medical volunteer report in minami-sanriku-cho

8/6/2019 Medical Volunteer Report in Minami-Sanriku-Cho

1/14

Medical Volunteer Report in Minami-Sanriku-cho

by Yoshihiro Yoshimura MD.Department of Surgery, Sakurajyuji Hospital,

Kumamoto, Japan

IntroductionI offer my condolences to those who died in this tragic earthquake and I would like to send my sympathies to all those

who have been affected by this tragedy. Regardless of the level of damage, all the victims are suffering. People in the

hardest hit areas are getting a lot of attention, but people with less damage may be forgotten. I had an opportunity to

participate in medical relief effort for a week in Minami-Sanriku-cho of Miyagi Prefecture.

It was a valuable week to experience the unimaginable mental state of the victims directly instead of what is reported inthe media such as on TV and in magazines. I hope my report can help you to understand the reality of the victims a little

bit better than what media can tell you.

To Minami-Sanriku-cho, Miyagi PrefectureHere I am reporting all the activities during my participation as part of a medical support team in Minami-Sanriku-cho,

Miyagi Prefecture, where the entire town was affected in the Great East Japan Earthquake.The head nurse of our

hospital, Mr. Nasu and I participated as members of NPO group AMDA (The Association of Medical Doctors of Asia). I

was asked to work in Minami-Sanriku-Chos Shizukawa area (the center of the town) from April 8 thru April 15. Almost 4weeks after the disaster, the people in the area still dont have any electricity, gas or running water. Before leaving, all

the hospital stuff gave us words of encouragement and emergency food such as candy. Office staff member, Shimamura

let me borrow dry-cleaned sleeping bag and Dr. Kuwahara gave me black lame leg warmers. Ms. Yoshie Nishikawa gave

me a handmade amulet (lucky charm) and told me to open it when I really need to.

Departure at Kumamoto Airport

On April 7 we left for Kumamoto Airport in the afternoon after a departure ceremony at the hospital. Between two of us

we had 4 suitcases that weighed over 110 kg together because we had to pack lots of bottled water for the trip. When

we checked our baggage in at the airport, they did not charge us for the overweight luggage fees because we explainedthe items in the suitcases are disaster relief supplies. Normally they charge extra for luggage that is weighs over 15 kg.

When we flew into Tokyo we hardly saw any bottled water left on the shelves in convenience stores that we visited near


2/14

Tokyo Railroad Station. I am not sure if it is because of people buying out the bottled water out of fear or an actual

distribution problem.

Few bottles left in the store

While I checked in at the hotel we stayed at in Tokyo, there was an earthquake early warning announcement on theradio. In a few seconds, the earthquake shook the whole room vertically. Mr. Nasu and I checked on each other right

away. According to the news report it was a large aftershock which epicenter was the city of Miyagi.

In Tokyo, the strength of the aftershock was magnitude 5.6. I wonder how much it shook in Miyagi. I was nervous about

all of the activities that tomorrow would bring. At that time, I opened the amulet from Ms. Nishikawa. Inside, I found a

group letter of encouragements and a photo of Mr. Nejime with a big smile. I was a little surprised, but it left me very

encouraged about our trip.

On the morning of April 8th, staff from another area of Japan joined us and we left Tokyo on our way to Tohoku on a

charter bus. Including us, there were 12 staff members in total, 3 doctors, 5 nurses, a coordinator and tour operator

from Okayama, Kanagawa and Tokyo. Members of two different teams rode together on the bus. One team was going to

Minami-Sanriku-cho in Miyagi and the other team was going to Ohtsuchimachi in Iwate. The route to Ohtsuchimachi via

Minami-Sanriku-cho was announced. The coordinator explained to us that there were some closures on the northern partof the highway due to the large aftershock last night. We left Tokyo anyway. The driver expected us to arrive in Minami-

Sanriku-cho after midnight in case we couldnt use the highway. Since passenger vehicles with a doctor on board can run

on the closed section of the road with an emergency certificate, on our way there the coordinator started the procedure

for getting the certificate issued while in touch with the headquarters.

