquake-prone regions (Kose, 2002). The Low Fertility Rate, Demographic Change and Its Implications Another prominent factor in the changing contexts surrounding disability and accessibility is JapanÕs aging society, in tandem with the ever-shrinking fertility rate. Kose (2002) states that prior to passing the Accessible and Usable Building Law, the Building Standards Law was passed more than 40 years prior when the elderly comprised only 5% of the population, average life expectancy was approximately 50 years, and PWDs were rarely seen in public. Therefore, it is not surprising that pedestrian overpasses without elevators, overcrowded trains, flights of stairs at stations, and city buses with steps were all designed for the ÒnormalÓ body with upright posture, walking, healthy, and strong. This narrow standard of the human body that negates bodily diversity and capacity is referred to as ableism (Imrie, 1996). However, the burgeoning demographic shift has changed societal viewsÑideas about accessibility have shifted from benevolent facilities designed for the disabled only to an environment in which the entire aging population may live in coming years (Nomura, Hagisu, Sugiyama, Nozawa, & Hatougo, 2005; Tanaka, 1998). With the establishment of the Dwelling Design Guidelines for the Ageing Society in 1995, the housing industry has become more conscious of the needs of the aging population (Kose, 2002). Within the state government, newly employed Ministry of Construction bureaucrats now receive training that includes simulated experiences of mobility impairments by the wearing of braces or casts (Kose, 2002). Another area seriously affected by aging is tourism. For example, the city of Kyoto is one of the oldest cities and boasts a long list of nationally renowned sites or architectures, many of which are filled with barriers such as stairs or pebble-filled paths. Due to these physical obstacles, an untold number of elders and PWDs have given up visiting and worshiping at temples or shrines. However, aging baby boomers possess purchasing power and an abundance of time after retirement. Thus, the Kyoto tourism industry is prioritizing barrier-free or universal design. In 2000, 15.1% (611 million people) of all visitors to Kyoto were over 60 years of age, and this number increased to 17.4% (822 million) in 2005 (ÒYasasii kyo no tabi,Ó 2006). Thus, under the tide of aging, the ableist landscape begins to be considered not only socially unjust but also economically unsound. Nomura et al. (2005) reported that the barrier-free movement started originally to improve the lives of PWDs, and later included the elderly due to JapanÕs aging society, and more recently has included child-rearing parent(s). Parents (especially mothers of small children) have joined the alliance under the slogan of Òbarrier-free for parentingÓ (http://www.yomiuri.co.jp/iryou/kyousei/geneki/20050803ik08.htm?from=goo). In 1989, the government report of JapanÕs fertility rate of 1.57, which was subsequently called Òthe 1.57 shockÓ, stunned the nation. The fertility rate has not recovered, and in 2005, for the first time since the first national census of 1899, in the absence of an external factor such as a war, the Japanese population decreased. While many reasons are suspected for the lowering fertility rate (e.g., diversified womenÕs lifestyles and their increased participation in the workplace, high cost of education, or shortage of childcare facilities), negative perceptions and child rearing experiences in ableist environments have been acknowledged as contributing factors. When the city of Tokyo asked for public comments for improvements to the environment, more than 3,000 comments were sent in. Many of them raised concerns about current environments that are unwelcoming for many people, including child-rearing parents. More importantly, these comments pointed out that Òbarrier-fullÓ environments discourage people, especially women, from having children, and this trend further reduces the overall fertility rate (ÒTokyo koso,Ó 2000). For example, a poll shows that although more than 95% of surveyed mothers wish to go out, the majority has become nearly housebound and feels distressed as a result (ÒHirogare,Ó 2007). With a small child, parents (especially mothers) are aware of their communities from a different perspective and often are astounded by the existing obstacles. A mother with small children, one of whom is eight months old, reveals that she becomes very nervous about anticipated barriers before leaving home (http://www.yomiuri.co.jp/iryou/kyousei/geneki/20050803ik08.htm?from=goo). For example, a stroller is generally expected to be folded on the bus,10 and in stations without elevators, the stroller must be carried up and down stairs with the baby inside. Connecting the dots between living in a Òbarrier-fullÓ society, the added or perceived parenting stress, and reluctance to have a child, the Japanese government has begun promoting the slogan, Òbarrier-free for parentingÓ. Accordingly, a white paper published in 2005 was devoted to the issue of low birth rate and acknowledged the environmental factor on the dwindling births, reflecting that conventional, ableist living arrangements have undermined Òother bodily configurations,Ó including child-rearing parents, the elderly, and people with disabilities (ÒShoshika hakusho,Ó 2005). The 3.11 Shock and Beyond ÒItÕs been enough.