Kay Fukuda & Aiko Humaguchi
Japanese American Nurses
This story begins with this photo of nurse Kay Fukuda, photographed by renowned landscape photographer Ansel Adams in 1943. After three months documenting the lesser known stories of nurses of color through this project, we received this photo via email along with the question: “Do you know this nurse?” As we approached Asian Pacific Heritage month, we bookmarked her name and began scouring the internet — yet, nothing. We then searched academic databases — and again, nothing.
While looking to reveal the story of Kay, we also came across powerful images of nurse Aiko Hamaguchi (below), also photographed by Ansel Adams and also in 1943— again, the internet provided no further biography about her that we could find, nor could academic databases. While our search left us empty-handed for any information about their personal or professional lives, we found out the circumstances around how these nurses met this renowned photographer and we will share the context with you here, as it further reveals why little is known about them.
Note: The rest of this story details Japanese internment camps and a brief history of Japanese American nurses during World War II. Please take a moment to pause, breathe, and discern if you should continue reading at this time or return when you are more prepared to confront this painful history of our country.
History of Manzanar & Japanese Internment
The photos of these two nurses were taken at the Manzanar War Relocation Center in the Owens Valley of eastern California. Now a designated national historical site, it is described by historian Max Page as a place-based example of injustice — a site of conscience which serves to memorialize the more than 10,000 Japanese Americans and Japanese immigrants ineligible for citizenship and who were held there, imprisoned, concentrated, and interned behind barbed wire through the end of World War II.
Within two months of the bombing of Pear Harbor, President Franklin Roosevelt issued the executive order in February 1942 to authorize the Secretary of War to relocate and intern Japanese Americans among 10 inland camps across California, Arizona, Wyoming, Colorado, Utah, and Arkansas. This totaled over 120,000 Japanese, about 60% of which were citizens. During this same time there was never incarceration of U.S. residents who traced their ancestry to Germany or Italy, America’s other enemies.
According to the National World War II Museum: “Families were given only a few days to dispose of their property (or their homes, farms, businesses, and most of their private belongings were otherwise lost forever) and report to temporary “assembly centers,” where they were held until the larger relocation centers were ready to receive them. Living conditions in these makeshift camps were terrible. One assembly center established at Santa Anita Park, a racetrack in southern California, housed entire families in horse stalls with dirt floors.” Loyalty tests were also conducted and those supposedly more loyal to Japan over the U.S. were sent to their own camp to mitigate dissidents.
The Manzanar camp was under martial law following a riot/uprising that left two dead (17 and 21 years old) and nine who survived their gunshot wounds. Following the riot/uprising, a strike was also held that temporarily closed the schools. Half of the camp’s population were comprised of children and teens — infants, school-age children, and young adults, not yet of voting age. Efforts to maintain normalcy are documented in the establishment of newspapers, markets, schools, gardens, and even police and fire departments, while high school students had their own band, sports teams, clubs, and activities like senior prom, yearbook, and student council.
December 1944 marked the end of incarceration, during which over 1800 died and $400 million in property is estimated to have been lost by the Japanese. Congress provided $38 million in reparations in 1948 and in 1988, Congress passed, and President Reagan signed into public law that acknowledged the injustice of internment, apologized for it, and provided an additional $20,000 cash payment to each person who was interned which could be claimed through 1998.
Nisei Nurses
According to registration records from the relocation centers, 130 Japanese nurses entered the camps as interned citizens and were then “relied on and exploited” (Smith, 1999; cited in sources section at the end) across the camp locations to provide healthcare staffing for the 120,000 interned occupants. While 70 midwives were documented on registration records, none were permitted to practice except for pre or postpartum care and all 6,000 babies born in the camp were delivered in the camp hospital without midwife support.
Smith’s research on nurses during this period (the only we could find), describes how the relocation center and internment camps offered white nurses supervisory positions, some of them doubling their salary from previous employment and working in better equipped facilities, while other white nurses refused to work in any capacity that would aid the health of the Japanese and accused nurses who did so as traitors. These nurses worked alongside Japanese nurses, healthcare workers, and Ivy League educated Japanese surgeons who received virtually no pay.
