Wednesday, February 23, 2011

It’s not a cold!: On colds, flu, hygiene, sanitation in Japan

There are many discrepancies in the Japanese language that I have become aware of since being here, whether it’s words with double, conflicting meanings, or just plain lack of clarity. One of the hardest to discern happens to be kaze, what we are taught to understand as a cold.

You would think that clarity in medical terms would be important. The word either has a broader meaning than cold, or there is something strangely different about the medical understanding of a cold in Japan.

A cold, as I have grown up to understand it, is a respiratory problem. Sinuses stuffed, cough and/or runny nose? That right there is a cold. In Japan, however, the term kaze is also used to diagnose digestive symptoms like diarrhea.
With some of the strange explanations from Japanese medical professionals I’ve heard vicariously, I wouldn’t be surprised if the Japanese perspective of a cold greatly differs from the west. Kaze could be more accurately compared to the non-technical phrases like “caught a bug.” It seems to be much more encompassing than just a respiratory cold.

A couple times a week, it seems, I overhear the phrase “choushi warui” being exchanged between my host parents. It’s basically a shrouded statement, “My condition is bad,” most commonly used with reference to digestion. You can almost always assume it means, “I’m irregular.” What immediately follows without fail is the comment, “I hope it’s not a cold.”

Let me quickly give an example of what I have heard.

Host dad: “My condition was bad this morning, but I got better throughout the day. I’m glad it’s not a cold.”

I have never connected a cold with excremental problems, and I doubt I will ever be convinced of that. I can say by simple observation that any problems with digestion are not likely caused by a cold, rather food preparation and sanitation if anything. Leftovers at my homestay do not get packaged up and refrigerated. They get placed in a covered pot on the stove or lightly draped with a sheet of saran wrap on the table and left to sit overnight. The lack of dish soap usage is concerning (it’s there, please use it). Not to mention the handling of meat products… and wooden cutting boards. [I often drizzle some dishsoap on the scrubber when my host parents aren't around to feel a bit more comfortable]

Several weeks ago Alexa came down with a fever. My host mom’s reaction was immediately that it must be a cold. When Alexa went to the clinic, however, she tested negative for influenza. She was told it was probably still influenza, but that it probably “hadn’t reached” her nose where they tested. What?! Something seems a bit wonky to me, and I’m not sure I’m comfortable with that.

Japan’s solution to influenza and colds is wearing a facemask. I’m more than skeptical on the true effectiveness of a piece of paper preventing contraction of germs or a virus. At least it’s something, but there are other factors to Japan that I find to be blatantly ignorant.

Proximity is probably the biggest problem Japan has when it comes to spreading sickness. Population is dense, and a huge portion of the population relies on public transport for their daily commute. Said public transport is a deathtrap, being crammed shoulder to shoulder and breathing the same air stuck in an underground, enclosed train car. There was even a news feature recently along the lines of “Ride bus = Get influenza!” They recognize it too.

It’s true that many people do not wash their hands after using the restroom, but as a person who absolutely does, I am often struck clueless as to the unavailability of soap in many public restrooms. If soap is available, it’s quite watery to the point where one might assume it’s been diluted. Not to mention that sinks do not produce warm water almost anywhere. Often there are air driers for some peoples’ cold rinsed hands, but in some places there are none. Automatic air driers are a good step in the sanitary direction, but often it is expected that people carry their own handkerchiefs for drying their hands, if they feel like rinsing them that is.

The common advice for preventing colds and flu? This gets even more frustrating.
• Wash hands
• Gargle
• Wear a mask

I’ve already expressed my lack of confidence in masks and the complications for accomplishing a real hand washing, but gargling? Gargling is going to do nothing against those pesky germs and viruses out to get all of us. It just doesn’t make sense. It often feels that the Japanese are living under this veil of illusionment, but no one is going to speak out about things because that is just the way they are and expressing one’s own view is not commonly accepted.

It’s almost just as silly as being warned that if you only take a shower and not follow it up with a bath you’re going to catch a cold. Come on already! Taking a bath after a shower in the near equivalent of a rickety outhouse in the middle of winter is not going to make any difference. Your body is wet either way, and it’s just plain cold. The same rule still applies during summer.

