There are some services available for your children. Be prepared ahead of time for this
emergency situation.

1. Day Service for Recuperating Children and Infants ( Infant’s Health Support Day-
Service)

If a child is recovering from an illness and you can’t look after him at home, they can
temporarily be taken care of at facilities affiliated with medical institutions in the city. 　　　　　　　　　　

Please note all of the following conditions in order to use this service.
-1. Your child must be the age of 5months up to 3rd grade of elementary school, living in Sapporo.
-2. He/She is recuperating from sickness and can’t go to his /her day care.
-3. He/She can’t be looked after at home, because you have to go to work, have a disease or injury, have given birth or attend a wedding or funeral, etc.
-4. His/Her doctor agrees with the use of this service.
**If the doctor doesn’t agree with this, because his/her condition is too severe to be
looked after, you can’t bring him/her to the facility.

The following diseases will be accepted. :
*Common diseases among infants such as common cold and stomach flu.
*Contagious diseases such as chickenpox and rubella.
A child suffering from these contagious diseases will be separated from other children.
*Chronic disease such as asthma.

【Fee】¥3,000+ lunch ¥300
　　
Day care is for free for residential tax-free households but ¥1,500 is charged for
income tax–free household. Both must pay for lunch separately.

Registration is required. 　

Inquiries:
Hokkaido Social Insurance Child Day Service Center（at Toyohira ward）
北海道社会保険子どもディサービスセンター（豊平区）
☎831-3300（at Hokkaido Social Service Center ）

Teine Keijinkai Child Day Service Center　(at Teine ward)
手稲渓仁会子どもディサービスセンター
☎681-3266 (adjacent to Teine Keijinkai Hospital)

Nire-no-kai Child Day Service Center (at Atsubetsu ward)
楡の会こどもディサービスセンター
☎898-2768（at Nire-no-kai Child Clinic）

Kin-ikyo Kikusui Child Day Service Center (at Shiroishi ward)
勤医協菊水こどもディサービスセンター
☎823-9272 (at Kin-ikyo Kikusui Kodomo Clinic)

2. Sapporo Child Emergency Support Network

【services available】
If your child cannot go to Day Care because of any sudden illness, if you need emergency childcare because of sudden overtime, if your child needs a place to stay overnight etc.
Your child will stay at your house or a supporting member’s house, depending on circumstances. Registration is required.

【Hours】
For sick children: 7:30 to 6 p.m. from Monday to Friday 7:30 to 1p.m. on Saturday
For non-sick children: 7:30 to 11 p.m.
For overnight stays: after Day Care or after-school care until your child goes to Day Care or school

【Fee】
For sick children age 5 months until the 3rd grade of elementary school :
¥500 per half an hour for the first 3hours,
¥150 per half an hour after 3hours.
For non-sick children:
¥500 per half hour 7:30-6 p.m.
¥600 per half hour 6 to 11 p.m.
For overnight stays: ¥12.000 (under 3 years old)/¥10.000 (over 3 years old)
*You may have to pay transportation expenses etc.
For inquiries:℡621-6626　　Sapporo Family Support Center ～
http://www.jaaww.or.jp/service/support_net/index.html
http://www.jaaww.or.jp/service/support_net/index.html (Translated by google)

If you want your children to go to Day Care Centers from April 1st 2013, at the beginning of academic year, please apply by Friday, February 22nd.
Fees vary depending on your household income. The selection of applicants will be conducted by Sapporo City.

*1 admit children at least 57 days old.
*2 admit children at least 5 months old.
*For more information, contact your local Ward Office.
*Hitsujigaoka-Fuji Hoikuen (羊丘藤保育園) will accept 120 children, who must be at least age of 5 months, starting the 1st of April. It is located at 1-3, Fukuzumi, Toyohira-ku.

The following Day Care Centers opened on April 2nd 2012.

※ For more information, contact your local Ward Office.

Certified day care in kindergarten

The following kindergartens will start day care service certified by Sapporo city on April 1st 2013.