The north bound side of the highway had hardly any traffic other than special vehicles of the Self-Defense Force,

transport company's heavy trucks, and personal vehicles with labels carrying relief goods. The service area we stopped

by in Fukushima Prefecture had power outage due to the aftershocks. It was pitch dark in the store and they were using

a calculator and flashlight because they could not use the register.

The highway was reopened to Sendai before noon and we were in Sendai by early afternoon. Just past Ishinomaki our

cell phones were out of service. As originally planned it took us 8 hours to get to Minami-Sanriku-cho. The reason the

bus had to slow down more than necessary was not because of the traffic lights or the traffic jam, but because the road

was damaged in so many places. The landscape suddenly changed outside as we got closer to Minami-Sanriku-cho and

what we saw left us speechless.


3/14

On the way to Minami-Sanriku-cho

Like a BattlefieldMinami-Sanriku-cho located in northeast of Miyagi Prefecture is a harbor town. The key industry was fishing and there

were citys central facilities like many houses, businesses and city offices there. Most small towns nearby facing the

Pacific Ocean were completely destroyed by the tsunami. Most flat lands were destroyed leaving only a very small range

of higher grounds in Minami-Sanriku-cho unaffected. The basic lifeline of water supply, electricity and gas was totally

destroyed. Plus transportation and the network services were shut down as well. The whole town lost its ability to

function. It was not just damaged by the tsunami, but it was like the whole city was gone. The population of the city was

18,000. As of April 8, almost 400 people killed, 8,000 people evacuated, and the rest are still missing.

I tried to walk through the town on foot, but as Mr. Nasu put it, the area was like a battlefield. The roads there were

severely damaged and debris was piled up as far as the eye can see. There were skeletal remains of buildings with justtheir steel frames left standing. There were ponds made of the seawater and sludge left by the powerful tsunami. A

motorcycle was completely submerged when I looked into one of the ponds. They marked the car doors and collapsed

walls of crumbling buildings with red Xs and blue circles. Red tape fluttered on the tips of bamboo poles in the middle of

piles of rubble. I could only guess what those marks represented. The only thing I could hear was the wind and the

sounds of heavy machinery in the distance. There was no sign of life.... Silence ruled... There was a terrible smell of the

mixture of salt and motor oil. When a vehicle passed by, you could not see 50 meters ahead of you because of the large

amount of dust in the air. If you were to describe the impression of the city, it was as if a naughty child took a miniature

of the city and shook it over and over then submerged it under water. The area that once was a city had just turned into

ruins.

Debris piled up all over the town

The Tohoku Electric Company was rebuilding the utility poles on the side of roads at a rapid pace. There already stood

more than 100 utility poles along the highway. Self-Defense Forces were using heavy equipment to move the wreckage

(overturned vehicles and the boats that washed up on the shore) to a better location. Prior to the tsunami, a lot of the

rubble probably was someones important furniture, trading tools or a childs stationery. When SDF found things like

photo albums and books under the debris, they have placed them gently on the visible location in silence.

At the same time, everyday dead bodies were found throughout the wreckage.


4/14

Like"a battle field"

What I have noticed looking around the city was there was hardly any damage on the hillside even near the port while

the tsunami reached a few kilometers inland and wiped almost everything on flat areas.

There were even some residents who were gardening or waking their dogs on the hillside, but below the hills it wascompletely covered with rubble. The difference between the high ground and low lands was like Heaven and Hell. The

priority should be to get to the high ground as quickly as possible when the powerful tsunami hits.

ShelterOur base of operations was Shizukawa Elementary School, as it was one of the largest shelters in town. The Shizukawa

area is the center of Minami-Sanriku-cho. It has four small hills and none of these hilly areas were affected by the

tsunami. People in this area have been educated in school to escape to high ground when a tsunami hits. This area has

been hit by two huge tsunamis during time of the Meiji Sanriku Earthquake (M8.5) in 1896 and the Showa SanrikuEarthquake (M8.1) in 1933. City planners built public facilities such as an elementary school, a middle school, a high

school and the Bayside Arena on higher ground to be used as emergency shelters.

