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Saturday, Jan. 28, 2006
ENSURING SUFFERERS GET CARE AMID RISING RATE
Metro interpreters join fight against TB
By ERIKO ARITA
The Tokyo Metropolitan Government has recently begun offering interpreters for Chinese, Korean, Filipino and Thai residents who have come down with tuberculosis.
More than 2,000 people in Japan died from TB in 2004 and the number of non-Japanese sufferers in Tokyo has been rising in recent years, according to the metro government. It wants to ensure people get proper care and help stem the spread of the contagious disease
The metro government is focusing on ethnic groups that figure prominently in government TB statistics.
The number of non-Japanese in Tokyo diagnosed with TB in 2003 was 5.8 percent of total cases, or 235 people, up from 194 in 1998. The figure includes 87 Chinese, 40 South Koreans and 35 Filipinos. Of them, 157 had been in Japan for less than six years.
Metro officials said many of those people cannot speak sufficient Japanese or English to understand their medical treatment and cannot find doctors who speak their languages. Because of the language barrier, many may not seek out or will stop visiting a doctor and will hence not take enough medicine to recover completely.
Early-stage TB is not infectious.
Under the new system, doctors who diagnose TB in people who speak Chinese, Korean, Tagalog or Thai will inform public health centers, which then ask the metro government to provide interpreters and public health nurses, according to Tokiko Kunugi, a public health nurse with the metro Infectious Disease Control Section.
Tagalog interpreter Eri Utsumi went with a 31-year-old Filipino woman Tuesday to Fuchu Hospital in western Tokyo on the first assignment since the program began.
Utsumi "helped me a lot to understand the explanations from the doctor," said the 31-year-old woman, who asked to remain anonymous. "I was worried about my disease. But now I feel all right."
When she went to a doctor alone, the doctor spoke only a little English and it was difficult for the patient to understand him.
Utsumi, a naturalized Japanese born in the Philippines, has been working as an interpreter in various fields here for 20 years. She interpreted when the public health nurse explained about the 13 kinds of medicines the woman needs to take.
The 11 registered metro interpreters have been trained to explain TB treatment and how to deal with people's anxiety about the disease, according to Services for the Health in Asian & African Regions, a nonprofit group based in Tokyo's Taito Ward that recruited and trained them.
Public nurse Kunugi said some of the people infected, including those from China, South Korea and the Philippines, may have contracted TB in their home countries. Several neighboring nations have higher infection rates than Japan.
The immigrants unknowingly may carry TB into Japan, and if they are exposed to a lot of stress, including through hard work, their immune system weakens and they begin to show symptoms of the disease, according to Kunugi.
Unlike other infectious diseases, TB requires a long period of treatment -- between six to nine months, including an average of three months of hospitalization.
TB can be dangerous because some symptoms, including coughing, can disappear in several weeks, and people who do not understand the course of the illness may think they can stop taking their medication, the nurse said.
"We ask the interpreters to contact the patients often and tell them not to stop taking their medicine," she said.
The budget for the interpreter program this fiscal year is 2.5 million yen, according to the metro government. Tokyo is the first municipality to provide interpretations service specifically for TB treatment.
Foreign residents with low incomes and a lack of health insurance often do not go to the hospital because they cannot pay for care, Kunugi said.
But interpreters can play a valuable role because they can explain to sufferers that they are eligible for financial assistance.
Because of the danger to the public, someone with severe TB symptoms can be ordered hospitalized under the Tuberculosis Control Law.
All medical costs for such severely ill people whose households pay 1.5 million yen or less in income tax are covered by the metro and central governments.
In early-stage TB, the governments pay 95 percent of the medical expenses.