Given the serious shortage of medical and nursing care workers and nurses, lifting certain restrictions so qualified foreigners in these fields can apply their skills in this country is an obvious solution.
In its fourth basic immigration control policy plan compiled late last month, the Justice Ministry stated it would reexamine the mandatory limit on the length of time foreign nurses and dentists can work in Japan when they hold residential status.
Even if non-Japanese qualify to work as a nurse or dentist after passing state exams, they are not permitted to work here for more than seven years and six years, respectively. A four-year limit is imposed on public health nurses and midwives.
Many foreigners with such qualifications desire to continue working in Japan beyond the set limits. Their aspirations are rightful in view of the fact that they have passed national exams and conquered the Japanese language barrier.
The limits on working years for non-Japanese were mostly probably introduced out of concern that Japanese might be deprived of working opportunities. The restrictions have been criticized as excessive for years. The time limit for foreign doctors was dropped four years ago.
Speed up ordinances’ review
The ministry plans to revise relevant ordinances to abolish time restrictions on all remaining medical professions, including nurses. This is a necessary corrective step. We want the ministry to accelerate its work on revising these ordinances.
The ministry’s fourth basic immigration control plan incorporates a policy to study accepting foreigners in the nursing care field on condition they graduate from universities in Japan and pass state exams.
The population of elderly people requiring nursing care is growing at an ever-quickening pace. The nation has about 1.24 million nursing care workers today; estimates suggest the nation will need almost double that number in 2025.
Meanwhile, many Japanese who have earned qualifications as care workers then opt to work in another field. The physical and emotional demands of a career in nursing care, combined with the low pay, often are too much to bear.
To alleviate the manpower shortage in nursing care, the first step is to improve the working environment for Japanese. However, there is a limit to just how quickly the ranks of Japanese nursing care workers can be increased. Because of this, opening the door to foreign nursing care givers is the right decision.
Remove language barrier
More help also should be extended to the people from Indonesia and the Philippines whom Japan has been accepting as candidates to work as certified nurses and care workers based on economic partnership agreements with the two countries.
National exams for nurses and nursing care workers are dotted with difficult kanji. Last month, 254 foreigners took the exam for nurses, but only three passed.
Indonesian and Philippine examinees have acquired licenses and expertise as nurses and nursing care workers in their home countries. Considering that the pass rate for Japanese examinees stands at nearly 90 percent, the extremely low success rate for foreign examinees can be most probably be attributed to the kanji barrier.
The Health, Labor and Welfare Ministry is reexamining the content of national tests. The revisions include replacing difficult terms with easier ones, such as “jokuso” [褥瘡] with “tokozure” [床擦れ] to mean bedsores.
We welcome this move. But the ministry should go a step further and print kana readings alongside kanji and allow examinees to use dictionaries in their exams.
Nursing
Migrant children struggle in public schools
With the recession taking a particularly heavy toll on migrant communities, many schools for children of Japanese-Brazilian and other backgrounds have closed their doors after struggling through falling enrollments and nonpayment of fees.
The closures have forced many children of migrants to enter the public school system, a daunting prospect for those whose entire schooling has been conducted in another language and who don’t speak Japanese at home.
To help them better integrate into the public school system, the education ministry launched the “Rainbow Bridge classroom” project last fall, providing additional Japanese-language instruction.
But the ministry is struggling to win over migrant parents, many of whom resist the idea of sending their children to Japanese schools.
There were about 90 Brazilian schools across the country at the end of 2008. The number had fallen to around 60 this February. Many parents lost their jobs, leaving them unable to pay their children’s tuition. Others returned with their families to their home countries.
The Colegio Brasil Japao, a Brazilian school in Minato Ward, Nagoya, had 80 students at the end of 2008, but the number dropped to 49 at the end of last year. Each month, 10 to 20 students failed to pay a monthly fee of about ¥30,000, forcing the school to post a monthly loss of around ¥800,000.
“We have tried our best, but there is a limit to what we can endure,” said the school’s principal, Carlos Shinoda, at a January meeting to notify guardians of the suspension of some classes.
None of the parents said they wanted to send their children to Japanese schools.
