“Heroes do not come to help” Nankai Trough earthquake Doctor's warning December 20, 16:42
“Even if you call for help in a disaster area, no hero will come,”
said a leading expert in disaster medicine based on his own research results.
When the Nankai Trough earthquake occurs, there will be a serious shortage of doctors in the affected areas.
In a huge earthquake, what will happen to hospitals and medical care that save our lives?
A warning from doctors.
(Corporate News Reporter Goichi Miyahara / Kochi Broadcasting Station Reporter Shiori Ito Kensaku Furukawa)
Great earthquake "Not enough doctors"
On March 11, 2011, after the Great East Japan Earthquake, emergency physician Hideaki Anan was at the Disaster Medical Center in Tachikawa, Tokyo.
This is because he will lead the coordination of medical teams dispatched from all over the country to the disaster areas in Tohoku.
The team is "DMAT = Disaster Dispatch Medical Team".
It consists of doctors and nurses, and in the event of a disaster, goes to the disaster area within 48 hours.
The team is professionally trained in disaster medicine.
Adjustments were extremely difficult.
About 340 teams of about 4 people can be dispatched from all over the country to the affected areas.
How many teams should be dispatched to where in the disaster area, which stretches several hundred kilometers from north to south.
Medical care in the disaster area is tight, and requests to "provide more support" are coming in one after another.
On the other hand, due to the nuclear accident in Fukushima, the hospitals to which we dispatched teams sometimes told us that they could not send staff to Fukushima.
Mr. Anan recalls, "It was a situation where bullets were flying from both the front and the back."
Reality seen in the disaster area
I worked day and night and was able to return home from the hospital nine days after the disaster.
About two weeks after the disaster, I had the opportunity to work in Ofunato City, Iwate Prefecture.
Mr. Anan was overwhelmed by the damage of the tsunami, which he had never seen before.
It is said that there was a scene where he was keenly aware that "this is a disaster area."
It was a scene in which local doctors hugged each other in joy, saying, "You're still alive!"
The reality was that they were busy with medical treatment without even having time to confirm each other's survival for two weeks.
He said that he realized the importance of external support for the disaster area.
Dr. Hideaki Anan
: “I thought it would be really difficult to provide medical care in the field when support was stagnant, and I thought about how to respond to the needs of these people. For the next disaster, we need to use our imagination to provide what the site really wants before they ask for it. I think it is necessary to share a realistic image and work out in advance what can be done.”
Medical care after the Nankai Trough earthquake...
After the Great East Japan Earthquake, Dr. Anan once again started working to improve the DMAT system.
The Nankai Trough earthquake is the one that Anan is most concerned about right now.
In the worst case, it is estimated that 323,000 people will die and 623,000 will be injured due to building collapses and tsunamis.
What will happen to the medical care in the affected areas when this unprecedented huge disaster occurs?
The research group led by Dr. Anan conducted a simulation.
We investigated 10 prefectures (Shizuoka, Aichi, Mie, Wakayama, Tokushima, Kagawa, Ehime, Kochi, Oita, and Miyazaki) that are expected to suffer particularly severe damage.
After assuming which prefectures would dispatch medical teams to which prefectures, we calculated the number of medical teams needed in the disaster area and the number of medical teams that could be dispatched from all over the country.
(Medical team consists of 4 people such as doctors and nurses per team)
First trial calculation More than 30% of the required number
Your medical team can help you in many ways.
These include hospitals and prefectural government offices that serve as bases for medical care, and hospitals whose buildings were severely damaged.
After calculating the number, the number of medical teams required reached 1756 teams.
On the other hand, the number of DMAT teams that could be dispatched immediately by land from all over the country was 600 teams.
At just 34% of the required number of teams, it could be significantly short.
For the first time, concrete figures have revealed that in the event of a Nankai Trough earthquake, there will be an overwhelming shortage of medical resources in the affected areas.
By prefecture, all prefectures were below 50%.
And Anan says it could actually be more serious.
A Nankai Trough earthquake is expected to cause major damage to prefectures other than these 10 prefectures, and it is possible that doctors will not be able to be dispatched as planned.
Furthermore, as roads are disrupted and arrivals take longer, fewer teams will be able to operate.
``The Nankai Trough is a special disaster''
Based on these results, Dr. Anan proposes to change the conventional disaster medicine.
Until now, the focus has been on “wide-area medical transport,” which transports patients out of the disaster area.
However, in the case of the Nankai Trough earthquake, it is said that it is necessary to "strengthen the medical system in the affected areas."
Dr. Hideaki Anan
: “The Nankai Trough earthquake is an exceptional disaster that cannot be dealt with as an extension of conventional disaster countermeasures. Heroes of justice will come and help us when we are in trouble. No. There is also the problem of caring for tens of thousands of hospitalized patients, so I am sorry that we need help from outside to move the patients out of the disaster area and provide medical care. We have to change our way of thinking so that we will continue to work hard to continue.
