If you have specific allergies that are debilitating or life threatening, or if you have a medical condition that is not immediately apparent or easily identifiable (such as diabetes, severe food allergy, allergies to drugs, or epilepsy), you should wear a medic alert bracelet and notify the Nakatani RIES Fellowship of your condition prior to departure.

You can also obtain Japanese-language translation cards on a number of allergies and medical conditions that you can carry with you in your wallet from a company like Select Wisely or you may be able to find these for free online or through applicable organizations that provide support for your condition/allergy. These cards can be customized for a variety of medical conditions or dietary restrictions, allergies or dietary preferences. If the card you need is not available, email or call Select Wisely and ask if they can make you a custom card.  You may also be able to find an applicable card you can download and print off at one of the following websites and learn more about dietary restrictions in Japan.

• Select Wisely: Translation Cards
• Printable Cards for Communicating Dietary Restrictions in Japan 
• Allergy Translation Cards 
• Food Allergies and Dietary Restrictions in Japan (GaijinPot) 
• The Essential Gluten Free Guide to Japan
• Getting Gluten Free Food in Japan

Even if you have intermediate or advanced Japanese language skills, it can be very difficult to explain your specific condition or needs in a medical emergency or in a loud restaurant. Being able to simply show the translation card, in Japanese, ensures that the person you are communicating with clearly understands your condition, needs, or preferences.

You should also notify your roommate, housing manager, and research lab advisor and mentor of severe allergies or medical conditions so that they know what to do in case of an emergency.

While Abroad: International Health Insurance

All Nakatani RIES Fellows are provided with overseas health, accident, illness, repatriation, and evacuation of remains coverage through a CISI insurance policy for the duration of their stay abroad. Participants will receive a CISI insurance card to carry with them in their wallet while in Japan and a detailed booklet outlining the coverage amounts provided. You can call the number on the back of this card at least 24 hours prior to your appointment to see if CISI can arrange for pre-payment of your medical care. However, if you are experiencing a medical emergency or CISI cannot arrange for pre-payment you will need to pay all medical costs up-front individually and then you will need to file a claim for reimbursement directly with CISI.

Note: The CISI insurance does not provide coverage for routine, non-emergency dental care or eye care. 

International SOS Coverage

All Nakatani RIES U.S. Fellows will be covered by Rice University’s existing Global Assistance Program through International SOS.

While Abroad: Medical Services in Japan

The style of medical care abroad is largely dependent on the country. While medical care in Japan is quite good, English-speaking physicians and medical facilities that cater to Americans’ expectations are expensive and not widespread. The US Embassy in Japan maintains a list of Medical Resources in Japan that includes English-speaking clinics and doctors.

Selected participants will be asked to complete a Health Information & Emergency Contact Form. In this form, please make the Nakatani RIES Fellowship aware of any medical issues, disabilities, or special needs that you may have so that we can provide you with advice and recommendations on resources and the facilities/accommodations that you can anticipate in Japan. If you suffer from a chronic or serious physical or behavioral health condition (including eating disorders), you should consult with a health care professional before making the decision to participate in this program. We cannot guarantee access to the same kind of medical care, medications, facilities, accommodations and services that you receive in the U.S.

English-speaking Doctors & CISI Insurance

Nakatani RIES Fellows are provided with overseas health, accident, illness, repatriation, and evacuation of remains coverage through a CISI insurance policy for the duration of their stay abroad. Participants will receive a CISI insurance card to carry with them in their wallet while in Japan and a detailed booklet outlining the coverage amounts provided. You can call the number on the back of this card at least 24 hours prior to your appointment to see if CISI can arrange for pre-payment of your medical care. However, if you are experiencing a medical emergency or CISI cannot arrange for pre-payment you will need to pay all medical costs up-front individually and then you will need to file a claim for reimbursement directly with CISI.

If you need to seek medical care during the Orientation program, please notify the Nakatani RIES Fellowship as soon as possible so that we can provide you with any necessary support or assistance. During the Orientation Program in Tokyo, Nakatani RIES Fellows will be taken to a nearby International Clinic for non-emergency medical needs.

Immediately upon arrival at your research internship site, all Nakatani RIES Fellows students should speak with their research advisor or lab secretary about available medical facilities for foreigners and what to do if you should become ill or need medical care at your host lab. The US Embassy in Japan maintains a list of English-speaking doctors and clinics in cities throughout Japan. This is a useful site to review with your lab to determine which doctors or clinics are closest to the university and your housing. The university may also have on-campus medical facilities available that you can utilize as well. If your lab knows that you are going to see a doctor they will likely offer to send someone with you to help translate as necessary.

