These Indonesian and Filipino nurses and carers are required to attend six months of Japanese language training as well as pass Japan’s national qualifying exams in Japanese within two to four years of their arrival. They will face repatriation if they fail the exam. They must prepare for the difficult exam in Japanese while actually working. In the meantime, they are demoted from qualified nurses to nursing assistants.

According to Yumiuri Shinbun, all 103 foreign nurses who arrived in 2008 failed the first national examination in February 2009. The main hurdle: language, specifically Kanji.

“Nearly all the exam questions include technical terms and difficult kanji that even most Japanese could not read at a glance. For example, the questions include kanji for “jokuso” (bedsore), “gyogai” (lying on one’s back) and “doseki” (push or strain).” (8 January 2010)

To this end, there has been an increasing call for a review of the exams. For example, the Yomiuri Editorial is suggesting that they should be allowed to use a bilingual dictionary or furigana should be written above or next to the kanji in text questions. However, there is mounting opposition to this. The Health, Labor and Welfare Ministry and the Japanese Nursing Association are concerned that foreign nurses’ lack of proficiency in Japanese, particularly Kanji, may cause fatal accidents. JNA’s executive director, Shinobu Ogawa, says a kanji for ‘right’ is very similar to a kanji for ‘left’ and the consequence of confusing them could significantly compromise patient safety.

Indeed, the issue of Kanji is something my family and I experienced with my father’s home-nurse. Growing up in Brazil as a third-generation Japanese, Tokiko had very limited Japanese proficiency. In the beginning, she had difficulty reading the medicine labels and the shopping lists my mother put together. Naturally, this was of great concern. However, a solution to this came rather easy to my mother – she simply started writing shopping lists in hiragana and put furigana to every kanji in the medicine labels. The language problem subsided, Tokiko proved to be the most professional, caring and devoted aide we could ever have.

While the debate about changing the examination system continues, there seems to be less emphasis on finding pragmatic and equitable solutions to communication problems. It is unlikely that Kanji would be the biggest problem in the workplace, but if they are, how can solutions such as those of my mother’s be institutionalised? The first important task, however, is to gain situated knowledge of where, when and with whom they experience the real, actual communication problems. It’s obviously important that their language learning is assisted. But as Ingrid has argued here and elsewhere, putting this responsibility squarely on their shoulders would not work. The way forward, then, is to look into how the communicative burden can be shared among the foreign workers, their Japanese colleagues and management.

Piller, I & Takahashi, K. (2011). Language, Migration, and Human Rights. In Wodak, Ruth, Paul Kerswill and Barbara Johnstone. Eds Handbook of Sociolinguistics.