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Fukushima disaster: road to recovery remains long
World Report
Fukushima disaster: road to recovery remains long
Masaaki Shimanuki was sitting at his consulting room desk in Rikuzentakata, on Japan’s northeast coast, when he felt the ground start to shake on the afternoon of March 11, 2011. Just over 30 minutes later, he and other staff at Iwate Prefectural Takata Hospital were frantically trying to move 51 inpatients to the building’s upper floors as warnings came through that the town was about to be hit by a towering tsunami. “Our priority was to help get our patients out of danger”, Shimanuki said during a break from his duties at Rikuzentakata’s only major hospital—a single-storey prefabricated structure that has been rebuilt on higher ground. “We moved them up to the fourth floor, but even that wasn’t high enough.” In the end, the only place that stayed out of reach of the waves was the roof, added Shimanuki, a 73-year-old doctor in the hospital’s internal medicine department. By the time the tsunami had subsided, 15 patients had died— four of them from exposure to the freezing conditions on the roof. Nine staff were also dead, including the hospital’s radiologist, office manager, and three kitchen staff. The 2011 earthquake and tsunami destroyed hundreds of hospitals, clinics, and other medical facilities along a 250-mile stretch of Japan’s northeast coastline. Doctors and other medical staff who delayed their evacuation to help patients were among the 19 000 people who died in the disaster. 5 years on, reconstruction of the health infrastructure in the worsthit prefectures of Iwate, Miyagi, and Fukushima is proceeding slowly, hampered by the huge cost of rebuilding entire communities on higher ground and an exodus of young people, some of whom might have www.thelancet.com Vol 387 March 12, 2016
been expected to pursue careers in health care. The tsunami, combined with the large-scale evacuation forced by the triple meltdown at the Fukushima Daiichi nuclear power plant, has seen the population of the region drop by more than 150 000 people in the past 5 years, according to a survey by the Asahi Shimbun newspaper. Almost 60 000 people, many of whom are elderly, are still living in makeshift housing complexes.
“Almost 60 000 people, many of whom are elderly, are still living in makeshift housing complexes.” “More than a third of the households here are elderly people living alone”, said Kazuo Sato, a former fisherman who runs the office at a temporary housing complex in Rikuzentakata. The average age of the 100 residents is about 60 years. Sato and other younger residents check on their neighbours after several elderly people living alone were found dead in other housing complexes, sometimes weeks after their deaths. “We ask them [elderly neighbours] to keep their doors unlocked so we can get inside quickly if we suspect something is wrong”, said Sato, who blames the stress of living in the cramped unit he shares with his wife and three children on the minor stroke he had last year at the age of 49 years. “There is no privacy here, which adds to people’s stress. We’re always trying to defuse arguments caused by complaints about noise, or after people have had too much to drink.” Local health experts say that they have observed a rise in the number of tsunami survivors with mental health issues, with many
still having flashbacks. A survey by Tohoku University, Sendai, found that a quarter of people living along the coast of Miyagi suffer from symptoms associated with depression. “With the recovery in the housing situation and their surrounding environment now within sight, it appears that more people feel a sense of relief. But many others are still having a hard time”, Atsushi Hozawa, a professor of public health at Tohoku University, told the Mainichi Shimbun newspaper. Soon after the doors have opened at Takata Hospital, the corridor outside Shimanuki’s office is already lined with patients all wearing obligatory surgical masks to prevent the spread of viruses at the height of the influenza season. On a typical day, the hospital’s five on-duty doctors and 30 nurses see 170 people, about a quarter of whom are still living in temporary housing. Internal medicine aside, the hospital offers ophthalmological, ear, nose, and throat, orthopaedic, paediatric, and maternity care. Influenza symptoms, insomnia, high blood pressure and cholesterol, and diabetes are among the most common complaints. Patients requiring surgery are sent to a larger hospital in the neighbouring town of Ofunato. Although it will be several years before a permanent replacement for the original hospital is built, the sight of a packed waiting room is a sign that life is returning to normal, however slowly. “We never thought about giving up, even during those dreadful days after the tsunami”, Shimanuki said. “We received so much help from outside that we had no choice but to carry on. But if there is one thing I could have right now, it would be more doctors and nurses.”
Kazuma Obara
Reconstruction of hospitals and homes is happening slowly in affected areas, with thousands of people still living in temporary accommodation. Justin McCurry reports from Rikuzentakata.
