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The government's lame-duck policies towards the homeless are not heavily criticized and may be explained by the fact that homelessness is not widely recognized or discussed by the citizens of Japan. "There are almost no written material or television broadcasts on the plight [of the homeless] and the average Japanese may have no knowledge about the existence or scale of the problem," he said. This is because homelessness, culturally, is a sort of "taboo."
Society labels homeless men as shakai no haji, or the embarrassment of society: they are the failures, the ones that cracked under the pressure of the Japanese corporate system, the ones that couldn't make it or chose to take the easy way out. The homeless are shameful, and rather than dealt with, are ignored.
The homeless men themselves feel this shame too. When Higuchi is asked why he did not move back to Fukushima to live with his wife and daughter, he looks down and replies that he has not spoken to them since he became homeless. "I'm already ashamed that I can't support them. How could I live with the shame of burdening them further?"
In a country infused with deep-rooted patriarchal customs, it is disgraceful for a man to fail to be the daikokubashira, the big black pillar, and financially support his family.
Shame is what dictates the lives of these men. They stop keeping in touch with their families. They choose to remove themselves from the eye of the public by living under bridges and in the back of public parks. They even go as far to isolate themselves from mainstream society by forming their own communities -- villages of exiled, blue tarp tent-dwellers in places like Yoyogi Park. This behavior only perpetuates the ignorance of most citizens, and perhaps politicians, who are unaware of the scope of the problem.
Although these isolation methods may keep these men from continuous humiliation, it cannot keep their health from deteriorating. Not surprisingly, Higuchi and other homeless cannot afford adequate healthcare with the little money they make. As a result of old age, limited diet, and harsh living conditions, many homeless have chronic diseases including hypertension, asthma, and gastritis. There is also an extremely high occurrence of tuberculosis; the TB rate among the homeless men is 870 per 100,000, a rate higher than countries like Cambodia and Zimbabwe, says Taku Nishimori, a primary health-care worker in Osaka. This shockingly high rate of TB, among other problems, is what Doctors Without Borders teams have been dealing with in Japan since they launched their initiatives with the Osaka homeless in 2004. That the presence of the organization Doctors Without Borders is typically associated with disease-ridden developing nations further attests to the grave situation of the homeless in Japan.
The medical doctor, nurse, social worker, and logistician administrator who make up the Doctors Without Borders team were able to consult over a thousand homeless people in 2005 by canvassing parks throughout the country. Although the organization has attempted several times to establish a fixed clinic, discrimination against the Japanese homeless is fierce and widespread, and the organization's attempts have been met with "continual opposition from some of the local communities and authorities," resulting in failure, reports the organization. Although all Japanese citizens are granted universal healthcare in theory, the rules and requirements of the Japanese national healthcare system exclude most of Japan's homeless.