More than a decade ago, a large number of non-Japanese were hospitalized due to HIV/AIDS complications. These non-Japanese learned about their HIV infection after they had developed AIDS. Seeing that they lacked the proper resources to make well-informed decisions, doctors and counsellors in Japan felt there was a need for a civic organization that would respond to their needs.
Founding CHARM
The Center for Health and Rights of Migrants (CHARM) was founded in 2002 and sought to “realize a society where everyone has access to medical service.”1 It primarily deals with non-Japanese and those who are disempowered, such as those with “language barriers” and “lack of information about the [Japanese] welfare system.”2 Its mission is twofold: 1) to provide individual support to people living with HIV/AIDS (PLWHAs) and their families/partners; and 2) to cooperate with government agencies and private sectors to facilitate better access to medical services by non-Japanese.3
It works with “hospitals, government agencies, private organizations, business sectors and concerned individuals to fill the gap between people's needs and services specialized institutions offer.”4 It also works with local government agencies regarding policy formation. It provides data to these government agencies to aid them in policy making. In addition to policy formation, CHARM works directly with local government officials in the field. For example, CHARM has partnered with local government employees in a health outreach program for non-Japanese.
Activities and Services
CHARM offers a wide range of individual support to PLWHAs, victims of domestic violence and even those seeking employment. Their main services include a multi-language telephone hotline service, individual assistance, and group programs. When CHARM was initially founded, the majority of their clients were migrants (approximately, 80 percent non-Japanese, 20 percent Japanese). However, over the course of their near fourteen-year existence, CHARM has experienced a large increase in needs among Japanese clients who have no support system.
CHARM maintains a multi-language (Portuguese, Spanish, English, Thai, Filipino, and Japanese), anonymous and free telephone hotline, which aims to provide information on HIV and sexual health and is available Tuesday thru Thursday. In addition, one can inquire about health facilities that provide free, and anonymous, sexually transmitted infections (STI) and HIV/AIDS testing and are English-friendly. Moreover, one may call the telephone hotline to inquire about anything related to sexual and reproductive health. The scope of its telephone hotline service is quite broad – CHARM assists with anything related to HIV/AIDS, sexual health, and overall well-being, regardless of one’s HIV status.
In addition to maintaining a telephone hotline, CHARM offers a consultation service for PLHWAs. This service is meant to help alleviate any problems clients may have. As part of this service, CHARM staff listens to the client, helps the client organize his or her thoughts, brainstorms ideas on moving forward, assists in establishing goals and creating a viable framework for the future. Further, the consultation service is free of charge and appointments can be made by phone or e-mail.
Lastly, CHARM offers consultations over the phone and at their office in Osaka.5 Other services include an interpreter service, mobile home and prison visits, and referrals for HIV/AIDS treatment in other countries.
As part of CHARM’s interpreter service, CHARM provides an interpreter for PLWHAs to accompany them at a visit of particular importance, such as an appointment with a medical professional or a discussion with a social worker. Although this service is limited to HIV/AIDS related matters, CHARM is very accommodating as the service is completely free of charge and works with the client to come up with a consultation schedule and other conditions of the service. CHARM’s “home and prison visit” service is available to those who do not have the
means to travel to CHARM’s office. In such a case, CHARM sends a social worker, nurse, or student to the client’s home to attend to the clients’ needs. CHARM also tailors their visits according to the unique circumstances of each client, meaning those with barriers in accessing CHARM’s resources, either geographically or financially, such as prison inmates, those hospitalized, or those with limited means, can still be accommodated. Lastly, CHARM has connections with organizations around the globe to assist clients who seek HIV/AIDS treatment and services in other countries. When needed, CHARM can inquire and refer clients to an appropriate support organization located outside of Japan.
Health Fiesta
One of its major events is the “Health Fiesta,” which aims to enable non-Japanese residents to feel secure in dealing with their own health issues. It is organized along with various civic organizations and the local governments. The “Health Fiesta” is held every November in Kyoto at the Fushimi Youth Activity Center. The program is co-sponsored by the Fushimi Youth Activity Center, with the cooperation of the Fushimi Public Health Center, Kyoto International Foundation, Kyoto Fushimi-ku Council of Social Welfare, Kyoto YWCA's Asian People Together, Kyoto Pag-Asa Filipino Community, Kyoto Association of Pinoy Scholars, and Bazaar Café.
