This document provides a summary of a workshop on advocating for yourself in the Japanese healthcare system. The workshop covered: an overview of Japan's universal healthcare system; why doctors may approach care differently in Japan; resources for information and support; the importance of mental health; and a Q&A session. The key messages were to take an active role in your own healthcare, support other women, and maintain gratitude and appreciation when navigating Japan's healthcare system and life as a foreigner in the country.

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

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
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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
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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)
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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
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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
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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.
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✓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/
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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

14. D. Q AND A
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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)

16. E. PERSONAL Q AND A
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