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February 1 marked one month since the earthquake on the Noto Peninsula. Many people in the area are still forced to live as evacuees. Doctors in Ishinomaki city, who have been providing medical care to disaster-stricken areas, are increasingly concerned that sanitary conditions in evacuation centers are deteriorating and there is a risk of increased deaths from natural disasters. I’m Shinsaku Ueda, deputy director of Ishinomaki Red Cross Hospital. After the Noto Peninsula earthquake, he visited the affected areas twice and led the provision of medical assistance and improvement of conditions at the evacuation center. A month after the earthquake, 9,199 people in Ishikawa Prefecture are still sheltering in primary evacuation shelters set up in gyms and other places. Dr. Ueda is concerned that the evacuation period is getting longer. This is an increase in “disaster deaths” caused by the burden of living in evacuation centers. Shinsaku Ueda, deputy director of Ishinomaki Red Cross Hospital: “We already know that poor evacuation conditions can cause harm to health, which can lead to loss of life in a disaster. This was also demonstrated during the Great East Japan Earthquake. This was also mentioned in the case of the Kumamoto earthquake. Although we should have known that this could lead to loss of life, little effort was made to proactively improve the situation.” cold, hard floor and it was difficult to maintain privacy. The Great East Japan Earthquake killed 3,794 people and the Kumamoto Earthquake killed 221, accounting for 80% of the total deaths caused by earthquakes. Based on his experience, Dr. Ueda notes that the combination of “wearing shoes in an evacuation center” and “sleeping on the floor” significantly increases the risk of death from a disaster. Shinsaku Ueda, deputy director of Ishinomaki Red Cross Hospital: “If you enter an evacuation center with shoes on, the dirt on your shoes may turn to dust. According to Dr. Ueda, when people walk, dust flies. up to about 30 centimeters above the ground, approximately at face level, when they lie directly on the floor. Dust contains bacteria and viruses that can lead to various types of infections and life-threatening diseases such as pneumonia. Shinsaku Ueda, Deputy Director of Ishinomaki Red Cross Hospital: “Even if you say you can’t wear shoes in the gym, it’s cold there and the floor is such that people end up trying to wear shoes…” On the other hand, this risk was already known after the Great East Japan Earthquake. This is what the Kesennuma evacuation center looked like a month after the Great East Japan Earthquake. Rules required people to remove their shoes upon entry, and measures were taken to prevent dirt and dust from entering from outside. Shinsaku Ueda, deputy director of Ishinomaki Red Cross Hospital: “During the Great East Japan Earthquake, the dust was particularly bad, but we know that living in evacuation centers with shoes on or sleeping there poses a health risk.” Improvement in the evacuation center began from an early stage, but this time progress was slow and many were left without shoes even after about two weeks. I felt that the experience of previous disasters was not used. good use.” The earthquake in the Noto Peninsula occurred on New Year’s Day, when administrative agencies were also on an extended vacation. Dr. Ueda believes another contributing factor was the failure to assign people with knowledge to apply the lessons learned. Shinsaku Ueda, deputy director of Ishinomaki Red Cross Hospital: “Every city and mayor’s office has a public health nurse. In the city of Suzu, more than half of the public health nurses were affected by the disaster. Their role is to encourage people to do it, and these are the people who can do it. I believe this may have happened because they were unable to complete such activities to the fullest extent because their home was damaged by a natural disaster.” To improve this. In this situation, Dr. Ueda advocated the use of cardboard beds in the facility. This is said to not only reduce the risk of inhaling dust, but also retains heat well. In addition, the problem of toilets becomes more serious as the evacuation period increases. In Ishikawa Prefecture, where water continues to be cut off to more than 40,000 households, sewer systems have also been damaged and flush toilets are missing in many places, leading to deteriorating sanitation conditions. Shinsaku Ueda, deputy director of Ishinomaki Red Cross Hospital: “We know what will happen if there is no toilet, so the first thing we do is avoid defecation. Simply put, don’t drink water and don’t eat. We know that each of these factors causes health problems.” Dr. Ueda is concerned that when older people skip meals to avoid going to the toilet, their muscle strength declines and they may become bedridden. Shinsaku Ueda, Deputy Director of Ishinomaki Red Cross Hospital: “During the Great East Japan Earthquake, elderly people who were initially able to stand and walk showed a decline in their ability to be independent to the point that they required assistance even indoors after life. in an evacuation center for a month. If older people don’t eat, their bodies will become weaker.” So far, 240 people have been confirmed dead in Ishikawa Prefecture. At least 15 of these deaths are believed to be related to natural disasters. Shinsaku Ueda, deputy director of Ishinomaki Red Cross Hospital: “If the environment is bad, people will definitely get sick, and there are different ways to get sick and die. Usually, if the current situation continues, the number of people will increase. in the future