FUKUSHIMA Lives on the Line

124D) aims to share guidelines for psychiatric care facilities affected by nuclear disasters.Regarding A),1) Dr. Tetsuo Kumakura of the Kanamoriwashin Group reports on the evacuation from his hospital. Dr. Kumakura manages Hibarigaoka Hospital, one of the hospitals forced to transfer its patients and close down on March 17 because it is located within 30 kilometers of the Fukushima Daiichi plant.2) Dr. Akira Wada (mind–body medicine department, FMU Hospital) reports on the transfer of psychiatric inpatients after the disaster and nuclear accident.3) Dr. Takako Konishi (Musashino University), who provided aid and psychiatric healthcare to other aid workers, reports on the psychiatric health of over 50,000 refugees (as of July 10, 2011), stranded because they could not return to their original dwellings due to the Fukushima Daiichi nuclear power plant accident.Regarding B),4) Dr. Takako Tominaga (National Institute of Radiological Sciences) shares information about the true state of nuclear power in Japan, the types of radiation exposure incidents that are possible in the event of a nuclear accident, and potential treatment measures.Regarding C),5) Dr. Hideyuki Nakane (Nagasaki University) writes about nuclear disasters and radiation exposure incidents from across the world and associated psychiatric disorders.6) Dr. Yoshiharu Kim (National Center of Neurology and Psychiatry) assisted in the creation of the National Institute of Radiological Sciences manual. Dr. Kim provides guidelines to avoid radiation exposure and ways of providing psychiatric healthcare in the event of a nuclear accident.7) Dr. Seiko Minoshita (Kawamura Gakuen Woman’s University) shares her research about psychiatric disorders associated with the Tokaimura nuclear accident in Japan, causing two deaths and 667 cases of radiation exposure.Regarding D),8) The Self-Defense Forces, fire departments, and police departments were mobilized to support the evacuation of inpatients in hospitals within 30 kilometers of the Fukushima Daiichi nuclear power plant in response to the nuclear accident. Dr. Shin-ichi Tokuno (National Defense Medical College) provides guidelines in case a nuclear disaster requires an entire medical facility to evacuate its patients.4. Addressing Anxieties about Low-Dose Radiation ExposureIt was around March 16, as I recall, that FMU Hospital began to distribute iodine solutions to employees aged 40 and younger, assuming repeated explosions at the Fukushima Daiichi plant. In case of a Chernobyl-style nuclear reactor explosion, or atmospheric radiation continually measuring above 20 µSv/h, the hospital would issue a code red alert. According to the alert, all employees aged 40 and younger are instructed to swallow these iodine solutions and others in the contaminated zones must shut all windows in the hospital buildings and stay indoors for 72 hours. Iodine is not to be consumed repeatedly, but the risk of a shortage still remains. Thus, I walked with a co-worker to pharmacies across the town to buy povidone-iodine solution; however, every pharmacy we went to was already out of povidone-iodine. I was shocked at the strength of people’s wariness and anxieties that led them to buy up all the iodine.Thankfully, no code red alert was issued. But people’s wariness about radiation exposure grew stronger as the actual levels of radiation contamination became clear.Parents of infants and small children were particularly concerned. Many families kept their children outside of Fukushima until their schools reopened in April. Several parents used the summer vacation in August as an opportunity to transfer their children to schools outside the prefecture. Each area was differently affected, but in the case of Fukushima City, about 10% of children in elementary schools transferred to a different school. While some experts were saying “there are areas in the world with natural radiation levels much higher than those in Fukushima, but there is no data that they have high cancer rates, so it should be fine,” others were saying that “the risks from low-dose radiation exposure are still not clear, and we cannot be sure of their long-term effects.” Thus, people became confused with the ambivalence in expert scientists’ opinions. Moreover, because the government did not provide effective decontamination measures for the expanding contaminated area, the number of families abandoning the prefecture increased. “Safety” and “peace of mind” are two concepts that generally go hand in hand. However, even rational explanations that low-dose radiation exposure is scientifically safe do not assure peace of mind; people separated the concepts of safety and peace of mind. Peace of mind came after decontamination activities Lessons from Fukushima: What We Can Learn about Psychiatric Care from the Radiation Exposure Incident