FUKUSHIMA Lives on the Line

52Two Weeks after the EarthquakeCritical Stage of Evacuee Patient CareOver three days we had a total of 168 emergency patients, of whom 93 were tagged green, 44 yellow, 30 red, and one black. Most of the patients were from the Hamadori area. The disrupted water supply affected the hospital’s functionality. We could not conduct dialysis, biochemical testing, sterilization, and irrigation. Moreover, we could not cook for patients, use the toilets, or wash our hands. Dialysis patients with serious problems were transferred by ambulances and buses to hospitals in other prefectures, such as the University of Tokyo Hospital. We realized the need for emergency medical supplies that could be used without water, such as replacement fluids for hemofiltration. On March 25, we received intake information about patients with head and neck cancer under the names of the directors of the Japan Society for Head and Neck Cancer and Japan Society for Head and Neck Surgery. Ohta Nishinouchi Hospital in Koriyama City used this system to send over head and neck cancer patients. We thank them for their timely and appropriate support.The hydrogen explosion in the nuclear power plants caused the evacuation of many Hamadori residents. One after another, ambulances and helicopters from the Self-Defense Force, support ambulances from municipalities across the country, and buses came for the patients hospitalized in Hamadori hospitals. Since the telephone lines were down, we lacked precise information about whether patients would come or if they were already in the hospital and their time of arrival; however, satellite phones worked flawlessly. Our hospital set up beds in the waiting area by the main outpatient entrance and the nursing department so that several patients could easily be taken in when they arrived; patients came in the middle of the night and in the early hours of the morning. Fourteen hospitals in the Iwaki and Soso areas had about 1,300 patients to transfer, of whom 175 patients were for triage and 125 for hospitalization. A radiation survey was also conducted on about 500 people due to the dispersal of radioactive material from the nuclear power plant. Our hospital is a secondary emergency medical response facility for radiation exposure; thus, it has equipment for decontamination and measuring internal radiation exposure. However, because we only have one piece of equipment that cannot accommodate many people at once, we also had Self-Defense Force tanks and decontamination vehicles parked outside. In addition, we had many radiation experts and REMATs come from Hiroshima University and Nagasaki University.For one week, employees could not use the baths and had to sustain themselves with rice balls, instant noodles, and bottled tea. The convenience stores and supermarkets in town were sold out of goods. Moreover, because we did not have gasoline, we could not go too far to buy goods and commuting otherwise was difficult. We had just enough stock to suffice the patients’ food intake. The food prepared for the patients tasted delicious , and food testers were the only employees lucky enough to consume it. On Friday, March 18, our supply of drinking water was restored. Upon hearing this, everybody cheered in the middle of a lecture. We were able to endure the situation without stepping back from the front line. Had the water supply taken another three days to be restored, the hospital functionality would have been in a desperate state. “Disaster Medicine during the Earthquake, Tsunami, and Nuclear Accident: A University Hospital on the Front Line”Koichi Omori, Vice President, Fukushima Medical University HospitalFrom: Japan Society for Head and Neck Cancer, “Briefing Session on the Great East Japan Earthquake and Tsunami,” June 9, 2011.