• Surviving Japan’s Medical System (Tofugu) 
• Lady Doctor Basics: Women’s Health in Japan (GajinPot)
• Going to the Gynecologist in Japan (SavvyTokyo) 
• JNTO: If You Become Ill 
• The Expats Guide to Japan: Medical Care 

Be sure that your research lab advisor and lab secretary know which clinic you prefer to use in case of medical emergency. Please also notify the Nakatani RIES Fellowship as soon as possible if you have sought medical care so that we can provide you with additional support and assistance as needed.

While Abroad: Resiliency and Well-Being

Studying, living, and conducting research abroad is inherently stressful. Every day you are faced with speaking in a foreign language, dealing with different social and cultural expectations, navigating the newness of everyday tasks (e.g. where do I buy groceries, navigating public transportation, where can I get a haircut?, etc.). At the same time you are also conducting research in a new lab group where you may be working on a topic you have little prior familiarity with and often must try to make progress on your project in a very limited time-period.  Just one of these things is hard, all taken together can some days feel a bit overwhelming.

There are also some key and very normal emotional stages of studying abroad and these can sometimes feel a bit like being on a roller coaster.  There are also common stages of cultural adjustment that can be quite challenging to navigate at times. Some of the common feelings our students express include:

• Preparing to Go: Excitement! I can’t believe that in one month I’m going to be in Japan. But oh my gosh, I’m feeling stressed too. I have to finish finals, pack, and spend time with my friends and family because I won’t see them for 13 weeks. How am I going to get this all done?
• Leaving Home: Wow, saying good-bye was harder than I thought. Did I pack everything? Did I forget anything?  What if I didn’t bring the right clothes, or gifts for my lab.  Man, I’m gonna miss my own bed and my family/friends and pets. Am I really doing this?  Am I ready to spend a summer in Japan?
• Arriving: Excitement!!!! Oh MY GOSH! I cannot believe I am actually in Tokyo???? Did this really happen? I want to see, do, and eat everything. All the fellow students on the program are so cool.  They are already my best friends and I’m so excited I get to spend the next 13 weeks with them.  Did I mention I’m in Tokyo???!!!!
• First Week: Did I mention I’m in Tokyo?  Every day is a new adventure and everything is so cool!  I don’t want to sleep because there is too much to see and do. But man, jet lag is really rough. I’ve been waking up at 4 AM and by afternoon I’m so tired and it’s really hard to stay awake in the seminars.  Language classes are a lot of fun but hard too. My brain hurts a little but it’s okay, I can sleep when I’m old right?  I just want to do everything and not miss out.
• Second and Third Week: Man, I’m starting to feel pretty tired.  I guess I should probably stay in tonight and sleep/rest.  I don’t want to get sick and then not be well when I start at my research lab. I can’t believe I’ll be there so soon! Time has gone by too fast.  But I do miss home a bit. It’s hard to talk to family/friends due to the time difference and I miss my college cafeteria and/or kitchen sometimes.  It’s a bit hard to constantly figure out what to eat (especially because a group of 12 people can never make up their minds). Maybe I just need to go out on my own and explore a bit more? I love my fellow participants, but sometimes I get a little tired of the group and want to experience Japan on my own too….
• Arriving at My Research Lab/Relapse: Excitement! I can’t believe I’m in (Host City Name)! And I’m gonna start to do research – finally. It was great to meet my lab and I want to work hard and get good results to show by the Mid-Program Meeting.  But right now I’m waiting on training or they want me to read more papers. It’s kinda frustrating because I just want to do research but I haven’t quite started yet and I have such a limited amount of time.  Also, I’d just figured out where everything was in Tokyo and now I’ve got to find the laundromat, grocery store, and learn a new subway route.  It’s a little overwhelming… can I really do this on my own? I’m really missing home and my friends/family now since I’m on my own and not with the other Nakatani students too.  Maybe I should plan a weekend trip to meet up with (X) in (city name)?  That might help…
• Settled In:  I’ve got this.  I’m feeling good about my day to day routine and have a better sense of what I should be doing on my research project.  It’s not all going smoothly but that’s okay, I know that’s normal, but I’m a bit nervous about whether I’ll get results and I have to give an introduction to my topic a the Mid-Program Meeting.  I’ve made friends in my lab/host city and have found my favorite restaurant/bakery/shop and am really enjoying exploring my host city. I’ve even done a weekend trip or two on my own to meet up with friends or explore Japan.  Overall, I’m feeling pretty good.
• Leaving Home (Again): Wow, is the research internship really almost done?  I can’t believe it’s time to go back to Tokyo already and this time next week I’ll be back in the U.S.? That’s crazy! It seems like I just arrived in Japan yesterday.  Man, I’m stressed though. I’ve got so much to do in just a week or two. I’ve got to hurry up and finish my project because my poster is due and I also want to do (X, Y, and Z) before I leave Japan.  There isn’t enough time!!! I wish I could stay longer.  I’m really gonna miss my lab/friends/host city.
• Arriving (Again): Hm, coming back to the U.S. is – odd.  Everything is so big, the American flight crew on the plane back was so loud (and a little rude) and I’m really going to miss the subway and trains in Japan. I could so easily go anywhere I wanted but now (without a car) I’m a bit stuck.  The Re-Entry was good and I’m proud of the poster I presented but it feels really weird to now be back in my room at home with nothing urgent/pressing to do and no where new/neat to explore. Everyday was something new in Japan – now what?

