Kokusai Hoken Iryo (Journal of International Health)
Print ISSN : 0917-6543
Volume 28 , Issue 4
Showing 1-10 articles out of 10 articles from the selected issue
Original Article
  • ∼The Perspective of Early Pioneers∼
    Kazumi Takesako, Yasuhide Nakamura
    2013 Volume 28 Issue 4 Pages 279-286
    Published: December 20, 2013
    Released: January 14, 2014
    JOURNALS FREE ACCESS
    Objectives
    To analyze the professionalization process of medical interpreting in the United States. The findings are expected to provide suggestions for Japan, a nation primed to educate its future professional medical interpreters.
    Method
    Initial members of the world’s oldest medical interpreters association were interviewed. The transcripts were analyzed through thematic analysis.
    Results
    A group of staff interpreters met to share stories of difficult cases and dilemmas at work in the 1980s, later forming a professional organization in Boston, Massachusetts, in 1986. Later, they began to discuss common issues and developed some standards to clarify role definitions. They advocated for the profession with an aim to increase employment by collaborating with stakeholders to enact the first state law of medical interpreting. Out of eight participants, six worked as a professional interpreter and trainer simultaneously, thus educating newcomers to the profession. Conferences enabled professional medical interpreters and stakeholders to expand their network for local or joint initiatives to further develop the profession. The state government provided grants to medical interpreting education projects and issued guidance to hospitals for best practices.
    Conclusion
    To establish medical interpreting as a profession, organizational and advocacy activities were vital. Pioneering medical interpreters played an important role in the process of developing the profession by forming a professional organization, creating standards, approaching stakeholders, and becoming professional trainers to educate newcomers to be skillful enough. This network expanded through conferences enabling multiple stakeholders to take initiatives and accelerate the process. The participants pointed out the lack of training courses, difficulty in building relationships with physicians, and self-stress control. A survey conducted in Japan revealed that medical interpreters pointed out a lack of training courses, a lack of understanding by physicians and patients, and a lack of mental support. This study provides important lessons for burgeoning interpreters in Japan, with these commonalities in mind.
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Forum
Information
  • Makiko Shimomura, Yasuhide Nakamura
    2013 Volume 28 Issue 4 Pages 293-303
    Published: December 20, 2013
    Released: January 14, 2014
    JOURNALS FREE ACCESS
    Since it first accepted 138 participants in 1954, the Japan International Cooperation Agency (JICA) has accepted approximately 270,000 participants from developing countries for training in Japan during the past 57 years.
    In order to verify factors that contribute to the utilization of knowledge and techniques/skills after participants have returned to their countries, questionnaires were distributed through e-mail to 856 former participants, of whom 601 were Indonesian (total response rate: 24.4%), and 264 were Laotian (total response rate: 31.9%)
    Interviews were conducted with 28 Indonesian and 15 Laotian ex-participants through snowball sampling.
    In the questionnaire, most ex-participants stated that JICA training was valuable. The reasons they mentioned were that they could understand conditions in Japan through field trips/observation, gain up-to-date knowledge about Japan, and learn about the process of technological development in Japan.
    About the usefulness of knowledge and techniques/skills gained in Japan for their work, knowledge was considered to be slightly more useful than techniques/skills.
    On the other hand, the participants had some difficulties in utilizing knowledge and techniques/skills because of a lack of budget or facilities/equipment, and differences between conditions in Japan and their own countries’.
    In the interview survey, the majority of ex-participants provided examples of good practices in which they actively utilized skills/techniques and knowledge they gained in Japan after returning to their countries. The three factors contributing to this result were (1) their needs matched Japanese resources used in training. (2) Ex-participants developed awareness and learned new things spontaneously during the training. (3) Ex-participants and Japanese instructors maintained a long-term relationship after the training.
    This study suggests that in order to enable participants to apply knowledge and techniques/skills gained in Japan to their local circumstances, JICA needs to identify appropriate technology that developing countries wish to implement and to conduct follow-up related to adoption and diffusion in their countries through ongoing dialogue.
