Medical Page

Health Insurance Health Insurance The Government has a health insurance system for all those who are not members of private health insurance organizations. There are three categories of public health insurance (kenko Hoken ���N�ی�) exist in Japan: 1. Employee�fs Health Insurance 2. Health Insurance for Workers in Special Occupations 3. National Health Insurance The first category is divided into government-managed (seifu kansho kenko hoken ���{�Ǐ����N�ی�)�@and those managed by health insurance societies. Those Japanese and foreign residents who are employed by a government agency (ie most JETs) are enrolled in the government managed plan which is handled through the Prefectural Social Insurance Office. Those not eligible for categories 1 and 2 such as exchange students, may apply for National Health Insurance (kokumin kenko hoken �������N�ی�). Those whose visas are less than a year are not eligible for National Health Insurance. All JETs are enrolled in a government managed plan and are given a card to be used whenever visiting a hospital or a doctor. If you have dependants, they must have their names included on your health insurance card. The moment you walk into a doctor�fs clinc or a hospital you should present this health insurance card. Failure to do so, will mean that you will have to pay the full amount of consultant/treatment before you leave the clinc or hospital. The card covers about 70% of the total cost, you will have to pay the remainder in cash. Sometimes you may need to go to the chemist, in which case you also present your insurance card, and you will need to pay the remainder 30% in cash. Keep receipts as JETs also have private health insurance which will reimburse any outlay for consultantions/treatment and medicines. Dependants are not included in your JET private insurance, so you will have to cover 30% of all treatment and consultations from your own pocket.

Health Care Centres There are many clincs and hospitals in Okinawa, and virtually all of them are affiliated with the National Health Plan. Most people don�ft make appoints, they tend to turn up. They are usually open from 9am till 5pm, Monday through to Saturday. Most of the larger hospitals have emergency wards open 24hours. With smaller clincs a word of caution, sometimes you may come across doctors who are not very good. I would suggests that if problems persist after two visits got straight to a hospital.

Visting hospitals Allow a few hours for a hospital visit, as they make take x-rays, blood tests, cardiovascular scans, etc, the results of which may take up to two hours to come out, during which time you�fll be in the waiting room. Generally when you come in reception will ask you to fill out a preliminary form, which you had back to reception with your insurance card. They will probably give you a thermometer and expect you to take your temperature. The average temperature for an adult is 36.5 C degrees. For a child 37.5 C degrees is considered a mild temperature, 39.5C degrees and above is considered dangerous for small children, and they should be given medication to bring the temperature, or taken to hospital. Make sure that you understand what types of checks the doctor intends to conduct before he/she does them. In regards to x rays, find out what the doctor is looking for, or what sort of blood tests will he/she conduct, etc. One thing that has surprised me about hospitals in Okinawa, (I�fve visited four different ones so far) is that nurses do not wear disposable gloves when giving injections or taking blood samples. Not to say that there is a high probability of catching a transmittable disease, however you should be aware that standards may be different from our home country. If your dependant gets admitted to hospital, be prepared to pay for a fridge to store foods, milk etc (about \100 per day at Naha shi ritsu hospital) and pay for hot water (about \10 to boil a kettle). After you�fve consulted the doctor you will be asked to wait in the waiting room, while the doctor figures out his prognosis. You will be called up to reception and they will give you back your insurance card, and issue you with a hospital card, for you to use on your next visit. They will also give you the bill which you are expected to pay there and then. Sometimes the bill includes medicines, certainly with larger hospitals this is the case and you will be asked to wait for your medication. Switch off your Keitai when you go into a hospital as microwaves interfer with sensitive hospital equipment.

Dealing with Doctors Most doctors have a good technical English vocabulary, but may not be conversant. The average Japanese/Okinawan person does not ask their doctor very many questions, as questions are view as a lack of confidence in the doctor�fs judgement. However, I have found that being passive and not questioning is not necessarily the best way to go. Most doctors are research orientated, and are more concerned with specialist symptoms, rather than practical diagnosis. From my experience by confronting the doctor and asking questions, you will get some understanding of what the doctor is looking for and what sort of tests are required. If you are visiting a hospital or a clinc for a second time you may deal with a difference doctor, if you wish to see the same doctor you saw previously, it is advisable to call before making your visit.

