FUKUSHIMA Lives on the Line

164Reflecting on the Great East Japan Earthquakecomplex disaster that was both natural and manmade. The natural disaster was the earthquake, tsunami, and nuclear accident; whereas the manmade disaster was the series of impacts on commerce, agriculture, fisheries, industrial products, early childhood education, and other levels of schooling. Recently, we have been faced with challenges, which are both friend and foe, superseding our professions as doctors and physicians; this is because we stand on the front lines of the battle. These challenges include the so-called “information damage” caused by the tangled mass of emerging information, which is necessarily related to our responsibilities or actions as health care professionals.2. University Policies1) Sharing Information and Educating the PublicThe initial information that a nuclear crisis was bearing down upon us due to explosions in the cores of the nuclear reactors was an immense shock to the FMU faculty. With evacuation as a viable option, we decided that maintaining regular operations at the hospital would not be possible. In April, campus-wide meetings were held two or three times per day (later changing to once per month) (Figure 2); by November, a total of 42 meetings had been held. During these meetings, risk communication experts informed us that “Radiation is scary, but ignorance, indifference, and bias are scarier.” In addition, the importance of combating misinformation with the power of science was communicated to us. In other words, it is up to medical professionals to present a fundamentally objective stance to society. This includes objective data that is accurately interpreted.Apart from the campus-wide meetings, executive manager meetings were held simultaneously, during which strategies were formulated and prompt decisions were made. A total of 81 meetings were held by November. These meetings reflected the university leaders’ belief in their entire faculty. The facts that support activities must not sacrifice the security of support workers, and that the proper sharing of information is a life and death situation for the implementation of decisions and actions and greater organization, were reiterated.2) Accepting and Transporting Patients to FMUThe treatment and hospitalization of patients from medical institutions in the evacuation area began on March 12 (Figure 3). Procedures were divided into responses to the nuclear accident, disaster medicine during the supercritical period (immediately after the earthquake), and treatment for evacuee patients during the critical period (after the supercritical period). Two wards at FMU hospital were emptied, and extra beds were accommodated in the available shared spaces. After triage, 173 patients were hospitalized on the premises (Figure 4).Figure 3: FMU’s ActivitiesFigure 2: Emergency Campus-Wide Meetings Including All University EmployeesEarthquake occursWeek 1 ~Week 2 ~Patient evacuation responseCritical phaseResident evacuation responsePost-critical phasePatients from five hospitals in the Iwaki Soso areaApproximately 2,000 patients transported outside the areaApproximately 175 patients admitted to triage midway through transportation (125 seriously injured patients given inpatient hospital care)Wide area emergency medical support1. Advanced Emergency Medical Care Support Team2. Regional and Family Medicine TeamOutpatient treatment and scheduled surgeries cancelledTotal resources put toward emergency medical responseApproximately 1,000 disaster patients admittedDisaster medical responseHypercritical phase11 patients given high-level radiation exposure decontamination; three hospitalizedApproximately 500 disaster victims surveyed for radiation exposureNuclear accident response