The center of town viewd from the shelter on the high ground

At night, it was so dark that it looked as if there was no electricity in the world. It was freezing cold in the gym and

many people spent restless nights with the fear of aftershocks on a daily basis. The little stoves were not affective at all

in keeping warm and the gym felt like a big cold cave. Once you stepped outside one could see a beautiful starry sky,

but it is very dangerous and you could not go out very far because the scattered debris lying around all over the place.

About 1,000 victims were evacuated and stayed at Shizukawa Elementary School since the day of the earthquake. Therewere about 400 people still living there when we arrived as people were moved out of the shelter into less affected

areas. There was no electricity, sewerage, gas and other essentials at the shelter. Water was very precious there and the


5/14

level of hygiene was very poor. The government response was slow but volunteers from all over the country managed

the shelters. They asked for assistance from government officials right after the earthquake, but the answer was

Everybody is having a hard time everywhere, so you have to take care of yourself independently. Of course, local

government offices were destroyed and officials were also victims of the earthquake and tsunami. I heard people were

outraged when the local politicians finally visited the shelters three weeks after the disaster and asked, Is there

anything that is troubling you?.

Inside the school gym with refugees

During our stay the Secretary General of the Democratic Party came all the way from Tokyo to Bayside Arena, which was

one of the major shelters in the area. Everyone in the shelter was a little nervous before he came. However, he flew right

back to Tokyo after shaking hands and greeting the media at the reception area without actually entering the shelter and

meeting any of the victims. Mr. Okada, it would have been better for you not to come to visit the affected areas at all.

A generetor arrived at the shelter

Around the same time, a couple of generators we all have been waited for arrived at the shelter. We turned the

generators on for short periods of time in the morning and in the evening in order to save on precious gasoline. There

was a crowd of people in front of the TV in the gym during the hours the generator is on. The news on TV was all about

the troubled nuclear power plants. Everyone must have had mixed feelings about the news. There were pretty good

supply of batteries and it was possible to charge such things as cell phones and flashlights as long as you had chargers.

During the day most cell phones did not get any reception because the mobile antenna that was mounted on a van

provided a very weak signal for people with cell phones. We heard many people at the shelter speculate that it was dueto so many people from the news media using the 3G networks to transfer large amounts of data to report daily events

and stories.


6/14

Searved soup-run meals

Soup-run meals were served twice a day, 7:30 AM and 4:30 PM. Dinner is served early because it gets dark after 5:30

PM in the Sanriku Region. The simple meal usually consisted of rice, miso soup and one simple side dish. Other than

that, we were able to eat some instant noodles, stored packed food and some canned goods. One day I had instantnoodles for all three meals along with the rice balls and miso soup they served me in the morning and in the evening.

More than 80% of people at the shelter suffered with high blood pressure because of the meals consisted of large

amounts of carbohydrates and high levels of sodium. It seems like their blood pressure was 30-60 mmHg higher than

normal. I was surprised to see so many people with over 200-mmHg systolic blood pressure rates. Protein deficiency

would be a concern in the long term. Decreases of the strength due to Disuse Syndrome and increase in needs of care

are major concerns for the victims living in the shelters for a long period of time. Nursing support is also an urgent issue

in the near future. The early morning exercise was continued right after the earthquake in consultation with the medical

support team and the council.

The early morning exercise

Thanks to the endless support from across the country, they had lots of supplies there. There were needs for a large

number of disposable plates and chopsticks for every meal to prevent gastroenteritis infection because there isnt a

working sewage system and water is so precious. It seems like they need a few thousand sets of clean plates and

chopsticks per day. Helicopters brought tons of disposable tableware the other day as well. The relief goods arrive daily.

