|Women's health care is one aspect of life in Japan that many
non-Japanese women find difficult. It tends, unfortunately, to be a "hit
or miss" proposition, with some happy with the services available. Others
are not as impressed.
The overriding concern for non-Japanese women residing in the Osaka area is to
find a gynecologist or obstetrician willing to provide information as well as
medical services. While the idea of "informed consent" (telling patients
of the risks of and alternatives to any treatment) has been adopted by the Japanese
medical community, many of the 28 women asked to evaluate women's health care
services in Japan felt that too little information was available.
"Nobody wants to talk about things like 'pap smears,' 'birth control,' or
even 'breast cancer,' " one woman said. "It's like they believe that
if you don't mention it [a problem] it won't happen. But I was raised to feel
that it was better to ask and find out because you're the one that has to make
Even women who considered themselves as having a good command of Japanese, those
in Japan for seven or more years, reported frustration in getting information
about their own health care.
As one woman reported, "Japan may have a law that says doctors must give
out information, and get consent for treatment, but it hasn't done much."
The solution, for many, was to find an English-speaking physician. However, this
is not always a viable option. Non-English speakers, and those living in less
urban areas, reported the greatest frustration with health care.
In addition, women from Asian countries (Korea, the Philippines, and Malaysia)
reported experiencing negative attitudes from some physicians. One woman, married
to a Japanese, said that when she visited a local clinic, the doctor suggested
she would be happier with another clinic. "He made me feel as if I were a
Attitudes and lack of information are not the only concern. Women also commented
on such issues as the Japanese Ministry of Health and Welfare's decision to approve
use of Viagra, a treatment for male impotency, only six months after the drug's
maker applied for approval. In contrast, tentative approval for the low-dosage
birth-control pill was finally given by the Advisory Board in June, 1999, more
than a decade after its application was filed and nearly 40 years after it became
"My doctor seemed shocked
when I first asked about it [the pill]," said one woman. "It was just
a lot easier to import a year's supply than go through the hassle here. And I
certainly didn't want the high-estrogen pill, anyway."
Reports from various news organizations indicate that the pill will be approved,
but not covered by National Health Insurance, in late summer or fall of 1999.
The women interviewed said the delay in approval was primarily a gender-issue.
"It doesn't seem strange to me," said one woman. "Look at the composition
of the Ministry [of Health and Welfare]. It's a bunch of middle-aged and old men.
They are not that interested in giving women any sort of power over their own
The government's arguments that approval of the low-dose pill would decrease already
low birth rates or increase sexually transmitted diseases (STDs) are contradicted
by the evidence, one woman pointed out. Rates for gonorrhea and chlamydia (two
STDs) have increased in Japan but decreased the United States, where the low-dosage
pill is available. In addition, U.S. birth-rates remain higher.
Lack of adequate education is the major reason for this. According to one woman,
whose Japanese husband is a physician, "There is a great deal of description
about 'sex' and 'sexuality' available, look at the manga [comics], but not much
about 'sexually transmitted diseases,' 'birth control' or controlling your own
Overall, those interviewed felt that lack of education and information is the
greatest challenge facing women, regardless of nationality, seeking adequate health
care in Japan.
As one respondent said, "Everyone would benefit if more women, especially
Japanese women, knew about their health care options."