FUKUSHIMA Lives on the Line

173chap.IVPatient Relief Activity Records [Essays and Research Publications]FUKUSHIMA: Lives on the LineImage 2: Location of Hospitals and Care for Evacuee Patients1,333 people hospitalized patientsFukushima Prefectural Oono HospitalFukushima Daiichi (No. 1) Nuclear Power PlantFukushima Daini (No. 2) Nuclear Power PlantFutaba Kosei Hospital20–30-kilometer zone could no longer support medical functionality. This condition necessitated a more widespread transfer of patients. Therefore, teams comprising members from the Cabinet Office, DMATs, the FMU disaster medicine coordinators, Self-Defense Forces, the coast guard, fire departments, disaster prevention departments, and police departments began the widespread transfer of patients to disaster base hospitals in neighboring prefectures (please see the Cabinet Office’s disaster prevention information webpage http://www.bousai.go.jp/3oukyutaisaku/kouiki.html). This task involved the transfer of approximately 450 patients, who on March 18 were hospitalized in medical facilities within 20–30 kilometers from the Fukushima Daiichi plant. These patients were relocated to disaster base hospitals in Niigata, Gunma, Tochigi, Saitama, and Ibaraki prefectures between the 19th and the 21st. However, the nuclear disaster complicated the widespread medical transfers from Fukushima. Patients leaving the medical facilities had to be screened for radiation contamination at points set up outside the 30-kilometer zone. In addition, only a limited number of staff was allowed into the 20–30-kilometer indoor refuge zone (Image 1). To conduct the transfers more efficiently, the staff permitted into the 30-kilometer zone shuttled back and forth (from the medical facilities within the zone to the screening points), and another team led patients from the screening points to the disaster base hospitals.On March 19, the medical transfers were conducted using land transportation, and on the second day (20th), we expected Coast Guard and Self-Defense Force helicopters to help with the transfers. However, bad weather permitted only one airlift in the morning. Thereafter, all transfers were conducted on the ground and our work continued into the night.The physicians and staff at the receiving hospitals were of enormous help. I would like to use this opportunity to once again express my gratitude to them. Immediately after the earthquake, medical facilities transferred patients who could walk voluntarily, or those in relatively good condition, to facilities in less damaged areas of the prefecture. They used their own routes or were provided help by the prefecture’s Disaster Response Headquarters. A majority of these patients were either elderly or in conditions that would render them reluctant to be transferred. These patients were first brought to FMU Hospital, and the following day, they continued on to their destination hospital. A list of transfer patients is extremely important for this type of successive transfer, and the relevant medical facilities had to make this list in one evening. Some of the patients who had emergency hospitalizations because of the earthquake and tsunami had to be transferred without us knowing their identity or family information (we did not know the names or health insurance information for many patients). In retrospect, the ruptured functionality of government offices at the time was an unavoidable situation.The Role of Transmitting Information in Disaster Medicine