Deloitte Gen Z Millennial Survey 2024_India_Full length report_.pdf
BWIJ 2018 Dr Flo's Workshop
1.
2. BE YOUR OWN
ADVOCATE
~HEALTHCARE
IN JAPAN~
Workshop Session 2C
February 17, 2018 (13:50 - 14:40)
Florence Orim MD, PhD.
Black Women in Japan
February 17 - 18, 2018
Nanzan University Nagoya, JAPAN
3.
4.
5. “ Give thanks for a little and you will find
a lot.
-The Hausa of Nigeria
6. WHY ARE WE HERE?
1. To get simple, useful tools to advocate for yourself/your family, and
successfully navigate healthcare in Japan
2. To answer personal questions and offer medical support as needed
3. To build communities of “Women supporting women”
Advocate - WHY?
I need to be proactive in my own care - Not leaving my health in Drs hands
• There are barriers to getting the help we need
- Language
- Social differences
• You know your body best
6
7. WHAT WILL WE TALK ABOUT?
A. Japan’s healthcare system: Why (Japanese) Drs do what they
do
B. Resources
C. A word on mental health
D. Q and A
E. Personal Q and A
7
8. A. JAPAN’S HEALTHCARE SYSTEM
Japan has the world's highest level of life expectancy and healthcare standards through a
Universal Health Insurance Coverage system
✓Universal Health Insurance Coverage System (by the government and not Tax)
• Universal coverage - All citizens are covered, all can access healthcare
• Free access - Freedom to choose medical institution
• High-quality, low-cost medical services - Co-payment based on social insurance system
(Patients pay 10%, 20%, or 30% based on age, income; Japanese government pays the rest /70%)
✓ Medical fees are regulated, so cannot be increased randomly
✓ Invalidity benefits (reimbursement for sick leave/salary deductions), insurance for low-income or single-parent
households
✓Allowances: maternity, childbirth, funeral cost, high-cost medical expenses, elderly living and hospital care visits
✓Access to specialist medical care - Zero/short waiting time to see specialists at clinics and referral centers like
University Teaching Hospitals, Research Center hospitals
Average waiting time of patients from time of referral to a hospital until they are treated by a specialist= 8.6 weeks
(2009)
Specialists are easy to find in most neighborhoods/cities
(dentist, pediatrician, gynecologist, orthopedic surgeon, ENT surgeon)
8
9. A2. WHY (JAPANESE) DOCTORS DO
WHAT THEY DO
✓ Medical science is universal
✓ Practice is different from one country to the next
✓ Language, social differences, and even religion
✓ Doctors all over the world are over worked
✓ Pressure to perform - language limitation
✓ Required to give diagnosis at all costs: you may get a grave diagnosis, worst case
scenario - not meant to scare but to prepare you
Tips
✓ Write out/list all your complaints
✓ Go with a friend or interpreter or just use your phone
✓ Request a second opinion
9
10. B. RESOURCES:
✓You - Intuition, listen to your body, ask what do I need?
✓Others - women supporting women, Japanese friends/ colleagues
✓ Information centers
• City hall
• Kokusai center
✓Online directories
• Kikuko’s Website http://kikuko-nagoya.com/html/secondhand-kids.html (God bless her abundantly!)
• English-speaking specialists
• Interpreting services
HIV/STI screening: Nagoya http://www.npo-jhc.com/sakae-kensa/en/index.htm
Tokyo : Tokyo Metropolitan Testing & Counseling Office
3F Minami Shinjuku Building
2-7-8, Yoyogi
Shibuya-ku, Tokyo Tel: 03-3377-0811
10
11. B2. WOMEN SUPPORTING
WOMEN✓Search for what you need- don't give up
✓Expertise varies from hospital to hospital; be
willing to try elsewhere or go to a bigger
hospital even after visits to a private clinic
✓Diagnosis: if you feel uncomfortable get a
second opinion, or third or fourth…
✓Prepare psychologically: get support, go with
a friend
✓Pregnancy - be willing to shop around for
what you want, go and see…
✓Understand that practice differs across
continents - have an open mind
✓ Ask (nicely) - or no one will tell you…
✓Clinical skill some Drs have great clinical skill
but poor bedside manner, others have great
bedside manner but poor clinical skill - you
have the right to choose.
