Medical Information

Introduction to Basic Toyama Medical Information

Toyama ken has loads of hospitals, big and small. Traditionally it was the center of pharmaceutical production in Japan. The medical and pharmaceutical university has many doctors who have studied abroad, as well as some foreign doctors. Other large hospitals, especially those in the cities, usually have a few English-speaking doctors, and most doctors in general seem to be able to speak a limited amount of English, even in the smaller hospitals. In Toyama city there are four big hospitals, plus two in Takaoka and one in Kurobe.

Two types of medicine are practiced in Toyama. Oriental techniques include herbal treatments, acupuncture, moxibution (the heat thing), and massage. Most hospitals and clinics practice Western medicine, although you may be a little surprised by some of the procedures.

The number for the Tokyo International Medical Advice Center is 03 5285 8088. They speak really good English and they will research any particular health problems you have and call you back to tell you where the best place in your area is to be treated, the name of the doctor, and opening hours, etc. They are also really useful for advice on vaccinations.

Visiting a Hospital

Don’t worry if people try to persuade you to go to a hospital for things that seem to be quite minor. Most Japanese people will go to a hospital for ailments that you may usually only go to a local clinic for. Use your sixth sense. It has also been said that the smaller local clinics tend to be a bit old fashioned, and the doctors may not have kept up with all the most modern practices.

Wherever you go, you must take your medical insurance card. All JET Programme Participants are covered under “Shakai Hoken” (Public Health Insurance), and have a card. You should carry this card around with you in case you are in an accident and need to be seen in an emergency. Take this card with you whenever you go to a medical facility so that you will receive the proper insurance benefits. If you forget to bring the card with you, just fill out the paperwork there and bring your card to the medical facility at your earliest convenience (you can still receive the same benefits).

When you get to the hospital you will need to fill out various forms (see following form for an English translation!) and you will be given a hospital card (which sometimes looks like a credit card). This will have all of your pertinent information on it and you need to take it every time you visit that hospital. Some JETs advise getting a card made early on in your stay (with the help of a Japanese speaker) so that later on if you have a medical issue that you don’t want others to know about, you can go to the doctor and not have to worry about filling out the initial Japanese paperwork on your own.

Although the staff in the hospitals are generally very friendly and helpful, the receptionists tend not to speak English. If at all possible you should try to take a Japanese speaker with you.

Emergency rooms are not likely to be as private as you are used to. Not all hospitals have Emergency Rooms, and if they do they are not necessarily open 24 hours a day. In Toyama City the 24-hour Emergency Room rotates in some hospitals. In the case of a daytime emergency go to the best hospital you know of in your area.

Always remember to take money with you when you go to a hospital – at least 5,000yen – as well as any previous prescriptions or packets of medicine.

Dealing with a Doctor

You should first try to find doctor who speaks your language (Chuo Hospital has Chinese, German, etc…). In the larger hospitals there are usually several of them and it will save a lot of problems if you can explain the problem in your native language. Often these doctors have studied abroad which tends to make them more receptive of western attitudes towards medicine (this is especially important if your concern is of a sexual nature).

If you are unable to find an English-speaking doctor (or doctor who speaks your language), refer to your JET diary for translation of medical terms and other helpful information. You may find that if you take a Japanese friend with you, they become extremely uncomfortable if you start to question the doctor. This is because in Japan, doctors are held in great respect (they are referred to as sensei). It is sometimes considered rude to question them, but they will not necessarily volunteer information about your condition so you should not feel inhibited about asking questions. Actually, at the larger hospitals, the doctors are well aware of the needs of their Western patients and are more willing to give you any information that you might want. However, if you feel uncomfortable with what is happening, I would suggest that you ignore cultural sensitivity, and ASK!

Often, doctors will prescribe a lot of medication that you may think is unnecessary. Ask if you are unsure what they are for. Some doctors do this as a gesture on every visit, and others because pharmaceutical companies give them a percentage for what they prescribe. Either way, use your discretion about what to take, but remember that if you start a course of antibiotics, you MUST finish it.

You are not obligated to take the medicine that the doctor gives you. You can return anything you do not use on the follow-up visit.

