FUKUSHIMA Lives on the Line

135chap.IIIStruggle Against RadioactivityFUKUSHIMA: Lives on the LineNumber of patients (total)(Month)Image 1: Change in the Numbers of Orthopedic Outpatients at Kashima Kosei HospitalAfter the earthquake, the number of patients decreased due to the temporary suspension of hospital services. But with the construction of many temporary housing facilities around the hospital, more patients are being seen now than before the disaster.Table 1: Number of Orthopedic Inpatients Injured in the Disaster (March–June, 2011)This table shows the number of orthopedic inpatients directly affected by the earthquake or tsunami. The figures do not cover all of Fukushima Prefecture. The number of orthopedic patients that required hospitalization due to the disaster was not as high as we had anticipated.Care at the Orthopedic Departments in Fukushima Each hospital provided care to the best of its capacity. In particular, Fukushima Prefectural Oono Hospital dispatched full-time orthopedic surgeons within the evacuation zones (20 kilometers from the Fukushima Daiichi plant and 10 kilometers from the Fukushima Daini plant). Once the evacuation orders were disseminated, the surgeons left with little more than the clothes on their backs. They had to move to temporary evacuation centers outside of the evacuation zone without patient records and documents. They also began referring patients to other facilities, including our hospital. The patients’ referral forms began with the surgeons apologizing for the lack of patients’ medical records, due to which they could not provide detailed information. Table 1 may not cover all data from the entire prefecture, but it shows the number of seriously injured orthopedic patients requiring hospitalization due to the disaster at FMU orthopedics department and other hospitals. Examining this data shows that not many orthopedic surgery patients needed hospitalization because of the disaster.The authors have been providing outpatient consultations at Kashima Kosei Hospital in the Kashima Ward of Minamisoma, approximately 32 kilometers from the Fukushima Daiichi plant. Kosei Hospital does not have a full-time orthopedic surgeon; thus, we were sent from the hospital to provide outpatient consultation three times a week before the disaster (two full days and one afternoon) and four times a week post disaster, that is, after the holidays in May (three full days and one afternoon).Image 1 shows the trend of outpatient consultations before and after the disaster. The number of patients fell after the earthquake due to the temporary suspension of hospital services. In addition, the population of Minamisoma as of the end of December 2011 is only about 60% of what it was before the disaster. However, the number of patients increased due to the many temporary housing units built around the hospital and the increase in elder-patient visits. At the temporary housing facility, few children received compulsory education. Many families have been forced to live apart, with the elderly staying in temporary housing close to their homes and children living in different areas to prevent exposure to radiation. Caring for Those Exposed to RadiationPrior to the hydrogen explosion in the Fukushima Daiichi Unit 1 Reactor, pressure valves were opened to relieve the built-up pressure, with possible release of radioactive radiation, suggesting potential risk of radiation exposure to local residents. But the opening of the pressure valves was not effective as hydrogen explosions occurred in the Unit 1 Reactor on the 12th and in the Unit 3 Reactor on the 14th. On the 15th, an explosion in Unit 2 was heard and Unit 4 caught fire. According to our records, four patients suspected of radiation exposure visited the university hospital on the night of the 12th. Thereafter, the radiology department Number of orthopedic inpatients affected by the disasterNumber of bedsMarchAprilMayJuneIwaki1814941,034Kenpoku3825581,322Koriyama, Kenchu, and Kennan2310631,106Aizu, Minamiaizu2554260Contribution of Fukushima Medical University and its Orthopedics Department, and the Current State of Fukushima Prefecture