Japan follows US practices for public services and has done since the end of WW II – it would be a trivial amount of paperwork to get the script legitimately converted.
Added to which about 60% of the country is now middle aged cat ladies (although they now keep pet owls, fish, basically anything that can survive a crumbling half radioactive country) and/or old men who (when not designing the last generation of SUVs and TV-sets that could rightly still be called “Japanese”) are also keeping half the zoo for pets (as they do not have any kids or grandchildren). The youngest people in many areas are in their 40s and half of them are emigrating to Malaysia.
A once proud and thriving nation is now becoming a retirement village for seniors. It it not going to be short of prescribed painkillers…
