MANILA – Filipino nurses and caregivers already in Japan under the bilateral economic partnership agreement and those to follow need more support, not just to help them pass the Japanese license exam but also to encourage them to stay permanently.
Academic and industry experts from the Philippines and Japan say that while much is demanded from candidate health workers, the governments of both countries, other agencies and Japanese health institutions have a responsibility to help achieve the agreement’s objectives in Japan’s employment of Filipino nurses and caregivers.
At a recent symposium titled “Migration of Filipino Nurses under the Japan-Philippines Economic Partnership Agreement (JPEPA): Trends and Challenges” at the University of the Philippines, Keizo Takewaka of the Japanese Embassy in Manila acknowledged “much more” improvement is required in the program’s implementation even after the introduction of enhancement measures over the last few years.
“It’s still a work in progress,” he said.
So far, only 15 nurses and one caregiver have passed the license exams since 2010 even though nearly 240 nurses and 400 caregivers have gone to Japan since 2009.
Miyoko Miyazawa of Eisei Hospital in Tokyo, which accepts Filipino nurses and caregivers, said during the symposium that as part of preparations for the transfer of Filipino health workers to Japan, educational institutions in both countries should collaborate to make Japanese courses more available in the Philippines, allow exchanges of instructors for better appreciation of each country’s health care practices and conduct joint training.
Miyazawa stressed the importance that both sides understand each other’s sociocultural context, especially in health care, so it will be easier for Japanese society to adapt to the reality that Japanese patients are being treated by Filipino nurses and caregivers.
The same goes for the Filipino health workers, who have to adjust to the Japanese health care system and practices.
Miyazawa said Japanese have a perception of Filipinos being “unconscious” of time, being used to longer periods of leave from work and sending money to their families.
A Filipino nurse assigned to Eisei Hospital in 2009 who passed the license exams in 2012 helped them understand these Filipino characteristics.
“The Japanese must address how to accept such elements of the Philippines to utilize the competency of Filipino nurses effectively in a Japanese context,” Nagasaki University professor Yuko Hirano said.
Conversely, Filipino health workers need to adopt the Japanese way of assisting patients by spending more time at their bedside, among other issues, Miyazawa said.
“Filipino nurses must understand the cultural and social environment of Japanese society as well as their workplace,” Hirano said. Even so, Japan has to “respect the effort of foreign nurses in trying to understand Japan and contributing to Japanese society.”
It would also motivate candidate nurses and caregivers to take Japan more seriously if, aside from the predeparture language program, they are assured of government support to become permanent residents.
“The Japanese government needs to establish a comprehensive migration policy, including the predeparture language program and granting more attractive citizenship (including visa) options to foreigners (who pass the exams) and their spouses,” said Shun Ohno, a professor at Seisen University.
Cora Anonuevo of the University of the Philippines said Filipino nurses “may decide to remain in Japan if they have relatives who could provide psychosocial support.”
In Japan, Filipino health workers have to have constant support from their superiors, Japanese coworkers and the Japan International Corporation of Welfare Services for their continuing study of the Japanese language, actual training in their respective facilities about the Japanese health care system when they are about to take the license exams, and for their living and training conditions, the experts said.
“Japanese employers are required to show a clear picture of the future, a brighter life, including promotion to higher positions, if they wish to employ (Filipinos) for longer years,” Ohno said.
In her conversation with the Filipino health workers, Anonuevo learned that some of them find it difficult to adjust to nursing aide tasks in Japan such as feeding, bathing and assisting in the toilet needs of elderly patients, as well as “distributing tea to patients, dusting, wheelchair repair, changing of diapers, mopping and toilet cleaning,” since they are already professional nurses with at least three years of hospital experience in the Philippines.
Miyazawa said there might also be a need to consider extending the maximum length of Filipino health workers’ stay until they pass the license exams from three years to five or seven years if they so wish and also allow returnees to take the exams in the Philippines.
“For nurse candidates who are not able to pass the national examination, there must be a safety net so they are not immediately sent home after failing the third time. Giving them a fourth chance should be a possibility in case they opt for it,” Anonuevo said.
“At the more supportive health care facilities, Filipino nurses are highly motivated to study, pass the exam and work in the care facilities as long as possible,” Anonuevo said.
Those who have passed the exam have seen changes in the way they are treated, aside from additional compensation benefits.
Citing Japan’s aging population and the Philippines’ production of health workers, the experts said there is no room to scrap the program and it has to be made better in the coming years, despite the absence of a model elsewhere in the world from which it could take pointers.