All Japan Hospital Association (AJHA)
May 16, 2011

1. About All Japan Hospital Association• Established in 1960
• 7th President : Hirotoshi Nishizawa• Number of member hospitals : 2,338•••

27% of all hospitals in Japan
98% of member hospitals are private hospitals
the largest private hospitals association• Our mission: The All Japan Hospital Association(AJHA) is dedicated to improve the quality of hospitalmanagements and the health and welfare of thesociety by offering high quality, effective andvaluable healthcare service.
22-1. Outline of the Earthquake• Date and Time : March 11, 2011 14:46:18• Epicenter : 72 km east of the Oshika
Peninsulaof Tohoku• Scale : Magnitude 9.0• Number of the death :15,782 (On Sep 11th)• Number of the missing :4,086 (On Sep 11th)• Number of the refugees :82,945 (On Sep 6th)
• Features : Tsunami, Nuclear accident, Blackout32-2. Feature of the earthquake : Tsunami• Cause of death••••

Drowned : 92.5%
Crushed or damaged : 4.4%
Burned : 1.1%
Unknown : 2%

• Rate of death by drowned•••

Iwate prefecture : 87.3%
Fukushima prefecture : 87%
Miyagi prefecture : 95.7%

Damage of Tsunami
・Drowned・People Aged• Age of death••••

Over 80 years : 22.1%
70-79 years : 24.0%
60-69 years : 19.1%
0-9 , 10-19, 20-29years: each are less than 4%
Published by National Police Agency, April 19 20114

2-3. Feature of the earthquake :Nuclear Accident and Blackout• Fukushima Daiichi Nuclear Power Plant
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INES(International Nuclear Event Scale)：Level 7Accidents in reactors 1, 2, 3 and 4
Evacuation of residents
Emission of radioactive material
Food, water, sea and soil contaminated with radioactivity
Damage caused by harmful rumors or misinformation
Out and shortage of stock of foods and daily necessities• Scheduled Blackout•••••

Rotation blackout due to declining of electrical power
Power saving
Suspension of public transport, disorder of timetableThousands of citizens without any means of going home
Concern about shortage of electrical power in summer

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3-1. AJHA’s Main Activities by Time Series (On Apr 30th)
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March 11: Occurrence of an earthquake
March 13: Investigation of member hospital in stricken area
March 14: Establishment of Headquarters for Disaster Control
March 15: Establishment of bank account for donation
March 16: Dispatching 1st Medical Relief Team (6teams, 21 staff): Demanding for medical reconstruction loan toMinistry of Health, Labour and Welfare
March 18: Accepting suffered 20 patients by member hospital
March 22: Attending “Team Meeting of Health for the Suffered”
hosted by ruling party
March 26: Publishing statement of AJHA
April 1: Investigation and transporting materials by Vice president Inokuchi
April 5: Discussion of medical care and long term care flow chart
April 9: Inquiry for member hospital by President Nishizawa
63-2. AJHA’s Main Activities by Functions(On Apr 30th)
Headquarters for Disaster Control
Medical Support TeamMeetings*Consist of doctor, nurse, clerk*Dispatching 1st team on March 16*Totally dispatching 73 teams (293member staff) on May 1*To Miyagi prefecture andFukushima prefecture*Attendance to “Team Meeting ofHealth for the Suffered”*Attendance to “ Meeting of HealthSupporting for the Suffered”

Donation*For emergency and recovery*Assistance form People’s Hope Japan
Goods Assistance*300 Computers, 100 Printers*Daily necessities (blanket, diaper, etc)

Demanding and Proclaiming*Demanding to ruling party andMinistry from hospital associations*Proclaiming by AJHA
Investigation*Investigation of damage ofmember hospitals
74．Proclaiming of AJHA
We sincerely pray for the people who killed by Great East Japan
Earthquake on March 11 2011, for maintenance of health of thesuffered and for recovery of stricken area as soon as possible. We
also pray for healthcare facilities which was suffered and lost staff.
We are very moved and proud of our fellows who keeps on
supplying health care service in damaged situation and who helps
these health care facilities in the stricken area.
We strongly claim to government to support for suspension andrestriction of healthcare facilities in the stricken and surroundingarea accompanied with earthquake, tsunami nuclear accident andscheduled blackout.
Not only stricken area but also whole Japan suffer great damage
directly and indirectly. We claim to government to consider andindicate quickly and clearly the strategy of recovery about theseemergency situations to the people.
All Japan Hospital Association declares to active for recovery withall our best
March 26, 2011
96th Conference of Representatives, All Japan Hospital Association85-1. Investigation of member hospital instricken area
• Subject : 218 hospitals from 9 prefecture of Aomori, Iwate,Miyagi, Akita, Yamagata, Fukushima, Ibaragi, Niigata, Nagano• Means of sending questionnaire : FAX and E-mail• Response number : 202/218 hospitals ( Response rate : 92.7%)“Outline of the result”
1)DamageNoYes
InvalidTotal

