FUKUSHIMA Lives on the Line

254handling a scenario changing minute-by-minute, where individuals must make on-the-spot decisions as best they can, it is incumbent upon the members of the medical community to base their actions on the principle that they will exhaust every recourse and take every action they can to help the sick and the injured.Sophisticated Medical Support for the Fukushima Residents at the Evacuation CentersWe witnessed an example of FMU’s “wisdom” during the chronic phase of providing medical assistance to the evacuation centers, when specialist clinicians were sent to various regions. If the university’s mission of “Local Contribution—Safety and Security for Fukushima Residents” was to be fulfilled, the university HQ would need to accept and support action plans of individual academics as well as specific departments (courses). The “Specialized Healthcare Teams” formed autonomously by each specific department performed activities at each evacuation center throughout the prefecture. They provided nursing services and protective medical treatment in the areas of circulatory cardiology, cardiovascular medicine, pediatric medicine, infection control, and psychosomatic care (“Care for your Heart”).The “Care for your Heart” team formed the center of the psychosomatic care unit. It was designed to help with the unique stresses caused by problems associated with movement into disaster refuge and the radiation emergency by performing support activities domestically and globally as well.The “Economy-class Syndrome” team formed the center of the cardiovascular care unit. This team performed ultrasound screenings, checking for symptoms of venous thrombosis (blood clotting) in the lower limbs, which can be caused by dehydration and lack of exercise associated with prolonged stays in evacuation centers or living out of cars due to the disaster. If proper care is not administered in such cases, thrombosis can cause embolism in the pulmonary artery and become a cause of sudden death. The detection rate for venous thrombosis is greater than 10%, and appropriate treatment can be administered after detection. To the extent of my knowledge, we did not witness any case of sudden death caused by acute pulmonary arterial thromboembolism among those staying in disaster shelters.I would also like to discuss FMU’s perspective of its activities promoting international cooperation during the disaster. Many Japanese people were not used to interacting with foreign nationals as they collaborated in providing medical services during the disaster. It was not difficult to identify negative factors with respect to the difficulties with English, mismatched needs, dysfunction at the disaster sites, and administrative burdens carried by the refugees’ self-governing bodies. There were many debates regarding whether we should accept international medical assistance during the chaos of the critical phase of the disaster.FMU received medical assistance from the nation of Jordan in the Middle East as the “Economy-class Syndrome” team. Mr. Shin-ichi Kikuchi, President of the University, accepted their offer with a view that this international collaboration would be long-term and ongoing. The university decided that it was necessary to take a more global approach in the future, as it poised to become an international center of medical care services with respect to the effects of radiation on health as well as disaster scenario healthcare. Four members of the Royal Jordanian Medical Team joined the University’s “Economy-class Syndrome” team, and during their one-month stay in Japan, they performed lower-limb ultrasound examinations for over 2000 people in the disaster shelters. The team was able to correctly and effectively conduct its activities only after confirming their orders and instructions given to them by the university’s team leader at the meeting held just two hours earlier. In an emergency, they would act as military units, so it is quite natural that they have sufficient capabilities to carry out their tasks during the disaster.The reasons for the success of this international collaboration were the participation of each of the members of the “Advanced Emergency Healthcare Support Teams” set up by FMU, the movement from the chaos of the critical phase of the disaster to the chronic and then recovery phases, and the necessity of the work done by the “Detached Management Team” in returning the operations of FMU Hospital to normal function. The teams were able to render their assistance to the people in the disaster shelters in a friendly and peaceful manner from beginning to end, and the evacuees thanked them, and said that “We are so thankful that people would come from such a far away country to help us.”Emergency Radiation Medical Care: Secondary Radiation Medical Treatment FacilitiesIn 2001, FMU Hospital organized a secondary radiation medical treatment facility called the “Emergency Radiation Care Ward.” The ward was organized to perform radiation screenings and decontaminations as well as provide early-stage urgent care to emergency patients suffering from the effects of Fukushima Medical University: Managing Risks, and Prospects for Recovery after The Great East Japan Earthquake and the Accident at a Nuclear Power Plant