The following kindergartens started daycare service on April 2nd 2012.

Ask them directly about the details and you can apply by January 31st, 2013. Your qualifications will be reviewed. The selection of applicants will be conducted.

Hoiku Mama Services available

The Hoiku Mama and supporting staff take care of children at the Hoiku Mama’s house between 9 am and 5pm, Monday through Friday (except holidays and New Year’s Holidays). The child must be at least 5 months old and up to 3 years of age. Fees vary depending on your household income.
Your qualifications will be reviewed. The selection of applicants will be conducted by Sapporo City.

Hoiku Mama started from the beginning of October 2012, at the following locations.

*South 1 West 9 Chuo-Ku, *South 6 West 23 Chuo-ku, *Tonden 9-1 Kita-ku
*North 11 East 3 Higashi-ku, *South 34 West 9 Minami-ku, *Hachiken 4 West 4 Nishi-ku
*Shin-Hassamu 6-2 Teine-ku

Apply to Kenko Kodomo ka at your local ward office by Friday, February 22, 2013.

However we most concerned about whole-body BCG infection to occur in the immune-deficient babies, who are born as many as 20-30 in one million births. By the age of 4months, it will become apparent if the baby is not immune-deficient.
Please understand this policy of the Japanese vaccination administration, then decide what you will give to your babies.

Keiko Fukuyama M.D.

Keiko Fukuyama M.D.

For information access:
http://www.mofa.go.jp/mofaj/toko/medi/(Japanese)
http://www.mofa.go.jp/mofaj/toko/medi/(Translated by google)

The Ministry of Foreign Affairs of Japan

Group B Streptococcus Infection (GBS)

When vaginal discharge tests are performed on pregnant women, 2 to 30% test positive to GBS.
At this hospital, the culture test is performed between the 30th and 33rd week of pregnancy.
Death can occur from either of the two types of GBS infection; early –onset GBS infection occurs within a week (seven days) of delivery and late-onset GBS infection occurs after seven days or more from the time of delivery.

It is estimated that around 100 to 150 newborns die each year due to GBS infection. It is also estimated that newborns from approximately one out of every 2000 to 3000 deliveries will develop a GBS infection.
Because the infection can be transmitted from mother to child (transbirth canal infection), the newborn may develop problems such as: pneumonia, sepsis, meningitis and other serious complications (mental retardation, hearing or visual impairment), or even death.
When a pregnant woman who is GBS positive is admitted to the hospital in labor, she will be prescribed IV antibiotics administered on a schedule until the time of delivery.
According to studies, this preventive IV drip decreases the chance of early-onset GBS infection to one-third.

However, the preventive IV drip does not reduce the chance of late-onset infection.
If a baby is infected with late-onset, he/she may display symptoms after being discharged from hospital. If your baby appears feverish, weak or listless, please contact the maternity ward.

For those who are not immune to rubella

Rubella (German measles) is an infection caused by the rubella virus. It is usually a mild illness that causes a rash, sore throat and swollen glands. It occurs most commonly in young children, but can affect anyone. It is usually mild. However, if you are pregnant and catch rubella, it can cause serious damage to your unborn child.

If you have not already been vaccinated against rubella, or if you have not had a past infection, you will be at higher risk of catching it. You are normally considered at risk if your antibody levels against rubella are less than 1:16 IU.

●What if a pregnant women catches rubella?
If a pregnant woman catches rubella during her first 20 weeks of pregnancy, it can cause birth defects in her unborn child such as cataracts, glaucoma, deafness, heart defects (heart abnormalities) etc. This is called congenital rubella syndrome (CRS) and it is transmitted to the baby through the placenta. The risk to your baby is 100% during weeks 4-6 of pregnancy, 80% during weeks 7-12, 54-56% during weeks 13-16, 6% during weeks 17-20 and no risk after the 20th week.