The Nakatani RIES program structure and mentorship model is designed to help students navigate these challenges and the inevitable ups and downs you will face while abroad.  Students are encouraged to turn to Nakatani RIES Program faculty and staff, both in the U.S. and  Japan, at any time throughout the summer for assistance.  Students will also be able to seek support from their host professor and mentor and assigned U.S. co-advisor; particularly with struggles related to research.  We also hope that the Nakatani RIES students network will also be somewhere you can turn as your fellow participants will best understand your day-to-day challenges and be able to offer suggestions and advice on how they dealt with difficult situations.

However, at times you may still find yourself struggling.  It is not uncommon for students who go abroad to have certain issues re-present or come up for the first time.  Being away from your day-to-day life while abroad often allows us more time and space to think and reflect on things we may not have had the time, or desire, to want to deal with before.  This can be good, but sometimes it can be difficult to process everything all by ourselves.  In these moments it can be very helpful to turn to a counselor who can offer unbiased support about where you are today and help you identify ways to move towards where you would like to be in the future. It is common to at times needs this type of outside support and no different than seeking a doctor’s advice when you have an illness or injury.

The Nakatani RIES Fellowship encourages students to seek out the support they may need to ensure their well-being at all times and we encourage participants who have concerns about another student to contact the program for advice.  The Nakatani RIES staff can facilitate arrangements for in-person or, if possible, telephone/Skype counseling session for students while abroad and these services are available 24/7 through our CISI International Insurance plan.  When in doubt and when you have been struggling for too long by yourself and it is not getting better – call.  We will be here to help and support you in any way we can as the #1 concern of our program is for our participants’ well-being before, during, and after the program has ended.

These resources may also be helpful for students who are abroad:

CISI International Insurance Assist America Helpline:  This is a 24/7 hour help-line that can be used for all urgent or emergency situations.  If you are abroad and need immediate assistance, contact the Assist America phone number on your insurance card and ask if they can connect you with a counselor.

Rice University Counseling Center: All participants in this program are enrolled as visiting students through the Rice University summer school and, if needed, can call the Rice University Counseling Center for assistance and support.  This number will be answered 24/7 and can be used in case of an immediate need to speak with someone.  The Rice Counseling Center cannot, due to legal limitations, conduct phone or Skype counseling but they can be a resource and connect you with the support of other campus or CISI resources as needed. If it is outside of normal working hours, you may need to wait on hold a little bit to be connected with the counselor on call. From Japan, you would dial 010 1-713-348-4867.

Resilient Travel:  This is a website that was created by the University of Michigan to support their students and graduate researchers while abroad. Resilience is the ability to adapt or rebound quickly from change, illness, stress, adversity or bad fortune. The content on resiliency and its applicability to international travel was developed by the University of Michigan Psychological Clinic staff. The concern to develop psychological resilience in students going on overseas experiences came from many years of clinical work. We are aware of the profound impact that unforeseen challenges can have on students’ lives both in the field and when they return to university life. We offer these tools and insights to assist in that transition including modules on:

• Resilient Coping
• Resilient Skill Sets
• Loneliness
• Culture Shock
• Group Conflict
• Personal Struggles
• Self-Assessment: To yourself or if you are concerned about another

Dealing with the Blues, Homesickness, or Depression While Abroad: Remember, what goes up, must come down.  And no matter how excited you are to be abroad there will be times when you feel lonely, homesick, or overwhelmed.  A down day or two is normal, but if it lasts for a long time and you feel you are getting stuck and aren’t sure what to do call the program staff or CISI insurance and seek out a check-in with a counselor to help give you the support you need.  We all need help and support at different time and learning how to turn to and utilize your networks is a valuable skill that will pay off in the future too. The following resources may also be helpful.

