FUKUSHIMA Lives on the Line

162IntroductionAt 2:46 pm on March 11, 2011, the largest earthquake on historical record struck. The ensuing tsunami swallowed multitudes of people, leaving many dead and missing. This alone was an unprecedented calamity. Further damage, however, came in the form of electrical outages at the Fukushima Daiichi nuclear power plant, located along the Pacific coast of Fukushima Prefecture. The plant went offline and control of its machinery was lost. Then, on March 12 and 14, hydrogen explosions tore through the plant. Disasters of a scale and description that the populace could not have imagined became a reality. This paper focuses on the nuclear disaster, explains the circumstances faced by FMU, and describes our responses to them. In light of the situation’s rapidly evolving nature, this study presents the lessons that must be communicated to posterity.I. Impact of the Nuclear Disaster on the Region’s Medical InfrastructureOn March 12, evacuation orders were issued to residents within a 20-kilometer radius of the nuclear power plant. The area had 70,000–80,000 residents, with approximately 62,000 becoming refugees.The total number of hospital beds available at medical institutions within the 20-kilometer radius was approximately 500, excluding those in geriatric facilities. Of the four hospitals designated as primary radiation treatment institutions, three were shut down by the disaster and one was limited to outpatient care. This must be taken into careful consideration when reviewing the locations and capacities of primary radiation treatment institutions.The four institutions providing mental health care lost access to their facilities, which were within the 30-kilometer radius of the disaster. Emergency care facilities were also damaged and their patients became evacuees as the facilities were unable to fulfill their health care roles. Only two hospitals outside the 30-kilometer radius were able to maintain their in-patient services. Two other hospitals, a prefectural hospital and a hospital established by JA Zenkouren, had been slated to merge as of April 1. This merger aimed at bolstering medical infrastructure in the area of the nuclear accident Reflecting on the Great East Japan EarthquakeA message From Fukushima Medical UniversityShin-ichi KikuchiPresident and Chairman of the Board of Trustees, Fukushima Medical University,Department of Orthopaedic SurgeryJournal of Orthopedics and Traumatology, Vol. 55 No.3 2012, “Experiences from the Massive Earthquake: Lessons for Posterity” published by Kanehara & Co., Ltd.SummaryThe March 11, 2011 Great East Japan Earthquake was calamitous and historically unprecedented. Moreover, the operational failure at the nuclear power plant, which led to the radiation contamination of a densely populated area, has been a first-of-its-kind scientific challenge for humanity and our modern society. First, the administration of Fukushima Medical University (FMU), who saw their hospital become the last outpost of safety, has been called upon to be a central communication source that is unified and open to all. Second, we have been called upon to illustrate leadership and the ability to make prompt decisions without the luxuries of time or consultation. Those exercising leadership in a confused and disconcerted situation are inevitably confronted by discord. However, initiative and swift actions must be taken and issues must be prioritized if matters are to be brought under control. In other words, leaders must show consistency and authority; their responsibilities are akin to guarantees stipulated in business contracts. If these actions are systematically executed, staff members will be afforded a measure of relief and will be able to band together in the face of challenges.Key Words: Great East Japan Earthquake, tsunami, Fukushima Daiichi nuclear accident