While there are many things in great supply, they is a shortage of items like combs, nail clippers, cotton swabs that

would raise the quality of their lives. There was a clear mismatch of supplies and victims daily needs. On the other handthe shelter had at least the minimum standards of living. Although the daily life of victims seems rather calm, people

were at a loss because they have lost the very foundation of life and economic activity.

Seaweed, abalone and octopus are the primary source of income in Minami-Sanriku-cho, but they were all pushed onto

the land and all the fishing boats were washed away. The rebuilding of their industry is far from over.

Since the Kobe earthquake, more and more people want to serve the victims of this disaster by volunteering, as well

donate goods and money. The desire to offer help and send donations is very helpful for the victims, but what victims

actually need vary type of a disaster and its location. People have received a large number of childrens clothes from the

individuals and the organizations delivered to the Shizukawa Elementary Schools gym. There were some very old and

mostly useless clothes. It is preferred that relief goods are delivered through some type of organization or group. People

should not send what they think the victims need on their own. Boxes of kids clothes were occupying precious space in

the elementary schools classroom. Most of the items has to be disposed of before school begins.I met a lady at the makeshift clinic. Luckily she survived the tsunami having been swept in and found at low tide. Several

people who were carried by the tsunami with her still are missing. One afternoon, in between treating other patients she


7/14

served me some green tea. I cannot forget a word she mumbled in our conversation. She said, I feel guilty about

surviving when everyone died. I wished I could have died

There was a lady who kept telling people from the second floor of the emergency building to evacuate to high ground.

Her parents named her Miki () for a great future and hope. A large number of residents evacuated to high ground

following her voice and escaped the great tsunami. However, the three-story building she was in was overtaken with

water all the way up to the roof when the tsunami hit and she has been missing ever since. We met people like the

mayor who was saved by holding on to an antenna on the roof of a building, a lady who swallowed greasy sea water inthe tsunami, a man in tears who had to let his parents hands go in order to survive, a mother who has been looking for

her missing children, a immobile elderly man who was swept away in his hospital bed, and his caregiver who was

helpless to rescue him and could only watch him get washed away. We felt so helpless since the situation was so dire

and it seemed almost impossible to encourage them in such heart wrenching situations.

The public emergency buildingMany kids were playing with smiles on their face outside of the shelter where SDFs cars were parked, but quite a few

children had lost their parents. There also was a teacher who begun living in Sendai with 20 children who lost their

parents. When we talked to the kids outside of the shelter, everyone answered us with a smile. They enjoyed the very

little time we had playing soccer and playing catch. The children have a hard time to talk to others about how they feel

inside. Over time, the children would display signs of behavior modification in the form of social anxiety and being social

withdrawn. I cannot imagine how much sadness they hold in their little hearts. They will need long-term help from

clinical psychologists and psychiatrists. Plus adults around them must pay careful attention to how those kids act or what

they say.

For some reason the elderly at the shelter had a philosophical outlook of their situation and a real reserved look on theirfaces. I wonder it was because they felt lost or depressed before the catastrophe. Or they could already have accepted

everything and worried about their life from this point on. All the local nurses, pharmacists and caregivers who worked

with us at the makeshift clinic at the shelter took care of the patients with smiles despite being victims themselves.

A wallclock in the classroom stopped at the very time of earthquake

Everyone gathered at the gym for a moment of silence, at preciously 2:46 PM on April 11, a month after the earthquake.

The temporary staff at the clinic, elderly people, council members were all crying when I opened my eyes. It was very

impressive when the chairman of the local government who is a victim himself deeply mourned those who died and

made a strong commitment to complete the restoration of the town.

Makeshift ClinicThe school gym has been remodeled into a makeshift clinic and waiting room. We saw patients 24 hours a day. During

the day a couple of doctors, nurses, and pharmacists stayed there and at night we were on-call. There were usually 20-

60 patients during the day and 1-2 patients at night. Most elderly have chronic diseases such as high blood pressure,


8/14

diabetes and insomnia. Public hospitals including the main hospital and neighborhood clinics in the area were out of

commission due to the tsunami. Of course, there were no medical records of the patients. We had a hard time figuring

out what medication they have been taking since we were prescribing the medication based on the information the

patients give us.

