The language barrier and unfamiliar workplace environment pose daily challenges to the 205 Indonesian nurses and caregivers who began working at hospitals and nursing facilities nationwide about a month ago.

But because they will need to pass special exams in three or four years to stay on, there has been little excuse to slack off.

Mohamad Yusup, 27, and Erli Ridwan, 35, who started work Feb. 16 as nursing aides at Kawakita General Hospital in Tokyo, always carry a dictionary in case they need to check the meaning of a Japanese medical term and are still learning how to communicate with their Japanese coworkers and patients.

“I learn new Japanese conversational terms every day. Nurses at the hospital teach us a lot about life in Japan,” Yusup said. He and Ridwan started studying Japanese after arriving in the country last August.

The two men, who both worked in hospitals in Jakarta, are among the first nurses and caregivers to participate in a program under a bilateral free-trade agreement.

Under the accord, Japan plans to accept 600 caregivers and 400 nurses from Indonesia over a two-year period. The arrangement is expected to bolster the ranks of short-staffed medical and nursing services as the population rapidly ages.

Although the two nurses have finished a six-month Japanese language program, kanji remain a challenge. To help them cope, hospital staff have attached simplified “furigana” kana readings next to the characters and show the pair pictures of medical instruments to help them memorize the Japanese names.

Tomoyo Mizumachi, a nurse in charge of mentoring the two, said, “We are anxious because we know we should teach them accurate Japanese and also the philosophy underlying the Japanese way of nursing care.”

Ridwan said Japanese patients are generally older than their Indonesian counterparts, and he admitted being perplexed at first at having to wash patients and change their diapers. In his home country, he said, family members usually stay at hospitals and take care of those tasks.

Danta, 28, who does not have a family name, and Nurma Eksita, 23, have been working since Feb. 2 at Shin Tsurumi Home, a nursing facility in Yokohama. They also found it initially difficult to assist the elderly properly.

“I learned how to communicate with child patients in Indonesia, but it is my first time to provide care to the elderly. I’m learning about that every day,” Eksita said.

She completed her nursing science studies in her home country.

Emiko Nakashima, a senior official at the nursing home, acknowledged that daily conversations in Japanese are still a bit beyond the two Indonesian caregivers, but their “genuine smile” and “attentive attitude” are appreciated by the elderly patients as well as the rest of the staff.

The Indonesian caregivers basically receive the same salaries as newly recruited Japanese. The Kawakita hospital and Tsurumi home also provide them with various kinds of support, including rent subsidies, donations of furniture and electric appliances, and translation services by outside volunteers.

The two male nurses and Eksita are Muslims. They are allowed to pray during their breaks in rooms set aside for that purpose, according to staff at the hospital and the nursing home.

The host facilities are eager to help the Indonesians prepare for the national language exams and make time for them to study, because if they fail to pass the tests within three to four years, they have to return home under the terms of the accord.

Although Indonesian nurses will have the opportunity to take the annual exams three times within three years of their arrival, caregivers can only take the test once, because the exam requires candidates to have three years of work experience as caregivers.

Yusup and Ridwan said they took the first exam in February but will probably fail this year because they had trouble understanding Japanese questions written in kanji.

“I didn’t understand the meaning of the Chinese characters, but am confident that I understand what was being asked in the exam. Next year, maybe I can correctly answer 50 percent of the test and eventually pass it within three years,” Yusup said.

Supporters of foreign medical and welfare workers have called on the Health, Labor and Welfare Ministry to attach furigana readings to multiple-choice questions written in kanji, but the ministry said that at present it would be difficult to give special consideration to non-Japanese candidates.

Kimiko Suzuki, who supervises Danta and Eksita, is optimistic that the two will pass the exam. Although the pass rate for the national caregiver qualification is about 50 percent, many Japanese applicants usually start preparing for it some six months ahead of time.

“They have already started preparing and still have plenty of time,” she said.

Nakashima of Shin Tsurumi Home said the Indonesians will need to break through the language barrier to provide proper care, but having a sincere attitude in dealing with the elderly is more important than language.

Danta said even if she does not understand what nursing home residents are saying, she will “just stand by them to offer them comfort.”

“Sometimes, even Japanese staff cannot communicate well with the elderly. The most important thing is ‘heart,’ regardless of nationality or language,” Nakashima said.

She said the facility decided to accept non-Japanese caregivers because it believes that sooner or later, Japan will see an influx of workers from overseas to make up for the inevitable coming shortfall in the nation’s labor force.

“The number of people who need nursing care is going to increase sharply, but Japan does not have enough people to support them. Unless we accept many foreign workers, in 30 years it will be a luxury to be taken care of by Japanese women, and we may have to depend on nursing robots,” Nakashima said.

Under an FTA with the Philippines, up to about 450 Filipino caregivers and nurses are scheduled to arrive by early May. Tokyo is set to accept 1,000 Filipino workers over a two-year period.

The second batch of Indonesian workers, up to about 800 nurses and caregivers, will arrive around November.

It is unclear whether Japan will receive more Indonesian and Filipino workers beyond the two-year period, because both the Japanese Nursing Association and the Japan Association of Certified Care Workers claim the government should prioritize preventing Japanese workers from leaving their jobs.

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