Emergency snapshot

April 7, 2017

Trove of medical records snapshot of doctors’ plight after Fukushima

http://www.asahi.com/ajw/articles/AJ201704070001.html

TOMIOKA, Fukushima Prefecture--Hastily scribbled notes by overworked doctors paint a daunting picture of the challenges they and evacuees faced in the chaos of the Fukushima nuclear disaster that started in March 2011.

“Insulin, doses for two more days left. Not taking medication for blood pressure, from March 12,” reads a doctor's report for a patient on March 17, six days after the disaster triggered by the Great East Japan Earthquake and tsunami.

The following day, the doctor wrote, "Which hospital is best?" as he pondered his options in referring a patient.

In another memo written March 17, a doctor appears stumped at the enormity of the challenge ahead: “Chronic diseases, heart failures etc. ... elderly and those needing a high degree of nursing care ... evacuees with all sorts of health problems are here! Patrolling, every corner of the facility.”

This extraordinary record from the aftermath of the triple meltdown at the Fukushima No. 1 nuclear power plant was published as a book March 23 by town authorities of Tomioka as they prepared for the April 1 lifting of the evacuation order issued for the coastal community just over six years ago.

Medical staff working at a makeshift clinic in a mass evacuation shelter set up inland in Koriyama that once housed more than 2,000 evacuees left 8,000 medical reports and log books in bundles.

The notes and memos were jotted down on whatever paper was available, instead of proper forms, and lay forgotten after the shelter closed six months later.

They offer a vivid record of the on-site emergency and the difficult decisions doctors were forced to make, and provide a valuable lesson for both medical service providers and people with medical problems: to be better prepared for a disaster in the future.

As the nuclear crisis unfolded, the government issued evacuation orders over several days. Chaos reigned at evacuation centers in the prefecture as Fukushima residents fled their homes to take refuge.

Big Pallet Fukushima in Koriyama, a complex of large exhibition and convention halls, was one such emergency shelter. At its peak, it housed about 2,300 evacuees. A large portion were residents of Tomioka, located a few kilometers south of the stricken nuclear plant.

The makeshift clinic at the shelter was mainly run by doctors who had also evacuated from the town.

On especially busy days, 200 or so patients waited patiently to see a doctor. The clinic operated until the shelter closed in August 2011.

The memos, medical records and staff log left by the medical staff were spotted by Keizo Kawamata, 44, a visiting researcher for arts at Ibaraki University, in 2012 in a clinic that had opened at a temporary housing settlement for Tomioka residents.

The records show that one in three patients who visited the temporary clinic were aged 65 or older. There were almost 400 people taking medication for high blood pressure or diabetes, but only 12 of them fled their homes with their “medication record” booklets. This is a small notebook used by pharmacies that list the names of prescription drugs that patients are taking. The government has been encouraging people to keep a record book to avoid unexpected drug interaction.

Without them, or proper medical records kept at hospitals and clinics, doctors had difficulties deciding what to prescribe, and what treatment patients should receive.

On the other hand, there were many instances where Tomioka residents were able to see their family doctors, as they, too, were at the shelter. As a result, their consultations were processed more easily than others.

“Taking pictures of prescription drugs or the list in the medication book with a mobile phone camera would come handy in times of emergency,” Kawamata suggested as one way to keep personal medical records at hand. “Having family doctors is also important.”

The Tomioka government decided to compile the records and publish them in book form, while personal details in the notes were edited out so individuals cannot be identified.

The evacuation order for Tomioka will be lifted on April 1, apart from parts of the town that are still highly contaminated.

The book will be available at government buildings and libraries.