Being unwell is no fun, no matter where you live. When you’re in another country, far from your family, friends, and a more familiar-looking healthcare system, even minor illnesses can be much harder to deal with.
There are plenty of 'what to do if you get sick in Japan' blog posts out there. But they sound as generic as Japanese drugstore painkillers. They don't read like the writer’s ever had to actually use the services, facilities and medicines they're suggesting.
I've recently been very unwell (by my standards), and dealt with a lot of these things first-hand. So here's my personal experience of getting sick in Japan. If it helps even 1 person out there have an easier time dealing with an illness, I think it's worth posting.
(I’m also assuming, dear reader, that you’re on a Japanese health insurance plan and don’t need that whole system explaining to you. This isn’t about how health insurance works, this is about what to do when you’re sick. But always have your health insurance card with you.)
What should I do if I don't feel good?
How 'not good' is 'not good'?
For common colds, minor coughs (not coughing stuff up), a dodgy tummy, or general aches and pains, over-the-counter pills and potions should work fine.
Be aware that standard dosage levels in Japan are often lower than in other countries. That applies to a lot of things: painkillers, cough syrup, antibiotics, and so on. The amount you'd usually take in 1 dose back home could be the amount the Japanese instructions suggest taking in 1 whole day.
I can’t advise taking more than the recommended dose of anything without talking to a doctor.
What should I do if I need general help and I know some Japanese?
For more serious but not immediately life-threatening stuff - flu, weird itchy rash, pain that won't go away - an appointment or walk-in at a clinic or hospital is a typical first step.
You want either 外科 (geka, external medicine like skincare and plastic surgery) or 内科 (naika, internal medicine). General naika clinics are common, and you should be able to find one near your home or work with minimal effort.
They’re not open all day, or every day – you’ll need to get in during morning or afternoon reception/consultation hours. See Google Maps, check their website, or call them and ask.
Many places ask you to make an appointment if it's your first visit. After that, you can often just show up during reception hours for follow-up care. You’ll also be charged extra on your first visit to a clinic or hospital, and/or if you go there very early or late during their open times.
If you’re prescribed medicine, you’ll either be given it when you pay or directed to a pharmacy. The reception staff should know where the nearest pharmacy is.
What should I do if I need general help and I don’t know any Japanese at all?
I don’t expect full access to healthcare in English to be a right, or a guarantee, in any country where English isn’t an official language. So that includes Japan. If us expats are going to live here long-term, it’s entirely on us to learn enough Japanese for when things go wrong.
I’ve been able to explain my medical history and symptoms well enough, with the words and phrases I know, to get decent care here. I understand that means I’m lucky, and puts me in a position to get quicker, better service. But if I knew zero Japanese… I honestly have no idea what I would’ve done.
If you live in Tokyo, you probably have the largest amount of options. Outside Tokyo, English support can sometimes be surprisingly rare, even in bigger cities.
I live in one such big city, Osaka. When you search for ‘English speaking doctors in Osaka’ or ‘English speaking hospitals in Osaka’, the results list is tiny. One page I found had 4 hospitals listed. 4 approved options total, in a city of nearly 3 million people.
Some clinic and hospital websites say that if you can't communicate your condition and symptoms well enough, they reserve the right to refuse to treat you.
And where English support is apparently available, don't count on it being available at the time you visit. The communication level may not be great. There may only be interpretation by phone, not in person. You might have to pay for the interpreter, and they’re not cheap.
So this is a great time to start learning Japanese medical terms. Some basics:
Cold – kaze (風邪)
Flu – infuruenza (インフルエンザ)
Pain – itami (痛み) (point to where it hurts, or learn some body part names)
Cough – seki (咳 or セキ)
Phlegm – tan (淡 or たん)
Fever – netsu (熱)
Sneezing – kushami (くしゃみ)
Runny nose (snot) – hanamizu (鼻水)
Blocked nose – hanadzumari (鼻づまり)
Vomiting – tobutsu (吐物)
Diarrhoea – geri (下痢)
Insomnia – fumin (不眠)
And some more serious stuff:
(Contagious) infection – kansenshou (感染症)
Bronchitis – kikanshien (気管支炎)
Pneumonia – haien (肺炎)
Cancer – gan (がん) (usually said after the part of the body it applies to)
Broken bone – kossetsu (骨折)
Asthma – zensoku (喘息)
I’ve learned so many new words and kanji in the last 3 weeks, it’s crazy.
