FUKUSHIMA Lives on the Line

86Posted on the Fukushima Medical University homepage: the Earthquake Special Report pagesInternational Medical SupportMedical teams from Jordan and ThailandMay 27, 2011, Fukushima City, JapanHere, Dr. Shinya Takase reports and reflects on refugee care jointly provided by teams from FMU and the Hashemite Kingdom of Jordan. Dr. Takase leads FMU’s Deep Venous Thrombosis (DVT) Prevention and Care Team, and is a lecturer in the Department of Cardiovascular Surgery.Refugees and Shelters in Fukushima Prefecture as of May 11, 2011There were 8,085 primary refugees living among 142 shelters, and 16,413 secondary refugees living in 491 locations. Most of the 24,498 total refugees are people displaced from cities, towns, and villages along the Pacific coast of Japan’s Tohoku region.Activities of the FMU DVT Prevention and Care TeamDVT prevention and care activities for refugees began on March 28, 2011. As of May 11, teams had contributed a total of 22 days of care at refugee centers.Team members visited refugee shelters around the prefecture and screened refugees deemed to be at high risk. These include people with swollen feet, bedridden or immobilized patients, people with other injuries or cancer history, refugees who had lived in a car, pregnant or new mothers, recent surgical patients, and anyone with varicose veins, DVT, or DVT-like symptoms.High-risk refugees were interviewed and screened with a portable ultrasound device. Thrombi are especially common in veins below the knee. When ultrasound revealed a large or fresh thrombus at risk for pulmonary embolism, the refugee was referred to a nearby core hospital for further examination and care. When no thrombus was detected, guidance on DVT prevention was offered. Refugees with larger-than-normal vein caliber were given support hose designed to compress external veins and minimize thrombosis formation.As of May 11, the team examined 2238 patients (28% of the primary refugees). Of these, 219 tested positive for thrombosis, and eight were hospitalized immediately for urgent care. Overall, 9.8 percent of primary refugees were diagnosed with DVT, and 874 sets of support hose were distributed (a number corresponding to 39 percent of those who were examined).Activities of Volunteers from the Hashemite Kingdom of JordanThe Jordanian care team consisted of two vascular surgeons and two nurse/ultrasonographers (male and female). Dr. EL-ABDALLA Omar Nayel, Dr. RASHAIDEH Mohammed Ahmed, Mr. ALZU’BI Abdallah Hayel, and Ms. SHAQDIH Eman Hasan joined FMU’s DVT Prevention and Care Team on April 25, 2011, and worked 8 long days from the start. Visiting 20 shelters and 4821 refugees, they screened 736 and detected thrombosis in 10.6% of cases. The Jordanian team distributed 327 sets of support hose.Personal ReflectionsWe did not know in advance what level of skill and service to expect from our Jordanian colleagues. Upon their arrival, we got better acquainted conversing in English. Concerned about their ability to communicate with refugees, we hoped to find a translator fluent in Arabic and Japanese, but none were available on short notice.Working closely with colleagues from another country, we encountered different eating habits, religious views, and such. But it was clear that they were highly Jordanian and FMU Teams Cooperate in Refugee Care