FUKUSHIMA Lives on the Line

128Figure 3: State of Disaster Conditions within Fukushima Prefecture (March 11, 2011)(Inside Fukushima City)(Minami Soma city)Responses to Radioactive Contamination and the Evacuation Order after the Great East Japan Earthquakeand we dedicated all activities toward specialized disaster response. Thirty-five DMATs from across the country gathered at FMU and provided emergency medical support to areas throughout the prefecture. Emergency aid vehicles and helicopters from Fukushima and nearby prefectures also gathered on the campus. Of course, physicians, nurses, and technicians from medical departments across FMU, as well as faculty, researchers, and student volunteers cooperated to provide emergency medical care. Immediately after the disaster, a large number of emergency patients were expected. However, until Day 3 (58 h after the earthquake), fewer patients had arrived than expected. In triage, the numbers totaled 168 patients: 93 green tag, 44 yellow tag, 30 red tag, and 1 black tag. In later days, it became clear that more harm was caused by the tsunami than that by the earthquake. Since the onset of a tsunami basically results in either life or death, the vast majority of tsunami survivors did not present with external injuries, etc. (Figure 3). In other areas, some hospitals within the city were rendered unable to provide care, and several dozen patients on artificial respirators were rushed to our university hospital. In addition, because of the disrupted water supply, our hospital and several others lost their dialysis treatment facility, which meant that we had to locate facilities that could perform dialysis so that we could transport patients to those locations. The network including the Japan Society for Dialysis Therapy and others was instrumental in this effort and helped tremendously to transport quite a number of patients in ambulances and helicopters to the Kanto area.On March 12, it became clear that a true nuclear accident had occurred, soon followed by two hydrogen explosions. As explained above, the size of the evacuation zone increased rapidly, meaning that the university's off-site center in Okuma Town was of no use and had to be quickly changed to the Fukushima prefectural building. A radiation emergency medical assistance team also arrived on the scene and was stationed at FMU for a long period, during which it provided medical care to radiation victims. At this point in time, the scale of the nuclear accident was considered to be of a magnitude that might be equivalent to that of the Chernobyl explosions, which would cause a code red alert to be issued and call for a survey assessing the safety of all university students, university hospital patients, and university faculty. A code red alert is issued depending on: 1. Communication from the off-site center, 2. TV and Internet broadcasts, and 3. Environmental monitoring reporting radiation greater than 100 µSv/h. In these cases, announcements on campus, in the hospital, as well as on electronic medical charts indicated the code red status. If a Code Red alert is issued, all windows and building entrances are immediately closed, air circulation equipment is halted, individuals are prohibited from leaving the buildings (except in emergencies), and if going outdoors are necessary, N95 medical masks and protective clothing are required. Fortunately, none of this was actually necessary, as no further reactor core explosions occurred, and therefore, no code red alerts were issued.However, with the emergency evacuation zone declaration, hospital patients inside the zone who were unable to evacuate on their own, as well as individuals in welfare facilities, had to be transported to safety. Self-Defense Forces members, fire department officers, and local municipality officials were the chief actors who cooperated to fulfill this need. Approximately 1,300