Makeshift clinic staff

A lot of people were calm even when they found out their blood pressure was over 200 mmHg. Initially I was surprised

by this fact, but I gradually got used to it. We mainly gave calcium antagonists as medication for high blood pressure,

but the mixture of medications usefulness was unexpected due to the issue of compliance.

One patient lost his oral hypoglycemic drugs and insulin prescribed for diabetes during the earthquake. When he came

to see us at the makeshift clinic, his blood glucose at the time was over 500. We prescribed him effective insulin and told

him to drink enough water, get moderate exercise, and watch his carbohydrate intake. We also gave him a self-blood

glucose meter we found in the relief supplies. We gave him lesser glycemic control considering the risk of a

hypoglycemic episode.

Drug supply

Many patients told us that they were taking a blood-flowing agent. Originally anti-platelet and anti-coagulant drugs have

different mechanisms of action, so they must be used properly. Anti-coagulant drugs need to be used for venous fibrin

thrombosis such as deep vein thrombosis and cardiac thrombus with atrial fibrillation. And anti-platelet drugs need to be

used for atherosclerosis. We decided to prescribe the anti-platelet drugs when we could not make a decision about thebest course of treatment since it was difficult to measure the PT-INR at the shelter. When we saw patients who were told

by their doctors not to eat any Natto (fermented soybeans) before and we thought they need anti-coagulant drugs for

sure, we prescribed just a little amount of warfarin.

Due to the side effects, we postponed a prescription drug such as stomachic and anti-flatulent with a explanation to the

patients. Everyone had insomnia, so we prescribed hypnotic pills and anti-anxiety drugs to most of the patients who

came to see us. Many of the medical staff members were taking sleeping pills regularly as well. It seemed like Mr. Nasu

was taking sleeping pills since the first day of our trip. Hang in there, Mr. Nasu!!!

There were few trauma patients who were injured during the removal of debris. They all had minor injuries. However,

the occurrence of tetanus has been reported in a nearby shelter and we arranged to get some tetanus toxoid. We did

not use it since there were no more trauma patients after that.


9/14

Trauma therapy

We needed to be considerate when we talked to the patients. We often asked them, Did your family make it safely out

of the tsunami? However, there were some patients who broke down and cried on the spot. I realized there were many

people who have mixed and complex feelings at the shelter. All the elderly from Tohoku region were very gentle andwelcomed us with smile, but I felt that it was better to proceed with treatment calmly since we sometimes had to see so

many patients in a very short time.

OutbreakInfection was the biggest concern from the beginning at the large shelter with no form of a lifeline. Especially

gastroenteritis by Noro-virus and respiratory tract infection by onset of influenza made all the council staff and medical

stuff nervous. Noro-virus outbreak. The first case of the infection started at the shelter where we were staying and it had

developed into many cases over the next few days. The rapid stool test kits showed positive results one after the other.We asked the schoolteachers to provide us 4 rooms to make 3 isolation rooms and 1 observation room. It was extremely

difficult to ask the hospitals in the neighborhood to take so many patients with infections, so we had to add a hospital

feature to the shelter.

A timetable of isolation rooms

We created a awareness campaign such as hand antisepsis using hypochlorite, disinfection of handrails and door knobs,

hand washing and the use of masks, limitation of volunteers at the shelter, a call for the educational activities and

placements of posters. We also made sure the toilets were cleaned thoroughly and the health team picked out from our

medical team checked the whole shelter periodically.


10/14

Bottles of hypochlorite

One day, two nurses who had been caring the patients in the isolation room and observation room had the onset of

diarrhea and vomiting. It was so obvious that it was due to the infectious gastroenteritis Noro-virus. They must felt very

unlucky, but they were isolated from the shelter for the purposes of infection control. However, through infection control

had paid off. There were no more new reported cases 5 days after the first reported case and the outbreak has ceased

after only 10 days. Our medical team was holding hands with feelings of joy.