Fortunately in Japan, doctors will give you a thorough examination. At home, some doctors are all too ready to dish out pills and potions by just going on what you said. In Japan, they might hit you with hammers (gently!), squeeze your fingernails, or roll your arms around. You have to accept that although western medicine is widely used here, many old eastern methods are still very popular.

If you have a specific problem then you will get referred to a specialist. If you have a back problem, you see a back specialist or if you suffer from panic attacks you go to the psychiatrist. They have it all.

Staying in the Hospital

If you have to stay in the hospital, there are a few essential things that you should take (check with your doctor):

• Nightwear and robe
• Toiletries
• Towels (several)
• Bed sheets, although you can usually rent the futon and sheets
• Alarm clock
• Plate, cup, knife, fork, chopsticks
• Laundry soap
• Health card, alien registration card, money, phone cards
• Comfort items: books, walkman, teddy bear

When you leave the hospital, you should offer small gifts to the doctors and nursing staff. Sometimes they will not be accepted (some hospitals don’t like to encourage this), but it’s a good plan to offer anyway.

If you visit someone in the hospital you will need to know the visiting hours. Some hospitals don’t have them, but others are quite strict in enforcing them. Good presents to take are sweets and flowers, but DON’T take potted plants as these imply a long stay.

Being sick from school

Unfortunately, most hospitals are only open from 8:30 to 11:30 am. JET participants are all entitled to sick leave (byoukyu) by contract, but contracts differ slightly from person to person, so you should check your contract and consult with your supervisor beforehand. You may need a doctor’s note. (The note has been said to cost money, something like 3000 yen. However, it varies from place to place and my local practitioner does not charge me.)

Often you will find that the school will automatically take paid(nenkyuu) leave from you if you are ill. In the case that you are very ill and must take more than one day from school due to your illness, you can ask them to take sick leave rather than paid leave. Sometimes you will find that they don’t even realize that it is a possibility since the Japanese teachers don’t have an equivalent in their contracts. One way to avoid suspicion is to go into school when you are ill and ask a teacher to take you to the doctor. That way they can see that you are really sick. Some ALTs have been known to even go and sleep in the nurse’s room, so that no one can say that they are not officially at school! You will find that teachers go into school even when they are apparently quite ill. Don’t abuse the privilege of sick leave. A cold is not really a good enough reason for staying away. But, if you really are ill, you are entitled to push for byoukyu rather than nenkyu.

Claiming Back Insurance

If you are a city ALT the city office will take care of this. Otherwise, you should show your insurance policy to your supervisor and they should be able to help you. Basically, you are covered by the government for 70% of the cost, and you will only need to pay 30% at the hospital. If this 30% exceeds ￥60,000, you can apply to the National Health Insurance Program for the amount that exceeded ￥60,000. The Yasuda Fire and Health Insurance coverage is extra and you have to claim that back. You need to keep all your receipts and send them with the claim form to the Company. If your claim is less than ￥50,000 you will not need a doctor’s note, but if it is more, there is a form that the doctor must fill out before you can get your money back. It usually takes about three weeks to be processed.

Here is a tip that you can use for your medical insurance.

You can use your medical insurance card for medical treatments that you have outside of Japan!　So if you are back home or in another country and go to the doctor and receive medical treatment you can use your insurance to get 70% of what you paid for your medical treatment back. Just remember bring a receipt and medical statement back with you to Japan. However, this refund does NOT include regular check ups.

Seeing a Doctor from a Woman's Perspective

If you have a gynecological problem, don’t worry. Japanese gynecology is advanced and up-to-date, and despite popular belief, you can get hold of the low dose contraceptive pill here as well, though you will find that very few Japanese women visit a gynecologist regularly. You may find that your normal doctor doesn't do gynaecological stuff, so you'll need to go to a bigger hospital or a special women's clinic and see someone there.

Don't hesitate to ask questions or speak up if you feel you have not been understood, and you can request a female doctor. Once again remember that the approach will be different to that in the West, and this might lead to some frustrations. If you do need to visit a gynecologist you probably won’t have to tell your teachers exactly what is wrong, unlike if you just had a cold, or had broken something. The word gynecologist (fujinka), is usually enough to satisfy them.