Yojiro Arlindo Ogasawara, 40, whose three children attend the Brazilian school, said, “If they attend a Japanese school, they will be left behind academically while trying to learn the Japanese language.”
He continued to send his children to the school, even after losing his job, because he said his eldest son had been bullied at a Japanese nursery school, where he was told, “Foreigners are stupid.”
Many guardians are worried that their children will be treated only as “guests” in public school classrooms unless they know the Japanese language.
“Enrolling in Japanese schools is the last resort,” said a 38-year-old mother. “I would like to continue to send my daughter to a classroom where the atmosphere is warm.”
Thirty-two organizations, including boards of education and nonprofit organizations, were running Rainbow Bridge classrooms in Ibaraki, Gunma, Saitama, Kanagawa, Yamanashi, Nagano, Gifu, Shizuoka, Aichi, Mie, Shiga and Okayama prefectures as of February, to teach Japanese to foreign children. Portuguese lessons are also offered.
“Public schools are given the cold shoulder by foreigners because of experiences and rumors of bullying,” said Akio Nakayama, representative in Japan of the International Organization for Migration, which is promoting the project at the request of the education ministry. “A coordinator at each classroom is visiting families to urge them to take part in the class.”
Besides Brazilians, there are foreign children who can’t attend public schools because they require special assistance, and even if they are enrolled in such schools many refuse to attend.
Although the Rainbow Bridge role in classrooms is becoming increasingly important, Nakayama pointed to the need for schools to do more to assist foreign children.
“In addition to the creation of a framework by Japanese public schools to receive and support foreign children, roles like the one performed by coordinators at Rainbow Bridge classrooms should be institutionalized,” he said.
Such classrooms accept not only Brazilian but also other foreign children.
Indonesians seek flexibility in exam for foreign nurses
Indonesia’s nursing association has called on the Japanese government to be more flexible in the national nursing exam so more foreign nurses can pass it and work in the nation.
Achir Yani, president of the Indonesian National Nurses’ Association, made the call following a recent announcement by the Health, Labor and Welfare Ministry that only three nurses — two from Indonesia and one from the Philippines — passed this year’s exam.
They were among 254 foreigners who took the exam in February and are the first successful applicants. Last year, none of the 82 foreign applicants passed.
Yani said the two Indonesians — Yared Febrian Fernandes and Ria Agustina, both 26 — have proved that “what is impossible is now possible,” referring to how difficult the exam is.
The Japanese-language requirement and technical terms used in the exam are thought to pose a high hurdle for foreign nurses.
“I myself am not satisfied because I know that (Indonesian applicants) are very competent, but the language (requirement) has made them fail,” Yani said.
During an ongoing survey her association is conducting in cooperation with a Japanese university, the professor at the University of Indonesia said the nurses expressed a wish that “furigana,” a kanji pronunciation aid, be allowed.
They also requested four chances to take the exam, instead of three, considering the first opportunity comes only six months after their training.
“So, for sure, they are not going to make it,” Yani said.
She expressed concern that unless the government accepts the requests of the foreign applicants, Indonesian nurses, especially those who have not been recruited yet, will be discouraged.
She also suggested that hospitals in Japan take note of the efforts made by the hospital where Fernandes and Agustina work to support them in their Japanese-language study.
Both women came to Japan from Indonesia in 2008 and are working at a hospital in Sanjo, Niigata Prefecture.
“That can be a lesson learned by other hospitals so their nurses will also be able to pass the exam with the support they have,” Yani said, adding it is her understanding that numerous hospitals in Japan appreciate the contributions of their Indonesian nurses and want them to become registered nurses.
Japan began accepting foreign nurses and caregivers in 2008 to address labor shortages in the medical and nursing service fields.
Foreign nurses are required to return to their home countries if they fail to pass the nurse qualifying exam within three years. Caregivers need to clear the qualifying exam within four years.
In talks with Indonesian and Philippine officials in January, Foreign Minister Katsuya Okada promised to consider addressing the language barrier for foreign nurses.
The health ministry is now studying the use of simpler terms in the exam and helping foreign nurses study the Japanese language, officials said.
In the 2008 and 2009 fiscal years through last Wednesday, Japan accepted 277 nurses and 293 caregivers from Indonesia. In 2009, 280 health care workers came to Japan from the Philippines.