• Combating Culture Shock: Tips from a Survivor (GaijinPot)
• Cultural Adjustment: Studying Abroad and Mental Well-Being (U of  WI)
• How to Deal with Homesickness While Studying Abroad (StudyAbroad.com)
• 26 Ways to Reduce Homesickness Abroad (Go Overseas) 
• It’s Okay to be Homesick While Abroad (Bustle) 
• How to Deal with Depression While Studying Abroad (Go Overseas) 
• 5 Tips to Overcome Depression While Studying Abroad (International Student Insurance)

Other Resources for Resiliency and Well-Being: Yoga, mindfulness meditation, journaling, and exercise/sleep logs are all great ways to keep track of your physical, mental, and emotional well-being while abroad. Developing a new  healthy habit, such as meditating each day, can actually be easier to do while abroad when you may have more free time and fewer day-to-day demands that if you were at home and juggling school, work, family/friends, extracurricular activities, and research all at the same time. In addition to the resources below, you can find many related apps available for download on Google Play or the Apple Store.

• How to Stay Healthy and In Shape While Studying Abroad
• 9 Ways to Stay Healthy While Studying Abroad
• Self-Directed Yoga Videos
• Japan Running: Routes, Trails, and Races
• 10 Best Places to Run in Tokyo (CNN) 
• Importance of Keeping a Journal While Studying Abroad
• Tips for Keeping a Gratitude Journal
• Mindfulness Meditation: Where to Begin
• UCLA Free Guided Mindfulness Meditation

While Abroad: Mental and Behavioral Health

Traveling or studying overseas is not a cure for health conditions such as depression, eating disorders, attention deficit disorder, etc. Sometimes going abroad may in fact amplify a condition.  A student may not have adequate access to their prescription medication or mental health professionals and facilities.  In addition, culture shock, language barriers, and homesickness can deepen isolation or depression.  Young adulthood may also be the most likely time for certain conditions to present (first occur) and the stress of going abroad can cause a re-occurrence of conditions you may have dealt with in the past.

Workable Plan: Before traveling, create a workable plan for managing your mental health while abroad.  The availability and quality of mental health services differ widely from country to country. Mental health care coverage is included in the CISI International Health Insurance policy that all Nakatani RIES Fellows will be issued, but the availability of English-speaking mental health care counselors or professionals will vary based on your host city. Additionally, some medication that is legal and commonly prescribed in the U.S. may be unavailable to illegal to prescribe or bring into Japan.  This is why it is very important that all Nakatani RIES Fellows self-declare any possible mental health issues or concerns to the program prior to departure. This will enable program staff to work with you, our insurance company, and your health services provider to put together a workable mental health plan before you go overseas.

• If you have a medical or psychological condition that may require treatment while you are abroad, discuss this ahead of time with your doctor.
• A vacation or study abroad is a great opportunity to try new things but this is not the time to experiment with not taking your medicine or mixing alcohol with medicine.
• Research the social culture of your destination to learn about how mental illnesses are viewed.  Attitudes toward mental health can greatly vary between countries.
• If you are studying abroad through your university, talk to your university about access to mental health services on overseas programs. Your study abroad office can help you decide what program would be best for you.
• If currently receiving mental health services – including prescription medication – find out if those services and/or medication are available at your destination. Be sure you carefully review the Importing or Bringing Medication Into Japan for Personal Use site with your health care provider to ensure that you can legally bring your medication into Japan and submit a request for a Yakkan Shoumei (import certificate) well in advance of departure if you need to bring in more than a one-month supply of prescription medication.
• Consider the support system you’ll have in place while abroad.  If possible, know ahead of time who you can consult with about your mental health.  Please notify Nakatani RIES of any mental health issues so that we can provide any necessary assistance and support to you both prior to departure and during your stay in Japan.
• Your CISI international health insurance policy provides coverage for behavioral health care abroad in Japan and the US Embassy in Japan maintains a listing of English-speaking Behavioral Health Care Professionals in Tokyo and other cities throughout Japan.
• Share information on your condition with the Nakatani RIES Fellowship so that we can advise you regarding the likelihood of any necessary health care services or support in Japan and work with you, the CISI insurance company, and your health care providers to develop a workable plan for the summer.
• Be prepared for some homesickness or ‘down’ days while you are abroad but contact the Nakatani RIES Fellowship if these last more than 5 – 7 days in a row or if the symptoms are very severe.
• While you are abroad, if you experience any new or re-occurring symptom that may be a concern, share this information with the Nakatani RIES Fellowship as soon as possible so that we may assist you to the best of our ability. If you have a concern about a fellow participant, call the Nakatani RIES Program office.