11
✓Drop the notion (Japanese) Drs are… - they
are Drs
✓ Be open to alternative options like therapy
and lifestyle changes
✓ Mental Health - make it a priority
✓ Cultivate a healthy social life
✓ Eat healthy, nurture friendships
✓Focus on the good - its a vicious cycle -what
you focus on is what you get
✓ Be willing to ask questions - reach out to your
Japanese/English-speaking friends married to
Japanese nationals
✓ Choose a positive attitude
✓ Don't take no for an answer - you have
options
✓ When you're ill you may have no energy to
advocate for yourself - call a friend, reach out
12. C. A WORD ON MENTAL
HEALTH✓ Health involves my body, mind and spirit
✓Mental health affects physical health and all aspects of our lives, so you need to take care of yourself
mentally - especially as women
✓ Black women experience life in different ways, intimate partner violence, abuse, emotional, verbal,
financial, work-place, school.
Challenges…
✓Confidentiality
✓Social and cultural bias
✓ Stigma
• Foreign-trained therapists and counsellors within and outside Japan - No language barrier
Domestic violence helplines: Nagoya 052-961-1111, Tokyo:
Adjustment guidance: http://www.adjustmentguidance.com/about-us
Cell phone: 080-9170-8822; email: adjustmentguidance@yahoo.com
Life Matters: http://www.lifematters.jp/about.htm
Cell phone: 090-4163-3392; Email: jillian@lifematters.jp
TELL Help-line: http://telljp.com/
12
13. TAKE HOME
MESSAGE
• Live from a place of gratitude
and appreciation to find your
way through the maze of
healthcare (and life) in a
foreign country
• Take your health into your own
hands, be active not passive -
you have options
• Support other women by
sharing helpful information
15. ACKNOWLEDGEMENTS
1. Melisanda Berkowitz Phd International Liberal Studies
Chukyo University, Nagoya, Japan
2. Sumire Kanda MSc Leader, Seto Ossekkai Project
(Community Volunteer Group)
Advisor, Employment Service
Center for Foreigners
3. Ruth Chibueze MD PhD National Center for Child Health
& Development Tokyo, Japan
4. Maria Vassileva DVM, PhD Department of Biological
Sciences
Nagoya University, Nagoya, Japan
5. BWIJ Organizing Committee
Music: Simi (Owambé)
Good afternoon. Welcome, Thank you for honoring me with your presence.
My theme today is Be your own advocate - healthcare in Japan.We all know where we are - my name is Florence Orim and I will be hosting this workshop.
I’d like to take us back to the process some of us went through to come to Japan. The visa application, anticipation, the expectation, all the preparations. Some of us were even refused visas the first time and had to apply again. Then you got the visa, and the stamp of landing permission and voila - next slide Welcome to Japan.
So in advocating for ourselves and navigating the healthcare system here, I’d like us to connect to that initial feeling of excitement or gratitude, looking forward to new experiences in a new country that we felt when we first got here.
Give thanks for a little …
I’d like us to come from a place gratitude when we look at finding our way and accessing healthcare in a foreign country ‘cos there’s so many challenges and barriers and I believe in the power of gratitude to change outcomes…
So why are we here?
First is to get simple, useful tools to advocate for yourself/your family, and successfully navigate healthcare in Japan.
2. To answer personal questions and offer medical support as needed.
3. Underlying all of this for me is the concept of Women supporting women. In Beyonce’s world girls run the world, but I live in a man’s world and feel honored to work to support women and encourage other women to do the same.
So why advocate when I can just walk into the clinic and see the Dr…
To advocate means to champion to support, to promote - it is not being confrontational. It is being assertive but not aggressive.