Several programs are held simultaneously during the “Health Fiesta.” The main stage, food court, and workshop areas of the Fushimi Youth Activity Center were used to provide health checkups, health consultations with volunteer medical professionals, general consultations, HIV/STI testing and chest X-rays. Other activities include gynecologist consultations on women’s diseases, individual consultations, health checkups for body fat and BMI, and a breast self-examination tutorial. Volunteers and other organizers, including those from CHARM, disseminate information at universities and other spaces where there are many foreigners. CHARM also maintains a Home Page, an SNS blog, a Facebook, and a Twitter page to disseminate information about the event. 151 persons from the Philippines, Thailand, U.S.A., China, Brazil, Peru, Korea and Japan attended the event a few years ago. Twenty-six people took an HIV/STI or X-ray test. The health checkup corner, which was a new program in the event, was very popular and crowded with people. Five persons consulted medical professionals for their health concerns. The next “Health Fiesta” will be held in Kyoto on 19 November 2016.
CHARM has also partnered with local governments in creating a health consultation outreach program on health issues for foreigners. On 23 October 2016, in the Namba district of Osaka, CHARM along with local government employees (a Health Nurse and two Child Rearing Assistants) from Osaka city Chuo ward office, will be providing free health consultations and information to foreigners.
Health Issues
CHARM serves as a first step towards solving problems. CHARM’s specializes in handling issues surrounding HIV/AIDS and sexual and reproductive health. On other issues such as domestic violence, education and employment, CHARM refers the client to organizations or institutions that specialize on the issues. Health and human rights are closely intertwined and thus, someone whose rights are violated will likely have health issues.
Domestic violence not only causes physical harm to the victim, but also psychological harm, which may have a rippling effect later on in the victims’s life. Consequently, domestic violence is unquestionably a health issue. CHARM is connected with several other non-profit organizations (NPOs) that specifically deal with these issues and refers victims of domestic violence to these organizations. Moreover, CHARM holds drop-in lunch meetings for people living with HIV. During these lunches, no topics are off limits. Discussions are broad in scope as the purpose of the lunch is to create a safe and welcoming environment where men and women can express their troubles freely and without judgment.
Materials
CHARM disseminates a variety of informative materials (in five languages) such as HIV/AIDS information on transmission, prevention, and awareness. Moreover, they have materials covering testing, services offered at public health centers in Japan, the medical system in Japan, the social welfare system in Japan, and basic information about HIV infection.
The Future: Continued Operations
CHARM has been providing community support for PLWHAs for nearly fourteen years. Though it has been a vital resource to the community, CHARM faces the challenge of an aging population that brings novel problems. Naturally, clients are older now than when CHARM first began operation. With older clients comes new issues, such as preparing for the client’s final phase of life. Each client’s case is unique but all cases involve difficult decisions and require a considerable amount of thinking and decision making. CHARM will need to respond to these ever increasing needs by expanding its services. For CHARM to be effective in carrying out its mission, it is imperative that it has the financial resources to adapt to the needs of their increasingly demanding clientele base.
Throughout its almost fourteen-year existence, CHARM has made tremendous strides towards reaching its vision of “a society where everyone has access to medical service.” Though it will undoubtedly face new problems related to an aging clientele base, funding, and resource allocation, CHARM will continue to make a difference in providing access to health and in promoting the human rights of both non-Japanese and Japanese. The amount of societal goodwill CHARM provides is just too essential.
Tex Boonjue was an intern of HURIGHTS OSAKA during the July-August 2016 period. He is currently taking a juris doctor course at the Indiana University Robert H. McKinney School of Law (Indiana, U.S.A.).
For further information, please contact Tex Boonjue at this e-mail address: Tex.Boonjue@gmail.com.
Endnotes
1 CHARM website, www.charmjapan.com/index_e.html
5 CHARM’s address: 10-19 Kan-ei-cho, Kita-ki, Osaka-shi, Osaka, 530-0031, Japan. It can be reached by phone (81-6 - 6354 - 5901 [English service] and 81-6-6354 - 5902 [Japanese service]), fax (81-6-6354 - 5902) and e-mail: office@charmjapan.com.