Korean worker who sued Tokyo govt retires
Public health nurse Chong Hyang Gyun was all smiles when she retired from the Tokyo metropolitan government recently, even though it had refused to let her seek promotion because of her South Korean nationality.
A second-generation Korean resident of this country, Chong sued the metropolitan government in 1994, demanding she be allowed to take a promotion exam for a managerial post. The trial went on for 10 years of Chong’s 22-year career with the metropolitan government.
Ultimately, Chong was not able to be promoted because the Supreme Court overturned her victory in a lower court. Upon her retirement, however, she smiled and said, “I have no regrets.”
Chong officially retired Wednesday, as she had reached her mandatory retirement age of 60.
Chong was born in Iwate Prefecture. In 1988, she was hired as the first non-Japanese public health nurse to work for the metropolitan government.
Her application to take the internal exam to become a manager was refused, however, because of the metropolitan government’s “nationality clause,” which prohibits the appointment of non-Japanese employees to managerial posts.
The Tokyo District Court decided against her in 1996, ruling that the metropolitan government’s action was constitutional.
In 1997, the Tokyo High Court ruled that the metropolitan government’s decision violated the Constitution, which guarantees the freedom to choose one’s occupation, and ordered the Tokyo government to pay compensation to Chong.
The metropolitan government appealed this decision and in 2005, the Supreme Court nullified the high court ruling and rejected Chong’s demand.
After Chong openly expressed her disappointment at a press conference about the Supreme Court ruling, she received critical e-mails and other messages. Chong also said she sometimes felt it was hard to stay in her workplace.
However, a sizable number of her colleagues and area residents understood her feelings.
“I was supported by many people. I enjoyed my job,” Chong said.
For two years from 2006, Chong worked on Miyakejima island, helping residents deal with difficulties resulting from their prolonged evacuation.
Just before her retirement, Chong visited health care centers in Tokyo and other related facilities as chief of a section for preventing infectious diseases and caring for mentally handicapped people.
She was rehired from April as a nonregular employee at her workplace’s request, but she will work fewer days.
“I’ve been tense ever since filing the lawsuit, trying not to make any mistakes in other areas. Now I can finally relax,” Chong said.
Chong recently has been interested in supporting Indonesian nurse candidates in Japan. During the New Year holidays, she held a gathering to introduce them to Japanese culture.
“Now that a greater number of foreigners are in Japan, society as a whole should think about how to assimilate them,” Chong said.
She said she believed her lawsuit has helped raise those kind of questions.
1st foreign nurses pass national exam
Two Indonesians and one Filipina have become the first foreign nurses to pass Japan’s national nursing qualification test after work experience at Japanese hospitals under economic partnership agreements, the health ministry said Friday.
The three are among the 370 foreign nurses who have visited this country under an EPA-related project launched in fiscal 2008, hoping to pass the nursing exam after receiving Japanese-language training and gaining working experience under the supervision of Japanese nurses.
In 2009, 82 foreign nurses took the exam, but all failed. This year, 254 such nurses applied for the test, with the two Indonesians and one Filipina passing it, according to the Health, Labor and Welfare Ministry.
The Indonesians came to Japan in August 2008, and both work at a hospital in Niigata Prefecture. The Filipina, who arrived in Japan last May, works at a Tochigi Prefecture hospital.
Foreign nurses who come to this country under economic partnership agreements are required to possess nursing qualifications in their own nations. After taking language training, they seek to pass Japan’s nursing test while working as assistant nurses at hospitals in this country.
They are required to pass the test within three years of arriving in Japan. For foreign nurses who came to Japan in fiscal 2008, next year’s exam will be the last opportunity to qualify as nurses in this country.
Foreign nurses wishing to gain qualifications in Japan are required to take the same exam as Japanese applicants. Technical terms used in the test pose a hurdle for them in accomplishing their aim, observers said.
This year, about 90 percent of Japanese applicants passed the test. This figure stood at only 1.2 percent for foreign nurses who arrived in Japan under the EPA program.
To rectify the situation, the ministry is considering replacing technical terms with easier-to-understand language in next year’s exam.