I need to Advocate for my health because we must be proactive in finding our way through the challenges that we face. You are actively involved in your healthcare, not leaving it all up to the Drs because you know your body best.
In accessing healthcare in Japan you face the challenges of language barrier and social differences
Be willing to take extra action to get the help you need
I want to give you what you need and what you want to know, I want to know what you need so together we can find a way to navigate this. But first I will discuss the Japan HC system and try to understand why Drs (Japanese) Drs do what they do
Then I will give some resources / tools that will help us on this journey
C. A word on mental health
D. Q and A - there are papers for that no name needed. Ask your questions - anything I will do my best to answer and if I can’t we will find a way/I will get back to you /find someone who can help.
E. Personal Q and A
Japan has the world's highest level of life expectancy and healthcare standards through the universal health insurance coverage system. They must be doing something right…
Universal Health Insurance Coverage System - Financed by the government and not by Tax.
In countries where heath is financed by tax coverage is limited …waiting times of months or even a year to see a specialist. Medical expenses per person are more than double those in Japan.
Universal coverage - All citizens are covered and all can access healthcare
Free access - Freedom of choice of medical institution/Dr./time of visit
High-quality medical services at low cost for example
(In case of the elderly in Japan, the amount paid at a medical
institution is about 40,000 yen if he or she receives 10 million yen of medical services per month.)
Co payment based on social insurance - Patients pay 10%, 20%, or 30% based on age, income etc. - Japanese government pays the rest /70%
Medical fees are regulated so cannot be increased randomly
Invalidity benefits (reimbursement for sick leave/salary deductions), insurance for low-income or single-parent households
Allowances: maternity, childbirth, funeral cost, high-cost medical expenses, living and hospital care visits
Access to specialist medical care
- Zero to Few weeks waiting time to see specialists at clinics and referral centers like Teaching hospitals, Research center hospitals
- Specialists are easy to find in most neighborhoods (dentist, pediatrician, gynecologist, orthopedic surgeon, ENT surgeon)
Drs all over the world go through years of rigorous training, and work very - extremely hard.
Medical science is universal - Drs generally speak the same lingo
There are standard systems and protocols, medical practice is universal,
But there are cultural and social, even religious differences that affect Med care
Doctors all over the world are over worked
Pressure to perform - language limitation
Required to give diagnosis at all costs: you may get a grave (mis)diagnosis, worst case scenario is not meant to scare but to prepare you
Tips
Write out/list all your complaints
Go with a friend or interpreter or just use your phone
Request a second opinion
You - you are your own best resource
Others….Others - women supporting women, Japanese friends/ colleagues
Information centers
City hall
Kokusai center
Online directories
Kikuko’s Website http://kikuko-nagoya.com/html/secondhand-kids.html (God bless her abundantly!)
English-speaking specialists
Interpreting services
HIV/STI screening: Nagoya http://www.npo-jhc.com/sakae-kensa/en/index.htm\
Tokyo : Tokyo Metropolitan Testing & Counseling Office
3F Minami Shinjuku Building
2-7-8, Yoyogi
Shibuya-ku, Tokyo Tel: 03-3377-0811
I “gathered” tips from some lovely women of varying backgrounds - different ages, nationalities, life experience. The one thing they have in common is that they are women who support women in Japan.
Natural birth story - called/visited/interviewed 15 hospitals and found that Nagoya city hospitals have a natural birth policy…
Health involves my body, mind and spirit
Mental health affects physical health and all aspects of our lives, so you need to take care of yourself mentally - especially as women
Black women experience life in different ways, intimate partner violence, abuse, emotional, verbal, financial, work-place, school.
If you are a woman experiencing domestic violence my heartfelt advice is to not talk to friends/family/religious leaders, I guess you would have already done so - seek professional advice - a therapist or helpline people who are trained to handle such issues.
What I need for us to remember is the you live from a …
Drs go through years of rigorous training, and work very hard.
There are systems and protocols, medical practice is universal, same all over the world