●Symptoms of rubella (in adults)
Patients may develop a rash, a fever, swollen glands, joints pain etc. Symptoms tend to be more severe in adults than in children. In rare cases, severe complications such as encephalitis or inflammation of the brain (approximately 1 in 6000); thrombocytopenic purpura, a condition where the blood doesn’t clot properly (approximately 1 in 3000) or hemolytic anemia (a type of anemia) might occur.
There is currently no treatment for rubella, once you have been infected. Therefore, treatment focuses on providing relief from the symptoms of rubella as the body fights the infection. This is called supportive care. Supportive care may include fluids, rest, and medications (such as acetaminophen or ibuprofen) to control the fever or pain.
If you have these symptoms or if you think you may have been exposed to rubella, contact your doctor/midwife right away.

●IMPORTANT
You must be careful not to get infected with rubella if you are pregnant.
-Keep away from crowds and places with many children.
-If members of your family have never been vaccinated against rubella, ask them to get vaccinated.

●After giving birth
We strongly recommend that you get vaccinated for any future pregnancies you may have. It will also reduce the risk of your spreading rubella. The earlier the better. You can be vaccinated against rubella while you are still in hospital after giving birth. It will cost 6300 yen. This is not covered by your health insurance.

※If your antibody titer is 1:16 IU, the efficacy of vaccination is reported to be approximately 82 % as your antibody levels might decrease after being vaccinated before your next pregnancy. However, if they are 1:8 IU or less, vaccine efficacy is reported to be over 95 %.

●Other important information
-You cannot receive the rubella vaccination after becoming pregnant.
- Adults who receive the rubella vaccine are more likely to develop swelling of the joints compared to children. In extremely rare cases, there is the risk of thrombocytopenic purpura, which is a problem where the blood doesn’t clot properly (approximately 1 in one million). However, the risk of catching rubella is far greater and more severe.
-You can breast-feed your baby as usual after vaccination.
- You should avoid pregnancy for two months after vaccination.

Kaori Nagashima M.D.

Some clients asked SEMI where they can find female doctors, so we sent a questionnaire to Hokkaido Medical Women’s Association(HMWA)(北海道女性医師の会). Here is a list of female doctors who are willing to provide their information on the SEMI webpage.
They are available to see English speaking patients.

Ob-Gyn
Name: Dr. Kaori Nagashima (HMWA)
Hospital/Clinic: Kin-ikyo Sapporo Hospital
Address: 1-9-22, 4 jo Kikusui, Shiroishi-ku, Sapporo Map
Phone: 011-811-2246
Website: http://www.satsubyo.com/about/

Gynecology
Name: Dr. Noriko Kobayashi
Hospital/Clinic: Hokkaido University Hospital
Address: Kita 14jo, Nishi 5, Kitaku, Sapporo Map
Phone: 011-706-5762
Website: http://www.huhp.hokudai.ac.jp/index.html
Please call in advance to find out when Dr. Kobayashi is available.

Neurosurgery
Name: Dr. Yumiko Sasamori (HMWA)
Hospital/Clinic: Takahashi Neurosurgical Hospital
Address: 20-1-30, Nishimachi Minami, Nishiku, Sapporo Map
Phone: 011‐664-7111
Website: http://www.Takahashi-nouge.or.jp/

Pediatrics
Specialized field: Pediatric Nephrology
Name: Dr. Sakurako Hoshii (HMWA)
Hospital/Clinic: Hoshii Shounika Seikeigeka
Address: 1-28, S4 W16 Chuo-ku, Sapporo Map
Phone: 011-561-2132　
Website: http://www.hoshiiseikei.com

Specialized field: Pediatrics and Allergy
Name: Dr. Yumi Shimano (HMWA)
Hospital/Clinic: Shimano Clinic
Address: 2-1-1-23, Hoshioki, Teine-ku, Sapporo Map
Phone: 011-694-2511
Website: http://www.shimanoclinic.jp/

Specialized field: Pediatrics(developmental disabilities)
Name: Dr. Keiko Fukuyama (HMWA)
Hospital/Clinic: Kin-ikyo Kikusui Kodomo Clinic
Address: 1-8-6, 4 jo Kikusui, Shiroishi-ku, Sapporo Map
Phone: 011-833-3633
Website: http://www.satsubyo.com/kodomosin/

Dermatology
Name: Dr. Reiko Morikawa (HMWA)
Hospital/Clinic: Kojinkai Megumino Hifuka Clinic
Address: 21-1, Nishi 6 chome, Megumino, Eniwa-city Map
Phone: 0123－37－3111
* Please call in advance to find out when Dr. Morikawa is available.