More language help neededIt is essential to improve the current Japanese-language training system for foreign nurses seeking to pass this nation’s nursing qualification test under the EPA project, observers said.
Foreign nurses take six months of language training after coming to this country. However, nurses at Japanese hospitals that host them, as well as volunteers who work to aid them, have complained that they have been left to teach the foreign nurses practical Japanese needed for their work at medical institutions.
It is also necessary to ensure foreign nurses are fully trained in using Japanese before arriving in this country, while also increasing the number of opportunities for them to take the national exam, observers said.
In fiscal 2008, the first batch of 98 foreign nurses came to Japan under the EPA program, including the two Indonesians who passed this year’s test. If anyone from the group fails to pass next year’s exam, he or she must return home.
If no one from the first group–excluding the Indonesians–passes the test, it means most foreign nurses in the group must return home despite their three-year work experience at Japanese hospitals.
Such a scenario could reduce the EPA project to an empty slogan. Still, foreign nurses must be able to communicate their ideas in Japanese to doctors and patients. This presents the greatest dilemma for the EPA program, according to observers.
With this in mind, the government should consider corrective measures, including an improvement in the Japanese-language training system for foreign nurses and an extension of their stay in this nation, observers said.
http://www.asiaone.com/News/Latest+News/Asia/Story/A1Story20100328-207241.html
Foreign trio clear nursing exam hurdle
Two nurses from Indonesia and one from the Philippines cleared Japanese-language requirements and passed the national nursing exam in February, the Health, Labor and Welfare Ministry said Friday.
The three, who are among 257 people in Japan under free-trade agreements with Indonesia and the Philippines, will be allowed to stay in Japan indefinitely.
The three were the first applicants to pass Japan’s nursing qualification exam among hundreds of foreign nurses in the country under FTAs.
The two Indonesians, who have been in Japan since 2008, are working at a hospital in Sanjo, Niigata Prefecture.
The Filipino nurse has been working at a hospital in Ashikaga, Tochigi Prefecture, since arriving in Japan last year.
Japan, a rapidly aging society, began accepting foreign nurses and caregivers in 2008 due to domestic labor shortages in medical and nursing service fields.
Foreign nurses are required to return to their home countries if they fail to pass the nurses exam within three years. Caregivers also need to clear Japan’s qualifying exam within four years.
None of the foreign nurses passed last year’s national exams held in February 2009 because, it is thought, kanji and technical terms used in the exam pose a major challenge for foreign nurses.
In talks with Indonesian and Philippine government officials in January, Foreign Minister Katsuya Okada promised to consider addressing the language barriers for foreign nurses.
The health ministry is currently studying using simpler terms in the exam and helping foreign nurses study the Japanese language, ministry officials said.
In the 2008 and 2009 fiscal years through this month, Japan accepted 570 health care workers from Indonesia — 277 nurses and 293 caregivers.
3 foreigners pass tough nursing exam
Two Indonesians and one Filipina have become the first among hundreds of applicants from their countries to pass Japan’s state nursing examination, the health ministry said Friday.
Yared Febrian Fernandes and Ria Agustina, both 26 from Indonesia, and Lalin Ever Gammed, 34, from the Philippines, were among 47,340 people, including Japanese, to pass this year.
The three are the first successful applicants from Indonesia and the Philippines since Japan began accepting nursing applicants in 2008 and 2009 under economic partnership agreements (EPAs).
The examination is conducted in Japanese, and 251 other would-be nurses from Indonesia and the Philippines failed this year’s test.
There were 82 applicants from Indonesia last year. None were successful.
Indonesians and Filipinos who are qualified as nurses in their home countries can only work in Japan in limited trainee nurse roles and must pass the state exam within three years. Failure means they have to return to their home countries.
The two Indonesians are training at Sannocho Hospital in Sanjo, Niigata Prefecture. They told a news conference that they were relieved and happy to pass.
Gammed is at Ashikaga Red Cross Hospital in Ashikaga, Tochigi Prefecture.
Fewer foreign trainees at hospitals
The number of Japanese medical institutions and other entities accepting Indonesians and Filipinos training to qualify as nurses or caregivers in fiscal 2010 will fall sharply compared with the current fiscal year.
