Pages: 1 2 3 4  Post 3/11

Part 2- The Aftermath: Concerns Spurred by a Devastating Earthquake and Tsunami

Nicole Gunawansa | January 29th, 2015
This interview was held on December 2nd, 2014 in Tohoku Medical Megabank Building

Ishinomaki Red Cross hospital was not damaged even if the 70% of city area was sunk down below sea levels (March 14th, 2011)

Question 4: What issues needed immediate attention after 3/11?

Major issues included limited transportation due to restrictions on gasoline, lack of communication (especially long distance telecommunication), lack of an integrated medical record system, and an insufficient number of appropriately trained medical staff in severely impacted areas. Our relief efforts were negatively affected by the lack of communication between different disaster location as it resulted in confusion amongst both disaster victims and responder teams. Confusion was also increased by the lack of patient records, which had been destroyed by the earthquake and tsunami. With no record of the medications (type, dose, etc.) needed for chronically ill patients, the limited number of available physicians found themselves spending excessive time on simple patient examinations. This prevented doctors from spending more time with seriously injured patients. We now realize the importance of having medical records on an integrated electronic server, and ToMMo is in the process of establishing this database. ToMMo has also established a system to ensure that more doctors are working in the affected disaster areas.

Question 5: What additional problems have been brought about after the Great East Japan Earthquake?

Since the disaster there has been an increase in the number of cardiovascular attacks and pulmonary embolisms experienced by disaster victims (especially the elderly)*. We also saw an increase in Economy Class Syndrome (also known as Traveler's Thrombosis) in evacuated disaster victims who were forced to reside in cramped spaces for an extended period of time after 3/11. This syndrome occurs due to a shortage of water and a lack of coagulation medications, resulting in increased thrombosis in the extremities. Within a month after the disaster, appropriate medical supplies arrived to the devastated area, but these medications require prescription from physicians. As I have mentioned there was a lack of doctors and patient records at the time, so obtaining a prescription medicine was a time consuming process. We dealt with this issue by using telemedicine for triage. For a temporary period of time, doctors in major hospitals across the country (and also from Thailand) could phone/video message doctors in the disaster areas and provide medical support. This solution was effective at ensuring that victims received better medical treatment following the disaster.

Question 6: Could you talk about your experience with the 1995 Great Hanshin Earthquake in Kobe?

Dr. Kiyomoto assisted DMAT teams to establish an emergency ward in a hallway of Ishinomaki Red Cross Hospital (March 14th, 2011)

I am from Kobe, and was living there when the Great Hanshin Earthquake occurred. My house was destroyed in the earthquake, but luckily we had another home that we could live in after the event. The disaster that occurred in Kobe was different than the one in Tohoku because it primarily damaged buildings, and there was no tsunami afterwards as it was an inland earthquake. However, the Kobe earthquake happened in the very early morning, when many people were still asleep. No one was expecting it, and no one was prepared; many people died while furniture and buildings fell, and those who survived did not have housing afterwards.
Similar to 3/11, communication after the Kobe earthquake was a big problem. There were also many dialysis related patient cases in Kobe. During the 1995 earthquake, crush syndrome occurred such that healthy people became dialysis patients due to acute kidney injuries induced by disaster related crushing accidents. Japan DMAT (Disaster Medical Assistance Team) was organized after the Kobe earthquake. DMAT is now the official first responder team that is sent out in any disaster situation, including 3/11. We hope that the aftermath of the Great East Japan Earthquake can also facilitate change, and result in greater collaboration efforts from all areas of Japan for an improved disaster medicine assistance program.

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*Reference
Ueda S, Hanzawa K, Shibata M, Suzuki S : High prevalence of deep vein thrombosis in tsunami-flooded shelters established after the great East-Japan earthquake.
Tohoku J. Exp. Med. 2012;227(3):199-202. doi: 10.1620/tjem.227.199