One beautiful Sunday afternoon, 3-year-old Tim was invited to his friend’s birthday party. After the kids exchanged presents and played together, cake and some snacks were provided. Tim had a bite of a home-made peanut cookie; a few minutes later, he began to cough repeatedly, and a rash appeared around his mouth, then all over his body. Tim’s mother thought he would be fine in a while, but his coughs were getting worse. She rushed him to a hospital nearby, it looked dark but she thought “There should be someone who can help Tim, this is a big hospital.” She asked a guard for help, shockingly he said “Hospital is closed, it’s Sunday, go somewhere else.”
Sounds shocking? But this is the reality. Not every Japanese hospital can accept emergency patients 24/360. Then, what do we do when we need help? Here is how the system works.
Rotation System of After-hour/Holiday Clinics
Your local city clinics/hospitals take turns to operate in after-hour on holidays for primary emergency care from about 17:00 to 21:00 (Hours vary depending on the area). Japanese clinics/hospitals are divided by their specialist departments, and often only internal medicine, pediatrics or surgery are available on holidays and at night. So if your little one has a finger fracture, it will be very challenging to find someone available or you will have to travel far to see a specialist.
To find after-hour/holiday clinics, visit the Medical Association Page of your local city（医師会 いしかいishi-kai）or some City Office that has the information on their web site.
Why can’t my child have a care from a big hospital when needed?
This rotation system makes it difficult to provide a care from one big, general hospital near you. Many people think patients can receive a care when they need, regardless of day/time for emergency, however it has a lot to do with luck.
If Tim was lucky on that Sunday afternoon and the hospital had a pediatrician on shift, he was able to receive a care that he needed promptly. His mum ended up calling many hospitals to locate a pediatrician available for Tim. She spoke some Japanese so commutation with the hospital staff wasn’t so difficult. But if she hadn’t been Japanese-speaking, things would have been extremely difficult. I will provide advice and what to prepare for non-Japanese speaking people in the next chapter.
Emergency Information Sheet
Pediatric emergencies happen at the most unexpected time. We advise to prepare the following information available on hand. It would be a good idea to put all the contact information in one sheet and stick it on a fridge.
Example of Emergency Flow Chart
Contact number and address of local after-hour and holiday clinic
Some cities provide after-hour and holiday clinics, often in the building of the local Medical Association. They can only offer general, non-surgery primary care for your children and in many cases not English-speaking, but you will find them very helpful for sudden fever or stomachache of your child. The care is covered by Health Insurance.
English-speaking pediatrician available on weekends
Although the number is very small, there may be some clinics available on weekends in your city. Possibly far away from your house, but worth preparing contact details and address.
Web site of Local Medical Association or City Hall
Many of them have a weekly or monthly list of after-hour and holiday hospitals/clinics on duty.
Ambulance call 119
For critical conditions or you simply don’t know what to do, call 119 for ambulance. There are English speaking operators in Tokyo, although this can depend on area. It is recommended to speak English slowly. You can call an ambulance from a home phone, mobile phone, PHS or a public telephone. 119 reaches the fire department and an ambulance will be sent from the local fire department in 5-10 minutes. In Japan, transporting patients by an ambulance is free, but the cost of care will be charged.
We understand it is always challenging to understand and use foreign medical services – especially Japanese healthcare systems are different from the West. Once you get prepared and learn to use the Japanese system, you will be surprised to find their services to be reasonable and affordable.
We understand many of the information you need to prepare in originally available in Japanese. JHI can help you put pediatric information together for you. Please contact us for details at firstname.lastname@example.org