The 2nd Autumn Congress of Japanese Association of Rehabilitation Medicine(2018/11/4)
Topics: Disaster Medicine and Rehabilitation Medicine: What can we do and how should we prepare.
Venue: Sendai International Center (Sendai, JAPAN)

On Nov. 4th, Professor Shinichi Egawa in Disaster Medical Science Division of IRIDeS lectured
on the symposium & debate in the 2nd Autumn Congress of Japanese Association of Rehabilitation
Medicine. Disaster medicine and rehabilitation medicine is strongly related because staying inevacuation center will deteriorate the daily activities and result in the exacerbation of noncommunicable disease or loss of motivation. The word “rehabilitation” is not only a medical
terminology, but is used as the recovery and reconstruction of buildings, cities and society which ismain process after disaster onset.
This symposium & debate session gathered experienced rehabilitation responders anddiscussed what we can do and how we should prepare.
Prof. Egawa lectured about the basic knowledge of disaster medicine especially the concept ofdisaster risk and the medical needs after disaster. The background of disaster related death after
2011 Great East Japan Earthquake was elderly with some comorbidities and the rehabilitation could
have stopped the deterioration of physical and mental expiration. The other speakers presented
the concept and framework of Japan Rehabilitation Assistance Team (JRAT), rehabilitation
response after the triple disaster in Minamisoma City in Fukushima, JRAT activities in Hiroshima
prefecture as a supporter in 2015 Kumamoto Earthquake but receiver/supporter in 2018 heavy rainin Hiroshima and rehabilitation response plan in Tokushima Prefecture assuming South TroughEarthquake. Individual team has identified the problem and is going to establish robust JRAT ineach prefecture.
In Japan, the JRAT is supposed to join the medical and public health headquarter in prefecturaloffice. Currently, the control and command is under the umbrella of Japan Medical Association
Team. This enabled JRAT to act with financial support from central government under Law ofDisaster Relief. However, the needs and supportive activity of JRAT tends to be longer than JMAT.
The middle to long-term support and recovery of local resource for rehabilitation medicine is themost challenging gap. The exiting strategy may not be difficult if the local provider has rich resource.
But if affected area lacked local resource even from before disaster, the “Build Back Better” is toenrich the resource of rehabilitation medicine in the affected area. Prof. Egawa insisted theimportance of human network and long-term rehabilitation care facility. Good example is the mental
health care center in Hyogo after 1995 Hanshin Awaji Earthquake.
In Minamisoma Municipal General Hospital, the 1/3 of health care workers evacuated after
Fukushima Nuclear Power Plant accident. The central government restricted the area of residence
and the hospital was enforced not to admit the in-patients. The rehabilitation medicine staff also
severely decreased. How to support the health care providers in the affected area is a big issue.
But if we understand the importance of their support, the relief aid is very effective.
The Hiroshima JRAT helped 2016 Kumamoto Earthquake, but they faced 2018 Hiroshima heavy
rain disaster with numerous landslides and floods. The coordination turned better after DHEAT(public health team) assisted the coordination. Tokushima prefectural government is willing toimprove the disaster medical response and actively organize the training opportunities.
The coordination between the needs in the affected area and capability of responders is critical.
Presentation in other medical sector is precious opportunity to promote mutual understanding tocreate team disaster medicine for more efficient response and preparedness.
Report by Shinichi Egawa (Disaster Medical Science Division)(continues to the next page)JRAT in disaster drill in Tokushima Prefecture

Team Disaster Mdicine