FUKUSHIMA Lives on the Line

252positions were held frequently by the University Disaster Response Headquarters. At these university-wide meetings, those in attendance were instructed to keep the following general principles in mind: (1) share all the information they could with respect to the disaster and the response measures being taken, (2) never guess or make undue assumptions, and make reports based only on facts, (3) resolve all problems that occurred in the field, (4) not criticize but support and encourage others, and (5) not forget their sense of humor.In general, academicians enjoy debates, but an argument without any visible compromise may cause great harm with no benefit at all. The Disaster Response Headquarters strives to make the best when this occurs. Simply passing the buck on to some other body is not an option. Having the ability to streamline decision-making is paramount in emergency situations. For a single issue, all of the available options are thought of, a decision is made, and authorities are delegated. Afterward, progress reports from the field are received, and the headquarters executes any further support measures it is capable of. This arrangement works like a game of catch: the headquarters receives reports from the affected areas and accordingly returns support. In this way, it was possible for the multitude of disaster response measures initiated throughout FMU to be carried out simultaneously. Under normal circumstances, it can take several days to contact and organize the supervisors from each of FMU’s departments, including university administrators, and gather them all in one location, but we never imagined that we would have to do so on the spot! In addition, there was a great sense of urgency with respect to affirming cooperation between each of the University departments, as well as identifying problems and obstacles in response measures. This enabled us to ascertain and obtain everyone’s agreement on the “best possible decision at the time.”Potential for Nuclear Panic and the University’s Response MeasuresThe day after the earthquake, March 12, 2011, television news stations reported a hydrogen explosion at the Fukushima Daiichi nuclear power plant and aired urgent reports warning of the dangers of the extremely critical state of a plant’s nuclear reactor. Droves of residents of the Hamadori area started moving into disaster refuge sites on an official government directive, and many residents of the Nakadori area as well began taking refuge outside the prefecture. During this time, no information pertaining to the status of containment of the situation at the nuclear power plant or the spread of radioactivity was disseminated. The government of the United States declared a 50 mile (80 km) radius surrounding the Fukushima Daiichi nuclear power plant a quarantine zone, and warned its citizens in Japan to evacuate. Fukushima City, where FMU is located, is situated within the quarantine zone established by the U.S. There was also a chance that panic regarding the nuclear situation could break out among the university staff, quickly leading to an evacuation of the hospital and a total breakdown of its services, which would effectively dismantle the core of the prefecture’s medical care capabilities in an extremely dangerous domino effect. What should we do in such a scenario?First, each of the university’s medical staff and instructors strive to achieve the greatest good, exemplified by the “always prepared” mantra of FMU’s administrative department. Second, all of the staff adheres to the policy of “complete transparency with respect to all risks” when in action, and even now this policy remains unaltered.On the third day of university-wide meetings, the general rule of sharing all information was established; this also applied to all available information regarding the nuclear situation. Despite virtually zero information regarding the nuclear power plant provided by the government, a team of radiology specialists from Hiroshima and Nagasaki universities provided real-time explanations of the rapidly changing situation particularly on the repeated hydrogen explosions. All of FMU’s staff was well versed in the use of the immediate information dissemination system when the nuclear accident occurred. The signal “Code Red” is used by FMU during emergency situations. With this signal, the standard operating procedure followed for protection in case of high quantities of airborne radioactive particulate is to take refuge indoors, isolate oneself from outside air, shut off any exterior ventilation, and administer iodine as well as apply protective facemasks. In addition to these measures, the university monitored the level of radiation on its grounds and the surrounding area utilizing real-time monitoring software developed by its own faculty, and published its readings with frequent updates on the University’s homepage. A decision to activate the university-wide Code Red signal was due to (1) an urgent communication from the emergency medical team at the nuclear offsite center, (2) television reports of the large explosions at the nuclear power plant, and (3) a sharp spike in the radioactivity levels detected within the University’s grounds.Through these actions, the university disseminated to each of its staff that “Though we are currently in a Fukushima Medical University: Managing Risks, and Prospects for Recovery after The Great East Japan Earthquake and the Accident at a Nuclear Power Plant