(CEGLOS 30th Anniversary Book Talk Series / Graduate School of International Relations, University of Shizuoka)
In April 2021, Foreign Nurses Working in Japan: Assessments of the EPA Program was published by the University of Tokyo Press.
About half of this academic work’s contributing authors are Indonesian and Filipino researchers with nursing licenses who have conducted medical/welfare fieldwork in Japan. Another feature of this book is its multifaceted approach to research in order to gain a more comprehensive understanding of the actual state of the EPA program. It covers nursing, the social sciences, cultural anthropology, and economics, amongst other fields.
To celebrate its publication, an online book talk was held on 10 July 2021 (sponsored by the Center for Global Studies, Graduate School of International Relations, University of Shizuoka; funding from the Toyota Foundation). The ninety-minute online program featured the editors, Professor Yuko Hirano of Nagasaki University and Associate Professor Michiyo Yoneno-Reyes of the University of Tokyo (at the time of the book’s writing; currently a professor at the University of Shizuoka), as well as contributing authors. Each participant presented the research they had carried out. This research included the background to the conclusion of EPAs, the EPA Japanese language education system, specific issues faced on the ground, and the economic burdens on host hospitals.
This article presents the voices of three of these speakers. They are licensed nurses from the Philippines and Indonesia.
Cultural differences on the ground in nursing
Cora Añonuevo, a former professor at the University of the Philippines’s College of Nursing who has also been in charge of the Professional Regulation Commission’s Board of Nursing in the Philippines, presented her findings based on interviews with six Filipinos who passed the Japanese national examination. After describing how the EPA nurses she interviewed were grateful for the generous support, she presented several issues that need to be resolved by the countries involved.
First, the time spent on work and study varies depending on the prospective nurses’ host facilities (hospitals, etc.). There is a strong sense of unfairness among candidates, and the length of study time and support provided leads to actual differences in pass rates.
The content of the work of EPA nurses (candidates) has become the subject of discussions by the Philippine Nurses Association and others since the conclusion of the country’s EPA with Japan. Under the current system, nurses are not allowed to work as nurses until they pass the national nursing examination in Japan, and this has been seen as a problem in that they cannot fully utilize their specialized knowledge and skills. However, Professor Añonuevo also made clear that when they assume the responsibilities of a full-fledged nurse after passing the national examination, the EPA nurses often find themselves at a bit of a loss due to the differences in nursing practices between Japan and the Philippines. The Japanese language skills required to pass the written national nursing exam and the Japanese language skills required for nursing work are also very different. Professor Añonuevo emphasized that nurses and hospitals say Japanese language education should continue even after passing the national exam.
Another issue: career paths
Professor Añonuevo also pointed out that EPA nurses cannot clearly envision their career paths in Japan. Similar issues were pointed out in the presentation by the ASEAN-Japan Centre’s Katrina Navallo.
For EPA nurses aiming to build a career in Japan, in addition to learning advanced Japanese, another obstacle is the Japanese government’s strict policy against family migration. If a married EPA nurse continues to work in Japan after passing the exam, they will have to decide where to make home―whether to continue living apart from their family in their native country or to bring their family to Japan. However, work restrictions are placed on spouses who come to Japan, making them effectively unable to find a full-time job. Such a system ends up being a barrier to continued life in the country, where living costs are high.
Also, there are many other factors faced by EPA nurses of child-rearing age, such as insufficient multicultural education programs in Japanese schools and family members being unable to stay for long periods to help with child-rearing. Professor Añonuevo argued, “So that EPA nurses can come up with clear career paths, and for other reasons as well, we need to address these multiple obstacles one by one.”
Theresia Maria Toji Pio (from Indonesia), who passed the national exam as an EPA nurse and is now working at the Akanekai Medical Corporation’s Nakashima Tsuchiya Clinic, was also one of the speakers. She gave a presentation in fluent Japanese on her impressions after reading this book while incorporating stories about her struggles due to language barriers and cultural differences. Although she described the period before passing the national exam as “the most difficult time in my life,” she also said with a smile, “Certification is just the start. I’d like to grow together with all nurses and caregivers of all nationalities.”
This book can be purchased in Japan at the University of Tokyo Press website and online bookstores. Please refer to the following URL for details: