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260for long-term health management. An overview of these examinations and their status is given below in a separate column.2. Health ExaminationsDetailed health examinations are being performed on the residents of evacuation zones and those deemed in need of health care based on their responses to the basic survey. The main objectives are to assess the examinees’ health conditions and achieve early diagnoses and treatment of lifestyle and other illnesses. The content of the examinations differs depending on the examinee’s age, although all tests included in “specified medical checkups” are typically conducted. At present, preparations are being actively made to conduct these examinations outside the prefecture as well.3. Mental Health and Lifestyle SurveysChanges in mental and physical health were indicated as the long-term effects of the Chernobyl disaster. Since psychological stress is conceivable in residents coping with life in evacuee shelters and anxiety toward the radiation, surveys are being administered to enable the provision of appropriate care. Residents in evacuation zones and individuals (about 210,000 people) deemed in need of health care based on basic survey results are asked to respond to questions about their current physical and mental condition, lifestyle (diet, sleeping habits, tobacco use, alcohol use, and exercise), how they have spent the past half year, and their experience of the Great East Japan Earthquake.Individuals who need counseling and support are provided with telephone consultations by a clinical psychologist or other members of the Mental Health Support Team. If the support team member decides that specialized treatment is required, a physician from the FMU Radiation Health Counseling Team responds and conducts examinations as necessary.4. Survey of Expectant and Nursing MothersA survey was administered to women who received their Maternal and Child Health Handbooks (approximately 16,000 people) within and outside the prefecture, and to those who underwent pregnancy checkups or gave birth after March 11. They were asked to respond to questions including the health and pregnancy checkups they received since the earthquake, their physical condition during their pregnancy, the birth of their child, and their mental well-being. Along with protecting the long-term health of expectant and nursing mothers, these efforts are intended to provide peace of mind to those planning childbirth in Fukushima Prefecture and help improve perinatal care in the prefecture.At the center, maternity and public health nurses are always on duty, handling calls and e-mails related to childcare and child rearing. For consultees who require further support, FMU maternity nurses and hospital nurses are available by telephone. In certain cases, the patient’s existing obstetrician or an FMU professor may offer support.Regular Health Checkups to Support Recovery EffortsThe surveys are intended as a specific response to internal radiation exposure. The standardization and close monitoring of diagnostic examinations outside of these surveys remain a pending issue in the context of long-term health management efforts. In particular, it is important for patients to understand that even if an ultrasound thyroid examination shows signs of pediatric cancer soon after we have commenced it, there is no tenable argument that could link that cancer to the recent radiation exposure. Going forward, we need to address the issue of incubation periods regarding examination results and the development of cancer. Also, we need to devise a regional cancer registry for patients.Birth, illness, old age, and death are inevitable, and a risk-free society is not completely achievable. Although much has been lost, some things have been gained as a result of this recent tragedy. Fortunately, there have been no deaths from radiation exposure due to the nuclear accident. It seems that being grateful for having life (being allowed to live) and facing difficulties alongside our companions contribute to further hope and courage.As we support residents in their recovery and return to their homes, understanding each individual’s condition with respect to radiation and regularly monitoring their health conditions contribute to the region’s rebirth and restoration. To that end, we plan to build and maintain a framework for residents to self-access information about their radiation dose rates and for the medical infrastructure to offer readily accessible health consultations and examinations.The challenges associated with the health care management of Fukushima Prefecture’s residents are numerous, and it is only with the support of everyone that we will be able to move forward with these projects. We humbly request the kind consideration and cooperation of the prefecture’s and country’s healthcare professionals.Fukushima Health Management Survey

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