EDITORIAL

Special Issue on the Great East Japan Earthquake
and the Activities of Members and Alumni of
the School of Medicine, Keio University
Seitaro Fujishima1 and Makoto Suematsu2
1Editor-in-Chief, The Keio Journal of Medicine

2Dean, The School of Medicine, Keio University, Tokyo, Japan

About the Earthquake

teams (DMATs) that can deploy to a stricken area mostly
within 48 hours, following a similar system to that usedin the U.S. In comparison with U.S. DMATs, Japanese
DMATs are smaller in size and are composed of one or
two doctors, nurses, and a logistical staff member, so asto be able to travel by car.3 In the current crisis, a totalof 340 teams from all over Japan were dispatched to Miyagi, Iwate, Fukushima, and Ibaraki prefectures during
the initial 12 days.4 In contrast to the 1995 earthquake,in which asphyxia and being crushed were the biggest
dangers, more than 90% of the victims of the Great East
Japan Earthquake died from drowning, and consequently
DMATs played a major role not in rescue, but in patienttransport, hospital support, and medical care, in cooperation with local medical professionals. In addition, a number of governmental and voluntary medical teams fromall over Japan and worldwide were deployed soon after
the disaster.
Since most of the stricken area was originally underpopulated with medical professionals and because fullrecovery of medical resources and public transport willtake a long time, support for regular medical care has
been persistently necessary, even though the acute phaseof the disaster has come to an end. Furthermore, the sustained release of radiation from the devastated nuclear
power plant resulted in a significant exodus of residents,
including medical professionals, from Fukushima, which
has hampered the recovery of medical networks in thisarea.

The magnitude-9.0 Great East Japan Earthquake,
which struck at 14:46 JST on March 11, 2011, was thelargest ever recorded in Japan. Strong quakes were felt
not only in Tohoku, the closest region to the epicenter,but also nationwide from Hokkaido to Kyushu. This exceptional event was followed by huge tsunami waves
that severely damaged the Fukushima Daiichi nuclear
power plant, which consequently developed into an unprecedented crisis. A huge amount of infrastructure andinnumerable buildings were damaged in more than 17prefectures, over 19,000 people died or went missing in
12 prefectures, and more than 5000 people were injured
in 20 prefectures.1 Successive failures or shutdowns of
nuclear and non-nuclear power plants brought a sustained
shortage of electricity across a wide area of Japan, a situation that seriously affected our university and hospital aswell as our daily lives and living environment.
In response to the crisis, in addition to national and local governmental initiatives, numerous voluntary organizations, companies, schools, and individuals from all overJapan and worldwide headed toward the disaster-strickenarea to help rescue victims, deliver subsistence goods,
remove rubble, and restore infrastructure. Thanks to thestrenuous activities of the Japan Self-Defense Forces,
United States (U.S.) Forces, and devoted civilians, major
items of infrastructure, including highways, shinkansen(bullet train) tracks, airports, and harbors were restored
quite quickly. The damaged nuclear plants were finallystabilized with the best possible efforts, although it will
likely be more than three decades before they are finallydecommissioned.2

Medical Rescue Teams from Keio University
Soon after the disaster, Keio University, including faculties of Keio University School of Medicine, started
planning to send medial rescue teams to the stricken area.
However, as was the case with previous disasters, it was
hard to access accurate information about what was going on and what we could do. In response to the call forvolunteers, many faculty members and fellows applied

Medical Care in Tohoku
After the Great Hanshin and Awaji Earthquake of1995, the Japanese Ministry of Health, Labor, and Welfare (MHLW) established disaster medical assistance
Copyright © 2012 by The Keio Journal of Medicine

