340被災地からの報告通り過ぎるとする日本的風土,多くを語らぬ東北の人の気質から問題を風化させないように,被災地の重荷を narrative に汲み取り,長い時間をかけても被災を軽減する努力を日本社会が寄り添って実践することが必要である.世代を継いで住み続けられる安心した豊かな里山と海を回復させるため,そして,この種の事故を再び繰り返さず次の激甚災害に備えるためには,個人として,(医療)組織として,地域として,日本として,誠実に振り返り,省察して学びとることが必要条件である.表2 福島の大震災の特異性原発事故と核汚染忌避心理による社会経済的影響•被災者・被災地域・周辺地域の不安が高まり,広域化する•自然災害と異なり,リスク(被曝・汚染)は継続・変化する•放射線は不可視・無臭で,リスクを自覚できないため,対応責任者の情報提供力・コミュニケーション能力が安心感・信頼感に大きく影響する•被災地であっても敬遠・回避が生じ,医療資源(人・物)が不足し孤立する•移動困難者の脱出・移送は行政の避難指示により警察・消防,自衛隊が介入し,医療者との連携が鍵となる•避難区域にとり残された場合,施設の医療・介護は凄惨となる(ありえない死も起こる)•2次医療機関は一般災害と放射線災害医療を同時に展開する実力を問われる•避難者が大量発生し,長距離の移動が発生するため,医療機関の対応は広域化する(初動から超広域的調整体制が望ましい)What has been brought to residents and communitiesby the nuclear power plant accident?Special and serious disaster relief procedure modificationafter the 2011 Tōhoku earthquake and tsunami in FukushimaKazunobuIshikawaAbstract After the catastrophic 2011 Tōhoku earthquake and tsunami which struck cities and towns on the Japanese Pacific coast, Fuku-shima has been the focus of special and serious disaster relief procedures modification regarding nuclear power plant accidents. To date, the Japanese government has repeatedly issued evacuation orders to more than 100,000 residents. Huge numbers of refu-gees are still uncertain if they can return home and re-cultivate their farm land. Ambiguous public announcements concerning the radiation risks seem to have aggravated feelings of insecurity, fear and the desire to escape, both at home and abroad. This disaster has seriously undermined trust internationally and locally in Fukushima. Harmful rumors added further difficulties. In re-sponse to this disaster, local government, medical institutions, care facilities, police, emergency services and the self-defense forc-es continue to put their utmost effort into reconstruction. This seismic disaster has reminded us that supplies of water, electricity, gas, gasoline and telephone/communication facilities are essential prerequisites for reconstruction and daily life. Disaster and radiation medical association teams actively participated in the rescue efforts, and a number of organized medical teams cared for about 15,000 refugees in 100 shelters. We also visited homebound patients, who were unable to evacuate from the 20-30km inner evacuation area. In this relief role, we need to consider the following; (1) professionals, both healthcare and nuclear engineers, must always be prepared for unexpected circumstances, (2) the daily organic cooperation of individuals and units is closely linked to readiness against sudden risks, and (3) appropriate accountability is essential to assuage the fears of residents and refugees. A sincere learning process may benefit those innocent refugees who may be forced to abandon their homes permanently.Key words: 2011 Tōhoku earthquake and tsunami, Fukushima, Nuclear power plant accident, Large-scale evacuation, Professional-ism(Nippon Ronen Igakkai Zasshi 2011;48:489-493)Center for Medical Education and Career Development, Fukushima Medical UniversityDepartment of Cardiology, Fukushima Medical University Hospital