Ó This was the last phrase Masaaki Sato gasped under a respirator when the Magnitude 9 earthquake hit and nearby family members were scrambling in an effort to rescue Masaaki (Kirikuri, 2011). The tsunami was about to wash everything away, including PWDs with limited mobility like Masaaki. The Great East Japan Earthquake took place on March 11, 2011, and Japan has been plagued with aftershocks ever since. This section details the survival experiences of PWDs in the earthquake aftermath in three consecutive stages. In August 2011, the author interviewed Awano, who works at a community workshop for PWDs and has visited quake-affected regions. Awano mentioned that a person with severe disabilities faces three hardships when and after a disaster hits (JDF, 2011). The first stage is when the disaster hitsÑthose with severe mobility impairment simply cannot escape on their own, as was the case for Masaaki Sato. A PWD also faces difficulties in the second stageÑat evacuation centers. Such centers, which include school gyms and community centers, are not an option for PWDs due to physical and psychological barriers. Awano, who visited many shelters, came to realize that very few PWDs stayed at evacuation centers in which survivors, with or without disabilities, slept on floors, and bathrooms and toilets have steps with little privacy. One party of 24 (4 staff and 20 people with psychological disabilities) was turned away from a shelter (Awano, personal communication, August 18, 2011). At least four individuals with psychological disabilities died after surviving the earthquake and tsunami (Nokura, 2011), and this number increases as the situation prolongs. In particular, the drastic changes in living environment can trigger seizures and/or worsen preexisted health conditions in some PWDs. For the majority of PWDs, evacuation shelters are inhabitable, and many have no choice but to return to their unsafe homes or stay with relatives (Awano, personal communication, August 18, 2011). Since relief supplies only arrive at evacuation centers, PWDs that decided not to stay at such centers were Òout of sight, out of reach,Ó according to Awano. Two month after the earthquake in May 2011, Miyagi prefecture reported that 15 PWDs died and seven were missing, despite the fact that there were more than 50,000 registered PWDs in the prefecture (Kyousaren, 2011). This blatant underestimation may be attributed to the new Private Information Protective Law, which was passed in 2003. Under this law, the whereabouts of PWDs must be concealed, contributing to the notion that the law presents an additional obstacle for confirming the safety of these individuals. The handling of private information during crises requires careful reconsideration. The third stage begins when survivors move into temporary houses and start rebuilding from scratch (Awano, personal communication, August 18, 2011; JDF, 2011). During an academic conference, which the author attended in August 2011, issues concerning the third stage were frequently mentioned and debated. For example, a conference attendee with a disability commented that newly-built temporary houses were small, built in remote areas, and uninhabitable for many PWDs. In response, a researcher involved with the housing project replied in an apologetic tone that a massive number of temporary houses had to be built in a short time frame (i.e., a few months); therefore, the issue of Òbarrier-freeÓ had been compromised. He added that although the bathrooms were designed with thresholds, the toilets had no steps. This was the aforementioned lesson learned from the Great Hanshin-Awaji Earthquake in 1995. Another bitter lesson from the previous earthquake was that during the third stage, tight-knitted communities were broken up and some survivors died in solitude while living in temporary housing (Tanaka, 1998). Not to repeat the same mistake efforts were made to have communities stay and move together to temporary shelters when possible. Since the 3.11 earthquake, Japan has never been the same. While no