Rikuzentakata, Japan, March 28, 2011
Justin McCurry 1045
Fukushima disaster: road to recovery remains long
Masaaki Shimanuki was sitting at his consulting room desk in Rikuzentakata, on Japan’s northeast coast, when he felt the ground start to shake on the afternoon of March 11, 2011. Just over 30 minutes later, he and other staff at Iwate Prefectural Takata Hospital were frantically trying to move 51 inpatients to the building’s upper floors as warnings came through that the town was about to be hit by a towering tsunami. “Our priority was to help get our patients out of danger”, Shimanuki said during a break from his duties at Rikuzentakata’s only major hospital—a single-storey prefabricated structure that has been rebuilt on higher ground. “We moved them up to the fourth floor, but even that wasn’t high enough.” In the end, the only place that stayed out of reach of the waves was the roof, added Shimanuki, a 73-year-old doctor in the hospital’s internal medicine department. By the time the tsunami had subsided, 15 patients had died— four of them from exposure to the freezing conditions on the roof. Nine staff were also dead, including the hospital’s radiologist, office manager, and three kitchen staff. The 2011 earthquake and tsunami destroyed hundreds of hospitals, clinics, and other medical facilities along a 250-mile stretch of Japan’s northeast coastline. Doctors and other medical staff who delayed their evacuation to help patients were among the 19 000 people who died in the disaster. 5 years on, reconstruction of the health infrastructure in the worsthit prefectures of Iwate, Miyagi, and Fukushima is proceeding slowly, hampered by the huge cost of rebuilding entire communities on higher ground and an exodus of young people, some of whom might have www.thelancet.com Vol 387 March 12, 2016
been expected to pursue careers in health care. The tsunami, combined with the large-scale evacuation forced by the triple meltdown at the Fukushima Daiichi nuclear power plant, has seen the population of the region drop by more than 150 000 people in the past 5 years, according to a survey by the Asahi Shimbun newspaper. Almost 60 000 people, many of whom are elderly, are still living in makeshift housing complexes.
“Almost 60 000 people, many of whom are elderly, are still living in makeshift housing complexes.” “More than a third of the households here are elderly people living alone”, said Kazuo Sato, a former fisherman who runs the office at a temporary housing complex in Rikuzentakata. The average age of the 100 residents is about 60 years. Sato and other younger residents check on their neighbours after several elderly people living alone were found dead in other housing complexes, sometimes weeks after their deaths. “We ask them [elderly neighbours] to keep their doors unlocked so we can get inside quickly if we suspect something is wrong”, said Sato, who blames the stress of living in the cramped unit he shares with his wife and three children on the minor stroke he had last year at the age of 49 years. “There is no privacy here, which adds to people’s stress. We’re always trying to defuse arguments caused by complaints about noise, or after people have had too much to drink.” Local health experts say that they have observed a rise in the number of tsunami survivors with mental health issues, with many
still having flashbacks. A survey by Tohoku University, Sendai, found that a quarter of people living along the coast of Miyagi suffer from symptoms associated with depression. “With the recovery in the housing situation and their surrounding environment now within sight, it appears that more people feel a sense of relief. But many others are still having a hard time”, Atsushi Hozawa, a professor of public health at Tohoku University, told the Mainichi Shimbun newspaper. Soon after the doors have opened at Takata Hospital, the corridor outside Shimanuki’s office is already lined with patients all wearing obligatory surgical masks to prevent the spread of viruses at the height of the influenza season. On a typical day, the hospital’s five on-duty doctors and 30 nurses see 170 people, about a quarter of whom are still living in temporary housing. Internal medicine aside, the hospital offers ophthalmological, ear, nose, and throat, orthopaedic, paediatric, and maternity care. Influenza symptoms, insomnia, high blood pressure and cholesterol, and diabetes are among the most common complaints. Patients requiring surgery are sent to a larger hospital in the neighbouring town of Ofunato. Although it will be several years before a permanent replacement for the original hospital is built, the sight of a packed waiting room is a sign that life is returning to normal, however slowly. “We never thought about giving up, even during those dreadful days after the tsunami”, Shimanuki said. “We received so much help from outside that we had no choice but to carry on. But if there is one thing I could have right now, it would be more doctors and nurses.”
Kazuma Obara
Reconstruction of hospitals and homes is happening slowly in affected areas, with thousands of people still living in temporary accommodation. Justin McCurry reports from Rikuzentakata.
Rikuzentakata, Japan, March 28, 2011
Justin McCurry 1045