Special

Article 1

Ensure No Foreign Residents Are Left
Behind in the Fight Against Covid-19
By Sato Kan Hiroshi

Author Sato Kan Hiroshi

Number of Foreign Residents Increasing

We can expect even 3% would be the case soon after Covid-19 isbrought under control.
The current breakdown of foreign residents (as of 2019) showsthat 83.9% are from Asia, mostly from China, South Korea, Vietnam,
the Philippines, Nepal, Indonesia, Taiwan, and Thailand. An additional
9.4% are from Central and South America, and this includes a large
number of Japanese Brazilians.
Of these foreign residents, 1.72 million, or approximately 60%,
participate in the labor market, working with a variety of residence
statuses (Chart 1).

The spread of coronavirus infections (Covid-19) has temporarily
reduced the flow of people into Japan from overseas, but since thebeginning of this century the numbers of both visitors to Japan andlong-term foreign residents have consistently continued to grow. Asof the end of 2019, the last year not to have been affected by Covid19, the number of foreign residents in Japan (not including tourists)
had reached 2.93 million. Given that Japan’s population is roughly
120 million, a foreign population of 3 million would mean thatroughly 2.5% of the population (or 1 in 40 people) are foreigners.

CHART 1

Number of foreign workers by residence status○ The number of foreign workers in Japan stood at a record high 1,724,328 as of Oct. 31, 2020.

○ By residence status, the highest growth rates have been among “Designated activities” (+10.9% YoY),“Specialist and technical fields” (+9.3% YoY), and “Technical intern training” (+4.8% YoY).

(Unit: 1,000 persons)
2,000

50%
Status based on own circumstances
Activities other than residence status
Technical intern training
Designated activities
Specialist and technical fields
Total
YoY increase / decrease (right-hand scale)

1,800
1,600
1,400
1,200
1,000
800
600
400
200
0

1,659
1,460
496

1,084
788

908

413

30%

459

19.4%

20%

686

682

718

297

15.5%
320

309

319

83
95
85

97
112
100

108

110

108

122

123
111

130
121

147
5.1% 145

124

133

147

167

201

238

277

2008

2009

2010

2011

2012

2013

2014

2015

2016

2017

2018

486
224

15.7%

253

5.6% 134

137

-0.6%

339

367
9.8% 192

15.3% 240

168

211

297

370

373

650

563

40%
546

532

1,279

1,724

344
18.0%

258

14.2%

384

308

402
13.6%

329

2019

46 10%

360
4.0%

0%

-5%
2020 (Year)

Note 1: “Specialist and technical fields” refers to managers, technicians, researchers, chefs of non-Japanese cuisine, persons with designated skills, etc. whose status
for the purpose of work has been approved.
Note 2: “Status based on own circumstances” refers to permanent residents, non-Japanese persons of Japanese descent, etc. whose status is based on their own
circumstances or position in Japan.
Note 3: “Designated activities” refers to non-Japanese persons engaged in activities that have been specially designated on an individual basis by the minister of justice.
Note 4: “Activities other than residence status” refers to students working part time, etc. who are engaged in employment other than the original purpose of theirresidence status (in principle, up to 28 hours per week for students).

Source: “Foreign Worker Reporting Statistics”, Ministry of Health, Labour and Welfare (released annually, as of the end of October)

https://www.jef.or.jp/journal/

Japan SPOTLIGHT • January / February 2022

47

Technical Intern Training Program
As Chart 1 shows, roughly one-third (32%) of foreign residents
are living in Japan based on their own circumstances (permanent
residents, spouses or children of Japanese nationals or permanent
residents, and other long-term residents), roughly one-fourth (23%,or 400,000 people) are technical interns, close to one-fourth (21%)
are students from abroad, and close to one-fourth (21%) havespecialist skills (residence status “Engineer/Specialist in Humanities/
International Services”). Of the 400,000 technical interns, whose
presence has been increasing in recent years, close to 10,000 (morethan 2%) escape from their workplace with their whereabouts
unknown (referred to as missing people) each year. According to theJapan International Trainee and Skilled Worker Cooperation
Organization (in the JITCO White Paper 2019), the number of interns
who went missing in 2018 was 9,052, of which the majority, at
5,801, were Vietnamese.
Social concern about the issue of missing interns has recently
been growing with the production of several movies on the theme,
including Complicity (2018), directed by Kei Chikaura, about a
Chinese trainee who goes missing, and Along the Sea (2020),
directed by Akio Fujimoto, about Vietnamese trainees who go
missing.
The media, civil society organizations, lawyers’ organizations, andothers have repeatedly pointed out that these interns go missing forreasons including harsh working conditions and low wages, andevery year in its Country Reports on Human Rights Practices, the US
Department of State criticizes the Technical Intern Training Program
as “modern slavery”. This is not to say that all workplaces that
employ technical interns are inferior, but, for example, the NHK news
program Nonare (“No Narration”, episode broadcast on June 24,2019) shocked viewers with the harsh working conditions oftechnical interns from Vietnam in the towel-producing region of
Imabari.