What should I do if I need to see a specialist?
In some cases, the doctor you visit might not know enough about your condition to properly diagnose or treat it. You need to see someone who’s trained more in that area.
You might get referred from the GP, or you might be able to go to a specialist clinic direct. If you already know roughly what’s wrong with you, that could save some time.
There are specialist clinics for all kinds of things. A few examples:
Women’s clinic – fujinka (婦人科)
Cardiologist – shinzounaika (心臓内科)
Respiratory medicine (chest/lungs) – kokyuukinaika (呼吸器内科)
Ear, nose and throat – jibiinkouka (耳鼻咽喉科)
Gastroenterology (stomach) – shoukaki (消化器)
And then there are bigger hospitals with specialist departments. Being referred to a hospital from a general clinic will save you money – with the referral letter, you pay less as a new patient.
Good luck finding a time to see that specialist, though. They keep erratic hours, and you’ll probably need an appointment. As an example, the lung/chest specialist at Nippon Life Hospital in Osaka is only on duty Monday afternoons, Wednesday mornings, and Thursday mornings.
What should I do if I get sick on a weekend?
Try not to panic, because your options get severely limited.
For clinics and hospitals to close – completely – on at least 1 weekday, Saturday afternoons, and all of Sunday is totally normal here. To me, coming from a country with 24-hour Accident & Emergency departments at most hospitals, that's crazy. People don’t just not get sick on Sundays.
If it's not an emergency, the most common thing people do is take OTC medicines (if they’re likely to help), and get proper care first thing on Monday.
If it’s an emergency… I’ll get to that in a minute.
Can I trust a Japanese doctor’s diagnosis?
People rant about their bad experiences on the internet more than the good ones.
You’ll find horror stories if you search for them. Misdiagnosis, the wrong surgery, everything you don’t want to read. But relax. Japanese doctors and nurses do know what they’re doing.
I feel like my diagnosis (acute bronchitis, in the end) was accurate. The complications with my treatment and recovery were caused – I think – by 1 bad choice of medication.
Remember I said Japanese medicine doses are often lower? Yeah, so mine weren’t working as well as I hoped. I was in a lot of pain, and I couldn’t sleep for more than a few hours at a time.
Tired, hurting, upset and anxious, I went back to my doctor and near enough begged for a stronger cough/pain medicine to help me sleep. Twice.
The doctor prescribed me something much stronger the 2nd time. I went home and took it that night. My coughing, and chest pain, went away almost immediately. In that sense, it was brilliant.
Except from the first night I took that medicine, I didn’t sleep at all. As it turned out, I didn’t sleep for 5 days solid. And that lack of sleep caused other health problems that set me back.
What should I do in an emergency?
In my opinion, if you think it’s an emergency: call an ambulance.
Call a damn ambulance, part 1
After a few cough-free but totally sleepless nights on the stronger medicine, my coughing came back at 4am on a Sunday. Non-stop, no time to breathe – like I was having an asthma attack.
Wanting some reassurance and advice on what to do in English first, because my brain was fried after spending that long awake, I searched around and found the 24-hour Japan Helpline.
Their website says:
“Welcome to the home of the Japan Helpline, Japan's only 24-hour non-profit, nationwide emergency assistance service. Call 24 hours a day, from anywhere about anything, anytime from a simple question to emergency assistance.”
Emergency assistance! Perfect. I called them.
The call was answered by a tired, fed up-sounding man (well, it was 4am on a Sunday). Before I could even fully explain what was going on, he interrupted and asked me if I was outside. Um, no, I said. Why not? Well, I’m still trying to work out what’s wrong with me and what to do-
I was interrupted again.
He went on a massive rant about how calling an ambulance in Japan is the worst thing you can possibly do. That it’ll take forever to arrive, that the drivers aren't medically trained, and that they'll drive you in circles for hours trying to find a hospital that’s willing to take you in.
He told me to go outside, get a taxi, and call back when I was in the taxi. Told me if you rock up at a hospital by yourself (car, public transport, on foot, whatever), they can’t refuse you care.
I hung up. And didn't call back.
