With growing numbers of resident foreigners and surging tourist arrivals, the nation is increasingly looking at the problem of medical care getting lost in translation.
This fiscal year, the health ministry began offering to subsidize the cost of English, Chinese and Portuguese interpreters at certain hospitals nationwide.
They provide a vital link when accurate information might mean the difference between life and death.
One example is that of 49-year-old Chinese translator Guo Jingyi, of Rinku General Medical Center in Izumisano, Osaka Prefecture.
In early August, Guo helped out when Xie Dandan, an expectant mother, came to the obstetrics and gynecology department to consult a doctor about her pregnancy.
“I feel nauseous and vomit every time I eat,” the 25-year-old resident of the city of Kishiwada said in Chinese.
Guo translated her comments into Japanese for the doctor. She then translated the doctor’s advice for Xie, who was told to drink lots of fluids and eat whenever she can.
Xie said she learned about the language assistance service at Rinku after trying a hospital in her neighborhood and finding she couldn’t communicate.
“(Here) I can be at ease because they will answer even the most trivial of my questions,” Xie said, smiling.
Language assistance is vital to patient and doctor alike.
Kaori Minamitani, head of Rinku’s department of international medical care, said that although she can speak some English and Spanish, “the interpreters are indispensable in order for us to make accurate diagnosis and to ensure that the patient comprehends.”
Rinku is the designated emergency hospital for Kansai International Airport. It has 65 registered interpreters, both volunteers and paid.
Those who are paid receive ¥5,000 a day plus reimbursement for travel.
Minamitani says the program should be expanded to ensure reliable access to interpreters.
“We need a system that offers even better pay — and guarantees their status,” she said.
Japan had about 2 million foreign residents at the end of 2013, according to Justice Ministry figures, and foreign tourists topped 10 million last year, according to the Japan National Tourism Organization.
The Health, Labor and Welfare Ministry recognizes the growing need to cater to people who don’t speak Japanese. This fiscal year it launched a project in which it subsidizes half of the cost of providing interpreters of English, Portuguese and Chinese at 10 hospitals across Japan.
The ministry plans to have 30 such hospitals available by 2020, when Tokyo hosts the Summer Olympic Games.
At the municipal level, the Tokyo metropolitan government began providing language training for nurses and other hospital staff this year.
At English classes taught by native speakers, topics include how to instruct patients to fill out medical papers and describe their symptoms.
In mid-August, one session at the Tokyo Metropolitan Hiroo Hospital drew eight participants, including nurses and pharmacists. They used role play to practice handling patients who show up without an appointment.
Their lecturer, an Australian, told them that gestures can improve communication.
Interpretation in the medical field requires not only accomplished language skills but also quick thinking to deal with different situations.
To help interpreters improve, Yokohama-based nonprofit MIC Kanagawa, which outsources interpreters to medical institutions, holds seminars every two months in various languages.
Kiyoshi Takayama, a member of the group’s secretariat, said the basic rule of interpretation is to convey what is said in its entirety “without adding, without subtracting.”
For cases that require special expertise, such as conveying cancer diagnoses or explaining a complicated surgery, more experienced interpreters are dispatched.
Yoshihiro Noguchi, 67, a Portuguese interpreter at the Rinku hospital, said that when he was working in Brazil a long time ago, a medical student helped him when his child fell ill. This prompted him become a medical interpreter — despite his aversion to the sight of blood and initial lack of medical training.
Noguchi says he tries hard to avoid misinterpretation, and to achieve that he always acquires a detailed explanation from the doctor when it comes to technical terms.
“I do get nervous,” he said. “But it feels great when being thanked.”