Toilet with buckets for flush

Visiting ClinicsThere were many victims whose cars were washed away. Also many people had no access to the makeshift clinic at the

shelter because they had no gasoline even if they had cars. Especially the victims in the remote mountain areas had very

poor medical information and they did not even know where they could get medical care. Therefore, we visited them

with a large amount of drugs delivered as relief supplies separated into hypertension, cold, allergies, insomnia and so on.

We visited an isolated village named Oomori. More than 10 people had formed a perfect line when we got there. People

in the Tohoku area are very patient and the long wait did not bother them. Also they always remember the words of

courtesy and appreciation for the volunteers who came from out of town. The makeshift clinic was just a table in a

parking lot under a blue sky. The lack of preparation and replacement of generic drugs and due to the limited medical

supplies made a difficult situation worse. However, I felt a strong sense of satisfaction after seeing nearly 20 patients

and being overwhelmed with fatigue.

Open-air clinic


11/14

Island survey by helicopterMinami-Sanriku-cho, Ishinomaki City, Rikuzentakata in Iwate Prefecture had extensive damage caused by the tsunami.

Ever since the earthquake media showed very realistic pictures of devastation repeatedly and the whole world paid

attention to this disaster. However, there are numerous small islands and villages scattered around off the coast of

Sanriku through Iwate and Miyagi Prefecture. Some regions do not have any media there. At times there were

discrepancies in the true level of need from what government has announced. In some areas the needed amount of

relief supplies are not being sent to areas with the most damage. I think it might be just that there is enough relief

supplies and the government is challenged with distribution problems or they are being used in the reconstruction effort.

There might be a lot of forgotten people who are hard to reach or have minor damages or are just taking time to rebuild

after the earthquake. Therefore, even though it wasnt scheduled initially, a NPO group (Child Flight Japan) in

cooperation with AMDA proposed to do field research on several islands scattered along the coast of Miyagi Prefecture

using helicopters.

Heavily damaged coast-line

I had to get on the helicopter on the second day of the mission. I have never even thought of my first helicopter ride

would be to investigate the remote islands in Sanriku area in Tohoku. There were many small villages we do not even

know the name of scattered around down below and we could see the damage caused by tsunami from the helicopter. I

have had the impression that reconstruction proceeded smoothly by over concentrating the recourses in a big city of

Kobe at the time of The Great Hanshin Earthquake. What about The Great Eastern Japan Earthquake? There are under

populated areas with many elderly people who are widely scattered around the Tohoku area. It would be extremely

inefficient use of reconstruction funds if the resources such as taxes and manpower were distributed unevenly in these

underserved areas. I felt that sometimes a bold urban plan like merging a few villages together with rough

reconstruction design rather than relying on an individual local government for reconstruction might be a more effective

use of resources.

A big ferry wrecked ashore

We were airlifted by helicopter to a remote island named Kesennuma. The preliminary study showed the population was

a little less than 2,000 and had a large harbor. It seemed that we would be able to walk around the whole island in

about an hour and half. When I walked around the island with Mr. Nasu, damage cause by tsunami along the coast was

unbelievable, especially the port where a large ferry was washed inland. The government has announced that electricityand water has been restored, but electric poles had been fallen and water supply had been disrupted in places. Many

relief supplies had arrived, but there were many things missing. The dispatch of doctors from Tohoku University was


12/14

there during the day, but there were no doctors available at night. They could not resume ferry service because the

harbor restoration work was scarce. That made the medical access very limited at night.

I felt that some people have been forgotten when I was seeing patients in the remote villages and doing research in

isolated islands. It is understandable that the medias attention and actual support go to the most damaged area when

there is lack of information or conflict of information. However, we need to be aware that people who are on the

borderline can be easily forgotten.This is not just confined to medicine.