Name: Dr. Yukiko Abe (HMWA)
Hospital/Clinic: Kobayashi Hifuka Clinic at Miyazawa Bldg., N7 W4 Kita-ku, Sapporo Map
Phone: 011-738-5511
Website: http://kobayashi-skin-clinic.com/info/index.html

Name: Dr. Kinuko Kobayashi (HMWA)
Hospital/Clinic: 8.3 Plaza Shinryoshitsu at 8・3 Plaza, N8.W3 Kita-ku, Sapporo Map
Phone: 011- 887-6877
Website: http://kobayashi-skin-clinic.com/info/index.html

********************************************************************************
Dentistry

Specialized field: Oral surgery
Name: Dr. Akemi Matsuda
Hospital/clinic: JR Tetsudo Byoin
Address: N3 E1, Chuoku, Sapporo Map
Phone: 011-208-7150
Website: http://www.jrsapporohosp.com/
Comment; Come with your　interpreter for the first visit.

Specialized field: Pediatric dentistry / Dentistry for disabilities
Name: Dr. Masaki Kudo
Hospital/clinic: Masaki shika・Shoni shika
Address: N8 W3, Kitaku, Sapporo Map
Phone: 011-756-4118
Website: http://www.4118.net/index.html

1. What are polio virus and poliomyelitis?

Poliomyelitis is caused by polio virus which enters orally and establishes infection in the intestine. Reproduced polio viruses are excreted in the stool and infect others orally again. In most cases, infections have no clinical symptoms, but induce immunization to polio viruses. However some may suffer from paralysis for their lifetime in their legs and arms caused by the polio virus that has invaded their spinal cords.

2. Inactivated Polio Vaccine (IPV)

IPV is a product made of killed polio viruses. IPV has no virulency causing paralysis but enough potency to produce immunity against polio virus infections.

Classification: inactivated vaccine

Age of the subject: 3 months to 90 months

Frequencies and intervals:

#For initial immunization: 3 times with intervals of more than 20 days

#For booster: added once more (fourth time) 6 months after the third injection

(Recommended schedules are: First three injectionswith intervals of 20-56days. Fourth injection at 12-18 months after the third)

((*As of September 1, 2012, the fourth injection is not included in regular immunization schedules, because the clinical trial for the fourth injection is not completed yet. As soon as the results come out, it will be included aspart ofthe regular immunization.))

Immunization Schedule for children who have never been vaccined against polioInitial immunization Booster First   Second  Third   Fourth (More than 20 days)       (More than 20 days)       more than 6 months (20-56days recommended)        (ditto)                 (12-18 months recommended)

Schedule forchildren who received oral polio vaccine onceInitial immunization Booster First (oral)   Second(IPV)   Third (IPV)   Fourth(IPV) (More than 27 days)                          (More than 20 days)          (more than 6 months)

3. Side Effects

The injection site may get red and/or swollen which will last a short time and disappear within several days. IPV does not include live viruses, therefore it will not cause polio-likesymptoms including paralysis.

4.Those who are prohibited to receive the vaccine

1. Those who have obvious fever.
2. Those who are acutely ill.
3. Those who haveexperienced anaphylactic shock after any vaccine and/or any medications.
4. Others whom the doctor diagnoses inappropriate to receive the vaccine.

5. Consultation with the doctor before the vaccination required for

1. Those who are ill of heart, kidney, liver or blood disease. Those who are not physically well developed and who are under the care of doctors and /or public health nurses.
2. Those who haveexperiencedallergic like symptoms such as fever, eruptions and urticaria within 2 days after vaccination.
3. Those who have experienced convulsion.
4. Those who have beensuspected to have immunological abnormalities, and/or whohaverelatives with immunological abnormalities.
5. Those who have allergies to IPV.

