FUKUSHIMA Lives on the Line

212Nollet Q&A with Mayo and ABCtechnologists willing to
transport emergency stocks by motorcycle. That’s the spirit! But how many
of us have dropped a transport container from a motorcycle or canoe to test
its durability and flotation? Ed Martinson (1912-2006) was an active amateur radio operator (call sign W0GYH) who helped with emergency communications in the days of blood and plasma in glass bottles. He told me about an airdrop exercise in which the “lifesaving plasma for a burn victim” was actually six bottles of beer for the local mayor. It landed safely, and the mayor was certainly pleased, but in modern times we would follow up that proof-of-concept with the real thing, and have electronic environmental monitoring of the payload.BK: How did Fukushima Medical University manage its blood supply while transportation was still limited? What kinds of communications should blood centers have with hospitals in setting emergency plans for disasters?KN: We stock red blood cells and fresh frozen plasma in-hospital, but the community as a whole is better served by keeping platelets at the blood center. Fortunately, we are staffed and equipped to collect platelets for research and whole blood for autologous patients. Employees, including me, were able and willing to serve as emergency blood donors. Among Japanese, however, the odds of a one-way HLA match are higher than most other populations, so irradiation of allogeneic cellular blood products is the norm. FMU was first in the world to adopt universal irradiation, and we’ve kept a validated SOP [standard operating procedure] in place, even after the Japanese Red Cross adopted universal irradiation. Sadly, our emergency donors were not needed, because this was a mass casualty event, rather than a mass trauma event.BK: What role did communication play within Fukushima Medical University, like the action meetings? Why were they so vital?KN: Let’s discuss communication in three categories.1. Mass communication. I was lucky to receive media training at every blood center where I have worked: American Red Cross in St. Paul, BloodSource in Sacramento, and Australian Red Cross in Brisbane. Knowing how to formulate an accurate, easy-to-understand message is essential. Having and holding a clear message helps the media, but sometimes they get it wrong. Two French journalists misquoted me and invented facts to suit their agenda. I gently rebutted them in one of my blogs.2. Collegial communication. This works well in Japan. Once again, prior experience prepared me. The Division of Transfusion Medicine at Mayo in Rochester meets twice a year with Red Cross in St. Paul, reviewing performance and discussing contingencies. The University of Minnesota hosts a weekly blood bank breakfast, with regular attendees from Hennepin County Medical Center, Minneapolis Veterans Affairs Medical Center, and two nominal competitors: Memorial Blood Centers and American Red Cross. In Australia, I spoke a few times at the Queensland Immunohaematology Discussion Group, a friendly cohort of transfusion laboratory professionals.3. Emergency communication. Even in the Internet age,
Amateur Radio operators play an important role when regular channels fail. Landline connections were destroyed
by the tsunami. In Tokyo, landline and cellular channels
were operational, but overloaded. I’ve earned an Amateur Radio license in every country I have ever worked. I don’t have as much time for the recreational aspects of this avocation as I once did, and my role is quite different in an emergency, but it helps to speak the language of those who will be speaking our language when they are called upon to communicate on our behalf.BK: How can blood centers prepare for emergencies in which water and electricity go out (or have to be conserved)? What lessons can they take from the way that Fukushima Medical Center dealt with such issues?KN: It’s important to know how much you use, where it comes from, where else it can come from, and what you can do to conserve. Government agencies and utilities maintain priority lists for restoration of services. Blood centers must take the initiative to be on those lists.KN: I think that what CBBS did was great in allowing you to publish news and observations from Fukushima. How is open communication with the public important in such disasters?KN: CBBS has Fukushima’s everlasting gratitude. In some cases, communication portals outside a disaster area are essential. In this case, FMU’s website remained operational, but our human resources had to be redirected. Moreover, CBBS is an internationally recognized brand that lent credibility and enhanced