Difficulties of families with handicapped children after the Hanshin-Awaji earthquake

Care of children in a natural disaster: lessons learned from the Great East Japan earthquake and tsunami

The Great East Japan earthquake was one of the most devastating natural disasters ever to hit Japan. We present features of the disaster and the radioactive accident in Fukushima. About 19,000 are dead or remain missing mainly due to the tsunami, but children accounted for only 6.5% of the deaths. The Japanese Society of Pediatric Surgeons set up the Committee of Aid for Disaster, and collaborated with the Japanese Society of Emergency Pediatrics to share information and provide pediatric medical care in the disaster area. Based on the lessons learned from the experiences, the role of pediatric surgeons and physicians in natural disasters is discussed.

Delayed recovery of caregivers from social dysfunction and psychological distress after the Great East Japan Earthquake

BACKGROUND

In April 2011, two hundred and eighty residents who were suffering from intellectual disabilities and their eighty caregivers at nine facilities in Fukushima were evacuated and moved to Chiba, Japan after the Great East Japan Earthquake. We investigated the impact of the evacuation after the earthquake on the caregiver burden.

METHOD

There were 41 participants from Chiba as a reference group and 32 participants from Fukushima as a case group included. Data were collected regarding their demographics and the General Health Questionnaires 12 (GHQ-12) score for both groups in two different points.

RESULTS

The evacuation was linked to a follow-up GHQ-12 global score ≥ 3 (RR=4.52, 95%CI; 1.32-15.47). There was no significant improvement of the GHQ-12 global score in the case group from Fukushima for the follow-up data compared to the baseline data. Social dysfunction had continued in the case group from the baseline data (p<0.01) during the follow-up period (p<0.001). A statistically significant difference was noted for the case group from Fukushima regarding psychological distress in the follow-up data (p<0.01), which was not found in the baseline data (p=0.07).

LIMITATIONS

The sample size was limited to a non-randomized and unmasked sample of 73 patients. No causal relationship could be determined due to the cross-sectional nature of the study.

CONCLUSIONS

The caregivers from Fukushima exhibited more psychiatric morbidity, which persisted for the duration of their evacuation after the earthquake. It is important to provide long-term support for such caregivers who have been evacuated after a major disaster.

Post-Traumatic Stress Disorders and mental health care (lessons learned from the Hanshin-Awaji Earthquake, Kobe, 1995)

The Hanshin-Awaji Earthquake of 1995 and has moved through the various phases into the recovery stage. After the earthquake we conducted two surveys involving approximately 8000 families with pre-school aged children and 466 families with disabled children. Symptoms related to PTSD were found more frequently in the small children whose houses had been severely damaged one year after the earthquake. Although the symptoms decreased, they were still present more frequently in the children and their mothers with severely damaged homes in 1998. Our results show children with intellectual or emotional disabilities displayed many behavioral problems. The physically disabled children required medical resources and specialized support in a structured environment. Both groups voiced the need to set up specialized facilities for people with disabilities. Following the Central Java Earthquake in 2006, we have engaged in "children house" activities in the disaster stricken area in collaboration with Gadjah Mada University. Through this activity, we have been able to share what works in helping children with disabilities and their families. From our experience we have found exchanging of information among the people in the disaster stricken areas helps to reduce the psychological damage of the children and aids in their recovery process.

Pediatric Terrorism Preparedness National Guidelines and Recommendations: Findings of an Evidenced-based Consensus Process

A cadre of experts and stakeholders from government agencies, professional organizations, emergency medicine and response, pediatrics, mental health, and disaster preparedness were gathered to review and summarize the existing data on the needs of children in the planning, preparation, and response to disasters or terrorism. This review was followed by development of evidence-based consensus guidelines and recommendations on the needs of children in disasters, including chemical, biological, and radiological terrorism. An evidence-based consensus process was used in conjunction with a modified Delphi approach for selection of topic areas and discussion points. These recommendations and guidelines represent the first national evidence-based standards for pediatric disaster and terrorism preparedness.