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  • Ikuko Tanaka, Satoko Yanagisawa
    2013 Volume 28 Issue 4 Pages 305-316
    Published: December 20, 2013
    Released: January 14, 2014
    JOURNALS FREE ACCESS
    Introduction
    The objective of this study was to explore experiences of immigrant medical interpreters working in Japanese hospitals and their view on how to improve medical interpreting services.
    Methods
    We conducted semi-structured interviews to five Brazilian and Argentinean interpreters working at two hospitals in Aichi Prefecture. The interviews explore their experiences since they started working as an interpreter focusing on difficulties and strategies to overcome them. We also asked how they saw medical interpreter system in Japan and how it can be improved. The interviews were recorded and transcribed. Descriptions related to difficulties and overcoming strategies were extracted from the transcription, coded and summarized into subcategories, then, to categories.
    Results
    Forty subcategories were extracted concerning difficulties and strategies immigrant medical interpreters experienced. They were integrated into eight categories. Their experiences were described as follows (« »shows categories). Immigrant medical interpreters started their career with«Groping due to lack of relevant experiences and training», therefore, they experienced«Initial difficulties and hardship». They devised various«Initial strategies to overcome difficulties»and improved their skills. Then they faced«Bafflement and dilemma as experienced». They struggle to bring«Change and contrivance as experienced»to themselves and to their colleagues. As they overcame serious difficulties, they gradually equipped with«Concern and consideration as a medical interpreter». Through experiences as an interpreter, they found out«Meaning of being an interpreter», and started«Taking on a new role»beyond what were assigned to them.
    Conclusion
    This study portrayed immigrant medical interpreters’ experiences on difficulties they faced as well as strategies to overcome them. It is important to enhance social recognition of medical interpreters and establish medical interpreter system in order to improve access of immigrants to health care.
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  • Chie Tsubaki (Koh)
    2013 Volume 28 Issue 4 Pages 317-325
    Published: December 20, 2013
    Released: January 14, 2014
    JOURNALS FREE ACCESS
    Objective
    This study aimed to clarify the status of implementation of sex education at home by parents and guardians of children attending Korean primary schools in Japan, and the requirements of in relation to school-based sex education
    Method
    Between June and November 2012, an anonymous 20-category written questionnaire survey was distributed to 289 parents and guardians of children attending Korean primary schools in Osaka and Kyoto.
    Results
    Among 289 questionnaires distributed to 8 schools, 49 responses were obtained, of which 45 were valid (valid response rate: 15.6%). Forty-two respondents (93.4%) answered that sex education at home was “Necessary”. Seventeen respondents (37.7%) stated they were implementing sex education at home, whereas 27 (60.1%) answered they were not. Among the 17 respondents who were implementing sex education at home, 8 (47.0%) started when their children were in the fourth grade, and 12 (70.6%) stated the topic of sex education was about “the difference between male and female bodies.” All 45 respondents answered that they believed school-based sex education was “necessary.” Most respondents (42, 93.3%) expressed a desire for sex education to be implemented by an outside teacher (nurse, health worker or midwife).
    Conclusions
    Although many parents considered home-based sex education necessary, few were actually implementing it, and as such school-based sex education plays an extremely important role for children. Furthermore, because Korean primary schools are required to use outside medical professionals to deliver sex education, medical professionals from within the community of Koreans living in Japan can be expected to play a significant role in this theme.
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  • Kazue Tanaka, Jun Nishitani, Kazuhiro Kakimoto
    2013 Volume 28 Issue 4 Pages 327-336
    Published: December 20, 2013
    Released: January 14, 2014
    JOURNALS FREE ACCESS
    Background
    Female Genital Mutilation (FGM), which can be considered as one of the harmful effects for the health of pregnant women and violence to women, is performed widely as a social custom in some African countries. Therefore, this study aims to clarify the situation of FGM prevalence and a recent trend of African countries by using published health statistics.
