Disaster Preparedness in Osaka: A Role and Relationship of the Core Medical Institutes in a Disaster

(76%) were transferred from affected hospitals to back-up hospitals, while 549 patients (24%) were evacuated directly to the back-up hospitals. The peak in transports came during the first four days. The family car was the most frequently utilized means of transport; ambulances were used in only 26% of cases, and the helicopters were utilized minimally. Conclusion: In the initial 15-day period following the earthquake, there was an unprecedented number of patients suffering from trauma, and they converged upon the affected hospitals. Subsequently, an increased incidence of illness was observed. The existing emergency medical services system was not adequate for this urban earthquake. From our vantagepoint, we are keen-ly aware of the need for improved communications between hospitals, a well-equipped patient transport system, and a well-coordinated disaster response mech-anism. (EMS); lev-els of operation and diverse requirements for decision into a coherent program of action. Yet, human decision makers have limited cognitive capacity. In rapidly chang-ing environments, they often are unable to process the amount and range of information required to make time-ly, informed decisions essential for adequate coordination among the multiple components of the response system. Accordingly, organized performance in complex environments has been viewed as necessarily limited by human information processing capacity. Advances in information technology and telecom-munications allow means to overcome the long-observed decrease in organizational performance in complex environments. Technical capacity to order, store, retrieve, analyze, and disseminate information to multiple users simultaneously creates the potential for innovative approaches to collective learning and self organization. These means extend information processing capacity beyond the limits of single individuals, and provide decision support to multiple managers address-ing the same problem at different locations at the same time. Linking organizational capacity for mobilizing the resources of a community to appropriate uses of information technology creates a "sociotechnical system" in which technical capacity to exchange timely, accurate information among multiple participants increases organizational capacity to solve shared problems that require action at local, regional, and national levels. This paper will present the concept of self organiza-tion in the mitigation of risk and mobilization of response to disaster. This concept depends upon the design and implementation of a socio-technical system that integrates the technical capacity of information technology with organizational design and communica-tion processes among major actors in a community response system. This paper will present findings from a field study of the Great Hanshin Earthquake of 17 January 1995 that shows the consequences of a major earthquake in a metropolitan area of 6 million people. Such an event disrupts the performance of the basic response systems of the community, including the capacity for medical response. This paper will identify possible ways to improve inter-organizational and inter-jurisdictional performance in risk reduction and response to disaster, focusing on medical response, through the appropriate design and application of information technology. for the victims from the beginning of the disaster. Also, the hospital received patients with a variety of stress-related health problems after the Earthquake. At the same time, the Medical School organized systematic research on the various medical and health problems among victims. Research works carried out at the Kobe University School of Medicine on the Earthquake victims has ranged widely from forensic analysis of the dead, crush syndromes, effects of stress on cardiovascular and diges-tive systems, psychological problems, care systems for the victims, etc. The research project involved more than 100 doctors and researchers. This paper reviews a wide range of bio-psycho-social impacts of the disaster to the victims, and analyses the longitudinal changes in health problems. Special attention should be directed to the psychological and psychiatric aspects. Also, some medical problems still are continuing even four years after the Earthquake.