The Great East Japan Earthquake Disaster: a Compilation of Published Literature on Health Needs and Relief Activities, March 2011-September 2012

The Great East Japan Earthquake Disaster: a Compilation of Published Literature on Health Needs and Relief Activities, March 2011-September 2012 May 13, 2013 · Research Article Sae Ochi, Virginia Murray1, Susan Hodgson 1 Health Protection Agency Ochi S, Murray V, Hodgson S. The Great East Japan Earthquake Disaster: a Compilation of Published Literature on Health Needs and Relief Activities, March 2011-September 2012. PLOS Currents Disasters. 2013 May 13 . Edition 1. doi: 10.1371/currents.dis.771beae7d8f41c31cd91e765678c005d. Abstract Objective To provide an overview of the health needs following the Great East Japan Earthquake Disaster and the lessons identified. Methods The relevant of peer review and grey literature articles in English and Japanese, and books in Japanese, published from March 2011 to September 2012 were searched. Medline, Embase, PsycINFO, and HMIC were searched for journal articles in English, CiNii for those in Japanese, and Amazon.co.jp. for books. Descriptions of the health needs at the time of the disaster were identified using search terms and relevant articles were reviewed. Findings 85 English articles, 246 Japanese articles and 13 books were identified, the majority of which were experience/activity reports. Regarding health care needs, chronic conditions such as hypertension and diabetes were reported to be the greatest burden from the early stages of the disaster. Loss of medication and medical records appeared to worsen the situation. Many sub-acute symptoms were attributed to the contaminated sludge of the tsunamis and the poor living environment at the evacuation centres. Particularly vulnerable groups were identified as the elderly, those with mental health illnesses and the disabled. Although the response of the rescue activities was prompt, it sometimes failed to meet the on-site needs due to the lack of communication and coordination. Conclusion The lessons identified from this mega-disaster highlighted the specific health needs of the vulnerable populations, particularly the elderly and those with non-communicable diseases. Further research is needed so that the lessons identified can be incorporated into future contingency plans in Japan and elsewhere. Funding Statement The authors report no source of funding to support the work on this manuscript Introduction Effective disaster preparedness can be achieved by taking a comprehensive and panoramic view of a disaster. So far no paper has reviewed an overall health impact neither from an urban disaster nor from an earthquake. The Great East Japan Earthquake Disaster (GEJED) in 2011 was one of the greatest natural disasters that occurred in modern society. An earthquake with a magnitude 9.0 on the Richter scale and the subsequent five to six tsunamis, reaching up to 38 m from sea level and flooded 561 km2 of the coastal area, killed more than 15,000 people in Japan.1 The GEJED was different from past earthquakes in many ways. Firstly, the unprecedented size of both the earthquake and the associated tsunamis were beyond the scope of even the most recent regulatory and operational projections. For example, the Fukushima Nuclear Power Plant to were prepared for an earthquake with magnitude 7.6,51 which turned out to be insufficient in this case. Secondly, this disaster had the distinct features of an urban disaster, typified by extensive power and water supply failures. Thirdly, recovery of infrastructure took much longer than anticipated in the current disaster management platform in Japan.3 Finally, the areas most affected were cities with a predominantly elderly population (30% above 60 years-old).1 The aim of this research is to understand what happens when a mega-disaster hit modern society. To achieve this objective, this paper reviews the available peer reviewed and ‘grey literature’ publications between March 2011 and September 2012, and PLOS Currents Disasters 1 summarises the health impacts at the time of the GEJED. Although the effect of the earthquake and the tsunamis impacted on the accident at the Fukushima-Daiichi nuclear power plant, this is specifically excluded in this literature review. This is because the health needs and health impacts related to the radiation exposure is very different from those related to the earthquake and tsunamis. Methods Publicly available information written in English or Japanese was obtained from the following sources. The relevant literature was analysed and descriptions of the health needs and relief activities at the time of the GEJED were identified. As stated above, because health needs/impact related to radiation exposure is different from earthquake and tsunamis, articles mainly focus on nuclear issues were excluded in this review. Identification 1) Academic and ‘grey literature’ English journals The key health journal databases (Medline, Embase, PsycINFO, and Health Management Information Consortium (HMIC)) were searched via OvidSP. As many different names are used for the GEJED in English articles, the keywords used were ‘earthquake’ [AND] ‘Japan’ [AND] ‘health’ in all fields; ‘earthquake’ [AND] ‘Japan’ [AND] ‘hospital’ in all fields; or ‘earthquake’ [AND] ‘Japan’ [AND] ‘medicine’ in all fields. 2)Academic and ‘grey literature’ journals and books in Japanese The literatures written in Japanese are often searchable in Japanese words. Therefore, the review was conducted on the database provided by the National Diet Library in Japan (CiNii), using search term ‘?????? (GEJED)’ [AND] ‘?? (Hospital)’; or ‘?????? (GEJED)’ [AND] ‘?? (Healthcare)’. Amazon.co.jp was searched for the books published in Japan from March 2011 to September 2012. The search term used were: ‘?????? (GEJED)’ [AND] ‘?? (Hospital)’; or ’?????? (GEJED)’ [AND] ‘?? (Healthcare)’. Books that write about hospitals, healthcare, and hospital staff in the time of the GEJED were obtained. Eligibility criteria 1) Inclusion criteria Articles were included in the review if they were: (i) written either in English or in Japanese; (ii) published from March 2011 to September 2012, and (iii) describing the experiences and interviews of rescue teams, on-site health needs, or the prevalence or characteristics of specific diseases, at the time of the GEJED. 2) Exclusion criteria Articles and papers were excluded if they were: (i) the bulletins from universities or private organisations; (ii) abstracts for conferences or lectures; (iii) about clinical interventions or basic science; and (iv) only on the radiation exposure or explosion of nuclear power plant. Results PLOS Currents Disasters 2 Fig. 1: Search strategy for literature review. A: Journals written in English B: Journals written in Japanese C: Books written in Japanese Figure 1 describes the search strategy. The literature search was conducted in September 2012. 85 articles in English, and 246 articles and 13 books in Japanese, were eligible for inclusion in the review (Appendix 1). The 85 English and the Japane (...truncated)