If time and location allow it, the Toyama University Pharmaceutical Hospital would be my first recommendation as there are many English-speaking doctors there. On my visit to this hospital, the staff went out of their way to help me, and to put me at ease. They understand that going to see the gynecologist is difficult at the best of times, let alone in a foreign country. They required a lot of information about me and my general health, I had to fill out a questionnaire beforehand, which was examined and discussed in depth when I saw the Doctor. The consultation was lengthy, but it was complete.

The gynecology department at the pharmaceutical University hospital is open on Mondays, Wednesdays and Fridays, from 8:30am to 12:30pm. If you don’t manage to phone in advance, just get there as early as you can, and expect to wait.

Additionally, there are a number of “Ladies’ Clinics” scattered across the ken. You can get checkups and the pill at ladies’ clinics, and some of them are staffed entirely by women. However, it’s not guaranteed that you will find an English-speaking doctor since these are often private practices. Ask your regional rep or the PA for suggestions.

If you can, have someone phone the hospital in advance to let them know when and why you are coming, and that you’ll need to see someone who can speak English (if possible).

If you want the pill, it’s best if you take along an old pill packet, instruction book or prescription, so that they can give you the closest match.

It may be necessary for you to obtain the morning after pill during your stay here in Japan. You can get this pill at the gynecology department at most General Hospitals (Sogo Byouin). It is very helpful to take someone who is fluent in Japanese with you or have them call the hospital ahead to avoid any confusion as to what you are looking for.

Getting tested for HIV, AIDS, and STIs

You've probably noticed that Japan has somewhat of an open attitude to sex... the HIV/AIDS awareness campaign has also been stepped up in recent years as the infection rates have begun to rise. To this end, the government has set up a testing programme throughout Japan.

The HIV Kensa site (http://www.hivkensa.com/index.html - in Japanese) has more information about the special testing facilities that have been set up. Unfortunately our nearest one is in Nagano.

However, most public health facilities should offer testing which can be entirely anonymous if you want it to be. They can also test for other STDs. If you contact the PA system we can find the nearest one to you. However if you don't want to talk to us about it, you can try to contact clinics yourself and see if they offer the tests you need. You could also get in touch with the JET Line/ AJET Peer Support Group (see the PA counselling contacts page) if you want help anonymously.

There are TWO different methods of HIV/AIDS testing available:

The ELIZA Test

The doctor will take a blood sample for this test, and it is very cheap. (I believe THIS is the test that is offered for free.) One important thing to keep in mind, however, is that there is a HIGH rate of FALSE POSITIVES. It is somewhere in the neighborhood of 15%. Please keep this in mind, because there is a significant chance of error should the doctor tell you your result came back positive.

In this case, the doctor should suggest a second ELIZA test. If this comes back negative, no worries. If it AGAIN comes back POSITIVE, then the doctor will most likely have you take a different test, the Western Blot Test.

The Western Blot Test This is much more accurate, although it is expensive and commonly NOT covered by JET insurance. This test is usually done in the event of previous positive-result tests with a high margin of error (ELIZA).

Hopefully you'll never need to use this information, but it's best to be prepared. Be careful and don't take any risks.

(Test information taken from a guide from the Tochigi PA)

Emergency Interpretation Service

Call the Emergency Interpretation Service in Tokyo if you need emergency medical interpretation in English. Operating hours are Monday-Friday from 9am to 8pm. TEL: 03 5285 8185

Medical Vocabulary

This is by no means exhaustive, but below are a few words that may help you out in a crisis. For a more comprehensive list - please check out your JET Diary. It has a huge list of medical terms in english, romaji and kanji - so if there's a communication breakdown you can show it to your doctor!

Eye doctor (optician) – ganka

Dermatologist – hifuka

Gynecologist - sanfujinka

Dentist – shika

Shot　(injection) – chuusha

~ check-up/exam - ~ shindan

Medicine – kusuri

Hurts – itai

Doctor – isha, ~sensei

I feel bad – kimochi warui (also means “gross”)

Bone – hone

Head – atama

Stomach – onaka/ i

Cold – kaze

Fever – netsu

Fracture – kega

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