It all started last week when I received a strange envelope from a colleague, who told me there would be a health exam on Tuesday. I opened the package to find 4 sheets covered in kanji, plus a small plastic container and bottle. I deduced that the bottle was for a urine sample, but everything else was a complete mystery.
Well, today rolled around, and before I knew it, I was in line for my first health check in Japan. After queuing up behind several other colleagues, I presented my chart to the health worker. Needless to say, I hadn’t filled in anything because I couldn’t read it, and no one had even mentioned that I needed to fill anything in! The principal was summoned and he kindly used his excellent English skills to translate for me. All the questions were about diet and exercise. Did I exercise 3 times a week? Did I drink less than 180ml of alcohol when I drank? Did I eat faster or slower than other people my age? Did I eat within 2 hours before bed?
I was then subjected to a chest x-ray, presumably to check for tuberculosis (which is apparently still a common health concern in Japan). The technician was male, and luckily I was wearing an undershirt, otherwise I would have had to be naked on top! Next was a waist measurement. Despite the fact that I am quite clearly not overweight, it had to be measured. (Japan is currently introducing nationwide waist measurement guidelines which everyone is supposed to conform to regardless of build, height, weight, etc.) In my haste to get dressed I forgot to tuck in my undershirt, which evoked an embarrassed giggle from the health check lady. She didn’t let me leave the room until I tucked it in.
Moving along the assembly line, I had my height and weight measured and entered into the computer to ensure I had a healthy BMI. Next were hearing and eye tests, and finally blood work. Being practically illiterate in Japanese, and not having had anyone inform me there would be a blood test, I didn’t know NOT to eat breakfast that morning. So my blood sample will undoubtedly show a high glucose reading and other such unacceptable things.
And- 終わります！(finished) I might mention that all of this, except the x-ray and waist measurement, was conducted in front of my workmates. Completely public. I personally didn’t have a problem with that, but there is little sympathy for people who might be embarrassed about their weight or anxious about medical tests. It felt a bit like boot camp induction.
I noticed that only the fairly young teachers were being tested today, so probably this round of checks is focusing on prevention of metabolic syndrome, or メタボ (metabo) in Japanese. It’s their code word for being fat, having a bad diet and lack of exercise. I recently read an interesting article about the newest health campaign in Japan- the fight against metabo.(http://www.nytimes.com/2008/06/13/world/asia/13fat.html?_r=2&hp&oref=slogin&oref=slogin) The government is going to start fining local governments and companies whose people fail to meet national waist measurement guidelines. There’s a whole marketing system going on, complete with catchy songs:
"…at a city gym in Amagasaki recently, dozens of residents — few of whom appeared overweight — danced to the city’s anti-metabo song, which warned against trouser buttons popping and flying away, “pyun-pyun-pyun!”
“Goodbye, metabolic. Let’s get our checkups together. Go! Go! Go!
Goodbye, metabolic. Don’t wait till you get sick. No! No! No!”
While I’m talking about health campaigns- in Japan, standardized health information is periodically distributed to schools, offices and companies. There’s a bulletin board at my school on which different posters appear every so often, informing students and staff about health issues they should watch for. In summer it’s heat stroke and sunburn, in winter it’s frostbite, and the rest of the year, it’s things like athlete’s foot, muscle injuries, coldsores, TB, gum disease, HIV and various other intriguing conditions. Invariably, the posters feature cute cartoons right alongside very graphic photos.
On top of that, we are given health newsletters every two weeks, containing useful advice like what to eat for breakfast, how to stretch, and how to treat a cold. There seems to be a particular emphasis on maintaining a daily body rhythm (‘keeping it regular’)!
Of course I think that raising awareness of obesity and encouraging people to live healthy lives can only be a good thing. But it’s hard not to question the effectiveness of the campaign in Japan. True, there are few overweight people here, especially compared to countries like the US and Australia. But at the same time, I don’t feel that the Japanese really live particularly healthy lifestyles. They still eat bowls and bowls of white rice every day, drink like fish, eat few raw vegetables, and gorge on fast food. Fruit and vegetables are astronomically expensive. You will see people lining up at Mister Donut with trays piled high with donuts- 6 per person, even (or especially) for skinny little high school girls. I honestly don’t know how people stay so small and slim. All I know is that excessive dieting does not seem to be considered a bad thing. Women’s magazines recommend eating energy bars for breakfast, lunch and dinner. And since there seems to be little awareness or concern about eating disorders, I wouldn’t be surprised if half the girls in my classes were bordering on bulimic. Most of them swear they are ‘fat’, even though their legs are barely thicker than my arms.
In spite of all the apparent efforts to prevent diabetes, heart disease and stroke by controlling people’s waistlines, smoking is still prevalent here in Japan. There is no negative stigma attached to it. In that respect, Japan feels like a smoker’s paradise: there are smoking rooms everywhere, vending machines sell cigarettes on almost every corner, and smoking sections in restaurants tend to be bigger and nicer than non-smoking ones.
I can’t help but feel that this latest national health campaign is not only about making everyone healthier, but also about controlling people (all that work we did on Foucault’s ideas- http://en.wikipedia.org/wiki/Michel_Foucault- in anthropology still haunts me). I won’t launch into a thesis, but I resent the fact that one’s workplace should be able schedule and control something as personal as a health exam. But, I guess maybe it’s preferable to having people avoid the doctor, and it’s nice that it’s free.
I’m sure in a few weeks I will receive another mysterious envelope containing reams of paper covered with kanji. And if it says I have TB or anaemia, who am I to know? Better brush up on that Japanese medical jargon!