Low Rate of Recognition of Refugees
Japan has also seen an increase in the number of people whose
status is uncertain while applying for refugee status. Japan signed
the Convention Relating to the Status of Refugees in 1981. This wasin response to growing criticism of the fact that during the 1970s,
when large numbers of “boat people” were leaving Vietnam andsurrounding countries and being accepted as refugees by countries
in Europe and the Americas, Japan did not accept them despite being
located in Asia. (Japan accepted its first refugee from the IndoChinese peninsula in 1978.)48 Japan SPOTLIGHT • January / February 2022

This was also the same time as the beginning (in 1981) of the
program to repatriate Japanese people who had been abandoned as
children in China at the end of World War II. This program included
Japanese language education and programs to adapt to daily life forthose children who were reunited with their families, and policies tointegrate refugees into Japanese society began to be fully put into
place.
Nevertheless, despite the fact that the number of refugee
applications subsequently grew, the annual number of people
recognized as refugees remains in the double digits. In 2018, forexample, 10,493 people applied for refugee status, of whom 42 hadtheir applications accepted, for a recognition rate of only 0.4%. As aresult, many people who have their refugee applications denied
repeatedly reapply, and although they are not held at Immigration
Services Agency detention facilities, their status is “provisional
release”, meaning they are not allowed to work and their social
standing is extremely vulnerable. This issue was addressed in themovie Tokyo Kurds (2021), directed by Fumiari Hyuga, about theuncertain state for young people in the Kurdish community in greater
Tokyo who repeatedly reapply for refugee status. There was also agreat deal of criticism from within and outside Japan in 2021 overthe death in a detention facility of the Sri Lankan woman Ratnayake
Liyanage Wishma Sandamali, who did not receive adequate attention
while complaining of ill health.

Impacts of Covid-19
The first diagnoses of Covid-19 in Japan were in early 2020, andthe negative effects on foreign workers became evident from around
March.
First, technical interns from Asian countries were not able toreturn home when their contracts concluded because their homecountries were in lockdown, and were forced to remain in Japan withno work or place to live. Students who were earning their living
expenses through part-time work also lost their jobs when theirworkplaces closed under states of emergency. Many students had nochoice other than to leave school because the loss of income meantthat they could not pay their tuition, but that also meant the loss of
their student visa, nullifying their residence status.
In addition, because of instructions to avoid the “3Cs” (closed
spaces, crowds, and close-contact settings) to prevent the spread of
the coronavirus, and to prevent the emergence of infection clusters
in detention facilities, these people were released despite having noway to earn a living.
Against this backdrop, infection clusters began to appear inforeign communities from the spring of 2020. The mechanisms wereas follows.
First, financially strapped foreign non-regular workers who had
lost their jobs often found themselves living in crowded conditions inacquaintance’s apartments. Next, if someone began showing signs
that suggested infection, language barriers made it difficult for themto get PCR tests, and their symptoms and condition worsened. We
cannot blame medical facility staff, because their hands were alreadyfull treating Japanese patients, and they had no extra time to deal
properly with foreign people who require more attention because oflanguage handicaps. In addition, foreign communities did not receive
sufficient information like avoiding the 3Cs to prevent infection, so insome cases they continued their religious and other practices
without taking proper preventive measures, and infection clusters
emerged.

Difficulties in Accessing Healthcare Information
There are several reasons for this undesirable situation. First,
necessary information did not reach foreigners’ communities,
meaning that the people in foreign communities did not use advice
centers set up by the government. Second, even if they were able toaccess one of those advice centers, it is very difficult to connect
foreigners to health centers and medical institutions, because ofvertical bureaucratic structures and a lack of coordination between
advice centers and medical facilities. Third, even if they could reach a
medical facility, they could not get diagnosed because they cannot
speak Japanese, or were charged high medical fees because they did
not have national health insurance. Fourth, interns who had gone
missing, students who had left school, and others who lost theirresidence statuses avoided examinations out of fear that immigration
authorities would be informed, and this fear contributed toworsening their conditions and infections spreading.
Against this backdrop, the Institute of Developing Economies (IDEJETRO) and the National Center for Global Health and Medicine(NCGM) began joint research in October 2020 to improve access to
information for foreigners’ communities in Japan, and they werelater joined by other organizations including the medical NGO
SHARE, and began operating as the Minna No Gaikokujin Network(Everybody’s Network for Foreign Residents; MINNA).
MINNA worked to provide foreigners’ communities in Japan withinformation regarding how to prevent infections and treat symptoms
in ways acceptable to their respective cultures and lifestyles, as wellas information for advice centers for foreigners that they could
contact without fear. MINNA also identified good practices that thepatient succeeded in getting smooth health care and medical
services, and prepared materials to pass on the lessons learned toother regions. A portion of the funding was provided by the Toyota
Foundation (Special Subject Grant, Migrants and Japanese Society).