When healthcare shortages began to increase outside the camp due to the healthcare providers joining the war efforts, the interned Japanese healthcare workers who received FBI clearance were able to leave the camps — thus leaving a staff shortage at the camps. While three camps were reported to hire Black nurses to fill the shortage without issue (a first in the segregated healthcare system and nursing profession at that time), the majority of the white directors of the healthcare facilities refused and instead worked to train the interned Japanese in various roles.
World War II marked the first time women gained increased access to serve in the military, as advocated by Eleanor Roosevelt. The areas of service opened to white women and some women of color (limited by quotas) included the Women’s Army Corps, Army Nurse Corps, and Cadet Nurse Corps. In February 1943, these corps began accepting Japanese American women — a year after the establishment of internment camps across the country. Nisei is a term used to distinguish American-born Japanese from Japanese immigrants. Nisei women were actively recruited from the internment camps with the promise of a 30-month free education so long as they provided nursing services for the duration of the war.
Even though the cadet nurse corps was recruiting them, there were still instances of nursing schools refusing to admit them as students due to the anti-Asian bias at that time, while others traveled thousands of miles to attend training. Smith (1999) states that “by 1944 at least thirty, and perhaps as many as seventy-five, nursing programs had agreed to accept Japanese American women” in the Midwest and East, some at institutions where Black nurses were still prohibited from working or studying themselves. It is estimated that 350 Japanese American women served in the cadet corps — including Kay Fukuda, photographed above.
Toward the war’s end it is estimated that nearly 500 Nisei women served in the military overall, though scholars have only recently begun to reveal this history over the last decades. While Nisei men who were serving in the military were segregated to their own Japanese American units, there were not enough Nisei women to form their own unit and thus, were integrated with the general white nurse corps. This was not the same for Black nurses who, despite finally being admitted to serve, were segregated to their own unit, primarily stateside, and relegated to care for Nazi POWs. Due to the implementation of quotas, Black nurses comprised about 500 nurses to 59,000 white nurses despite over 9,000 applying.
While decades of nursing integration have occurred since the end of World War II and post-Civil Rights, remnants of this past linger. Nurses who were recruited and educated from the camps were able to use the skills of their new profession long after the war. The Asian American Pacific Islander Nurses Association (AAPINA), established in 1992, lists five state chapters, including Arkansas — one of the locations of the 10 internment camps. In a 2018 co-authored paper by Dr. Inouye, a founder of APPINA, a “bamboo ceiling” persists in nursing leadership despite the larger proportion of Asian Americans now working in the healthcare/professional work force today.
Through Their Lens
The information we gathered to learn about these nurses was more retrievable on the photographers of Manzanar themselves than on the people they photographed. Of the photographers who captured the internment camps, two were assigned/invited by the War Relocation Authority and two, Jack Iwata and Toyo Miyatake, were themselves interned.
Dorothea Lange, known for her depression-era portrait of Migrant Mother, wrote to Ansel Adams about the impact of her experience after the War Relocation Authority captioned her assigned photos to create an upbeat, positive narrative: “I fear the intolerance and prejudice is constantly growing. We have a disease. It’s Jap-baiting and hatred. You have a job on your hands to do to make a dent in it — but I don’t know a more challenging nor more important one. I went through an experience I’ll never forget when I was working on it and learned a lot, even if I accomplished nothing.”
Affected by Dorothea’s words, Ansel’s photographs aimed “to depict the people there as Americans no different from those living outside the camps.” Adams took four trips at his own expense and was permitted to freely photograph what he saw — with the stipulation that he wouldn’t capture the barbed-wire fences or guard towers. States curator Anne Hammond:
He came to Manzanar to present his own kind of propaganda (not the government’s), in a documentary style: that the Japanese Americans in the camp were hard-working, acculturated Americans, who deserved the respect of their fellow American citizens — since they were at this time leaving the camps to find places back in the community…Adams wrote extensively of his hope that other Americans would welcome the Japanese Americans back once they were released from the camps.