    Method
    Demographic and Health Survey (DHS) full reports in African countries written in English in which topic of FGM is included and whose comparison was possible between the latest report and the one about ten years ago were obtained. And, indicators regarding FGM were compared by countries and years.
    Results
    Of six countries, the prevalence of FGM in five countries had a trend of decline, and their FGM prevalence rates were higher in rural areas than urban. In these countries, wider decline was seen in younger population. For example, in Tanzania, the prevalence changed from 13.5% to 7.1% in 15-19 years old, and from 22.2% to 21.5% in 45-49 years old between 1996 and 2010, respectively. On the other hand, the FGM prevalence of Nigeria was higher in urban areas than rural, and increased in younger women. Some DHS reported the variety of FGM prevalence by places and ethnic groups even in a country.
    Conclusions
    In many countries, the decline of FGM prevalence in young women could lead us to expectation of more decreased prevalence in the future. The health education to the young, who will become mothers, could be effective. However, since some countries have different characteristic features in the trend of FGM prevalence, it was suggested that sociocultural background should be individually considered for effective interventions.
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Special Contribution
  • Kazuyo Ichimori, Aya Yajima, Midori Morioka, Tomomi Fukuda, Yumiko Kam ...
    2013 Volume 28 Issue 4 Pages 337-347
    Published: December 20, 2013
    Released: January 14, 2014
    JOURNALS FREE ACCESS
    Since its establishment in 1948, the World Health Organization (WHO) has organized a series of expert committee meetings to address individual tropical diseases that are included in WHO’s list of neglected tropical diseases (NTDs) in order to formulate appropriate evidence-based control strategies. Between 1948 and 2012, as many as 66 resolutions have been adopted for individual diseases. In response to trends in the global public-health agenda—notably primary health care in the 1970s and the Millennium Development Goals in the 2020s—WHO established the Department of Control of Neglected Tropical Diseases in 2005. The aim was to contribute to poverty alleviation and achievement of the Millennium Development Goals by addressing 17 NTDs in an integrated manner rather than by vertical disease-specific programmes.
    Since then, WHO has led a dynamic trend in the global community to overcome NTDs, including organization of the first global partners meeting on NTDs in 2007, publication of the first WHO report on NTDs in 2010 and in 2012 the WHO roadmap to accelerate work towards the 2015 and 2020 targets for control, elimination and eradication of NTDs, and the announcement in 2013 of the London Declaration by 13 pharmaceutical companies and various donors and partners, and the publication of the second WHO report on NTDs. In May 2013, the World Health Assembly adopted the first resolution to call for increased efforts and support to control, eliminate and eradicate NTDs as a whole, contrary to the past disease-specific resolutions.
    The present paper is intended to introduce Japanese audiences in the field of public health to this 66th World Health Assembly Resolution on NTDs and to the work of WHO in leading the global trend towards control and elimination of NTDs.
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  • Kiyoko Ikegami
    2013 Volume 28 Issue 4 Pages 349-357
    Published: December 20, 2013
    Released: January 14, 2014
    JOURNALS FREE ACCESS
    Review of Millennium Development Goals (MDGs) and discussions on the development agenda after 2015 (post MDGs) have begun. It would be high time to try to integrate and/or merge environment issues into the development, since Sustainable Development Goals (SDGs), a new concept proposed in Rio+20, was brought into the scene of discussion on development agenda through Open Working Group (OWG) discussion.
    Development and environment issues must be addressed simultaneously in an integrated manner at all levels toward “One Framework” of development. Sustainable development calls for a convergence of three pillars: economic development, social equity and environmental protection. There is a lot of common space between two issues.
    Unfinished agenda and gender were the two common issues raised by interviewees. They also pointed out some unique perspectives, such as selection of indicators at country level, and political declaration which could include the cross-cutting and politically sensitive issues.
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Book Review
Best Oral Presentation/Poster Award at the 28th Annual Meeting 2013 in Okinawa
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