Be prepared to besieged in Kochi...
How are hospitals prepared to receive support from outside?
We interviewed a hospital in Kochi City, where serious damage is expected.
Shioe Takahashi Hospital is located in a district facing Urato Bay in Kochi City.
The hospital, which has 80 beds, is expected to be submerged up to 3 meters by the tsunami.
Mr. Hironori Matsuzaki, the office manager, showed us the boat.
The hospital has a three-day supply of food and drinking water for both patients and staff.
It is said that they are making it possible to replenish supplies themselves in case they run out and the flooding continues for a long time.
In addition, the in-house power generators required for medical equipment can currently only be operated for a few hours.
Under such circumstances, we are preparing to enhance the equipment and operate it for about 3 days next year.
This is an effort to extend the time that you can "siege" even a little.
One of the concerns about the measures being taken is the shortage of doctors and nurses.
Doctors and nurses may not be able to rush to the site at night, on holidays, or if the surrounding area is flooded by a tsunami.
With no prospect of external support, even hospital doctors and nurses are not sure if they will be fully involved in medical care.
Hironori Matsuzaki, Executive Director, Shioe Takahashi Hospital:
“Above all, there is a high possibility of flooding, so the staff members have homes and families, so is it really possible to gather together? There is a lot of anxiety about how much we can handle in a situation where there is a shortage of manpower.”
87% of hospitals are "anxious"
Other hospitals are also beginning to see concerns about securing doctors and nurses.
NHK conducted a survey from last month to this month on 33 hospitals in Kochi City with inpatient beds, which are expected to be flooded for a long time, and received responses from 23 hospitals, which is 70%.
As a result, 20 hospitals (87%) answered that they were "anxious" or "somewhat anxious" about securing emergency medical personnel.
“Non-specialized” doctors also learn first aid
With the shortage of doctors and other personnel becoming a serious issue, initiatives aimed at raising the level of human resources have begun.
This is training for doctors and nurses who are “out of the field” to acquire medical skills in the event of a disaster.
Last month, more than 20 people, including doctors and nurses who are not usually involved in emergency medical care, participated.
What you learn in this training is "triage" to decide the priority of treatment.
Review the procedure to identify those who need treatment quickly according to the patient's symptoms.
We also confirmed the response to stabilize the condition by administering first aid to the patient.
Whether or not Kochi, which will become an isolated island on land in the event of a Nankai Trough earthquake, will be able to protect lives depends on each of the doctors and nurses present today.
Participating nurse
: “Usually I only work in general hospital beds, but I was able to learn in a practical format, which was a great learning experience. When a disaster strikes, I want to help the victims as a nurse.”
One of the lecturers Chikamori Hospital Head of Emergency Department Inariyuki Inari
said, "Until support arrives, Kochi Prefecture's ability to develop medical care will be limited, so the theme we need to think about is how to effectively utilize the existing ability. I think it will come."
To overcome difficulties...
Dr. Hideaki Anan, a doctor who made a trial calculation of the Nankai Trough earthquake, has also started to take countermeasures.
We are trying to create our first "DMAT Initial Dispatch Plan" by examining where the medical teams should be most effectively placed for each earthquake occurrence pattern.
By analyzing various factors such as road data, we are preparing to dispatch a team to the affected area as soon as possible in the event of an earthquake.
Dr. Hideaki Anan
: “We will not abandon the affected areas just because the number of DMATs is overwhelmingly inadequate. I would like everyone to think together about how they can continue to work hard in the affected areas for as long as possible, and what they can do to prepare at home, in the community, and at the hospital. If you do, you will definitely be able to become a great force and overcome difficulties.”
what we can do to prepare
What can we do to prepare for the huge disaster of the Nankai Trough earthquake?
We have compiled a list of possible preparations in light of the medical crisis.
In order to reduce the damage, it is important to first understand this reality and steadily prepare for earthquakes.
I felt that each and every one of us needed to do our best and take measures forward.
Reporter
Goichi Miyahara Joined the Bureau in
2008 In
charge of the Great East Japan Earthquake Secretariat and the Japan Meteorological Agency After working at the Tokushima Broadcasting Station, etc.
Responsible for disaster prevention coverage such as the Nankai Trough earthquake Disaster prevention officer
Kochi Broadcasting Station Reporter
Shiori Ito Joined the station
in 2016
After working at the Hiroshima Broadcasting Station, she is currently in charge of disaster prevention coverage
.
Kensaku
Furukawa , a
reporter for Kochi Broadcasting Station Joined the station
in 2007
after working in the social affairs department.