title: Onsite medical rounds and fact-finding activities conducted by Nippon Medical School in Miyagi prefecture after the Great East Japan Earthquake 2011.
abstract: This report describes our onsite medical rounds and fact-finding activities conducted in the acute phase and medical relief work conducted in the subacute phase in Miyagi prefecture following the Great East Japan Earthquake and subsequent tsunami that occurred off northeastern Honshu on March 11, 2011. As part of the All-Japan Hospital Association medical team deployed to the disaster area, a Nippon Medical School team conducted fact-finding and onsite medical rounds and evaluated basic life and medical needs in the affected areas of Shiogama and Tagajo. We performed triage for more than 2,000 casualties, but in our medical rounds of hospitals, clinics, and nursing homes, we found no severely injured person but did find 1 case of hyperglycemia. We conducted medical rounds at evacuation shelters in Kesennuma City during the subacute phase of the disaster, from March 17 through June 1, as part of the Tokyo Medical Association medical teams deployed. Sixty-seven staff members (17 teams), including 46 physicians, 11 nurses, 3 pharmacists, and 1 clinical psychotherapist, joined this mission. Most patients complained of a worsening of symptoms of preexisting conditions, such as hypertension, respiratory problems, and diabetes, rather than of medical problems specifically related to the tsunami. In the acute phase of the disaster, the information infrastructure was decimated and we could not obtain enough information about conditions in the affected areas, such as how many persons were severely injured, how severely lifeline services had been damaged, and what was lacking. To start obtaining this information, we conducted medical rounds. This proved to be a good decision, as we found many injured persons in evacuation shelters without medication, communication devices, or transportation. Also, basic necessities for life, such as water and food, were lacking. We were able to evaluate these basic needs and inform local disaster headquarters of them. In Kesennuma City, we found that some evacuation shelters could not contact others even after 1 week after the earthquake. We realized from our experiences that, unlike our activities following more localized earthquake disasters, the first task following such large-scale disasters is to acquire information on basic life needs, including medication needs, and the number of persons requiring assistance. We must provide medical relief according to the unique characteristics of the disaster-affected areas as well as the specific nature of the disaster, in this case, a tsunami.
authors.affiliation: Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan. fuse@nms.ac.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Fuse
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Igarashi
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Tanaka
authors.forename: Shiei
authors.initials: S
authors.lastname: Kim
authors.forename: Atsuko
authors.initials: A
authors.lastname: Tsujii
authors.forename: Makoto
authors.initials: M
authors.lastname: Kawai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yokota
mesh_terms: D055866:Earthquakes; D004630:Emergencies; D060447:Emergency Shelter; D006801:Humans; D007564:Japan; D012066:Relief Work / Q000458:organization & administration*; D012577:Schools, Medical; D014218:Triage / Q000458:organization & administration; D057192:Tsunamis