FUKUSHIMA Lives on the Line

175chap.IVPatient Relief Activity Records [Essays and Research Publications]FUKUSHIMA: Lives on the Linepersonnel wearing tyveks* arrived and assisted with the evacuation operations. Concurrently, we were ordered to seek refuge indoors and stop patient transfers for close to three hours. We later learned that it was because of a leak at the nuclear power plant.At first, we transported ambulatory patients by bus, but we also had many litter patients. So we transported them using the Self-Defense Force’s large, twin-engine helicopter. Evacuating past the nuclear power plant by car, we heard what sounded like fireworks. We later learned that this was a hydrogen explosion in the Fukushima Daiichi plant’s Unit 1 Reactor. Evacuating along National Route 288, we drove under a bridge along the Joban rail line that had collapsed.March 13We began to transfer most of our evacuees to the Fukushima Gender Equality Center in Nihonmatsu, which was about 70 kilometers from the hospital. Radiation surveillance showed that there was no need for decontamination. After this, some of the patients were evacuated to the Saitama Super Arena in Saitama City, Saitama. I went to Saitama City as well.�(Shotaro Fujita)Fukushima Prefectural Ono Hospital, March 11, 2011We learned from the news (television and radio) that the earthquake had a magnitude of 8.8 and that many people were missing because of the tsunami. We also had many staff members whose houses were washed away or who could not contact their family. We medical professionals were strongly aware that we were also victims of the disaster. The next morning at 6 am, evacuation orders were issued because of the danger from the nuclear power plant. We used large buses and ambulances to evacuate patients and staff to a clinic in Kawauchi, which was 20 kilometers inland. Immediately after, we heard about the nuclear power plant explosion and that the evacuation zone had been expanded to within a 20-kilometer radius. We were forced to move yet again. The staff was in turmoil from the fear of this invisible danger. The System for Prediction of Environment Emergency Dose Information (SPEEDI) data released at a later date showed that radiation levels were exceedingly high in Kawauchi. If we had known this beforehand, we would have chosen a different evacuation route. Using the town office’s satellite phone we were able to contact our department at the school and secure an intake hospital. After shuttling the patients by disaster helicopter, ambulances, or minibuses, we had to look after ourselves; we were victims too. Some left for evacuation centers where family members were staying; others went searching for their family members in different evacuation centers. Presently, I am a surgeon in a hospital 120 kilometers away from the plant, with enduring thoughts of my colleagues who lost their hospital but persisted in their roles as medical professionals until the very last patient was transferred.�(Yasuhide Kofunato)ConclusionThese were the reports of the young faculty who fulfilled their duties toward the patients of their hospitals, which cannot be rebuilt and are located in areas deemed difficult to return to in the future. Our major source of information was mass media such as the TV, and the lack of accurate information stoked our anxieties and fears. In the midst of this massive confusion, it was a blessing to have a large group of medical professionals who fulfilled their responsibilities as medical professionals. I can still vividly remember my sense of relief at seeing the physicians safely return to our school after transferring all the patients to intake support hospitals, and receiving reports that there were no abnormalities in the radiation surveillance. What we must not forget is the marked ability of surgeons to steer us away from crises. Some important points for future surgical education are the ability to promptly and appropriately act and make decisions under extreme situations, and the development of knowledge, skill, and character to support such abilities, actions, and decisions.*Tyvek: non-woven polyethylene fibers that are used in uniforms for those working in areas exposed to radiationThe Role of Transmitting Information in Disaster Medicine