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to join the teams. The initial teams were organized toinclude a physician, a surgeon, a nurse, and a radiation
specialist; they departed for Kesennuma city, located at
the northern edge of Miyagi prefecture, 6 days after theearthquake, to collect accurate information and also togive medical care. One of the authors (SF) also joined
the team as a team leader. During our stay, to find sickpatients who needed to be admitted to a hospital and to
give primary medical care, we visited a small island andan isolated district. At one point, we arranged for a sickpatient to be transported to hospital by helicopter. We
also prescribed medicines for various chronic diseases,
such as hypertension, dyslipidemia, diabetes mellitus,
bronchial asthma, and thrombotic diseases, among others, in addition to medicine for acute infectious diseases
and mild psychiatric symptoms such as insomnia. Since
the level of daily medical care in this rural area was ashigh as that in urban areas, patients were relieved to beable to receive their regularly prescribed medicines fromsupplies that we took with us from Tokyo. On anotherday, we examined more than 100 patients and prescribedsimilar medicines at a temporary clinic set up in a sports
center that was housing more than 1000 refugees. Following us, teams two and three went to Kesennuma, teams
four to six to Rikuzentakada in Iwate, and teams seven tonine to Soma in Fukushima. Team members and the areas
covered were flexibly changed to maximally fit the local
needs at each time point.
In addition to the dispatch of medical rescue teams, of
our school of medicine numerous members and almuni
were actively involved in organizing or giving various
types of medical care. As we mentioned above, Keio University School of Medicine and Keio University Hospital,
located in the center of Tokyo, were significantly damaged and disrupted by the earthquake. Under the leadership of the School Dean and Hospital Director, we could
overcome such problems very quickly and systematically.
In this special issue of the Keio Journal of Medicine,which is published just 1 year after this unparalleled crisis,
representative activities by the faculties, members, andalumni of the School of Medicine, Keio University, arepresented. Concretely, the collaborative efforts between
Tohoku University and Keio University to help alleviate

the disastrous situation are reported by Prof. Okano, theinnovative mobile ophthalmologic clinic project “the Vision Van” is described by Dr. Oshima, the activities of
the regional medical association and pediatric care in Fukushima are depicted by Dr. Kikuchi, subacute mental
care activities in Fukushima are reported by Dr. Kato,and how to manage the issues associated with radiation
damage is described by Prof. Shigematsu. We hope thatthese featured articles will be of some assistance to those
who are involved in disaster planning or who may need toprovide medical assistance during a future disaster.
Acknowledgments
On behalf of Keio University School of Medicine, Keio
Medical Society, and Keio Journal of Medicine, we greatly thank Mr. Koki Ando and Mr. Noritaka Ando, CEOand CMO, respectively, Nissin Foods Holdings Co., Ltd.;
Nobutada Saji, Chairman of the Board, Suntory Holdings
Limited; and Professor Heizo Takenaka for their immediate and generous actions in supporting the logistics of ourrescue teams. We also thank Reijiro Hattori and numerous Keio and KP alumni for their ongoing support for
victims of the earthquake.
REFERENCES
1. Latest summary of the damage caused by the Great East Japan
Earthquake and associated police action (in Japanese). In: National Police Agency Emergency Disaster Headquarters Press Release.
Tokyo: National Police Agency; December 15, 2011. Available
from: http://www.npa.go.jp/archive/keibi/biki/higaijokyo.pdf
2. Status of Fukushima Daiichi and Fukushima Daini Nuclear
Power Stations after the Great East Japan Earthquake. [cited December 17, 2011]; Available from: http://www.tepco.co.jp/en/nu/fukushima-np/index-e.html.
3. Fuse A, Yokota H: An analysis of Japan Disaster Medical Assistance Team (J-DMAT) deployments in comparison with those of
J-DMAT’s counterpart in the United States (US-DMAT). J Nihon
Med Sch 2010; 77: 318–324. [Medline] [CrossRef]
4. Koido Y: DMAT activities in the Great East Japan Earthquakeand problems to be solved (in Japanese). In: DMAT Secretariat
Ministry of Health, Labor, and Welfare, Tokyo 2011; Available
from: http://www.mhlw.go.jp/stf/shingi/2r9852000001khc1att/2r9852000001khkf.pdf.