FUKUSHIMA Lives on the Line

251chap.VConveying to PosterityFUKUSHIMA: Lives on the Linecomprises numerous experts in various healthcare fields. In the university’s healthcare education programs, the local community-oriented mindset is strong. FMU Hospital prides itself as one of the last bastions of in-prefecture healthcare services, boasts a high rate of new patient admission, and specializes in high-quality, sophisticated healthcare service offerings. Its advanced emergency care center contains 40 beds, and serves almost exclusively emergency patients arriving from throughout the prefecture. The Hospital’s medevac helicopters can reach any location within the prefecture in 45 minutes or less.Immediate Aftermath of the Earthquake: Establishment of a Disaster Response FrameworkOn March 11, 2011, at 2:46 pm, a massive magnitude 9.0 earthquake struck FMU Hospital. TV news reports indicated that a massive tsunami had also formed in the waters of the Pacific Ocean off the eastern coast of Japan, and had struck the coastal regions of the prefecture. People asked, “What should FMU do in response to this?” The bigger question was “how should we function as a support organization when we ourselves are the victims?” FMU, as the core of all medical treatment in the prefecture, was responsible for the advanced treatment of a multitude of admitted patients. The Office of the Hospital Director immediately established the University Disaster Response Headquarters. It has two functions: maintain and manage the operations of FMU Hospital and utilize any remaining manpower to serve as management for operations directing all intra-prefecture disaster medical care services. The headquarters confirms the status of all medical treatment activities on the basis of reports received from each department within the hospital. Surgeries in progress were halted, and the headquarters confirmed the safety and status of all admitted patients. There were no patient injuries, and damage to hospital facilities and equipment was minimal. There was no power outage; however, water supply was suspended. The hospital had several days’ worth of fresh water stored in reserve tanks. Logistical operations including gasoline usage were suspended for one week.The prefectural government had established a disaster response body responsible for the greater region. It was possible for FMU’s disaster headquarters to maintain communications with the prefectural response body via the landline telephone network. A team of physicians, with the university’s head of the Medical School as its leader, was appointed immediately by the prefectural response body, and served as the primary overseer of communications between the university and the prefectural medical facilities. This team comprised professors and instructors of the clinical department, each with numerous physician acquaintances at healthcare facilities throughout the prefecture and handpicked for their expertise regarding medical institutions in Fukushima. It was necessary for the prefectural government to establish and maintain close contact with medical facilities in the region in order to prevent the deployment of improper care or its inefficient utilization, as well as to manage the chaos and confusion during the critical phase immediately following the disaster. There was almost no interaction between the prefectural government and the doctors at local healthcare facilities. Under such extenuating circumstances, it was virtually impossible to expect them to maintain both a grasp of the necessary situational information and also a mutual understanding of the issues at hand so that they could provide swift responses. A disaster information network was established between the prefectural disaster response body, FMU, and healthcare facilities throughout Fukushima as a result of the dispatch and residency of the handpicked team of specialists and their efforts as organizational monitors.Disaster Response at the Supercritical Phase: Tertiary Disaster Medical Response Activities through University-wide Unified EffortsIn the supercritical phase immediately after the disaster, all available medical capacity was diverted toward assisting those injured by the earthquake and the ensuing tsunami. General outpatient services and scheduled surgical procedures were suspended so that the hospital could unilaterally focus its human resource capacity on triage efforts and tertiary emergency services. The hospital’s emergency department organized a nationwide emergency medical team (DMAT: Disaster Medical Assistant Team), and at the same time specialized in disaster emergency medical care by transporting DMATs from the Hamadori area. In just a few days, the DMATs hospitalized and treated approximately 200 severely ill or injured patients with the cooperation of the hospital’s departments. What was necessary to organize and maintain the university-wide cooperative framework? It was necessary to maintain an open flow of information on the hospital’s medical functions and the status of the disaster response activities within the prefecture, as well as reaffirm the University’s mission to making contributions to local regions. University-wide meetings encompassing all