FUKUSHIMA Lives on the Line

chap.IVPatient Relief Activity Records [Essays and Research Publications]FUKUSHIMA: Lives on the Line205machine that keeps me warm.April 25, 2011A message to the California Blood Bank Society (CBBS) and the South Central Association of Blood Banks (SCABB) appears under Official Announcements, from FMU President Shin-ichi Kikuchi and FMU School of Medicine Dean Hitoshi Ohto. Let me add my voice to theirs in wishing CBBS and SCABB members a successful joint meeting, April 26-28.As Professor Ohto is also President of the Japan Society of Transfusion Medicine and Cell Therapy (JSTMCT), this might be a good time to share his answers to some of the questions that have come from friends and colleagues around the world.Question: What did the March 11 earthquake feel like? What happened afterwards?Ohto: The earthquake struck while I was in Kagoshima, on the island of Kyushu, at a meeting of the Japanese Society of Autologous Blood Transfusion (JSAT). We did not feel the earthquake in Kagoshima, but Japanese media participate in an alert system for imminent or actual disasters. I knew that FMU staff would be among the first responders. Healthcare professionals in the affected area attended to the immediate safety of patients in their care. Institutions made damage assessments, and communicated their operational status through various channels. Transfers were arranged as needed, for example, so patients on ventilator support could be assured of uninterrupted care. Japan has an extensive network of “Doctor Heli” air ambulances. One such helicopter is based at Fukushima Medical University, but in the days after the earthquake, we turned a soccer field into a helipad to accommodate four more Doctor Heli teams and larger helicopters from the Japanese Self-Defense Forces and Coast Guard.Question: Patients from Fukushima and other affected prefectures came to FMU for treatment. How did your facility handle the influx?Ohto: Fukushima Medical University is a tertiary referral facility for Fukushima Prefecture. Even so, we normally accept any kind of patient, in accordance with Japanese traditions of universal access to health care. To provide disaster-related services, we took the unusual step of redirecting all non-urgent outpatient appointments to other facilities. Especially for outpatients requiring ongoing care, such as those on dialysis, we sought operational facilities as close to patients’ homes as practical, but in some instances non-critical patients were transferred to Tokyo and beyond. The influx of critical patients was manageable. Sadly, one reason for this was that so many people were swept away to their death in the tsunami. Survivors came to our hospital not only by air and ground ambulance, but also en masse by specially commissioned buses.Question: How did FMU cope with the disruption of services and supplies?Ohto: We use about 150 tons of water on a normal day, and had a three-day reserve when the earthquake interrupted the municipal water supply. Conservation protocols were instituted immediately, not only for water, but also for heat and electricity. Hospital-based laboratory procedures were modified, where possible. Basic research came to a halt. Water was spared for patient-related food preparation. Conversely, employee cafeteria services were all but eliminated, and employees were instructed not to use tap water for their meals. Limited supplies of bottled beverages were available, and those who had queued for potable water in their neighborhoods were encouraged to bring some of it to the hospital. Caregivers were asked to use chemical toilets set up just outside of the hospital, so water for flushing – indoors – would be available for the elderly and infirm. Self-Defense Force teams delivered about 100 tons of water by tanker while municipal lines were being repaired. Running water was restored just over a week after the earthquake, but we are continuing to practice various conservation measures. As summer approaches, all major electricity users, including FMU, have been asked to reduce electrical consumption by 25%.Question: Is FMU still providing care to people from other prefectures?Ohto: Even in normal times, Fukushima Medical University attracts patients from around Japan. Airborne and ground-based ambulance retrieval from other prefectures has subsided, but people displaced from their homes outside Fukushima have been welcomed to refugee centers in our prefecture. Medical teams from FMU and other healthcare facilities circulate among refugee centers in Fukushima, Miyagi, and Iwate prefectures, providing immediate care and arranging hospital admission as necessary. Prefectural or national