Living and working abroad in a new country and culture can be very challenging and the Nakatani RIES Fellowship wants to provide you with the best support possible to ensure you have a positive and rewarding summer experience.

While Abroad: Eating Disorders and Food Issues Abroad

It is very easy when you are abroad to become susceptible to eating disorders or see an exacerbation or re-occurrence of any prior existing conditions. You are in a different place and the food is different. Your stomach may not agree with the types of food there, or you may feel like you’re eating too much. You may also be not eating enough if you are trying to save money on food so you can have more money to spend traveling on the weekend. Maybe you’ve never had to cook for yourself and aren’t sure what to purchase at the store to maintain a healthy diet. You may also experience depression or loneliness manifesting itself in the form of an eating disorder or food issues. If you think you may have a problem, notify the Nakatani RIES Fellowship so that we can provide you with additional support and assistance as necessary.

Please also turn to your fellow Nakatani RIES Fellows for support and encouragement during your time in Japan as they will likely be eager to explore new restaurants and types of food with you. They will also be able to better relate to your frustrations about the types of food that don’t agree with you or that you may be having difficulty with while in Japan. Remember, you don’t have to like everything you try and there may be some days when nothing satisfies you but good, old-fashioned American cuisine. Most Japanese cities have a range of international restaurants and you can find a wide array of Western food-stuffs in most large grocery stores; though Western options may be more expensive than their Japanese counterparts.

Your Alumni Mentor and research lab members will also have lots of great tips and suggestions for you on great places to eat and food to try. Don’t be shy about asking someone from your lab to go with you to the grocery store too and help you find the ingredients you need to prepare some of your favorite dishes on your own. Most labs also have times where members get together for pot-lucks or make lunch/dinner together so be prepared to bring some favorite recipes along with you to Japan to share with your new friends. Just remember, Japan uses the metric system so if you plan to bake or make very detailed or specific US recipes you may need to bring your own US measuring cups and spoons with you.

While Abroad: Sexual Health

Take adequate precautions to avoid contracting sexually transmitted diseases. Use latex condoms during vaginal, anal, or oral sex. Do not use intravenous drugs or share needles. Be aware that tattoos, acupuncture treatments, and injections for medical or dental procedures may put you at risk. Avoid the use of locally produced immune globulin and blood-clotting factors in countries where the blood supply is not routinely tested for communicable diseases. If a blood transfusion is necessary, contact the nearest American Embassy or consulate for advice. If you are concerned that you may have a sexually transmitted disease, see a doctor immediately.

• What Students Need to Know: Sexual Health Abroad (NAFSA – Download PDF)
• Sexual Health Abroad (UC Davis)
• Lady Doctor Basics: Women’s Health in Japan
• Lady Doctor Basics: Women’s Health in Japan (GajinPot)
• Going to the Gynecologist in Japan (SavvyTokyo) 

Contraception
Information on contraception and contraceptives may be more difficult to obtain outside the U.S. or not available in your host country. You should inquire before you leave. If there is any chance you may be sexually active while in Japan we recommend you bring your own supply of condoms and contraceptives. Condoms are the most common form of contraception in Japan, though the contraceptive pill can also now be prescribed, though this does require a doctor’s visit/exam.  If you plan to take the contraceptive pill it is best to bring an adequate supply for the summer with you to Japan.

Remember, if you are bringing in more than a one-month supply of prescription medication you will need to obtain a “Yakkan Shoumei” certificate. Please carefully review the US Embassy in Tokyo’s website for more information.

• Contraception in Japan (Savvy Tokyo)
• Getting the Contraceptive Pill in Japan (Savvy Tokyo)

While Abroad: LGBTQ in Japan

• LGBT Students and Study Abroad 
• LGTBQ Students Abroad (Diversity Abroad) 
• 9 Major Life Lessons I Learned Studying Abroad as an LGBT (Go Overseas) 
• LGBTQ in Japan: Finding Community and Getting Out There (GaijinPot)
• LGBT Tokyo (Time Out Tokyo) 
• LGBT Youth Japan
• LGBT Resources in Japan: Something for Everyone