Language problems apparently proved to be an insurmountable barrier for some.
According to the Japan International Corp. of Welfare Services, only 62 entities plan to accept 142 Indonesians from April 1, the start of fiscal 2010.
In fiscal 2009, 194 entities accepted 467 Indonesians.
As for Filipinos, 82 entities plan to accept 179 workers in fiscal 2010. That compares with 444 Filipinos at 175 entities in fiscal 2009.
Personnel at hospitals and other facilities say that training foreign nationals with a limited command of Japanese is difficult and takes up too much time.
The system to accept Indonesian and Filipino would-be nurses and caregivers was introduced in fiscal 2008, with a total of 850 trainees arriving.
Even as population shrinks, Japan remains wary of immigration
Much of what you need to know about Japan’s long-standing attitude toward immigrants is summed up in the logo of the nation’s official immigration agency: It depicts a plane departing, rather than arriving.
But today the country faces a demographic crisis, one that some here believe will finally compel a traditionally homogeneous Japan to turn that plane around and let foreign workers come. The population is aging and shrinking — a formula for economic calamity and social stagnation. Over time, there will be too few workers to care for the millions of elderly citizens, grow food on farms or fill the manufacturing jobs that drive this export-led economy.
Given the forces of history and culture, the notion of a multiethnic Japan may seem impossible, a tautology in a country where nationality and ethnicity are fused to the point of being nearly indistinguishable. Yet a multiethnic Japan is what the country needs to become if it is to survive among the top tier of the world’s powers.
Japanese leaders have tried other options, and failed. For two decades, Japan’s stubbornly low birth rate has barely budged, despite many government incentives for couples to have more children. The new left-leaning government’s recent move to boost per-child monthly cash payments to families will be cripplingly expensive and probably unsustainable. (It’s also unlikely to convince women, who are marrying later or not at all, to have more children with Japanese husbands who remain allergic to sharing child-rearing duties.) The result could be a working-age population cut nearly in half by midcentury.
So, can the Japanese shed their traditions and allow more foreigners in their midst? On a recent trip, I was struck by the range of people I encountered — government officials, politicians, bureaucrats, business representatives, demographers and others — who argued that the nation has little choice but to do just that. Unfortunately for the Japanese, it appears unlikely that they will do so in time, or at the pace needed, to reverse the population declines.
To some extent, the notion of Japan as ethnically homogenous is not exactly right. For years, the country has admitted increasing numbers of foreign workers, without fanfare, as officials have tried to plug holes in the workforce. The number of nonethnic Japanese residents has crept upward in the past few decades and now stands officially at 2.2 million — about 1.7 percent of the population.
Starting with more than 650,000 Koreans, a legacy of Japan’s occupation of the Korean Peninsula from 1905 to 1945, the country has also taken hundreds of thousands of Chinese, as well as tens of thousands of Vietnamese refugees, Filipino and Indonesian nurses, African workers, and others. In addition, about 500,000 Brazilians and Peruvians of Japanese ancestry have been allowed into the country since 1990, many of them to work in manufacturing plants.
The presence of these immigrants could be seen as the beginning of a revolution, or at least evolution, in Japanese attitudes toward foreigners. In Yokohama, Japan’s second-biggest city, I spoke to the director of a nursing home who recruited a pair of Indonesian nurses two years ago. The Indonesians — bright, able, outgoing and full of laughter — were among the most popular members of the facility’s caregiving staff and had set an example for what the director called their “standoffish” Japanese colleagues. The director shook her head in sorrow at the likelihood that the Indonesians would be unable to remain in the country unless they passed a tough licensing exam, given only in Japanese. “They have injected new life into this place,” she said.
At city hall, officials proudly displayed brochures with instructions for garbage separation and recycling — available in Japanese, English, Vietnamese, Chinese and Portuguese. “The big inflow of foreigners, Chinese and others, has changed the mind-set of Japanese here,” said Osamu Yamamoto, who oversees interethnic policy in the city of 3.7 million people.
However, a 2001 U.N. report found that just to maintain its population of about 125 million, Japan would have to permit average annual net migration of 381,000 people for 50 years — more than 17 million immigrants in that span. And to keep its working–age population at 1995 levels, the country would need 609,000 migrants annually, also for 50 years, or more than 33 million immigrants in all.