Facebook as an Information Source
In recent years, technical interns have expanded beyond urban
locations to rural areas because of worker shortages in the
agricultural and fishery industries. Some local governments in places
where a significant number of technical interns live have begun
posting information about municipal services on their websites in thenative languages of these interns (in addition to the previous Chineseand Korean, this can include languages like Vietnamese, Indonesian,
Nepali, and Burmese).
Nevertheless, we have learned that during times like the current
pandemic, foreigners “almost never” access the multilingual pages
on their local government’s website to obtain information. One
reason is that they do not know that this information exists, and even
if they do, the quality of translation into languages other than main
languages like English, Chinese, Korean, Portuguese, and Spanish is
not necessarily very high, and we often heard the complaint that the“message is unclear”. If city or village offices do not have staff who
are able to provide supplementary explanations in those languages,
the foreigner seeking advice reaches a dead end. One outstanding
good practice is the city of Mimasaka in Okayama Prefecture, which
engages a Vietnamese prefectural employee to support its
Vietnamese interns.
The information source on which most foreign residents of Japan
rely is, in fact, social media, with Facebook in their native language
being particularly important, and this is common across manynationalities. However, even if there are many foreigners comingfrom the same country, they will not necessarily be using the same
Facebook page, and we need to pay attention to the fact that
foreigners’ communities are divided into subcommunities.
Taking Vietnamese as an example, most students studying inJapan are from the south of the country and are relatively highly
educated, while most technical interns are from poorer agricultural
regions in the north, with a relatively low level of education. These
two groups, therefore, do not make up one single community ofVietnamese people in Japan. In the case of Myanmar as well, thecountry has many ethnic minorities and they live in communities of
their respective ethnic groups in Japan. In Nepal, the effects of acaste system remain, and we can see division by caste among
Nepalis in Japan as well.

Japan SPOTLIGHT • January / February 2022

49

Influential Social Media
Therefore, if we want to spread information in foreigners’communities, and taking into account the existence of these
subcommunities, we need a careful strategy for disseminating
information in those various languages. Before Christmas 2020,
MINNA prepared a video showing how to prevent the spread of
infections at parties in English, Vietnamese, Burmese, and Nepali,
and loaded the video to Facebook pages in each of those languages
with the hope that it would spread. The video was easy to follow,
used likeable animation, and was of high quality, but in the end it did
not spread to the extent we had hoped. The main reason was thatpeople did not go to social media when they wanted information
about preventing the spread of infections. For students who had losttheir part-time jobs and technical interns who had gone missing andwere looking for work, information about job possibilities was much
more important than information about preventing the spread of
infections.
Nevertheless, people were still concerned about getting infected,
so MINNA then prepared an illustrated chart explaining what you

should do if “you thought you might have contracted, or havecontracted, Covid-19”. This chart appears to have been circulated
among the Japanese people who are supporting those vulnerable
workers rather than the foreign residents themselves.
Going into 2021, MINNA found the information Facebook page
TAIHEN, which is very popular among Vietnamese, and operated on
a commercial basis. After the operator agreed to post information
about things like vaccinations, the Facebook page began being
accessed tens of thousands of times. This showed the necessity ofmaking the effort to directly contact influencers and produce content
together with them.
There are also people in foreign communities who have lived inJapan for a long time and have close connections with Japanesesociety, such as Filipino Roman Catholic priests and Buddhist monks
in Japan from countries like Myanmar and Vietmam. They carried out
activities based at their religious facilities to support people in need.
We also saw some types of self-help groups with leaders of
foreigners’ communities in rural areas using their personal networks
to support their compatriots. However, these circles encompass only
limited geographies, and cannot be expected to disseminate

CHART 2

Necessary steps for foreigners to reach health services2) Spread good practices of “Lead fromconsultation centers to medical institutions”
Residence status,
language barriers

Patient

Unemployed / Employed
Residence / Rent
Daily life / Meals
Health insurance /Health uncertainty
Depression
Pregnancy & childbirth
Family / Domestic violenceChildren’s education

Communities /Subcommunities offoreign residents

Supportactors?

