FUKUSHIMA Lives on the Line

167chap.IVPatient Relief Activity Records [Essays and Research Publications]FUKUSHIMA: Lives on the LineA message From Fukushima Medical Universityneeded help or collaboration. FMU’s collaboration with the prefecture for the administration of the university was essential. To this end, FMU and Fukushima Prefecture formed a dual organization immediately after the earthquake (Figure 5). No collaborative structure with other organizations within Fukushima Prefecture had been established. Therefore, upon the advice of the Ministry of Education, Culture, Sports, Science and Technology, we established Fukushima Prefecture’s Medical Support Body.Furthermore, since substantial measures were considered to be necessary in the mid- and long-run, after the critical phase after the accident, a cooperative framework was also established with Nagasaki and Hiroshima Universities. In addition, a council meeting was held by the governor of the prefecture to initiate policy discussion on medical treatment for victims of the nuclear disaster. FMU and six other research organizations participated in an event focused on the effects of radiation. The organizations gathered from across Japan and included the National Institute of Radiological Sciences (NIRS), Hiroshima University, Nagasaki University, Kyoto University, the Radiation Effects Research Foundation (RERF), and the Institute for Environmental Sciences (IES). The universities and research organizations were called upon to implement the cooperative efforts detailed below. Said efforts included the Prefectural People’s health management survey and other health management surveys for the future.3. FMU’s Support for Medical Care (Chart 3)1) Responses during the Critical Period after the DisasterWhile endeavoring to continue providing routine care and conducting health examinations, FMU was also faced with the sudden responsibility of emergency medical duties. In particular, this included postmortem examinations primarily performed by the life sciences faculty, medical rounds of evacuee shelters by teams of specialists, surveys and medical care—with the aid of the Self-Defense Forces—within the 20–30-kilometer evacuation zones, and the dispatch of physicians to hub hospitals surrounding these zones.2) Formulating and Implementing Recovery ProjectsA recovery plan was formulated under the slogan “Fukushima: Hope in the midst of adversity.” The guiding philosophy of these projects was transitioning from destruction, loss, and reflection to reconstruction, hope, and progress; in other words, it meant recovering from the situation caused by the nuclear disaster (Figure 7). A step that was immediately implemented was the health management survey of children, focusing on illnesses such as thyroid cancer, which spanned over a period of 30 years. Another step was an impact survey of residences within the disaster area to assess the extent of radiation contamination. We envisioned the establishment of a new organization to implement these projects. At the same time, we formulated a model for a university that would be more resilient to future natural disasters. In the recent disaster, we struggled to cope with the loss of water supply. Thus, the new model has been built around a robust lifeline of equipment and utilities, patient transportation hubs, functionality for temporary hospitalization and observation, and in-patient care.V. Lessons from the Massive Earthquake and Nuclear Accident (Chart 4) First, this earthquake, tsunami, and ensuing nuclear accident revealed Japan’s inadequate preparedness for a calamity of such intensity levels. Second, for a country that has atomic energy at the helm of its national energy policy, the education of citizens and health care workers about radiation is insufficient. Third, the number of engineers and academicians involved with atomic energy is limited and their demographic appears to be an aging one. Fourth, confusion was observed in the chain of command when the emergency was at its peak. Fifth, there was a muddied distinction between “safety” and “peace of mind.” The untimely debate hindered discussions. Sixth, we must recognize the importance of having a single point of contact for information that is broadly shared. Seventh, communicating information is absolutely vital. Eighth, infrastructure for evacuees was insufficient. And finally, during the emergency, it was Chart 3: Contributions that FMU can Make for Fukushima’s Present and Future Well-Being1. Radiation treatment and health care for workers handling the nuclear accident2. Responding to the medical emergency and evacuation order1) Specialists making medical rounds of evacuation shelters2) Surveying the 20–30 kilometer area around the plant and providing medical support3) Dispatching physicians to hub hospitals within the evacuation area3. Ways to help recovery in Fukushima1) Recovering regional medical infrastructure• Build a Fukushima-wide (All Fukushima) system (centralized and collaborative)2) Restoring Fukushima as a prefecture where parents and children can live with peace of mind• Long-term measures to handle the impacts of long-term, low-dose radiation exposure