That’s not going to happen; Japan may be changing, but at nowhere near the rate necessary to save itself. The country, which is likely to be overtaken this year by China as the world’s second-largest economy, seems to have made its choice.
The Democratic Party of Japan, which won last summer’s elections, has plenty to say about population decline, but the word “immigration” appears nowhere in its manifesto. And the government has taken an enforcement-only approach toward immigrants and foreign workers, rounding up undocumented workers for deportation but making no attempt to develop a coherent vision of whom to admit and how to accommodate them. “The biggest crisis,” an official at the Japan Business Federation told me, “is that the government has no sense of crisis.”
In public, the habit of describing a racially homogeneous Japan is deeply ingrained. In 2005, then-Foreign Minister Taro Aso hailed the country as “one nation, one civilization, one language, one culture and one race.” A senior official in Tokyo put it to me more simply: “This isn’t America. When we go to the hospital to have a baby, we know what we’ll get: black hair, dark eyes, skin more or less the color of mine.”
Indeed, Japan has hardly offered a welcoming environment to its imported workers, with treatment ranging from shameful to barely tolerant. Koreans, brought to Japan decades ago and often against their will, were granted citizenship, only to see it revoked after World War II. Although several generations have been born and have died in Japan, most are not naturalized citizens, nor can they vote. Vietnamese, thousands of whom began coming to Japan as refugees after the Vietnam War, remain scarcely assimilated; even if they grew up here and speak Japanese, intermarriage is rare.
Truong Thi Thuy Trang, 39, came to Japan from Vietnam as a boat person at age 12 and has spent much of her life in Yokohama, just south of Tokyo. An interpreter for a district office of the city government, she earns a decent living and has the confident air of a refugee who has made it. But her greatest aspiration for her 11-year-old daughter is that she leave Japan, preferably for Chicago or New York, where she has relatives.
“What troubles me a lot, and what I talk to my daughter about, is how she can be proud that she’s Vietnamese and enjoy a standard of living on a par with her Japanese peers,” she said. “I don’t think it’s possible here.”
Mention the Brazilians, and Japanese complain about parties (too loud) and clothing (too skimpy). Mention foreign students, and you hear the story of a provincial university that, facing complaints from neighboring farmers who feared the newcomers would steal their crops, built a separate dorm for the students and surrounded it with barbed wire.
Mention Vietnamese or Chinese, and you get an indictment of their alleged failure to respect rules governing trash removal and recycling (those multilingual brochures notwithstanding). In Yokohama, where the foreign population has more than doubled over 20 years, to 80,000, a municipal official gave me chapter and verse on the local garbage wars. “I need to take someone else’s trash into my home to sort it!” Noryoshi Sato complained.
Some Japanese seem embarrassed by their country’s hostility to foreigners. At a news conference in Tokyo last month, officials presented plans to resettle Burmese refugees now living at U.N. camps in Thailand; they will be among the first refugees Japan accepts in years. The officials described language and vocational training to help assimilate the first 30 refugees. Then a Japanese television reporter stood and asked to be recognized.
“The more they know about Japan, the more these refugees might not want to resettle here,” he said. It sounded more like a statement than a question.
http://www.washingtonpost.com/wp-dyn/content/article/2010/03/12/AR2010031201790_pf.html
Guiding hand for Indonesian nurses
Program helps hospital ease assimilation for newcomers
Cultural barriers faced by Indonesian nurses who come to this country to work are gradually being lowered, but the government has yet to help the Japanese hospital staff adapt, according to Keio University professors who recently launched an in-house training program to teach the employees how best to welcome the new additions.
Staff at Saiseikai Yokohamashi Tobu Hospital in Kanagawa Prefecture received training earlier this month from Naomi Sugimoto, a professor of communications studies in Keio’s faculty of nursing and medical care, prior to the arrival of two Indonesian nurses last week.
“The government runs training courses for the Indonesian nurses, but I saw that there was no training for the Japanese staff who are taking them in,” Sugimoto said. “The fact that hospitals are accepting foreign employees for the first time means that their staff have never worked with foreigners, so they are very nervous.”