Israeli Medical TeamIDF (Israeli Defense Force)s medical unit started medical assistance in Minami-Sanriku-cho on March 29. There was a

staff of 50 members, including 14 doctors, 7 nurses, and dozens of commanders who were all soldiers. They set up a

field hospital right away during the last years earthquake in Haiti and they treated about 1,100 people in 10 days

including surgeries. This was the first official aid from abroad Japan has accepted directly during this disaster and media

coverage was favorable. They were based on Bayside Arena (town gymnasium) where many people were using it as a

shelter. It is very appreciated and impressive for a country to send us manpower other than money or supplies. How

they had made a small hospital at the shelter!!! We make a makeshift clinic by tent in Japan, but probably there wouldnot be a field hospital equipped with an operating room.

Israeli Medical Team's field hospital

Their field hospital was equipped with X-rays, blood tests, 1 operating table, ICU with 2 beds, and a pharmacy and so

on. We ended up providing logistic support as medical interpreters. The only things we had at the shelter were

sphygmomanometer, stethoscope, oxygen saturation checker, earlobe blood glucose meter, etc. We did not have enough

medical equipment or medical personnel at the shelter. Everyone believed without doubt that they would play an

important role of assistance, but what was the reality?

Every morning at 7:30 all the medical staff from each shelter gathered together and had meetings at the yellow tent

next to the Bayside Arena. We shared a lot of information about the state of each shelter, number of patients, the status

of supplies, and reports of infectious disease etc. Or course, Israeli medical team shared their information as well.

Surprisingly they only saw 4 to 10 patients a day. The following two points were considered the reason.

Morning meeting in the tent.

First, this earthquake drowning was the cause 96% of the deaths and most of triage tags were either black or green

right after the earthquake. Therefore, the medical staff was mainly required to treat and manage chronic diseases.

Doctors saw the dying patients without any questions in Haiti, but the patients in Tohoku made the decision whether or

not to accept medical treatment.

Secondly, the Israeli medical staff had big and buffed bodies. Also their appearance was that of Westerners and you

could not communicate with them in Japanese. I wondered how they looked in the eyes of the elderly in the rural


13/14

Tohoku area. They even intimidated our medical staff members and the victims in Minami-Sanriku-cho hesitated to see

the Israeli medical staff. They choose to visit a small poorly equipped temporary exam room run by Japanese over the

well-equipped hospital run by foreigners. Israeli medical team has returned home after two weeks of work, but they

must have felt this was not what we were expecting. However, they did a great job up to the last minute.

Local Medical Reconstruction

All the clinics including the main hospital Shizukawa Hospital in Minami-Sanriku-cho were damaged in this earthquake.

The pressing issue was how the medical reconstruction needed to be done in the future. The victims who had lost

everything with this disaster appreciated getting free medical care. However, that would slow down the reconstruction of

local the medical insurance system in the long term. Although it was a difficult subject, in the daily meetings we have

gradually made the plans for the future.

The construction of the temporary clinic was considered a major task. However, the Israeli medical team has donated the

field hospital including all the medical equipment such as X-ray machine and blood tests kits. They have done such an

important thing.

Cherry buds ready to blossom

When we went outside of the shelter in the morning on the 15th (the day we were leaving), cherry buds that has

survived the long cold winter in Tohoku have had finally blossomed. That was also the day that a makeshift clinic run by

local doctors opened. Patients were asked to pay their portion of the cost of treatment. Despite the temporary opening,

there were about 50 people in line before they even opened on the first day. People have raised voices of surprise, but it

was the very moment we saw a bright future for local medical reconstruction.

Great thanks to AMDA staff


14/14

ConclusionThe following is the summary of our on-site medical assistance.

1. Medical exam in a makeshift clinic at the large shelter

2. To visit the isolated villages for medical care

3. Infection control in shelters

4. Psychological support for the victims

5. Logistical support for Israeli medical team (such as medical interpreters)

6. Activities with children in the shelters

7. Island survey by helicopter

8. Support for the establishment of a makeshift clinic for the future of a local medical reconstruction

Senbazuru: Strings of a thousand origami cranes

yoshihiro yoshimura

medical volunteer report in minami-sanriku-cho

Documents