6. Advice after the vaccination

1. Please stay in the hospital or in a place where you are easily able to get in contact with the doctor for 30 min. after the vaccination, because the vaccination might cause shock and/or an anaphylactic reaction.
2. Please consult with the doctor immediately if your child experiences high fever, convulsions and so forth.
3. Please pay attention to any side effects that appear for 2-3 weeks after the vaccination.
4. If your child is given other vaccines, please wait for more than 6 days after receiving the polio vaccine.

Your child may have IPV together with other vaccines after a consultation with a doctor.

5. Bathing is not prohibited, however avoid rubbing at the site of injection.

Keep the injected site clean and have your child follow his/her usual daily activities.Please avoid intense exercises.

7. Support Provided if Adverse Events occur

You will receive support and compensation for any side effects by IPV requiring any medical treatment and/or leaving any lifelong disabilities.

Please ask the hospital/clinic you had the vaccination for more information.

((IPV includes bovine serum protein from North America in its manufacturing process. There has been no report of TST (Transmissible Spongiform Encephalitis) due to IPV injections. It is impossible to deny theoretical risk for TSE; however it is considered to be of little risk.))

8. To Muslim families

IPV includes swine pancreatic trypsin in its manufacturing process. IPV is approved in 86 countries including Egypt, Saudi Arabia, Iran, Pakistan, Bangladesh, Indonesia and others.

Kikusui Kodomo Clinic Translated by SEMI

Starting in September 1 (Saturday) 2012, the previous type of polio vaccine
which is Oral Polio Vaccine (OPV) was changed to Inactivated Polio Vaccine (IPV).
Therefore, the vaccinations will not be given in groups at health centers,
but individually at designated medical facilities.
Children from 3 months to 7½ years of age are eligible.
The eligible children who are living in Sapporo can have IPV at designated
medical facilities for free.
IPV should be given separately 4 times. First 3 shots may be given at 20-56
days intervals by 12 months of age.
If the child has had one OPV before, IPV should be given separately 3 times.
If OPV has been given twice, IPV will not be needed.
The 4th shot will not be included in the routine vaccination until the results of the
trial tests have been released.
For designated medical facilities, please check the City of Sapporo website or
call the Sapporo Citizen Contact Center.

Contact: Sapporo Citizen Contact Center
TEL: 011-222-4894

Adapted from http://www.city.sapporo.jp/hokenjo/f1kansen/documents/leaf-2.pdf

If you are a female and 20, 25, 30, 35, 40, 45, 50, 55, 60 years old as of April 20 2012, you might have received this letter. It contains free coupon ticket(s) for cervical cancer screening and/or breast cancer screening.
URL:http://www.city.sapporo.jp/hokenjo/f9sonota/coupon.html
URL:http://www.city.sapporo.jp/hokenjo/f9sonota/coupon.htmltranslated by google

you can call to Sapporo city contact center in English for this information.
TEL011-222-4894　FAX011-221-4894
E-mail:info4894@city.sapporo.jp

May 2012 was the last time in Sapporo to receive the “live” polio vaccine (OPV: oral polio vaccine).

Here is the article from Japan Times:
**************************************************
Saturday, April 21, 2012
“Inactivated polio vaccines to get OK”
Health minister Yoko Komiyama said Friday the ministry will approve
inactivated polio vaccines shortly so they can be prepared in September for
immunizations.
A ministry panel Thursday recommended approving the vaccines to make
them available this fall.
Because live vaccines, currently approved for use here, have a child
paralysis rate of 1.4 per million, more parents are calling for approving
inactivated vaccines, which have a lower rate of paralysis.
The ministry is expected to approve the Imovax vaccine made by Sanofi
Pasteur SA of France, which is approved in 86 countries. The Kanagawa
Prefectural Government is already importing it.