Facebook
Surrounding people
Persons
Japanese
who can
Coworkers language
speak
schools
Japanese
Supporting organizations& individuals

Local organizations
Japanese language
volunteers

Comprehensive
consultation
advice centers

50 Japan SPOTLIGHT • January / February 2022

Hospital

Health centers

NGOs1) Fill in gaps in information to “Prevent
infection clusters and support foreigners toaccess consultation centers”
Companies/Employer
Commercial andindustrial associations
Universities

Source: MINNA

Medicalinterpreter

Local governments(municipalities)

3) Create policy
agenda to “Make asolid route fromconsultation centers
for foreign persons”
to medical
institutions

information to foreign communities in other areas.

Vaccine Information
Japan’s full-scale, nationwide vaccine rollout began in the summerof 2021, and foreign residents who wanted to be vaccinated tried toobtain information. Foreign people with a valid residence status andregistered with their local government were able to use the sameprocedures as Japanese residents. They receive vaccination
vouchers from their local government according to the schedule byage, so they should have had no particular problems. Nevertheless,the vaccination vouchers and questionnaire were in Japanese only,
so they needed to have someone who understood Japanese to
explain procedures to them.
Students at relatively well-run schools could be vaccinatedthrough their school, and technical interns working for large
corporations had opportunities for workplace vaccinations. However,short-term residents, interns who had gone missing, and otherforeign people who were not registered with a local government were
initially not eligible for vaccinations (this was the case for diplomats
as well). In terms of preventing the spread of infections it ispreferable that everyone who wants to get vaccinated should be able
to receive the vaccine, regardless of residence status.
In Tokyo, the metropolitan government’s first focus of attention
was on Japanese people who were homeless and not registered atward offices. In some wards, they would be issued vaccination
vouchers if it could be confirmed that they did in fact live in aparticular ward, even if they did not have a certificate of residence.
Similarly, some wards looked at ways to issue vaccination vouchers
to foreign residents without a valid residence status using theaddress of a support organization. Nonetheless, staff at healthcenters are obligated as civil servants to report persons who do nothave a valid residence status to immigration authorities, and many
foreigners without valid visas did not want to take the risk ofaccessing a medical institution.
For the sake of preventing infections of a communicable disease, it
is not desirable that there are barriers to access to medical
examinations and vaccinations for these people. Therefore, in June
2021 the Ministry of Health, Labour and Welfare issued a directive tohealth center staff and others that they could use their own
judgement in deciding to report vaccine recipients without a valid
residence status to immigration authorities (meaning that they could
decide not to report the person). Subsequently, support
organizations in various regions began working with local
governments to provide people without valid residence statuses withvaccination vouchers, and this achieved some degree of success.

The town of Oarai in Ibaraki Prefecture, for example, has a large
number of unregistered foreign workers and the municipal officesimplified its requirements for vaccination vouchers and responded
flexibly on-site, issuing vouchers to overstaying Indonesian residents
who had been identified by support organizations.

Toward True Universal Health Coverage
These good practices are to some extent carried out as“emergency measures” that place a priority on infection control.
However, they could be criticized as leading to “opening the door toimmigration” by “anti-immigration” people. Nevertheless, the UN’s
International Organization for Migration (IOM) has issued a policy
stating that based on the principle of non-discrimination, impartial
access to coronavirus vaccines should be guaranteed for all migrants
and their families, regardless of nationality or residence status,
meaning that those good practices are the correct policy in terms ofinfection control as well as human rights.
Japan is proud of providing universal health coverage, which is inaccordance with the Sustainable Development Goals. Then it is notdesirable that access to health and medical care in Japan is limitedby language and residence status.
Foreign workers are indispensable in Japan for avoiding industrial
decline from labor shortages. The government’s official position is to“have no immigration policy” and it emphasizes that it will accept
only “highly skilled professionals”. But looking at examples aroundthe world, no country has been successful in selectively accepting
only highly skilled professionals. In the first place, Japan will not be“chosen” by ordinary workers who are not highly skilled if theycannot live there comfortably, and highly skilled professionals willcertainly not come to a country that is not chosen by ordinary
workers.
The spirit of the SDGs is to ensure “no one will be left behind”.
How to support the lives of foreign workers, who tend to be forced
into vulnerable positions, is truly being tested now during the Covid19 pandemic, and this problem is the flip side of the coin as towhether Japan itself can create a sustainable society in the face of adeclining birthrate and aging population.

Sato Kan Hiroshi is chief senior researcher at the Institute of Developing
Economies (IDE-JETRO). A graduate of the University of Tokyo, he has been avisiting researcher at various institutions in Japan, Yemen and the United
Kingdom. His work focuses on the social impacts of aid projects, from primary
health care to rural development, and he has visited numerous developing
countries in Southeast Asia, South Asia, Africa, Central America, and the Middle
East.

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