Expert Commentary

* 医療施設の被害による東日本大震災の医学的および精神療法的対応への影響

Shinichi Niwa, MD

Professor, Dept Neuropsychiatry
Fukushima Medical University
Fukushima Idae, Japan

 

The Tohoku Earthquake of 11 March 2011 initiated the simultaneous triple disaster of an earthquake, a tsunami and multiple nuclear power plant accidents. Our experience may be instructive to clinicians dealing with similar complex circumstances

The impact of such a conjunction of events on medical response services can be considerable. Although my colleagues and I immediately joined the support group for areas which received the most damage we found that traffic was blocked, restricting access to patients. Furthermore, hospitals, clinics, and pharmacies were closed down. Survivors with previous medical conditions were scattered widely. For example, amongst the many people taking refuge in school gyms were psychiatric patients who had run out of medications. Although we began by identifying these patients, attempts to remedy medication lacks were hampered when all four regional psychiatric hospitals with their associated pharmacies were forced to shut down. This left many patients with nowhere to turn. Under such circumstances, new problems such as PTSD and depression began to arise.

Because of radiation problems, mothers with small children presented with many concerns both practical and psychological. In consequence of the nuclear power plant accident, there was little possibility that medical facilities within a 20-30 kilometer radius would reopen any time soon, making enduring remediation of these issues quite difficult. In an attempt to meet these challenges we opened a temporary outpatient psychiatry clinic in the relatively undamaged Soma General Hospital. Nevertheless, attempting to build a new psychiatric hospital system remains quite difficult given local circumstances. Thus, we have been caring for patients through new psychiatry clinics, and from there reaching out in the form of home care, ACT (Assertive Community Treatment) and other forms of community outreach.

Since this is a new experience for all of us, we welcome expert knowledge about low volume nuclear radiation exposure and suggestions on how to build a new medical system when regional systems and associated resources and personnel have been completely disabled or destroyed.

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