Finding suitable child care facilities is a daunting task for most working families in Japan, but when it comes to children with severe medical problems and disabilities, the options are virtually nil.

With a growing number of mothers working full time, the Tokyo-based nonprofit organization Florence has for the last decade offered a helping hand to parents who can’t take their children to a regular day care center.

But last September, Florence went a step further by establishing a specialized day care center that accepts children with disabilities and medical problems with special needs, becoming the first such institution using the national public child care benefit system.

The day care center, located in Suginami Ward, Tokyo, is called Helen — after the deaf and blind activist Helen Keller, who advocated for people with disabilities.

“About two years ago, we received an inquiry from a woman living in Tokyo’s Setagaya Ward who was having difficulty finding an institution that would accept her child,” said Michiro Morishita, manager of Florence’s Special Needs Childcare Division.

Morishita said he tried to help the woman find a place for her child, who has severe health problems requiring full-time care, and allow her to return to work after using up her child care leave.

“In such a big city like Tokyo with more than 12 million residents, we couldn’t find any institution that would accept just one child with a severe medical problem,” Morishita told The Japan Times in an interview.

The lack of such services is a major reason mothers with disabled children are forced to quit working. According to a 2009 survey by the Health, Labor and Welfare Ministry, 70.8 percent of women with disabled children exit the labor force entirely and focus on caring for their offspring, while only 5 percent of them worked full time.

“We wanted to help create a society where all children, regardless of their health condition, are given a chance to receive equal educational and growing opportunities . . . and parents can choose whether to focus on child-rearing or to continue working,” Morishita said.

Suginami Ward was the only municipality that offered financial support for establishing such a facility, he said.

Helen provides full-time care for children with severe motor and intellectual disabilities by handling special needs such as feeding by tube, helping with respiration devices and urinary catheters.

“Such care can only be provided with support from nursing and therapeutic staff,” Morishita said, adding that Helen’s two permanent staff nurses help differentiate the center from other day care institutions.

Children being cared for at Helen include those who are slow in developing mobility or other functions. All staff have been trained to work with children with such disabilities.

“But since Helen is a day care institution, we focus on doing fun things, such as reading for children or paper puppet performances,” Morishita said.

He stressed, however, that Helen’s education policy is mainly based on a movement education and therapy program, which focuses on awareness of the human body in movement.

“It supports children with developmental disorders but can be equally enjoyed by children with or without disabilities,” Morishita said.

Although Helen looks like a normal day care center geared for healthy children, he said the institution, which prioritizes safety, is prepared to provide the utmost care.

The institution is located near two large hospitals, providing quick access in the event of an emergency.

Children undergo medical checkups by a doctor who visits Helen every two weeks. The ratio of staff to children is 1-to-2.6 for kids who do not require special medical care and 1-to-1 for those who do.

Before Helen was established, such services simply were not available for parents working full time, Morishita said. There is also a lack of official financial assistance for caregivers to provide such services.

Morishita stressed that services such as those provided by Helen not only enable mothers to continue working but also help disabled children interact with people outside their family, because without such facilities children would have to spend all of their time with their mothers.

Offering a chance to gain social skills is a key factor in child-rearing, Morishita said. “This program also encourages those women who were not thinking about entering the labor force to do so.”

Florence has been told by mothers of disabled children that they never imagined having a chance to plan a career and balance it with motherhood, Morishita said.

“It offers them hope,” he said.

Florence is also preparing to introduce services in February for parents working part time who need child care for only a few hours a day or a few days a week.


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