I wasn’t going to hang there on a premium-rate phone line watching the taxi meter clock up, especially not when time was of the essence. If he was just going to tell the taxi driver to find the closest hospital, I could do that myself.
Maybe they’re great in other, less urgent situations, but based on my experience I can’t recommend the Japan Helpline to anyone in an emergency. There’s no real help to be had.
If anyone from there reads this post, whoever on your team took my call let me down very badly.
Call a damn ambulance, part 2
I searched online and found a 24-hour emergency centre at a hospital near enough to my home, so I went there. Their website had my condition/symptoms listed under things the centre treats.
I dragged myself downstairs and took a taxi to the hospital. That whole ‘going by yourself means you can’t be turned away’ thing had stuck firmly in my head.
When I got there, I was told by a confused-looking nurse that: a) I should’ve phoned ahead, b) the specialist for my symptoms wasn’t in, and c) that there was nothing they could do for me.
I was directed to call the not-so-emergency Japanese medical advice number – which is #7119, by the way – and ask them about other hospitals. I did that while still at the ‘emergency’ centre.
They gave me a list of 3 hospitals, none anywhere near me, that may or may not have a specialist on staff. I was told to call each of them in advance and confirm the specialist was on duty before going. Except – it was Sunday! and none of the hospitals were open until Monday morning.
I hope you’re starting to sense a pattern here.
Call a damn ambulance, part 3
I gave up, went home, took more medicine, and tried to calm down. Later that night, I had another health issue, heart palpitations – again caused by the medicine I took to calm down.
It felt like my heart was trying to beat out of my chest. I called a damn ambulance immediately.
The number’s 119 – it’s for both fire emergencies and ambulances, so make sure to say the word for ambulance (kyuukyuusha, 救急車) when they answer. The level of help in English may vary, depending on where in Japan you are.
I explained everything, and the ambulance arrived at my home within 10 minutes. They had medical equipment in the back, they talked everything over with me, and they found a nearby hospital that could take me straight away.
I spent about an hour there. They sent me home in a taxi when my heart rate slowed back to a reasonable BPM. It wasn’t a cheap hospital visit, all told… and the emergency team for that night still didn’t have a specialist doctor on duty. But I’m insanely glad I made that call.
What happens if I need to take time off work because of illness?
Feeling ill in Japan is compounded by work pressure. Not having many (or any) sick days to use, feeling like you need to dose up and go to work even when you're sick, and feeling like you should go back to work when you're not fully recovered.
That stress and anxiety can even mean it takes longer for you to get well again.
Time off for sickness is a case-by-case thing, influenced by your company's policies, but there are some basics to be aware of.
Japanese labour law specifies no legal minimum number of sick days that an employer has to provide. Yeah, you read that right the first time. None.
So some companies may not give you any - they don't have to, after all. Some might give you 3-5 sick days a year as a courtesy, just in case you need them. Some employers could even say 'take as long as you need to get well'. It all depends on where you work.
In most cases, when someone's sick they use their (already limited) holiday allowance. Whatever's left of it, that is.
If you're a freelancer, part-timer, own your own business, or you're not otherwise bound by a work visa and company rules... maybe missing work won't worry you as much. Or maybe it will - you're still not getting paid.
What about going back to work (or not)?
The next steps when you run out of sickness and/or holiday allowance also depend on your company’s policies, if they apply. You could be ask-forced to go back to the office. You could be allowed more time off, but unpaid. You could have the option to work from home.
If it’s a long-term illness that stops you from working for weeks or months, there’s a benefits scheme (Kyoukai Kenpo, 協会健保) that ensures you still get paid some money during that time. You need to prove you qualify, and that includes being signed off work by your doctor in writing.
There isn’t much info out there about Kyoukai Kenpo in English, but it’d be worth asking your company (or a friend who can help translate) about.
If life wants to throw even more your way while you’re sick, you might get fired for being unable to do your job. That’s one for the Labour Board.
How long’s it going to take before I feel any better?
To be honest, when I wrote and published this post I wasn’t 100% back to normal. I’m recovering physically, but the complications and scares have taken a heavy emotional toll.
It made me feel like I had a duty to write this. Something I could do that might help people when they need it the most. I’ve tried to give out as much advice as I can, and I really hope it’s useful for someone when the time comes.