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2006年 |
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【Advance preparation for supporting vulnerable populations in a disaster】
～Creating individual disaster response manuals for patients using artificial respiration devices.～
The Fukuzaki Health and Welfare Office Committee on Dealing Collaboratively with Chronic Diseases organized a meeting on the above theme, in which we participated as advisors. The meeting took place on February 8th, 2007. Fukuzaki Health and Welfare Office public health nurses reported on the process of creating individual disaster response manuals with patients using intracanalicular artificial respiration devices, their family care givers, and people involved in supporting home care. Based on this report, opinions were exchanged among health workers and supporters on ways to incorporate this experience into disaster preparedness, and ways to optimize the role of each person.
Patients relying on artificial respirators and other high technology medical equipment are at high risk in a disaster. While they need to be prepared at all times for unexpected disasters, this is not usually the case. The report highlighted the fact that the collaborative process in which these individual disaster response manuals were made was important in raising disaster awareness among patients, their families, and other care givers. (Reporter: Ushio) |
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2006年 |
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【Health Problems Connected to the Nobeoka Tornado Disaster】
On September 17th, 2006, Typhoon 13 ("Shan Shan") passed in a north-easterly direction over western Kyushu, including Miyazaki Prefecture. On the afternoon of that day, 3 tornadoes struck Miyazaki prefecture.
One of these tornadoes (150-250m across, traveling 7.5km on the ground) struck the city of Nobeoka. The forward speed of this tornado was 20m per second or 70km per hour. The tornado is reported to have left 3 people dead, 143 injured, and 765 houses damaged. A preliminary survey was carried out on November 10th to assess what kind of problems existed regarding health and daily life, whether any support could be offered, and what kind of activities should be carried out in the case of future tornado disasters.
When we visited, 7 weeks and 4 days had already passed since the disaster, but the scars of the tornado were still apparent in Nobeoka.
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| Photo 1: Nobeoka city seen from Atago-yama viewpoint |
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| Photo 2: Damaged house |
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The photo taken from Atago-yama viewpoint shows the trail of the tornado as a line of blue sheets covering houses under repair or still in their original damaged state (photos 1 and 2). Roads that had been transformed into seas of debris and glass for several weeks after the tornado, which we heard had prevented people injured by broken glass and so on from being transported to the hospital, had been cleared. When we looked at houses that appeared at first sight to have been repaired and cleaned up, it became apparent that the inside of the house had not yet been cleared, or that shards of glass kept surfacing in areas that had been carefully wiped clean.
Every time the disaster victims saw this, they would suffer flashbacks, and re-experience anxiety and fear. It was also reported that victims had become sensitive to even slight noises, fearing that another tornado would strike. One of the features of this tornado disaster was that it struck in a straight line rather than over an area. In a single apartment block, one room could have been damaged while the rooms next door were completely unscathed. In the case of a typhoon (or similar such disaster), it is usually a whole area that is affected, and there is talk, empathy and a sense of shared experience among neighbors.
However, with a tornado, this becomes difficult. Furthermore, the problem of tornado victims moving away and leaving their old neighbors lonely and anxious was mentioned. Providing support for this problem would seem to be a new issue.
In terms of physical problems, glass cuts were frequent, and although the area of the wound was small, the cuts were often deep. Although tornadoes have recently been frequent, they are difficult to predict. In other countries, it is normal practice to hide in a shelter when a tornado strikes, but such shelters are rare in Japan, and the best and simplest option at present would seem to be crouching or lying somewhere below ground level (for example, a gutter). |
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2006年 |
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【Typhoon 14 ("Nabi") in Miyazaki Prefecture: What are the health needs arising from flood disasters?】
At the beginning of September 2005, due to the slow progress of Typhoon 14, all areas of Kyushu were subject to continuous rain over a long period of time. In the city of Miyazaki, efforts were made to prevent flooding of the Ooyodo river (a major "class 1" river) by closing the floodgates of tributary rivers and pumping water out of the river, but the water levels rose (the total rainfall was over 1300mm) and this caused the tributaries to flood.
Miyazaki Prefecture suffered the greatest damage from this typhoon. The number of dead and missing in Miyazaki Prefecture was 13, about half of the national total of 29 people. In terms of physical damage, 1,031 houses were completely destroyed, 2,679 were partially destroyed, and 365 were damaged. 2,179 houses were flooded up to the floorboards, and 2,110 were flooded above floor level. Taking into account the various kinds of damage, this was the worst water-related disaster in Miyazaki Prefecture since 1971. Throughout Miyazaki Prefecture, 50,480 households were issued with evacuation instructions, and 15,161 households were issued with evacuation advisories.
