FUKUSHIMA Lives on the Line

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244National Institute of Radiological Sciences (NIRS) in Chiba and arrived in Fukushima by Self-Defense Force helicopters. When they went into Fukushima on March 14, they found the situation at the nuclear power plant progressively deteriorating. They first prepared for the secondary radiation screening of people with high levels of radiation exposure. With the passage of time, the situation at the site became worse. The media began to report that some power plant workers sustained injuries. At this time, the decision was made to establish the present system of screening and admitting patients. One of the nurses, a member of the Nagasaki University medical team, helped transport affected patients to the hospital by helicopter. We interviewed Ms. Kanami Hashiguchi, who specializes in radiotherapy. Ms. Hashiguchi was part of one of the first group of nurses who came to Fukushima with the team. She continues to work on site at FMU.Information Sharing with Radiation Emergency Medical Team (Twice a Day)Soon after the disaster, FMU Hospital was in a state of chaos. The hospital had a decontamination ward and instruction manuals, and training for radiation decontamination was being annually conducted. Yet, after the accident, the decontamination ward was not properly utilized and medicines were not always available. The radiation medical ward, a center for treating patients exposed to radiation, was supposed to be fully stocked with requisite medical supplies. In addition, outpatient care and scheduled operations were suspended so that round-the-clock care could be provided to disaster-affected people. Even today, we are making triage decisions and providing treatment to victims with the support of Disaster Medical Assistance Teams (DMATs) dispatched across the country. Under such circumstances, FMU Hospital organized a Radiation Emergency Medical Assistance Team immediately after the accident according to the instruction manual already in place. The team comprised more than a dozen specialists including a professor in the field of radiation as the team leader, emergency physicians, radiologists, radiation technologists, and nurses; some of the team members were from Nagasaki University and Hiroshima University. The team members now hold a meeting at 10 am every day. Information is shared via online conferences held every day at 3 pm. The members include FMU Hospital, Offsite Center, Anti-Seismic Building of the Fukushima Daiichi nuclear power plant (Doctors were dispatched from University of Occupational and Environmental Health), J Village Medical Center, NIRS, Hiroshima University, and Japanese Association of Acute Medicine. The sole purpose of these conferences was to share information on a daily basis about the status of injured or ill patients.In late March, we were able to take this practice of information-sharing to the next level. After the daily meeting at 3 pm, members would meet with the Radiation Emergency Medical Assistant Team at 10 am the next morning to share information and discuss the medical approach taken. In mid-April, Ms. Uezawa, a nurse certified in cancer radiotherapy and who had recently finished her training program in June, joined our team as a full-time member.As a radiotherapy specialist, Ms. Uezawa was knowledgeable about radiation exposure and radiation protection; however, her knowledge was somewhat limited because she had only participated in training sessions at NIRS. Nevertheless, she received the support of Ms. Hashiguchi and her colleagues from Nagasaki University, which she considered rewarding.Preparing for the Prolonged Nuclear Accident by Implementing Frequent Simulations Those who were taken to the hospital were in need of secondary or higher emergency care. As of the end of July, the number of radiation casualties was 11. “Fortunately not many patients were transported to the hospital, but the situation at Fukushima nuclear power plant was real and volatile; we did not know the kind of issues patients would come in with. We are unsure of what may happen to these patients as time passes. Thus, we are now working hard with Ms. Hashiguchi from Nagasaki University and Ms. Uezawa at FMU Hospital to put a support system in place” (Vice President Nakajima).The existing manual, drafted in 2002, only envisioned short-term medical care for a few casualties (Left) Ms. Uezawa giving radiation emergency medical trainingNurses from the hospital listening attentivelyThe University Hospital Closest to the Fukushima Daiichi Nuclear Power Plant

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