When the first group of potential nurses and caregivers arrived from Indonesia on Aug. 7 as part of a new economic partnership agreement (EPA) with Japan, the numbers were confusing. According to the agreement, Japan would accept 500 workers in the first year and facilities throughout Japan said they wanted to hire a total of 400. But Indonesia managed to solicit about 300, and only 200 arrived at Narita Airport.
A Yomiuri Shimbun article stated that one of the reasons for the lower head count was that more than half the applicants who passed the tests required for selection were men, and at least 66 of them were unable to secure employment with hospitals or nursing care facilities in Japan before the departure date. In Japan, male nurses are not much in demand.
Apparently, they aren’t considered as photogenic as female nurses, either. Forty percent of the arriving Indonesians were men, but TV reporters who met the group at the airport talked to the women. Print media published comments from both genders, but the photographs only showed females. Maybe it’s reading too much into the coverage, but the visual emphasis on the feminine, not to mention the repeated use of adjectives like “kind,” “cheerful,” and the ubiquitous “smiling” to describe these women, conveyed the impression that they were Florence Nightingales coming to Japan with the purest charitable intentions to comfort its aging population.
No doubt these young people want to help, but that isn’t the reason they came. They want to earn more money and gain experience. However, the reasons for the Japanese government’s acceptance of the workers is more conflicted. The finance ministry sees it as a means to conclude an EPA with Indonesia. The welfare ministry sees it as a partial solution to the problem of Japan’s lack of caregivers. And the justice ministry considers it a test case to see how foreign workers can be imported without upsetting the social order.
Japan wanted an EPA with Indonesia so that tariffs on Japanese goods would be lifted, but there are almost no tariffs on the small amount of Indonesian exports to Japan (coffee, for instance), so the only concession Japan could make was to accept a small amount of workers. As with Filipinos, thousands of Indonesian emigrants send money home, mostly from Chinese-speaking territories like Hong Kong, Taiwan and Singapore.
In an article published by the Mainichi Shimbun, a representative of the welfare ministry denied that the purpose of the program was to make up for a labor shortage, but the ministry is in a bind. Having reduced its subsidies to caregiving facilities twice since 2003, it has contributed to the shortage, since the already low salaries for professional caregivers have dropped even more as a result. The annual turnover rate for caregivers is more than 21 percent, and some 500,000 Japanese with caregiver licenses choose not to work in the field.
It is estimated that the Indonesians will earn about ¥180,000 a month, which is less than what licensed Japanese caregivers make but almost 10 times what they can make in Indonesia. However, the new arrivals won’t be working right away. They’ll spend the first six months learning the language and the social situation. That training, not to mention the Indonesians’ living expenses, will be paid for by the government and the facilities that have hired them. Thereafter, they will work as “assistants” in those facilities while they study for tests to qualify as full-time nurses and caregivers.
The Indonesians may have a hard time passing these tests since they will be working full-time doing things like emptying bedpans, bathing patients, and cleaning rooms. Mainichi estimates that a facility will spend ¥10 million per worker over the period of a worker’s visa — three years for a nurse, four for a caregiver — an investment it will lose if the worker doesn’t pass, since he or she will then have to leave the country. Yuko Hirano, an associate professor in Kyushu University’s medical department, told Mainichi that she thinks many will leave before then.
That’s because they will be doing work they are overqualified to do. The EPA condition for nurses is that they be licensed in Indonesia and have more than two years’ experience. There are no caregiver licenses in Indonesia, so caregivers are required to have at least three years of higher education, but most of the caregiver applicants are licensed nurses, too. These conditions were made by Japan’s nurse and caregiver associations, which are opposed to the acceptance of Indonesian workers. They believe that the working situation for all nurses and caregivers must be improved first. Even the Indonesian Nurses Association has opposed the deal, since they realize that the nurses will basically be hospital orderlies.
The EPA has no serious long-term vision. Asahi Shimbun put the matter into perspective by comparing the Indonesian EPA to a proposed EPA with the Philippines, which has so far rejected the Indonesian model. Some 18,000 Filipino nurses and caregivers go overseas every year to countries like Canada and the US, where they are accepted as professionals right away, and not just because they speak English. While the Philippine nurses association acknowledges that Japanese language ability is essential if its workers go to Japan, it also believes the conditions for acceptance shortchange their abilities.
According to Kinyobi magazine, a lot of Filipinos already work as caregivers in Japan. They are residents who are either married to Japanese or came with visas for other types of work and stayed. They do what immigrants have always done: filled those jobs that natives no longer want. They hold no licenses and many can’t read Japanese, but they work hard. Not surprisingly, they’re all women, but for some reason nobody wants to interview them or take their picture.