FUKUSHIMA Lives on the Line

237chap.IVPatient Relief Activity Records [Essays and Research Publications]FUKUSHIMA: Lives on the LineTable 1B: Issues and Problems with Prolonged Life as an EvacueeEarthquake and tsunami damage, evacuation zones, and planned evacuation zonesMany people sharing the same space (limited isolation from patients with a fever or contagious diseases)Difficulty in maintaining appropriate indoor temperatures (winter or summer)Poor air circulation (warm air leakage)Limited hand washing and gargling (water shortage)Bedding and mattresses (causing backaches, bedsores, insomnia, among other ailments)Privacy (causing irritation, anxiety, anger, depression, high blood pressure, among other discomforts)Long-term evacuation (leading to uneasiness, exhaustion, depression, among health-related disorders)Limited movement (causing disuse syndrome, interrupted rehabilitation, among others)Table 1A: Medical Visits to Evacuation CentersReference dates for evacuation center information (April 1, 2011) March 28–April 28, 2011AreaEvacuation CenterNumber of evacuation center visitsNumber of patients visited*1Number of patient records*2Number of facilitiesNumber of evacueesTotalsActual numbersKenpoku738,37632245,231746Kenchu748,67937234,477622Kennan168526656636Aizu443,81620142,272177Minamiaizu21610000Soso163,08422122,248562Iwaki583,38747161,040252Total30228,2051649515,8342,395*1 Number of evacuees visited in the evacuation centers *2 Number of patient records producedannual radiodensities exceeded 20 mSv. There were about 2,000 elderly people in these facilities, showing how much of an effort was needed in these areas soon after the nuclear accident.Medical Visits to the Evacuation Centers and Care for At-Home Patients in the 20–30-kilometer Indoor Refuge ZoneIn the two–three weeks of the early stages after the earthquake, even medical facilities had trouble securing sufficient gasoline, kerosene, and other fossil fuels. Public transportation systems outside the urban areas are not very convenient; therefore, personal cars, used to go to school, work, or shop, play a major role in daily lives. About 85% of Soso’s residents rely on personal cars to commute to hospitals (Fukushima Department of Health and Welfare Survey, January 2010). Thus, as of March 31, we began providing a wide range of medical support to those in evacuation centers and those at home who could not move around easily because of the effects of the disaster. 1. Medical Visits to Evacuation Centers (Table 1A)Three weeks after the disaster, 302 evacuation centers had been set up in Fukushima, housing 28,205 evacuees. FMU conducted visits to these evacuation centers with four teams specialized in pediatrics, contagious diseases, deep-vein thrombosis, cardiovascular health, and psychiatric health. In the month of April (till the 28th), we visited 95 places, including 164 centers and 15,834 patients. Most consultations in the evacuation centers were for chronic diseases (lifestyle diseases) such as high blood pressure (27%), high blood lipids (6%), and diabetes (5%), followed by communicable diseases (e.g., fever, cold, and influenza; 18%) and orthopedic disorders such as backaches (9%). Portable vascular ultrasounds revealed that about 10% had deep-vein thrombosis; we taught these patients appropriate exercises and distributed stockings. Because the disaster occurred in winter, acute pulmonary embolism and thrombosis, which were major issues as people slept in cars after the Chuetsu Earthquake, was not a big issue for us. In terms of mental health care, from an early stage, psychiatrists and clinical psychologists listened to and prescribed medicines for victims complaining of depression, anxiety, or insomnia. The inadequate implementation of a comprehensive nuclear disaster strategy and the lack of information about when the evacuation order would be lifted, allowing all evacuees to return home, placed psychological stress on the victims. Table 1B presents issues and problems about life at the evacuation centers. During this disaster in which life as evacuees was prolonged for months, government officials, volunteers, and the victims themselves who visited evacuation centers to solve small problems all played a significant role.2. Care for At-Home Patients in the Indoor Refuge ZoneDaily life was difficult for those in the 20–30 kilometer zone; many were ordered to stay indoors from Effects of the Nuclear Accident on the Community: Unique Aspects of the Fukushima Disaster