FUKUSHIMA Lives on the Line

189chap.IVPatient Relief Activity Records [Essays and Research Publications]FUKUSHIMA: Lives on the LineEmergency Medical Assistance Team (REMAT) in Japan, came to help our hospital. They let us know the severity of the plant's status despite the scarcity of accurate information and the prevailing confusion.During this time, REMAT was always in our side. Finally, they resuscitated us; they braced us up to take on facing the accident.When setting up our own REMAT against the nuclear disaster at our hospital, we had to share the recognition and role of our jobs, such as risky crisis intervention, focusing on the assistance of people who had been evacuated from the disaster site. We tried to share the scanty information to calm our anxiety, and to Figure 1. Summary of the Radiation Emergency Medical Service in Fukushima Medical University Hospital.We have examined twelve radiation-exposed and contami-nated patients. REM; Radiation Emergency Medicine, FMU; Fukushima Medical University, yo; years old, REMAT; Radia-tion Emergency Medical Assistance Team.Figure 2. Current Radiation Emergency Medicine Network in Fukushima Prefecture.Off-site center manages the patient information and controls the transport. Patients with radiation contamination cannot be accepted in the Primary Radiation Emergency Hospital at this point. Emergency medical helicopter can approach to 20 km radius to contact the non-contaminated patients at this point. Doctors can enter into the 20 km radius at their own risk. 1F; Fukushima Daiichi Nuclear Power Plant, FMU; Fukushima Medical University Hospital, NIRS; National Institute of Ra-diological Sciences.focus on the health problems of the plant workers. To prepare for some kind of adequate treatment of the radiation-exposed patients, we set up the daily morning conferences, web meetings, night lectures and simulations to brush up our skills and knowledge with the volunteer doctors, and also together with the Japan Self-defense Force NBC protective unit. We treated twelve patients in our unit from March 14 to April 15. Six of them were whole body contaminated, four were locally contaminated, and two only locally externally exposed (Figure 1).Fortunately, there were no radiation-exposed and contaminated patients in the nuclear power plant, in those days. At that point, we did not have an adequate Radiation Emergency Medical hospital, nor had enough local community medical hospitals, especially near the nuclear power plant because of the evacuation direction and hospital damage there. We had to reconstruct the Radiation Emergency Medical System nearly from the beginning and in short possible time (Figure 2).Very quickly, we became aware of another important problem of the emergency responders such as firefighters and ambulance crew in the disaster site. They were not only crisis responders but also disaster-associated victims as they began to suffer from post-disaster stress-induced psycho-somatic illness. They had not only exhausted themselves but also felt uncertain feelings about their own radiation consequences during the crisis. We, therefore, introduced them to the mental health care psychologist, and also set up a consultation clinic by ourselves for treating them.Simultaneously, we calculated the internal and external exposure dose by the data from whole-body counter and personal dosimeter in turn. Using the dose date evaluated, we were able to counsel them to relieve their mental stress over radiation related anxieties and their future. Two hundred and seventy-five persons were examined by September 11 as an acute internal exposure cohort. After 9.11, we are planning to examine them again to either deny or estimate the chronic internal exposure which may be from food consumption.Based on our own experience just after the accident, the established support system from the network related with radiation emergency medicine in Japan worked relatively effectively and efficiently. However, still the general citizens residing in the contaminated area of Fukushima have more unexplained fears about low dose radiation exposure, such as food contamination and 20 mSv topics. These fears may be exaggerated by misinformation; unreliable comments and rumors about radiation and its effects on human health. The lack of