70128
420234.7%63.4%
2.0%100%4)Damage to instruments

NoYes
Invalid
Total

6190
51
202

30.2%
44.6%
25.2%
100%2)Damage to inpatients
No147
72.8%
Yes
52.5%
Invalid
50
24.8%
Total
202
100%3)Damage to staff
No137
Yes
13
Invalid
52
Total
202

5)Damage to electrical power6)Reception of the suffered

No
Yes
Still
Invalid
Total

61
91
149
202

30.2%
45.0%
0.5%
24.3%
100%

No
Yes
Invalid
Total

886252
202

67.8%
6.4%
25.7%
100%
43.6%
30.7%
25.7%
100%
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5-2. Establishment ofHeadquarters for Disaster Control“ Members”•••President : Hirotoshi Nishizawa
Vice President : Takao Ando, Yuji Inokuchi
Masahiro kanno, Masataka Inokuchi
Others : Member of other committees of General Affairs,
Emergency Medicine and Disaster Damage Prevention ,and Public Relations
Office of Headquarters“ Main Role”
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Commanding all activities
Sending medical support team and good sassistance
Investigation of member hospitals in stricken area
Investigation of patients reception
Information network with administrative agencies
Dairy reporting twice a day at 10 and 18o’clock
Holding extraordinary conferenceMeeting10

5-3. Bank Account for Donation• Purpose for emergency or recovery support
1) All Japan Hospital Association* No tax deductible donation• Mizuho Bank
• Contribution over 10,000yen

Your cooperation
is greatlyappreciated.

2) People’s Hope Japan* Tax deductible donation• Mizuho Bank
• Mitsubishi Tokyo UFJ Bank
• Postal Transfer
115-4. Medical Support Team“ Schedule”
March 12 : Investigation of stricken area by Ishihara, board member of AJHA
March 16 : Dispatching 1st medical support team (6teams, 21member) to Miyagi
March 17 : Dispatching 2nd medical support team (4teams, 19member) to Miyagi••

May 1 : Dispatching 73 medical support team (293member)
June30 : Dispatching 115 medical support team (487member)

.....

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“ Main Activities”•••••

Check-up at shelter, support for stricken hospitals
Home-visit care and rehabilitation
Decontamination in Fukushima prefecture
Patients transportation reception
Administration, distribution, transportation ofgoods assistance12

Meeting with self-defense force and fire brigade
Visiting patients

Distributing drugs including Psychoactive drug and goods assistanceDecontamination13

5-5. Information Supplying Systems“ Homepage”••••

Situation of medical support team
Scheduled Blackout
Information from administrative agencies
Donation“ E-mail”• Scheduled Blackout• Sending questionnaire“ FAX”• Donation• Sending questionnaire• Request for medical support team14

5-6. DemandingFunctions(On Apr 30th)1) Demanding for Great East Japan Earthquake••••

On March 16
To Minister of Ministry of Health, Labour and Welfare
By Four Hospital Associations Meeting
Demanding further assistance due to lack of support from Welfare And
Medical Service Agency

2) Demanding for Administration of healthcare facilities
according to earthquake••••On April 23
To Minister of Ministry of Health, Labour and Welfare
By Four Hospital Associations Meeting
Demanding to ease regulation ofadministrating health care facilities
regulated by law

Demanding by Vice president Inokuchi (left) 15

5-7. Team Meeting of Health for the Sufferedand Meeting of Health Support for the Suffered• Participation in “Team Meeting of Health for the Sufferedhosted” by ruling party
dissolved and establised• Establishment and administration of “Meeting of HealthSupport for the Suffered”• Members :7 associations including Japan Medical Association, AJHA etc• Purposes : To grasp and meet medical needs
To dispatch medical assistant team in the middle-long term
To keep the suffered healthy

Address at press conference President Nishizawa ( 3rd form the left)165-8. Investigation and Transporting
Materials by Vice president Inokuchi• Person in charge : Vice president Masataka Inokuchi• Period : April 1st – 3rd• Place : 5 hospitals in Miyagi, 3 hospitals in Iwate, and Kesemnuma
first‐aid station• Activities : Investigation of damage and recovery of infrastructure
Grasping the needs and materials
Sending goods assistances

Sending goods assistances

Reception of hospital

Encouragement175-9. Encouragement by President Nishizawa• Person in charge : President Hirotoshi Nishizawa• Period : 1) April 9th , 2) April 21st
• Place :••1) President of Iwate branch and 2 hospitals in Miyagi
2) President of Fukushima branch and 2 hospitals in Fukushima• Activities : Encouragement, sending donation and materials

Donation from President Nishizawa(Left)

Drying paper medical records by drier6. Conclusion• Collect and centralization of information• Needs for seamless support from acute care tochronic and mental care
• Compartmentalization and cooperation with othermedical support teams• Medical support teams with or without subsidies ?
• Hospitals damaged indirectly such as suspension of
public transport• Distribution of collected man power and materials• Public hospitals supported easily from municipalities
VS private hospitals not supported very well19