FUKUSHIMA Lives on the Line

95chap.IIFukushima Medical University Record of Activities [Notes and Messages]FUKUSHIMA: Lives on the Linepatient’s well-being and family, and area peculiarities, and work together with all types of medical specialists and caregivers” This does not change in times of disaster. Rather, I am now convinced, because of my experience during the disaster, that especially during times of emergency, the role of family physicians becomes more important.In affected areas lacking medical resources, it is difficult to assemble teams of multiple physicians from different specialties and to rotate them among the evacuation centers. At such times, doctors such as family physicians who treat various medical ailments play an important role in increasing medical efficiency. Evacuation centers, especially, need to continuously and comprehensively treat common medical issues from colds, headaches, stomach aches, and backaches to high blood pressure, lifestyle diseases such as diabetes, and mental issues including insomnia and depression.Furthermore, the unique circumstances of disasters necessitate cooperation between all types of specialists and medical professionals to provide patients with care that fully considers the well-being of the patients, their families, and the community. These are the most suitable conditions under which family physicians can fully exercise their characteristic abilities.From Evacuation Center Care to Community-Wide Long-Term CareAs noted thus far, by visiting evacuation centers, I was able to get a glimpse of the complete picture of health issues and medical needs in the community; something I would never get by merely seeing patients who visited the hospital or clinic. There were people enduring major and multiple physical, psychological, and social problems. The emotional conversations with them taught me that my only purpose in this world is to be a family physician.The situation at the evacuation centers only partially reflects the harsh reality of the affected areas. Helping the elderly who live alone at home was of utmost importance. In addition, we needed to follow-up with those who relocated to temporary housing arrangements to ensure that the new life they lead is not solitary, but an autonomous, yet social livelihood. We were required to discern these cases and provide changing yet necessary forms of support continuing community-wide long-term care in an ever-changing environment, I strongly hope to prevent an increase in the solitary deaths and disaster-related deaths during the sweltering heat of summer.Collapse of Community Medical Care and Integrated Care during the EarthquakeThe most important element for achieving trouble-free provision of high-quality medical care in the community is the healthy cooperation of community clinicians and hospital specialists. Even during the critical phase after the disaster, community clinicians played a vital role in the care of patients with mild injuries, the ongoing treatment of chronic conditions, and lifestyle guidance for disease prevention. However, in reality, many local clinics could neither provide continuous treatment nor function as a network to support community healthcare. As a result, many people rushed to hospitals, and therefore, hospital staff were exhausted. Moreover, it became difficult for hospitals to fulfill their primary tasks: care for more seriously injured patients and specialized treatments. How did we get into such a situation?For some time, all methods of communication were severed in the affected areas. As a result, some have pointed out that this led to a collapse in community medical care because the system for cooperative medical care could not be carried out effectively. In addition, the provision of relief supplies were impeded because of the effects of radiation contamination from the nuclear accident, causing severe shortages in not only water and food but also gasoline in Iwaki City and the areas surrounding the Fukushima Daiichi nuclear power plant. This complicated the work of commuting medical staff, home doctors, and home nurses, and medical facilities, starting with small-scale facilities, had no choice but to gradually shut down. But were these truly the only reasons?Proposal from Fukushima for a New Medical SystemWhatever the circumstance, we citizens shall each push forward and create a functional, community-wide health system. (September 6, 2011)Collapsed corridor in a hospital after the disaster(source: Hoshi General Hospital Foundation)