FUKUSHIMA Lives on the Line

238Reports from Disaster-Affected AreasTable 2: Unique Aspects of the Fukushima DisasterSocioeconomic effects of the nuclear accident and psychological aversion to radioactive contamination●Increase and spread in anxiety among the victims, disaster areas, and surrounding areas.●Unlike natural disasters, the risks (radiation exposure) continue and change.●Radiation is invisible and odorless, and because people are unaware of the risk, the provision of information and communicative ability of responsible parties greatly affect the sense of trust and peace of mind of the public.●People avoid disaster areas, which must fend for themselves because medical resources, such as people and materials, are lacking. ●The police, fire departments, and Self-Defense Forces intervene to assist in the rescue and transport of those with mobility challenges after the government’s order to evacuate. Their cooperation with medical professionals is a key.●Medical and long-term care and facilities for those left within the evacuation zones becomes ghastly (causing unthinkable deaths).●The ability of secondary medical facilities to simultaneously address both general disaster medicine and radiation exposure medicine is put to the test.●Medical facility care must be widespread as large numbers of people are evacuated to distant locations (ultra-widespread care should be implemented from the start)March 15 because of the nuclear accident, while several residents chose to evacuate voluntarily. Many companies were ordered not to go near the nuclear power plant; thus, delivery was discontinued for aid supplies as well as gasoline, kerosene, food, and medical supplies. In the early stages, most medical teams and volunteers did not enter Minamisoma, which is located within this zone. Therefore, the Self-Defense Forces had to stop by every house and transport those who could not move voluntarily. However, about 500 patients stayed at home immobile, refusing to be transferred; thus, a team from FMU, University of Nagasaki, and the medical association collaborated with the medical branch of the Self-Defense Forces to conduct at-home consultations. By the end of May, we saw 1,500 patients. We identified five residents who required hospitalization (debilitation, pneumonia, bedsores, Parkinson's disease, and degenerated schizophrenia), and we followed up accordingly. A survey about the emergency evacuation of 164 at-home elderly who had difficulty moving and the evacuation conducted in Minamisoma in mid-April revealed that 68.3% obeyed the evacuation order, 26.8% refused to evacuate, and 4.9% did not declare a preference; this includes 54 bedridden respondents and 34 with difficulty walking. The results suggest that these respondents have little confidence in their own ability to move and prefer to live as evacuees receiving care.Effects of Widespread Evacuation due to the Nuclear Accident on Patients and FamiliesIn the early stages after the nuclear accident, the government did not release official data about atmospheric radiation diffusion. However, foreign agencies monitoring these levels constantly released data. In addition, taking into account the importance of weather conditions (e.g., wind direction, rain, and snow) and topography in terms of radiation dispersal, on April 23, Iitate and Yamakiya in Kawamata were designated as zones planned for evacuation within one month. At the same time, restrictions on the shipment and imports of agricultural and dairy products were also imposed, casting a dark shadow on the springtime harvest. Many residents, particularly the elderly who lived away from the coast and whose homes were not damaged, were unexpectedly ordered to evacuate. The evacuees from Fukushima surpassed 120,000 people. Many in agricultural villages were living in homes passed down through three generations and were living self-sufficient lives for years. However, because of the evacuation, and considering school, work, and commuting conditions, 35% of families are now scattered (NHK Survey, June 2011). More importantly, caring for the elderly had become an issue.Professionalism in the Medicine and Nuclear Power IndustriesProfessionals must have expert knowledge, the eloquence to reassure the general public, a trustworthy sense of ethics and humanity, and an altruistic attitude. We must vigorously review the efficiency of our nuclear safety management systems and the role of nuclear officials during this accident. This must be done from the same perspective as that adopted when medical accidents lead to improvements in safety management and respect for patients in medical facilities. Each individual should earnestly reflect, from his or her own standpoint, on whether this disaster was considered unthinkable because it was “beyond imagination” or simply because it was “beyond jurisdiction.” Unique Aspects of the Fukushima Disaster (Table 2)In addition to an earthquake and tsunami of this scale being a once-in-1,000-years occurrence, the disaster that struck Fukushima is historically unique because it was combined with the radiation accident at the nuclear power plant, which modern society had developed in an effort to pursue convenience and efficiency. Furthermore, it brought out the fear of invisible radiation, the socioeconomic repercussions (and rumors) of our