FUKU JOB: Helping Foreign Nursing Care Workers

In the late 1980s, Japan, which was in a boom time, began to accept foreign workers. At that time, there was a high demand for workers to sustain economic growth, and the economic disparity between Japan and neighbouring Asian countries was expanding. This is why numerous workers came to Japan for better employment opportunities. Afterwards, in 1989, even though blue-collar workers were in high demand, the Japanese Government enacted a law stating that only “professional and technical workers” would be accepted. This is because a great number of foreign workers in the period were believed to be illegal. In response, the demand for a supply of unskilled workers has been met by accepting people of Japanese descent, trainees, and technical interns for technology transfer to developing countries.

The population of Japan has been in serious decline for many years, and the shrinking and ageing population have become serious problems. The population in 2010 was 128,057,000, and by 2022 it had decreased to 122,030,523. In addition, the number of births in 2020 was 782,089, representing a considerable decrease compared to the 987,223 births in 2015. The decline in the birth rate has led to a decrease in the working-age population, and the current low birth rate situation cannot be easily gotten out of, further increasing the demand for foreign workers. In addition, there is a shortage of medical, welfare, and long-term care workers needed to support Japan’s future ageing society, which is a great challenge to cope with in a country with a shrinking working-age population (Miyajima & Suzuki, 2019) In other words, foreign workers are necessary for the sustainability of the Japanese economy.

According to the Ministry of Health, Labor and Welfare (MHLW), the number of notified foreign workers was about 480,000 in 2008. However, by 2020, this figure had increased to 1,724,000. Classifying foreign workers by nationality, workers from Vietnam and China (including Hong Kong) account for about half of the total, with 25.7% (443,998 workers) and 24.3% (419,431 workers), respectively. When classified by the status of residence, it can be divided into six categories: professional and technical field status of residence, specified activities, technical internship, activity other than that permitted under the status of residence, Permanent Resident and people of Japanese descent, and others. Permanent Residents (546,469 people) accounted for the largest share at 31.7%. In specified activities (45,565 people) and Unknown (72 people), there is no considerable difference in the percentages of the other three categories, each accounting for about 20% of the total.

The above statistics clearly show that the acceptance of foreign workers is progressing, and demand for nursing care workers, in particular, is expected to increase further in the future. MHLW announced in June 2015 its “Demand and Supply Estimates for Nursing Care Workers Toward 2025 (Fixed Figures),” estimating the gap between supply and demand for nursing care workers as of 2025 will be approximately 377,000. In addition, the Ministry of Economy, Trade and Industry estimates that there will be a shortage of approximately 430,000 nursing care workers in 2025 and 790,000 in 2035, according to one researcher (Yang, Josai University (2020).

In response to this situation, the Japanese Government is promoting the appropriate and smooth acceptance of foreign workers and improving the environment to build a symbiotic society. However, many problems need to be solved. A survey conducted by the Osaka Prefectural Government shows that employers and foreign workers face challenges. In the case of foreign workers, these include a lack of knowledge about lifestyle, residence status, labour laws and regulations, lack of consultation services, and difficulties in gathering information about daily life and disasters. On the other hand, the need for more understanding about accepting foreign labourers, the burden of improving the working environment and uneven policies in different industrial sectors are significant issues for employers.

FUKU JOB (FJ)

Numerous efforts are being made to solve these problems. In this project, we would like to introduce one of the organisations working in our local area, the Kyoto Prefectural Foreign Care Worker Support Center, called FUKU JOB. Their office is located in Nakagyo-ku, Kyoto, and their goal is not only to facilitate the acceptance of foreign caregivers but also to maintain, keep, and develop human resources. They emphasise the values necessary to accept foreign workers in the future, such as a symbiotic society and diversified work styles. They are working comprehensively to solve problems by providing support in both labour and daily life. In addition to supporting foreign caregivers and the offices that accept them, they also have the distinction of cooperating with related institutions and organisations in Kyoto Prefecture.

