Medical Problems and Concerns with Temporary Evacuation Shelters after Great Earthquake Disasters in Japan: A Systematic Review

Poor Environmental Conditions Created the Acute Health Deteriorations in Evacuation Shelters after the 2016 Kumamoto Earthquake

When disasters occur, affected people in evacuation shelters may experience health problems, such as exacerbation of chronic diseases or development of new diseases. This study examined the factors contributing to sudden illness in evacuation shelters used for the 2016 Kumamoto Earthquake. The subjects were evacuees of the Kumamoto Earthquake who were transported to hospitals from evacuation shelters by ambulance. Data on patients transported from evacuation shelters were obtained from emergency transport records at the Kumamoto City Fire Department and from medical institutions. The assessment of the living conditions in the shelter was obtained from the Emergency Medical Information System. A total of 576 patients were transported by ambulance from evacuation shelters in Kumamoto City. Of these, 300 patients for whom detailed information was obtained from medical institutions were included in the analysis. The median age was 71 years, and 213 patients (71%) were over 60 years old. There were 235 patients (78%) with pre-existing medical conditions. The most common reasons for emergency transport were falls and dyspnea, followed by fever, disturbance of consciousness, and abdominal pain. The most common final diagnosis at the medical institutions was trauma due to falls, followed by cardiovascular disease, infectious disease, and cerebral neurological disease. A survey of living conditions in the shelters identified problems with scarcity of space and provision of medical care and food. In order to prevent adverse health outcomes in evacuation shelters, the provision of appropriate living conditions and medical care is important from the acute phase of a disaster.

Implications of the evacuation of hospitalized patients in a nuclear emergency

In the accident at the Fukushima Daiichi nuclear power station following the Great East Japan Earthquake and tsunami, more than 50 hospital patients died during or soon after evacuation, primarily owing to the interruption of necessary medical care. To prevent the occurrence of such losses in the future, the focus of evacuation decisions should be on the health status of individual patients and not on currently evaluated non-human aspects such as the geophysical conditions and the status of the accident facility. This brief research report provides a conceptual basis considering the principle of justification for making more appropriate decisions on the evacuation of hospitalized patients by balancing radiological risks and evacuation-induced health risks. This research report is expected to foster discussions among stakeholders on how to protect vulnerable people more appropriately in nuclear emergencies.

Benefits and Drawbacks of Using Hotels as Shelters After a Landslide

OBJECTIVES

On July 3, 2021, a landslide occurred in part of Atami City, Shizuoka, Japan.

METHODS

The government of Shizuoka Prefecture requested the dispatch of Shizuoka Disaster Medical Assistance Teams (S-DMATs).

RESULTS

On day 2, the evacuees were evacuated into 2 hotels (A and B). Hotel A accommodated over 570 independent and dependent evacuees. Hotel B accommodated 44 dependent aged individuals, who lived in the same long-term health-care facility, together with their 11 caregivers. The evacuees in hotel B returned to the previous facility on day 10 without any specific medical problems. The evacuees in hotel A were managed in the guest rooms as family units. Individuals requiring care in guest rooms in hotel A became isolated because they could not call for help or walk. Furthermore, hotel guest rooms were not barrier-free. The S-DMATs supported the evacuees.

CONCLUSIONS

Independent evacuees received the maximum benefits from the use of a hotel as a shelter. In contrast, it was difficult for dependent evacuees to benefit from the hotel as it is as a shelter when living alone in the hotel. Dependent evacuees required appropriate support to eat, walk, use the toilet, and keep themselves clean when using a hotel as a shelter.