Between the Devil and the deep blue sea

With this issue begins a new era in the long and colorful 14-year history of Philippines Today as it continues to serve pro bono the thousands of Filipinos in Japan. After another brief respite and transition period, PT is relaunched with a new editor at the helm and a new focus on its contents. One thrust that PT intends to pursue is the emphasis on Nihon no seikatsu or “life in Japan.”

In pursuit of this vision, this column (formerly Musings) will see a slight change in focus. During its early beginnings, this space portrayed amusing aspects of Japanese culture (see the PT archives at www.philippinestoday.net or www.geocities.com/tpbnt/articles.htm), but over time, the focus has shifted to Philippine political and social scenes. Starting this issue, we change gear and return to our beginnings. Musings becomes Japan Beat.

This month, we tackle the currently controversial medical care in Japan, an issue that touches the heart of every Filipino expatriate’s life, particularly those holding invalid visas. Way back in March 2002, PT publisher Benny Tutor, Jr. wrote a piece entitled “When doctors can’t cure,” which described the “horror” stories of a Latin American student and a Filipino illegal alien who both died in the hands of Japan’s supposedly state-of-the-art health care system.

Back then, we asked the question: how can anyone in his 20s die of pneumonia in Japan? The Latino student initially went to the hospital with a cough, and probably because of his inability to describe his condition fully (his Japanese was deficient), he was diagnosed as having the seasonal cold and perfunctorily dismissed with the usual “rest and take lots of fluids” advice. Two weeks later, he was a dead body.

Benny’s piece also described the plight in 1999 of an “overstaying” Filipino who suffered a cerebral hemorrhage and was rushed to a government hospital in Tsuchiura City. Despite the patient’s barely audible complaint of severe neck pains, the doctor on duty advised that he be sent home to take bed rest. Two hours later, with blood gushing from his mouth, he was rushed back to the hospital where he breathed his last.

That was then. Now, the sad, sorry situation shows no signs of abating. Makoto Kondo, author of the book “Hey, Patient, Don’t Fight Cancer,” and “Hints at How to Run Away from Poor Treatment and Bad Doctors,” said “Not going to the hospital is better for your health.” He added that there are two kinds of medical malpractice in Japan: one is due to a careless slip; the other is due to lack of ability. “In Japan, cases due to lack of ability are extremely numerous,” he said.

From 1999 to February 2002, there have been 15,201 medical accidents in 82 of the top hospitals in Japan. Do the math and that is roughly 14 medical accidents per day, not counting utter negligence and lack of genuine concern as exemplified by the stories above. The traditional deference toward doctors, also called “sensei,” is slowly crumbling throughout the country.

Kondo estimates that as much as 2 percent of Japan’s 260,000 physicians should lose their licenses due to incompetence. “Treatments are becoming like experiments,” he said in a national daily. “There are few penalties and doctors just do what they want.”

In June this year, police investigated the death of a 5-year-old boy at a hospital affiliated with the Tokyo metropolitan government in Katsushika Ward. The police suspect professional negligence leading to the boy’s death after being left untreated of intestinal obstruction at the Tobu Chiiki Hospital in early March.

A hospital spokesman said that since the symptoms were subsiding when he was hospitalized, they did not think that he was seriously ill. “The doctor's visit was delayed due to a spate of urgent patients," he added. His family as well as police investigators wondered if his case was not urgent enough.

In another incident, a 16-year-old girl who had a lump on her throat was apparently given “a little too much” of an anticancer drug after surgery to remove the lump failed. Investigators later determined that she had been injected with a powerful drug for seven consecutive days, under a treatment plan approved by a senior professor. Six months after the onset of symptoms, she was brought home in a casket, her skin turned purple.

According to the health ministry’s Office of National Examinations and Licenses, not a single Japanese doctor has lost his or her license for malpractice since at least 1971. This is in stark contrast with the annual average of 38 out of 690,000 doctors in the US who lost their licenses due to incompetence, malpractice or negligence, a report said. In Japan, the stiffest punishment meted so far on a negligent doctor was the suspension of his license for one year.

The sick Filipino in Japan is undoubtedly caught between “the devil and the deep blue sea”: the seemingly precarious medical care here exemplifying “the devil,” and his gradual decline into ill-health as “the deep blue sea.” For those undocumented and without health insurance, the devil is Satan himself, and the sea, the Marianas Trench.

Given these medical uncertainties, the expatriate Filipino in Japan could do well by opting for healthier lifestyles and ensuring that he take the proper nutrition and rest. While he may be the so-called “Bagong Bayani,” he is the kind of hero his family and country would rather wish living than dead.

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