Aug 14

Nathaniel Simmons (Nara-ken, 2007-2009) is currently is currently a communication faculty member at Western Governors University and lives in Columbus, OH, USA.  He teaches a variety of intercultural, interpersonal, and health communication courses. He has researched and published several scholarly articles regarding privacy management between foreign English teachers and Japanese co-workers in Japan.

“Something of and in Japan, [is that] it doesn’t matter about who you are. Your health is never private.  They [Japanese] don’t see health as a privacy thing.  So you know, if you want to keep it private, don’t talk to anyone about it.” – Alice

After having my own interesting health experiences in Japan, I remained curious as to what other ALTs experienced.  Therefore, I went back to Japan and interviewed 10 ALTs (5 women and 5 men) about their medical encounters.  I quickly learned that it wasn’t “just me.”  I heard a lot of strong comments such as Alice’s.  In fact, everyone managed their medical privacy to some extent.  I share one story below:

“There were no barriers. Every person in the village, every school, you know everyone in the Board of Education, the whole school knew that I broke my leg and what days I was going to the hospital, and medication I’ve been given.  There’s no quiet, patient confidentiality.”

Meet “Jamie.”

An ALT in rural Japan like most of the ALTs employed by ALT organizations.  She loved her job, teachers, and students.  She worked hard and was enthusiastic about English education.

After breaking her leg, everyone knew.  But how?  She explained:

“It starts off with the supervisor who tells the Board of Education, they then informed the schools, and well, the schools tell the teachers, and the students ask, they tell the students, the students tell the parents, the parents go to the restaurant down the road and tell them, and the whole village knows.”

For Jamie, living in rural Japan meant that she wasn’t able to obtain her desired privacy levels.  Suddenly, she was not just the “foreigner,” but the “foreigner with the broken leg.”  She was the talk of the town.  Even her prescribed medication wasn’t a secret.  At the same time, Jamie was a “good sport.”  She laughed about the spectacle of her situation.  However, this somewhat uncomfortable experience influenced later health encounters.

After having appendicitis, Jamie didn’t want to go to the hospital as her doctor suggested.  She told her Board of Education (BOE) that she just needed to go home and “sleep it off.”  However, her tale doesn’t end there.

“I got a phone call from my Board of Education! [The] Doctor called the hospital when I didn’t turn up.  So, the doctor then called the Board of Education and told them everything, what he thought, and that I needed to go to the hospital.  The Board of Education called me and I said “No, I just want to sleep,” and they are like, “It’s too late. Your supervisor is coming to your house to pick you up, to take you to the hospital.”

Although somewhat comical to Jamie, she saw this as a privacy violation.  After-all, this isn’t a situation Jamie would have experienced in her home country.  People now knew information she didn’t want them to know.  She attempted to not have her school involved, but things didn’t go the way she planned.  In reality, the doctor’s decision potentially saved her life, but, at the same time, Jamie perceived her privacy to be violated.

This sentiment was echoed throughout stories of ALTs’ health experiences.  Someone told someone, who told someone else…and before they knew it, everyone knew information about them and, yet, they didn’t know much about anyone else.

How did ALTs manage their privacy in this study?

Withdrawing from workplace relationships (i.e., not talking to co-workers), lying, intentionally or through omission, and relying on the help of a non-workplace related friend (i.e., another ALT, Japanese friend, etc.) were the three most common strategies shared.  For example, if an ALT was on medication that they didn’t want their co-workers to know about, they might say it was an “allergy” pill.  If any ALT felt their privacy was violated, they stopped talking to co-workers…sometimes about everything.

Questions for you:

  • To what extent was privacy a concern for you?  Why/why not?
  • How did you protect your secrets?  (It doesn’t just have to be health!)
  • What do you recommend to current ALTs regarding their private health information?  Future ALTs?  Do you agree with Alice?

This blog post is an adaptation of the scholarly article: Simmons, N. (2012). The tales of gaijin: Health privacy perspectives of foreign English teachers in Japan. Kaleidoscope: A Graduate Journal of Qualitative Communication Research, 11, 17-38. Retrieved from

one comment so far...

  • gordon Said on August 22nd, 2015 at 7:20 am:

    Many of the ALTs are accepted as “family” in the rural areas of Japan. The locals are not treating the ALT in any special way. Other than they are “special” to their respective communities.

    The same sharing of personal information is common in many countries I’ve been in, it is not unique to rural/small town Japan. The locals are concerned about you. Worried about your health. A lesser version of this is also found in the bigger cities. (where no one will share your prescription information)
    In large corporations in Japan the HR dept will often not even tell you the TOEIC scores of your prospective students. Personal privacy is highly respected in this area. But, if you get sick don’t expect to keep it a secret. Everyone’s concerned about your health.

    If anyone going as a ALT or JET to Japan doesn’t want to be accepted into the community (with all of its foibles) DON’T GO TO JAPAN! STAY HOME.

    The values, beliefs, assumptions, expectations that you hold as an American have little worth outside of your own, insular, reality construct. “Truth” doesn’t travel well. It is highly dependent on time, place and context. A “we are the world” point of view is an arrogant, insulting and dangerous frame of mind in the best of situations if you transpose “Americans” for “we”.
    You are never “the world”. You can only be one point of view. The validity of which is often doubtful and you really need to examine your lack of ability to see the world through another’s eyes (values, beliefs, experience, needs, assumptions and expectations).

    There is a process which is highly recommended for any cross-cultural interaction, personal or business. It has been termed “Negotiating Reality”. Look it up, try it out.

    A parting comment:

    What you see is not always what you’re looking at
    We each deal with our own slice of reality
    –Get that down before you try on someone else’s

    Wearing your own reality is not always easy
    –ask the king…
    (Mostly subconscious, it’s largely non-visible)
    -Think about that when you ask someone else to wear yours

    and good luck!

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