FUKUSHIMA Lives on the Line

253chap.VConveying to PosterityFUKUSHIMA: Lives on the Linedangerous situation, each of us understands these risks quite well; we will strive to quickly grasp all accurate information in cases of emergency, and be able to take the appropriate measures.” This affirmation of “we understand the risks, and can manage them,” that is to say, through this risk management mindset, FMU believes that it is the “fortress of medicine” located 57 km from the site of the Fukushima Daiichi nuclear power plant, which was suffering a total loss of control. FMU also believes that the monolith of its medical team would hold firm through this formidable situation and that it would take action in the face of the unprecedented natural disaster.Fortunately, to this day, FMU has never needed to issue the Code Red emergency signal.Managing Cases where Support Hospitals are Disaster StruckFukushima City was hit by the Great East Japan Earthquake on March 11, 2011. Thousands of homes were affected, suffering power outages and suspended water supplies. Many of FMU’s staff and their families were among those who suffered such damages. How to manage an organization for social services, where its members were simultaneously victims and working to support others (the duality), was a critical theme throughout.The basic policy was that “Administrators would support University staff members as much as they possibly could to contribute 100% to the good of society.” FMU afforded time to its staff to check on the status of their own families and potentially return to their homes to make sure of their safety, or move them into refuge if needed, and provided every support so that staff would be able to return to their positions at the university with clear heads. The supervisors of each university department were also notified of this policy. It would be impossible for anyone to concentrate all of their energy day and night to making contributions to aiding society in this situation, given the inability to set aside their own fears and concerns for the future. At the organizational end, nominal tasks were greatly reduced and various noncritical day-to-day functions of the hospital were halted, such as general outpatient services and non-urgent, scheduled surgical procedures. If the hospital had no excess capacity, it would not be able to respond to unexpected situations.Many of the university nursing students remained on campus, and volunteered their time and energy toward performing radiation screenings and assisting with other disaster response measures. Though they acted out of their own accord, FMU executed an immediate temporary dismissal during the critical time of the nuclear situation. Then, we decided to accept the cases where they came to volunteer at their own discretion as responsible members of society but not as students. Most of the students continued to volunteer as members of societyMeasures Taken during the Evacuation of the Quarantine Area: Functioning as a Relay Station for Transporting VictimsThe national government and Cabinet joint directive mandating that all citizens take refuge at their homes or elsewhere due to the loss of control at the Fukushima Daiichi nuclear power plant was issued on March 12, 2011. Evacuation was deemed necessary for approximately 2000 hospital admittees and patients receiving nursing care within the refuge areas in the prefecture.The hospital functioned as a hub for transportation to the various refuge areas for hospital admittees and patients receiving nursing care during the evacuation phase. The hospital temporarily retained and cared for approximately 180 nursing patients who were being transported to the hospital day and night. Patients with severe injuries were brought in for immediate care, and those with less severe conditions were transferred to other hospitals. The actual transportation of the patients was extremely chaotic, as the information provided to the university was erratic and possibly speculative. It was also impossible to confirm the exact number of patients being transported, both when they arrived or when they were moved out, or even how they would be transported. Furthermore, there were numerous cases in which patients’ information was totally unknown, some of the elderly patients passed away during transportation, and patients’ medical conditions were exacerbated by the stress caused by evacuation to the refuge.FMU utilized the large space available for emergency use as well as the nursing department teaching faculty, and all other human resources with nursing ability, in addition to any general medical facility capable of handling patients. One could call the interaction between FMU hospital and the medical facilities throughout the prefecture a wide-ranging emergency medical transportation network. However, the rapidly swelling number of emergency measures needing to be taken made it impossible to simply follow the guidance of any manual. There was never any manual to address this kind of unprecedented situation in the first place. In order to maintain good communications in