NHK special on medical needs and issues in the aftermath of the EQ/tsunami

Aired on Sunday April 3 - English outline of the contents

Lack of chronic meds

AMDA part of govt revolving doctor rotation?

Ishinomaki hospital- 1 of 12 Japan Red Cross hospitals in the area

People come from throughout the area

Flu and stomach illnesses are common

About 300 patients a per day 2X the usual number

2.5 times busier than normal – ambulance

First they accepted anyone who came

now trying to go back to normal – but a sudden influx of patients

New problems in patent and outpatient care issues arising

Now they can not accept all, must put some people out

Concern than upon being let out there is no home to go to – so they must go to evacuation center

Recovered must go out to evac centers that lack basic support services

New issues are arising

Advanced and severe cases are mixed

Plus new issues due to clearing out destroyed homes and ruins - cut figures & tetanus

Hard to find other places to take the patients

Destruction of local med care systems

Severe cases - Transfer out of the area by helicopter

Touhoku hospital  - see new problems arising

Advanced services but damaged

Operations cut in half due to damage

Of 18 operation rooms only 3 can be used

No sterilization systems

Hard to treat serious conditions

Many smaller hospitals are sending patients to Touhoku hospital

Yamagata university hospital not damaged

Functioning well

Many people are sent here

But they face new problems - Too many patients

Older patients are being asked to accept postponing surgery

Patient: has to accept, not really a choice!

Balance of Emergency patients and original surgeries hard

Doctors are tying to catch up by doing extra surgeries but then there is Fukushima

People are also coming from Fukushima

Elders who left everything thing behind

Usually university hospital treat people and send them to local hosp for minor treatments but now there are no places to send them

i.e. past surgery then to be sent local hospital for recovery

some are still stuck at university hospital

Beds issue + Domino effect

New demands will arise need to consider future issues

Damaged hospitals at each level =>

Major send to central hospital=> university hospital => local hospital

Murayama Japan Red Cross

Like after the war

Acute phase is past but there is no exit

Medical system crisis spreading

Backup system working by sending patents to other places but …May need to expand the sharing patients system for back up of the nuclear power plant issue gets worse

People in Tokyo will be affected –sending other people in kantoh

Strain on the system – all must be ready to share the burden

Shortage of med supply and doctors is getting better but some places still are lacking

Hard to allocate resources as needed

Doctors and nurses doing visits - They are also survivors

Specialists are also limited

In Ishinomaki

Japan Red Cross shared Data to assess shelter health conditions

City officials are victims themselves

Survey of 1 shelter near Ishinomaki  (?higashi)

Goes way beyond city assessment

3/18 assessment

Watanoha elementary school 1000 evacuees

Poor sanitation at some shelters

Toilets baked up with waste

Water supply issues – school pool water for cleaning – wearing shoes inside

No water to wash hands – have news paper for feces but not possible to clean hands

Human waste trash is separate from other trash but building up

JRC Dr. Ishii => People must have water – health hazard

Public official => it is very difficult, we will tell the Government officials when we see them

JRC Dr. Ishii => do not wait just keep calling them

JRC Dr. Ishii

People do not want to leave – we must convince them

Still no tap water

If left alone spread infectious diseases

Clean water is the basic

Aircraft carrier hospital might be good – shelter and treat patients

Sumatra US did that => maybe we could try that

What is the G doing not really clear?

300 shelters => need to be more Streamlined to centralize medical services

Gather patients with particular illnesses

Divide the functions to reestablish the medical systems in some way

Keep doctors with roots in the area

Highly aging population particular needs and expectations

National govt responsibility? Local? Prefectural?

Power of doctors not enough - the system is broken

The government and the people need to do something