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520Beyond the day after tomorrow : community health in JapanHealth Exchange [http://healthexchangenews.com]Ryuki KASSAIProfessor and Chair Department of Community and Family MedicineFukushima Medical UniversityPosted on July 6, 2011 by Admin01 On Friday afternoon, 11 March 2011 the first earthquake and tsunami hit us in the Pacific Coast areas of the Tohoku region (the northernmost region of the main island of Japan). The disaster that we now call the ‘Great Eastern Japan Earthquake' was caused by the strongest earthquake ever recorded in Japan (magnitude 9.0) followed by a 15-metre tsunami and hundreds of aftershocks. According to the Japan Meteorological Agency, as of 8:00 am on 21 May there have been 459 aftershocks with a magnitude of 5.0 and above, with 76 registering 6.0 and higher and five at the 7.0 level or higher. According to a National Police Agency tally as of 20 May, 15,148 people are dead and 8,881 are missing with 91,484 houses/buildings completely destroyed and 40,454 partially destroyed. A major lesson from the first few days of the disaster was the need to resume information networks as quickly as possible. The telephone circuits were immediately shut down, due to the overload in the affected areas. Although the Internet was alive, its use was limited by the availability of computers and electricity. It was difficult for us to get a whole picture of what was going on in the prefecture and the region overall. Hundreds of patients were evacuated from community hospitals and nursing homes in the severely damaged tsunami-hit areas, especially in the towns very close to the Fukushima Daiichi (No. 1) nuclear power plant, and were transferred in chartered buses to facilities in safer places. Those evacuations had to be operated without notice to the receiving facilities. Damage to the electronic medical record systems of the sending facilities resulted in referral/transfer without necessary patient information about their medical condition. We need to invent some innovative Ryuki Kassai, MD, PhD, MRCGP Professor and ChairDepartment of Community and Family Medicine Fukushima Medical University1 Hikarigaoka, Fukushima 960-1295 Japan E-mail: ryukikas@fmu.ac.jpWhen the earthquake, tsunami and subsequent aftershocks hit Japan in early 2011, health systems and staff were tested to the extreme in trying to meet people's health needs. Ryuki Kassai, from the Department of Community and Family Medicine, Fukushima Medical University, tells the story of what happened and the lessons that he and other medical professionals learned from their experiences.Ryuki Kassai with a team next to the exclusion zone, Minami-Soma City. Credit: Member of Self Defense Forces (SDF)

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