There are five main activities of this organization. The first is a consultation at the center and visiting counsellors. The center provides a place where foreign caregivers can consult about their workplace and personal concerns. The second activity is holding conferences to support foreign caregivers and care facilities. This conference aims to exchange information on foreign workers, and meetings are held regularly with related facilities and experts involved in welfare, such as companies and professional associations on welfare. Thirdly, the center holds seminars and exchange events for host nursing homes and foreign caregivers. The seminar held in January 2023 included lectures by instructors on caregiving in Asian countries and Japan and the work’s rewards. The seminar aimed to inform participants about nursing care in other countries and consider the Japanese caregiving situation in terms of philosophy and how to manage long-term care. In addition, an event was held on the same day, where participants played games related to nursing care, discussed the situation in their home countries, and talked about their hobbies and interests. The exchange meeting aims to reduce the anxiety of foreign people through interaction and connection with other caregivers.

Next, a training project is provided for foreign workers to acquire and improve the caregiving and Japanese skills necessary for their work. The office staff also attends the training to promote mutual understanding among staff members and teach how to instruct foreign caregivers and essential things for them. In addition, the supervisory staff also participate in follow-up seminars to learn how to provide guidance and how to communicate. Finally, efforts are made to collect and provide information on foreign caregivers. Since 2020, the Center has surveyed corporations that accept technical intern trainees annually, with the survey results about the main reasons for accepting trainees, challenges in accepting trainees, and expected support published on the Center’s website. In addition, information on upcoming seminars, exchange events, and training opportunities is posted on the website and in the Center’s bimonthly magazine “With You.”

Interview

Interviewees:

Mr. Inoue – Chief Manager

Ms. Sakashita – Manager

Q: What is the center’s history (who founded it and when)?

Ms. Sakashita: The background to this was that the national Government began to move towards creating a residence qualification ‘specific skills (nursing care)’, and Kyoto Prefecture also began to consider support for foreign nursing care workers. In 2019, the Jobnet Cooperative Strategy Study Team started with a survey on accepting foreign personnel and worked on the following three things:

• Holding a seminar on the acceptance of foreign nursing care workers
• Visiting facilities accepting foreign workers and administrative organisations in   Kyoto as well as in other prefectures
• Surveying the situation regarding the acceptance of foreign nursing care workers

Subsequently, Kyoto Prefecture held a “Study Group on the Acceptance of Foreign Nursing Care Workers.” Afterwards, Kyoto Prefecture decided to open the “Kyoto Prefecture Human Resources Support Center for Foreign Nursing Care Workers” in 2020, and Kyoto Prefecture entrusts the management of our center to the Kyoto Prefectural Council of Social Welfare.

Q:What is your main role here?

Ms. Sakashita: I am the main person in charge of the Foreign Caregiver Human Resource Support Center. Since only a few people are in charge, I am sending out information through the PR magazine, planning training programs, responding to consultations, and attending meetings alone. In addition to this, I am also involved in a project called JOBNET, commissioned by Kyoto Prefecture, which aims to retain employees for nursing care.

Q: How many staff members and volunteers are there in total?

Ms. Sakashita: Basically, there are four of us, including myself, the section chief in charge, the director and the main person in charge of JOBNET, who also supports foreign personnel. Many volunteers are not involved in the work, but there are many who wish to help. We have asked these people to participate in training together and have had them act as facilitators and lecturers for group work. Also, during practical training, support is provided by staff with specialist knowledge who work in care facilities in Kyoto.

Q: What is the most common nationality of the users of your service?

Ms. Sakashita: I think most center users are from Southeast Asia. Originally, Vietnam was the leading country regarding the number of foreign caregivers as technical interns. Speaking of this point, the number of people from the Philippines, China, Myanmar, and recently Indonesia, are increasing. We conduct a survey of foreign caregivers once a year. According to last year’s survey, the most significant number was from Vietnam, followed by the Philippines and Indonesia.

Q: What are the main problems and difficulties faced by foreign workers?

Ms. Sakashita: More and more people have recently been interested in obtaining a residence status for specified skills. For international students at Japanese language schools, there is an option to go on to a care worker training school or vocational school after graduation. However, most will obtain a residence status for a specified skill if they intend to work immediately. We will consult them on what kind of system this specified skill is, what you need to do to find a job, and how to work in Japan. When seeking jobs, many people want to visit nursing homes and learn about the work in advance.

Q: Do the problems differ according to the countries they come from?

Ms. Sakashita: In the training group work, we often hear about what surprised them in Japan. However, everyone got a lecture that each workplace has many original rules. Thus, even if they feel that there are differences from the values of their own country, they manage to adapt to them. However, in some countries, there are prayer times for religious reasons. Many offices try to understand and deal with their values by creating time to take breaks during those times or by securing a place for them to worship. Conversely, foreign workers who cannot eat certain foods depending on the country, bring their own meals. Both sides are making efforts as best they can.