person was untouched by the incident, people with disabilities seem to have been affected the most drastically. Concluding Remarks The current paper details Japanese disability contexts that have been in constant flux between the universality of disability and fluidity of disability terrain. While the cultural or political tendency of being Òtight and collectivisticÓ and the Òequal resultÓ policy set a tone in disability environments, critical incidents noted in this article have drastically transformed circumstances for PWDs. Some events were international (the United NationÕs International Year of the Disabled Person and the Nagano Paralympics Games), while others domestic (the Great Hanshin/Awaji Earthquake, low fertility rate, and the Gotai-fumanzoku phenomenon), and all seemed to have affected the public perception of PWDs and accessibility. Aoi Shiba should not be forgotten, because their struggles and demonstrations in the 1960s opened the door for the Japanese disability movement and left a significant mark. Ableist living environments, with narrow definitions of Ònormalcy,Ó seem to have worked well in JapanÕs Òtight and collectivisticÓ society, which strictly dictates orderliness and stresses efficiency. After all, from an economic standpoint, it was the strict standardization and like-mindedness that resulted in the success of the Japanese economy (Nakajima, 2006). However, this was accomplished at the great expense of compromising diversity, including opinions and bodily configurations; that is, both in the ableism and like-mindedness (or Òtight and collectivistic,Ó to borrow terms from communication studies), diversity is interpreted as ÒnoiseÓ that undermines efficiency and the status quo. Nevertheless, since the 1980s, ableism has been seriously challenged by, for example, the demographic shift, accompanied by the declining birthrate and burgeoning older population. Aoi ShibaÕs protests of the 1960s and 1970s against the spatial architectural apartheid based on ableism is socially warranted today, as more people with or without disability have joined the barrier-free movement. Moreover, the movement in Japan has a spill-over effect especially in other Asian regions because the nation hosts people with disabilities from other countries for leadership programs and international networking (Ohtsuka, 2004). 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Contradictory messages surrounding disability, such as Òhelp the handicapÓ and Òtreat the disabled just like anyone else,Ó leave the non-disabled feeling tense, ambiguous, or uncertain about interacting with a person with a disability (Braithwaite & Braithwaite, 2003). Nakajima (2006) states that the aforementioned intrapersonal conflict creates a barrier when communicating with a person with a disability. 3According to Sugino (1993), around the turn of the 20th century, a group of people with visual impairments first mobilized a political campaign, the so-called blind movement. This movement originated from the need for employment security, which was bolstered by a vertical, master-apprentice occupational relationship; at the same time, this occurrence laid the groundwork for a horizontal, collegial consciousness among people with visual impairments (Sugino, 1993). 4In 1999, ridership at Tokyo Station was 30,174 per year and 2,514 per month. 5In 2000, the long-awaited Oedo line began operating a forty-kilometer loop railway circling outside of the Imperial Palace in the heart of Tokyo. This railway system was built to embody the philosophies of Òaccess for allÓ and the Transportation Accessibility Improvement Law. Eight months after its opening, more than 1700 wheelchair users were using the line every month and about 34 per 10,000 users are people using wheelchairs (ÒOedo-sen,Ó 2001). More importantly, the Ministry of Land, Infrastructure and Transport reports that the opening of the Oedo line has not only improved lives of PWDs in general, but also stimulated consumer activities of the elderly and PWDs; increased transportation means employment, a decreased burden on family members and station employees, and changed mind-set of PWDs ((ÒOedo-sen,Ó 2001). 6Ripple effects of these implementations by the UN seemed to have been felt in other world regions. The German Disability Movement was born at this time (Kobsell, 2006). 7The English title of this book is No One Is Perfect. 8Within a communication framework, Iwakuma (2003) discusses circumstances surrounding the Ototake phenomenon. 9In Japan, people wash outside of the bathtub. 10This Òfolding strollerÓ regulation has been changing, and increasingly in recent years, public transportation, such as buses and trains, allows unfolded strollers (ÒHirogare,Ó 2007).