Adams published his photographs in a book in early 1944 titled Born Free and Equal: Photographs of the Loyal Japanese-Americans at Manzanar Relocation Center, Inyo County, California in an attempt to more widely disseminate his images. Later that year they were displayed at the Museum of Modern Art (though they retitled the collection Manzanar), as well as to those featured in the photographs who were still interned at the camp. He donated the collection to the Library of Congress in 1965, which is the site where the sender of the email inquiry had first come across Kay Fukuda’s image and sent it to us. His letter with the collection stated: “The purpose of my work was to show how these people, suffering under a great injustice, and loss of property, businesses and professions, had overcome the sense of defeat and dispair [sic] by building for themselves a vital community in an arid (but magnificent) environment … All in all, I think this Manzanar Collection is an important historical document, and I trust it can be put to good use.”
Did Kay or Aiko continue to serve as nurses after the internment camps were closed? Were they nurses prior to going to the camps or because of being there? These are questions we so far cannot answer. Should you know more about either of these nurses photographed, please let us know at nursesyoushouldknow@gmail.com and we will incorporate any new information or insight.
Author’s Note This story was hard. My middle name is from my great-grandmother who had come to America while her family endured the Holocaust in Krawkow, Poland. In witnessing American culture over the decades, I know that hate is random, cyclical, and arbitrary. The hatred and othering that resulted in Japanese internment to today’s rise in Asian hate crimes felt almost inseparable as I researched and wrote. My close friends, peers, and colleagues are first generation Americans whose families immigrated from Taiwan, China, Vietnam, and the Philippines. Many times I had to pause and walk away from the research because of the visceral impact this had on me.
This project exists because we never learn these stories in nursing school. Our curriculum is incomplete if it is only about clinical practice and not the culture, history, and politics in which we work and live. Inclusive nursing history must become part of our nursing narrative for this generation of students if we are to ensure that we don’t repeat the mistakes, silence, and exclusionary practices of the present and past. A diverse nursing workforce that reflects our population only enhances nursing’s potential to innovate, mitigate health disparities, and advances the health of our nation. Our voices matter — when our profession stays silent around discrimination, racism, extremism, gun violence, police brutality, health disparities, maternal mortality, access to healthcare, voter suppression, immigrant rights, and the recent laws against trans youth, we are being complicit.
For nurses to advocate for our shared humanity, we too need to be treated as humans — not heroes. How we treat ourselves and each other, how we advocate for patients and communities, how we serve as change agents in a profit-driven broken healthcare system, and how we correct our professional narrative to embody a more truthful, inclusive history are necessary and urgent. As I write this during nurses’ week, days from Florence Nightingale’s 201st birthday, and within the Year of the Nurse & Midwife 2020-2021, it is evident that our profession’s forthcoming centuries cannot be beholden to the constrained ideas that founded our past.
Achieving a more inclusive profession starts with our education — and with consciously uncoupling from Nightingale’s Victorian-era ideals of obedience, whiteness, selflessness, subservience, and segregation that places nurses towards the bottom of the healthcare hierarchy where we are expected to be submissive and silent. Nightingale is not the only thought leader in our field and it is past time to more deliberately include their voices in our professional narrative. If there was ever a time to speak up and reimagine nursing from the ground up, the time is now.
Sources
Open access sourced for the information above are included in the embedded hyperlinks within the story. The following article, however, was accessed from a university database and proved highly valuable:
Smith, S.L. (1999). Women Health Workers and the Color Line in the Japanese American “Relocation Centers” of World War II. Bulletin of the History of Medicine 73(4), 585–601. doi:10.1353/bhm.1999.0190.
Learn More
To learn more about inclusion in nursing and be part of the national discussion to address racism in nursing, check out and share the following resources:
Know Your History
- Nursing CLIO to engage with historians and scholars committed to deep work around historical accuracy in healthcare and nursing.
- American Association for the History of Nursing to attend monthly webinars on topics of nursing history, view the calendar here.
Examine Bias
- NurseManifest to attend live zoom sessions with fellow nurses on nursing’s overdue reckoning on racism or to sign their pledge.
- Breaking Bias in Healthcare, an online course created by scientist Anu Gupta, to learn how bias is related to our brain’s neurobiology and can be mitigated with mindfulness.
- Revolutionary Love Learning Hub provides free tools for learners and educators to use love as fuel towards ourselves, our opponents, and to others so that we can embody a world where we see no strangers.
Support & Advocate
- National Coalition for Ethnic Minority Nurse Association to stay engaged with topics relevant to nurses of color.
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