Medicines Japanese medicines are different both in their doses and concentrations. I was very surprised to find out antibiotics were prescribed for only 3 to 4 days, compared with 7 to 14 days back home. You can ask for a longer prescription of antibiotics, as I did during the sixth visit to a hospital with my daughter who had been on this on-off antibiotics, on-off infection cycle for two continuous months. Prescriptions are called SHOHOSEN ����ⳁ@and those to be taken orally come in pills, capsules, liquids or powders. There�fs something about powders, they like to prescribe medicine that form.�@�@If you find poweders difficult to swallow, you can ask for sheets of gelatin paper OBURAATO(�I�u���[�g) which hold the powder, which you then swallow.

Dental Care Unfortunatley, your Health Insurance Card, nor your private insurance covers you for dental work. Dentists in Okinawa are not big on giving out anaesthesia unless it is absolutely necessary. Most foreign residents go to the Adventist Medical Centre for dental work, however there is usually a long wait. Teeth hygiene is an important consideration while in Okinawa, as they don�ft put flouride in the water.

General checkups Each year, your school or your office will conduct a general health check up. The Japanese (so are the Germans apparently) are big on urine testing and you will undergo some form of medical examination. At the extreme end, you'll get x-rays, blood tests, etc, at the very least a urine test. Other considerations such as Pap smears, you need to arrange yourself. In Japan, women under 35 aren't encourage to get Pap smears, however you should have one done once every two years. Pap smears are not free, but you can claim them on insurance. You should take your insurance card with you when you go to a clinc. There are specific clinc's for women.

Hospitals that treat foreigners
Naha Okinawa Kenritsu Naha Byoin 1-3-1 Yogi (098) 853 3111 (Opposite Yogi Park)
Naha Shiritsu Byoin 172-1 Furujima (098) 884-5111 (This has a 24 hour emergency ward) This hospital is also where all vaccinations are done for children, appointment necessary
Izumizaki Byoin 1-11-2 Naha (098)867-2116 (open from 8am-5.30pm)

Itoman Okinawa Kenritsu Nanbu Byoin 870 Maezato (098) 994 0501

Nishihara Rykyu Daigaku Igakubu Fuzoku Byoin (Ryukyu University Hospital) 207 Uehara (098) 895 3331
Adventist Medical Centre 868 Kochi (098) 846 2833 Dentist (098) 946 2834 (They speak English in this hospital, and most of there doctors are trained in the US)

Okinawa City Okinawa Kenritsu Chuubu Byoin 208-3 Miyazato (098) 973 4111

Nago Okinawa Kenritsu Hokubu Byoin 1609 Nago (0980) 52 2719

Counselling Services
Ms. Maxine Randall (Psychotherapist)
903-015207 Uehara, Nishihara-cho, Nakagamigun, Okinawa
TEL: (098) 895 3331
FAX: (098) 895 2966
Languages spoken: English
Insurance: National Health
Comments: Available in emergency

Dr Kazuyoshi Yamamoto (Psychiatrist)
903 0215 Uehara, Nishihara-cho, Nakagamigun, Okinawa
TEL: (098) 895 3331
FAX: (098) 895 2966
Languages spoken: English
Insurance: National Health
Comments: Phone counselling OK, Alcohol dependence, eating disorders, psychotic illnesses, depression, substance abuse, physical/sexual abuse.

Phone services
AMDA International Medical Information Centre
English, Spanish, Korean, Chinese Monday-Friday 9am-5pm
Portuguese Monday, Wednesday, Friday 9am-5pm
Filipino Wednesday 9am-5pm

Osaka (06) 6636 2333
English, Spanish Monday-Friday 9am-5pm
Portuguese, Chinese Please call for information or make an appointment.

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