Located in the heart of typhoon country, the city of Miyazaki (known as "Typhoon Ginza" in Japan) was prepared for the typhoon. Expecting a typhoon said to be bigger than Hurricane Katrina, staff were on standby and prepared at various places from the previous day, September 5th. In spite of this, the typhoon brought previously unknown damage to many areas.
With the cooperation of medical facilities and professional nursing groups in Miyazaki, we carried out a preliminary survey on Typhoon 14 and its effects about two weeks after it occurred. Nurses in the disaster area were busy working at first-aid stations, clearing up damaged hospitals, and visiting individuals in affected areas.
Specifically, a first-aid group had been formed on September 8th, with members working on a rotational basis at first-aid stations in volunteer centers. Nurses from the first-aid group worked in pairs at 3 first-aid stations under a volunteer coordinator. They provided care for people who had injured themselves while clearing up their houses or carrying out volunteer activities (many people were so involved in the activities that they did not realize until afterwards that they had stepped on nails, ripped off a fingernail, banged knees or so on), and also dealt with heatstroke, as people were working in temperatures of over 30 degrees Celsius (86 degrees Fahrenheit) under a burning sun. After floods and other water disasters , people often handle contaminated objects and what seems to be a minor wound can soon suppurate and become infected, so it is essential to sterilize the wound properly.
As there were hospitals in the city that could not offer outpatient services because of flood damage, having medical staff on hand at the first-aid stations to provide emergency treatment seemed to reassure many people. Also, since anything that was flooded was considered to be contaminated, people’s sense of loss was great. Furthermore, because the flooding happened so quickly, people did not have time to take appropriate measures, and some people who had lost houses, cars and other assets were very anxious about the future. Other health needs included a rise in the number of skin complaints due to not being able to keep clean, as well as many orthopedic problems suffered by people clearing away heavy water-filled items. |
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2006年 |
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【Preliminary investigation into the Fukuoka Prefecture Western Offshore Earthquake: Temporary housing relocation policies led by neighborhood groups and residents.】
At 10:53am on March 30th, 2005, a magnitude 7.0 earthquake occurred offshore west of Fukuoka, with seismic intensity measurements of weak 6-lower recorded in central Fukuoka. Damage caused by glass shattering from the windows of high-rise buildings was extensively reported. Residents of Genkai Island, which was the worst-affected area, had to evacuate to Fukuoka, where they began moving into temporary housings starting on April 25th.
On Wednesday May 11th, approximately one and a half months after the earthquake, we visited the “Kamome [Seagull] temporary housing complex”. A hundred households, including elderly people and children, that were affected by the earthquake on Genkai Island were living there. Since school children and preschoolers on Genkai Island normally play outside until evening, a nursery was built within the complex. The fact that the “Kamome temporary housing complex” was built facing Hakata Harbor, so that the sea was close for the fishermen, who could come and go in their own boats, and hang their lines on the quay, contributed to a sense of psychological stability.
Learning from the experiences of the Great Hanshin-Awagi Earthquake, where priority for admission to temporary housing was given to elderly people, a measure that led to great difficulties later in the recovery process, and from the 2004 Niigata Chuetsu Earthquake, where the entire population of Yamakoshi village was evacuated, neighborhood groups and residents were given the lead in decisions regarding admission to temporary housing. Specifically, the city of Fukuoka handed over sketch plans for the Kamome and Genkai Island temporary housing facilities right at the beginning, and left decisions concerning who would move into which building and who would live next to who up to the residents. Decisions about allocation to large and small families were also left to the residents. As the number of housing units available was limited, there were a few cases of people dissatisfied that their preferences had not been met, but overall there were very few problems. In the temporary housing, people were living in very similar social networks to before. Because of this, daily interactions and social life were not disrupted, links (social solidarity) between the residents were maintained, and it was easier for people to live in the temporary housing. Residents of this temporary complex are concerned for each other’s welfare.
As a result of such planning considerations, the health condition of people in the temporary housing was relatively good. For example, people who had been suffering slightly high blood pressure after the earthquake found that it returned to normal after moving into the temporary housing. In addition, there were those among the elderly people who found it convenient to live in Fukuoka because of the available medical facilities (Genkai Island only had a clinic), or because they could enjoy shopping or a wider social life. This was a case which seems to have been successful in providing support for the affected community at the same time as respecting the individual post-disaster needs of each individual.
Apart from this, attention was also paid to the fine details of adaptation. For example, there are no traffic lights on Genkai Island, so road safety classes were provided for children, and one of the teachers from the island accompanied them to and from school each day to ensure their safety. |
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Activity Report
