MANILA - Filipino nurses and caregivers who have arrived in Japan under the Japan-Philippines Economic Partnership Agreement and those to follow need more support not just to help them hurdle the Japanese license exam, but also to encourage them to live there permanently.
Academic and industry experts from the Philippines and Japan said that while much is demanded from candidate health workers, the governments of the two countries, other agencies and the Japanese health institutions also have the responsibility to achieve the agreement's objectives in Japan's employment of Filipino nurses and caregivers.
At a recent symposium titled "Migration of Filipino Nurses under the Japan-Philippines Economic Partnership Agreement (JPEPA): Trends and Challenges" at the University of the Philippines, Keizo Takewaka of the Japanese Embassy in Manila acknowledged "much more" improvement is required in the program's implementation even after the introduction of enhancement measures over the last few years.
"It's still a work in progress," he said.
Pre-departure training in Japanese language, extended recently from three months to six months, and some changes in the conduct of the Japanese exams have been implemented after the initial deployment of Filipino nurses and caregivers in 2009.
With these, the candidates are expected to learn Japanese fast, boosting their chances then in passing the Japanese exams.
So far, only 15 nurses and one caregiver have passed licensure exams since 2010 even though nearly 240 nurses and 400 caregivers have come from the Philippines since 2009.
Aside from the Philippines, Japan also accepts health workers from Indonesia under a separate agreement.
Miyoko Miyazawa of Eisei Hospital in Tokyo which accepts Filipino nurses and caregivers said in the symposium that as part of preparations for the transfer of Filipino health workers to Japan, educational institutions of both countries should collaborate to make Japanese courses more available in the Philippines, allow exchanges of instructors for better appreciation of each country's healthcare practices and conduct joint training.
Miyazawa stressed the importance for both sides to understand each other's socio-cultural context, especially in healthcare, so it would be easier for Japanese society to adapt to the reality that Japanese patients are being treated by Filipino nurses and caregivers.
The same goes for the Filipino health workers, who have to adjust to the Japanese healthcare system and practices.
Miyazawa noted Japanese have a perception of Filipinos being "unconscious" of time, being used to longer periods of leave from work and sending money to their families.
A Filipino nurse assigned to Eisei Hospital in 2009 who passed the licensure exams in 2012 helped them understand these Filipino characteristics.
"The Japanese must address how to accept such elements of the Philippines to utilize the competency of Filipino nurses effectively in a Japanese context," Nagasaki University Professor Yuko Hirano said.
Conversely, Filipino health workers need to adopt, among others, the Japanese way of assisting patients by spending more time with them by their bedside, Miyazawa said.
"Filipino nurses must understand the cultural and social environment of Japanese society as well as their workplace," Hirano said. Even so, Japan has to "respect the effort of foreign nurses in trying to understand Japan and contributing to Japanese society."
Moreover, it would motivate candidate nurses and caregivers to take Japan more seriously if, aside from the pre-departure language program, they are assured of government support to become permanent residents.
"The Japanese government needs to establish a comprehensive migration policy, including pre-departure language program and granting more attractive citizenship (including visa) to foreign passers (of the exams) and their spouses," said Shun Ohno, professor at Seisen University.
Cora Anonuevo of the University of the Philippines said Filipino nurses "may decide to remain in Japan if they have relatives who could provide psychosocial support."
"Most of them said it is important for the Philippine Overseas Employment Administration to screen the hospitals (in Japan) that will hire Filipino nurses not on a contractual perspective but on a long-term view," she added.
In Japan, Filipino health workers have to have constant support from their superiors, Japanese co-workers, and the Japan International Corporation of Welfare Services for their continuing study of the Japanese language, actual training in their respective facilities about the Japanese healthcare system when they are about to take the licensure exams, and for their living and training conditions, the experts said.
"Japanese employers are required to show a clear picture of the future, a brighter life, including promotion to higher position, if they wish to employ (Filipinos) for longer years," Ohno said.
In her conversation with the Filipino health workers, Anonuevo
learned some of them find it difficult to adjust to nursing aide tasks in Japan such as feeding, bathing, and assisting in the toilet needs of the elderly patients, as well as "distributing tea to patients, dusting, wheelchair repair, changing of diapers, mopping, and toilet cleaning" since they are already professional nurses with at least three years of hospital experience in the Philippines.
Miyazawa said there might also be a need to consider extending the maximum length of Filipino health workers' stay until they pass the licensure exams from three years to five or seven years if they so wish and also allow returnees to take the exams in the Philippines.
"For nurse candidates who are not able to pass the national examination, there must be a safety net so they are not immediately sent home after failing the third time. Giving them a fourth chance should be a possibility in case they opt for it," Anonuevo said.
And those who pass must also continually be given education both by the health facility and the government, Miyazawa said.
Anonuevo said, "At the more supportive healthcare facilities, Filipino nurses are highly motivated to study, pass the exam, and work in the care facilities as long as possible."
Those who passed also confessed changes in the way they are treated, aside from additional compensation benefits.
Noting Japan's aging population and the Philippines' production of health workers, the experts only see a better implementation of the program in the coming years, instead of scrapping it, despite the absence of a model elsewhere in the world from which it could take pointers.
Aside from catering to each country's immediate needs, as well as those of the future, the program is viewed to foster a "dynamic global society," owing to cultural diversity brought about by the interaction and exchange of the people from both countries, Hirano said.