Therese Zink M.D.

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Hygiene in Japan

Why am I writing from Japan?

Since the volunteer visa was not forthcoming in a timely manner, Reed and I returned to the US at the end of Feb. I had planned to work with Family Medicine in Palestine for 3 months, until my job in Rhode Island started in May. First, I was hugely disappointed that my work in Palestine was not possible. Suddenly we had two months on our hands and with no place to live, having moved our things into storage.Such unplanned time is both gift and curse. We regrouped checking in with family, checking on the horse I am trying to sell, sorting through mail and options. We headed west to pick up our dog, Conner, who was staying with my sis in San Diego.

Since the price was right (cheap flights from California) as well as the timing—you need snow in Japan to visit the red crested cranes and the snow monkeys—we booked a trip. Since we are little pre-Cherry Blossom time, prices are low. So here we are in Japan for three weeks. Since Reed has the travelogue covered, I am blogging with a health twist.

I have found myself fascinated by Japan’s very clean and very efficient attention to hygiene, which borders on compulsive, and the amazing use of space. First the toilets. Most seats are warm. That feels great when you come inside from standing outside watching the red crested cranes feed in a snowy field. In addition there are water spigots inside the toilet, an upgraded bidet of sorts, managed with buttons which alter the direction, pressure, and pulsation versus steady stream, all to cleanse your private parts. They are always instructions in Japanese, often in English and sometimes braille as well. These deluxe toilets--not the lap of luxury, but bum luxury--can be found in hotels, train stations, stores, museums, etc. Essentially they are the norm. Yeah, I have found a cold seat here and there and in some public places, people have the option to sit or squat. Toilet paper is always present and the stalls are spotless.

This is a big contrast from Jordan or my travels in Central South America where I always made sure I had a small pack of tissue. Instructions about where to put TP are also clearly written—in the toilet in Japan. This is also different from the Middle East and South/Central America where plumbing is less robust and can’t handle the volume.

Bathrooms like hotel rooms are small and planned in a sensible and orderly manner to make the most of the space. They are well stocked with amenities. In the bathroom there are individual soap, shampoo and conditioner bottles for personal use or larger dispensers. Our current hotel room supplies shaving lotion. Toothbrushes and paste have been supplied in every room to date. Individually packaged hair brushes, sponges and wash rags are often provided.

Closets offer clothing brushes, shoe horns, shoe-polish rags, slippers. Note: we are not staying in fancy places! Plumbing is efficient and ingenious in showers and sinks but easy to figure out. You have to step up into many hotel bathrooms which makes them not friendly to the elderly or disabled. Hotel bathrooms appear to be a container that is installed as one until like a shower to prevent water damage and make them easy to clean. No shower curtain racks are expanded for plus size users.

And then there are the face masks. Originally they were worn if you had a cold—how thoughtful. When a company introduced a new mask using a nonwoven material that was more effective at blocking pollen people started wearing them as allergy prevention. Sales figures show that the use of masks have tripled over the last decade. Our research suggests people use them to prevent getting ill due to all the time in public places given commutes and to protect their faces in cold weather. Who knows??

We have a rail pass, so we are taking bullet trains and the local diesel variety. All are spotless. In the Tokyo Rail station, the cleaning crew for the bullet trains were amazing to watch. Dressed in uniforms with a bag of cleaning utensils and materials slung over their shoulders, they lined-up and bowed as the train sped into the station. After passengers disembarked, the leader spoke, the workers responded with some salutation, then they bowed again and entered the train. They had only ten minutes to clean the train and bathrooms, rotating seats 180 degrees to face the other direction. When done they lined up, gave another salutation in unison, bowed and dispersed. Only they were passengers allowed to enter.

When walking the streets, you can’t help noting the cleanliness and order. There is no trash. Bushes are wrapped for the winter. Pedestrians do not jay walk and patiently wait for the signals to change. We have mended our rule-breaking ways (for now). Sidewalks in the cities have well marked pedestrian and bike lanes. Curbs at corners have a slope, making it friendly to roller-bags, wheelchairs and bikes.

We were shocked to see how poorly sidewalks and streets were managed in the wintery cities as we moved north. For the most part, salt is not used. As a result, sidewalks are an obstacle course of packed ice and melt and a set up for broken bones. If it was the US, there would be law suits galore for the city.

Odor-free. The Japanese appear to be obsessed with odors. Fans automatically come on in the bathrooms. Most hotel rooms have a fragrance-free spray bottle hanging in the small closet. Directions suggest use on clothes, bedding and in the room. Perfumes and colognes are popular—pleasant odors. Even the fish markets are odorless. Our Tokyo fish market made a point of pointing this out and reporting that there are no flies in the summer. To manage this they wash and scrub everything, use salt water from the bay which has a natural repellent and start early and wrap up by noon, before the heat.

It has been a pleasure to see the sense of order and attention Japanese bring to everything they do. There is also the team or community effort and spirit. Like the train cleaners, waiters work as a team. The group welcomes you when you walk in the restaurant and acknowledges your exit. It is so different from the individual focus in the US. Of course there are advantages and disadvantages to both. But for now I wait at crosswalks and savor the value and opportunity to experience such a clean, orderly and intentional society.