FUKUSHIMA Lives on the Line

145chap.IIIStruggle Against RadioactivityFUKUSHIMA: Lives on the LineLessons and Future Hopes from the Perspective of a Medical ProfessionalWhat follows is a straightforward and concise collection of what we feel is needed based on our experiences of the natural disaster.1. We need to acknowledge the importance of drafting a manual and implementing training. Even if incomplete, a manual must be made. Training exercises must be repeatedly held (both conceptual and actual exercises are important). Finally, plans must be made for incidents on the largest scale conceivable.2. We need to acknowledge the importance of mutual understanding between on-site personnel and central government personnel, particularly during a frantic disaster. Additionally, a framework for communicating decisions and instructions based on this mutual understanding and exercises to practice such communication are important.3. We need to acknowledge the importance of sanctioning individual decisions at the scene of the disaster, if they are deemed meritorious by those on the scene.4. We need to acknowledge the importance of respecting individual decisions made at the disaster site when communication is not forthcoming from the authorities. Training is very important for all of this. At the time of an emergency, the following approach is required from the individuals involved.5. Medical professionals must be trained in general radiation exposure treatments and must unfailingly spread knowledge to the general populace about radiation and measures to deal with it.6. FMU must revamp its framework for emergency radiation treatment and decontamination. Procedures for the use of stable iodine tablets must be established and supplies must be supplemented or stockpiled. Similarly, internal radiation sequestering agents such as Prussian blue or chelating agents must be stocked. A framework for assessing and explaining to citizens external radiation doses (e.g., with glass badges) must be put in place as a supplement to the prefectural health survey system. Similarly, a framework for assessing and explaining to citizens internal radiation doses (WBC) must be created.In addition to the above, Fukushima Prefecture’s health care system must be re-equipped and upgraded. Competent graduates must be retained within the prefecture as health care professionals. The level of health care must be raised (by implementing greater accessibility), and advanced medical facilities and equipment must be introduced. We dream of a bright future for FMU and the revival of Fukushima Prefecture.References*1 福島県保健福祉部,福島県緊急被ばく医療活動マニュアル(平成15年5月制定).*2 被ばく医療施設運営委員会マニュアル作成部会「福島県立医科大学医学部附属病院被ばく医療活動対応マニュアル」(平成14年5月8日制定).*3 青木芳朗,医学のあゆみ,239(10),973-976(2011).*4 神谷研二ら,医学のあゆみ,239(10),977-984(2011).*5 谷川攻一ら,日本救急医学会雑誌,22(9),782-791(2011).*6 日本医学放射線学会放射線防護委員会,原子力災害に伴う放射線被ばくに関する基本的考え方.http://www.radiology.jp/modules/news/articl.php?storyid=931*7 大津留晶,日本病院会雑誌,1112-1116(2011).*8 宍戸文男ら,Surgery Frontier,18(4),369-372(2011).