Colds are the result of germs and viruses, not skipping a bath. I’ll stick to just my shower, thanks.

8 comments:

  1. Before I begin, a cold and the flu are different viruses, though admittedly they have some similar symptoms. However, Japanese medicine is pretty impressive, so let's break this down a bit.

    1. The Mask issue. Ah yes, masks.
    Japanese people primarily use masks not to avoid transmission of infection directly, since obviously the virus easily passes through the fabric, but rather for two reasons:

    A) Avoid spreading the virus to the hands. The mask prevents individuals from touching their snot or other bodily fluids which may be infected, and thus avoids transmission. Flu requires entry via bodily orifice, after all. If my hand isn't infected and I open a door, I don't have to worry about passing it on to your hand, which will then likely scratch an eye, touch food, etc. The mask prevents my hands from contacting my nasty infected snot.

    B) In a lot of ways, it's used merely show others that one is sick so that those around you may take the appropriate precautions. See someone with a mask? Run run run, lolz.

    2. From what I understand, gargling can help with sore throats, but you're right, I doubt it helps cure any flu. But we have our own crazy ideas on curing colds, like chicken noodle soup (which makes no sense, since that stuff is loaded with sodium and dehydrates you).

    3. The method used to test for influenza in Japan involves either a swab via the throat, or a nasal cavity swab. They shove a long, narrow straw like swab into your nose, about 3-5 inches deep. Mmmmm.

    The issue with the swab technique is that if the infection is too early, the test won't detect the virus. If you jump over to the doctor as soon as you feel sick, they might not be able to get a formal diagnosis.

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  2. Thanks for the contribution, Mike.

    You are right about the mask. It is a good sign to others around you that you are sick.

    I get a bit ticked at how glorified it seems to become as a miracle solution, but I do exagerrate a bit. The contact issue is a good point, and it would help in that way.

    I, fortunately, have not needed to be tested for influenza. I hope it stays that way.

    Japan has conducted tests on the effectiveness of gargling, and it has shown little effect.

    To clarify, gargling involves either water or treatments. In the states, when recommended, cgargling involves warm salt water based on my experience. It helps to sooth sore throaths, so it does have some beneficial effects, but it is not a method of prevention.

    I have witnessed Japanese men gargle tap water in public bathrooms. Ick. I want to carry a spray bottle of lysol around with me.

    Japan Times has a good article on gargling:
    http://search.japantimes.co.jp/cgi-bin/fl20091215zg.html

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  3. While I think this is a very good insight, I do think there are some things to consider:

    I don't think anyone in Japan is saying that viruses don't cause "colds" (be it what we, westerners, consider to be a "cold," influenza, or other illness). However, it may be a cultural perspective that to rid the body of illness, cleaning one's self and making one's self more clean might enhance the body and "clean" away some of the disease.

    Though, if that is the case, it is a little surprising to me that they wouldn't have hand soap or other things in public restrooms. Perhaps it's better to clean the whole body as opposed to only parts.

    I know the word also means "wind," (though, I'm sure this is probably a completely different kanji character, no?)--is there something to do with the wind gods making illness in Shintoism? That might also play a role.

    I'm not saying these things as a criticism, mind you, but I think there's more here than what meets the eye.

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  4. You know how a lot of people carry sanitizer bottles around with them here? Are those popular at all there? Its not hand washing but its better than nothing - lol. If I were in your position I would probably start carrying around my own soap. Either a travel sized bar in one of those plastic soap containers, or some liquid soap in a small sauce container. (Maybe the kind that you pack liquids into bento with.)

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  5. Ashlee, good question.

    Kaze for wind is the symbol 風.
    Kaze for common cold is 風邪, basically meaning "bad wind."

    Given the meaning, one might discern that the terminology would still solely be used for respiratory related things.

    I kind of mentioned in my intro, but never followed through with the examination of whether the phrase has just become a figure of speech.

    Elizabeth, I haven't observed much sanitizer here for sale, nor people using it. It would be a good thing to further investigate, I think. Thanks for bringing that up!

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  6. What's the fundamental difference between a 'cold' (kaze) and 'influenza' in Japanese?

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