Q: What kind of things do you discuss at the liaison conference for supporting foreign caregivers?

Ms. Sakashita: In the meeting, people from related organisations exchange opinions twice a year. Until 2021, the meeting was held four times a year. However, in 2022, it was merged with a conference to encourage foreign people and more people to work in the nursing care industry. As a result, the conference is held twice a year as an exchange conference, and the remaining two conferences are held in combination with the conference for accepting diverse human resources and the exchange conference. At these meetings, we ask for opinions to decide our future policy. For example, we propose new training programs and receive suggestions from related organisations. We also have the Kyoto Prefectural International Center and the management organisations of technical intern trainees join the members of these meetings, which is a place to share information about the situation overseas and what each organisation is doing to help.

Q: What do you do to deepen mutual understanding with foreign caregivers effectively?

Ms. Sakashita: Many foreign workers who come to us speak fluent Japanese. However, we talk with them in person as much as possible because sometimes we cannot convey subtle nuances over the phone or by email. If we meet face-to-face, it is easier to explain materials and communicate the message. I also keep in mind to use simple Japanese and to contact them frequently.

Q: Mr. Inoue, what do you think is important to consider when accepting and supporting foreign personnel in the future?

Mr. Inoue: I am sure many things can be done, but the first is to create a framework that will include both a legal and an institutional design. After that, we must maximise our efforts. Especially since our primary focus is on nursing care, it is essential to have an international mutual understanding between the welfare facilities working with us and those who use those services and foreign workers.

Ms. Sakashita: From my past visits to and observations of various business establishments and workplaces, I have the impression that they are using multiple ways of accepting (foreign workers). There is no set formula, but everyone tries to do this independently through trial and error. Many establishments have introduced Japanese language learning during working hours and have prepared job manuals. Some establishments also exchange diaries between foreign workers and Japanese staff to improve Japanese language skills and communication. In this way, the retention rate of foreign personnel is high in establishments that have devised and created a good working environment.

Q: In what ways do you think FJ has a positive effect or impact on the people it serves?

Mr. Inoue: Although there are places in each prefecture that accept and provide consultation for foreign people, Kyoto is providing a suitable environment for centre users in terms of establishing a center and providing training and other services.

Ms. Sakashita: This is additional information; we offer work experience programs such as tours and one-day challenges before workers actually work there. This allows foreign people to understand the differences between nursing care in Japan and their home countries. In addition, some people who cannot communicate in Japanese fluently join them for their future. Suppose some people have concerns about such visits or experiences. In that case, our center staff will accompany them on the tour and tell the facilities their thoughts and feelings that they may not be able to communicate well. We can ensure they can participate in the program with peace of mind.

Q: Can you share one or two stories of individuals whose lives have been changed because of the efforts of FJ?

Ms. Sakashita: As one individual case, we supported a job change for a foreign worker who had been working in the manufacturing industry, not in nursing care. He wanted to work in nursing care, where he would have many opportunities to use Japanese to work as an interpreter. However, he wanted to stay in the area of northern Kyoto, where he lived, although there were considerably fewer nursing homes. Furthermore, the facility that met our requirements was one that had never accepted foreign workers before, so we discussed acceptance with the facility. As a result, the facility agreed to accept the person, and we worked together to find a registration organisation for the specified skill status of residence and accompanied the person to the interview and facility tour. This person was successfully hired and is still working there today.

Q: How does FJ keep supporters updated about its work?

Mr. Inoue: We use our reflections on any work to make improvements. In terms of updating our operations, for example, we used to conduct public relations (PR) activities only through our website. However, now we have started using social networking services such as Twitter and Instagram to keep up with the times.

Ms. Sakashita: As for our work, as I mentioned earlier, we are working on an assignment from Kyoto Prefecture. We are asked to provide training to improve nursing care techniques and Japanese skills. However, we also think about and implement training programmes regarding the training content. After each training program, we take questionnaires for improvement and update the content. For example, this year, many participants wanted to learn more that they could use in their jobs. Thus, to enhance the training time within a limited budget, we have incorporated both online and in-person training to ensure more time within the same budget. As for the exchange meetings, at first, only caregivers were invited to participate, but to attract more people, we now include foreigners living in Kyoto Prefecture as well. Some people were uncomfortable with face-to-face meetings due to COVID-19, so we have implemented it based on users’ opinions, such as making online participation possible.

Reflections

We investigated the employment of foreign personnel in Kyoto. Japan accepts foreign personnel due to a severe labour shortage caused by a falling birthrate and an ageing population. Still, one of the challenges is the low retention rate. In response, Fuku Job (FJ) is working to promote the employment of foreign carers through the following activities: setting up a consultation service, seminars and training to improve care techniques and Japanese language skills, and collecting and disseminating information on foreign personnel.

In Chivi, Zimbabwe, HIV/AIDS has left many children as orphans. However, there is no one to care for these orphans, leaving older people and widows to care for the children; a difficult situation. In addition, poverty and the social status of women are also significant challenges. In response, the Zienzele Foundation (ZF) is working to generate a source of income and solve health and nutritional problems through basket weaving and farm management, which not only leads to women’s empowerment and economic independence as women weave the baskets from the communities supported by Z,  but also provides income for the education of orphans.

One main difference between the two initiatives is that FJ promotes employment and mutual understanding between foreign human resources and employers, whereas ZF promotes self-reliance through job creation projects in impoverished rural areas. As Japan is a developed country with suitable employment opportunities, the emphasis is on establishing a new presence, such as foreign human resources, in the current situation rather than creating jobs. In particular, despite many employment opportunities in Japan’s care industry, the turnover rate is high due to a lack of mutual understanding between foreign personnel and Japan. Therefore, FJ supports making the most of the existing employment environment. On the other hand, ZF creates employment itself from scratch and creates a climate in which more people can be engaged. It then expands this income-generating system in the areas it supports, aiming for economic self-reliance independent of assistance. ZF is also working to prevent the reproduction of poverty and helps develop communities by providing educational support.

In terms of things in common, both FJ and ZF are creating new jobs; in the case of FJ, they are creating jobs by inviting foreign caregivers to work in facilities that previously accepted only Japanese caregivers. Another commonality is the provision of educational opportunities: while FJ provides the Japanese language, caregiving skills and knowledge of caregiving in Japan through workshops and seminars, ZF does not provide direct knowledge but offers opportunities to receive education in public institutions, including support for schooling and higher education. The ZF mainly supports local women and children, who are the region’s future leaders, thereby addressing current issues and investing in the region’s future. Likewise, FJ is strengthening its association with foreign personnel for the future of Japan, where further labour shortages are predicted.

In conclusion, both FJ and ZF are creating jobs, but FJ aims to diversify the care industry in Kyoto and promote mutual understanding. ZF, on the other hand, aims for community self-reliance and sustainable development through job creation. Although the countries and environments in which they operate are different, I hope they will continue to work together as an essential factor in tackling social problems.

References

FUKU JOB (n.d.) Kyoto Prefectural Foreign Care worker Support Center.Retrieved from https://fukujob.kyoshakyo.or.jp/kpfcsc/

Miyajima. T & Suzuki. E (2019) Gaikokujin roudousya ukeire wo tou: Iwanami Shoten.

Yang Y. (<n.d.) (2020) Issues Concerning the Development of the Admission Policy for Foreign Nursing Personnel in Japan: Josai University.

Ministry of Health, Labour and Welfare (2021) Summary of the Foreign Employment SituationRetrieved from https://www.mhlw.go.jp/stf/newpage_16279.html

Japan Starts Talks to Ease Foreign Care Worker Rules. (2023) Retrieved from https://japannews.yomiuri.co.jp/politics/politics-government/20230725-12504

Researchers

Hello everyone! My name is Yuwa Kan from Kyoto University of Foreign Studies. I live in Shiga, which is next to Kyoto. I am majoring in English, and I really love history. Speaking of history, what I am really interested in is rethinking history. By rethinking history we can understand new perspectives of culture or identity. This is fascinating to me. When I have free time, I like to go jogging, and although it’s tiring, I use it to refresh my mind. Recently, I started training my muscles, but because there are no gyms near my house, I am doing bodyweight training at home. Training is hard, but I am enjoying it.

Hello! My name is Yusuke Sakai, and I am currently a senior student at Kyoto University of Foreign Studies, Japan. My major is British and American Studies. I am studying development studies by myself because my future goal is to contribute to community development in developing countries and rural areas in Japan. Since learning new things is fascinating for me, I always try to acquire new skills and knowledge on a daily basis. Besides this, I love to watch documentaries and travel in my free time.