Fukushima Medical University

NOTE: These slides and associated notes are not for sale or rent. They
have been made available in PDF format by Fukushima MedicalUniversity’s Office of International Cooperation (http://fmu-global.jp).
Electronic and printed copies may be used as-is for personal
scholarship and non-commercial educational activities in accordancewith “fair use” copyright and other applicable laws. Notes under eachslide approximate what was said, with some editing for the convenienceof readers. “CLICK” may appear in the notes under slides that change
while the presenter is talking.
This presentation was given on 24 May 2017 at Hiroshima University, inconjunction with an IAEA Consultancy Meeting on Science, Technology,and Society (STS) Perspectives on Nuclear Science, Radiation, andHuman Health.

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Fukushima Medical University

Going global is not a new idea. One hundred and ten years ago, smalltown Minnesota surgeon William Worrall Mayo visited Japan, but long
before the Mayo Clinic was founded in 1864, Japanese and Western
people were earnestly studying medicine together in Nagasaki.

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Fukushima Women’s Medical College was our predecessor when theatomic bombs were used in war. So, in matters pertaining to radiation
medicine, Hiroshima University and Nagasaki University will always belike our older siblings. FMU was still a quiet, prefectural medical school
when 3.11 happened. Things have changed.

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We now partner with various international organizations, some of which
are listed here. These were chosen to illustrate three themes that guideour thinking.

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Theme number one: Today’s young people are tomorrow’s leaders.
Give them real-life experience as soon as possible.

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Theme number two: Value your contacts, not to use them, but to servethem.

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Theme number three: Travel is tedious. Make the most of every dollarand day.

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Let’s begin with today’s host, the International Atomic Energy Agency.

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Among many other activities, the IAEA has partnered with FMU to hostInternational Academic Conferences in Fukushima. In 2013, FMU
medical student Shohei ANDOH wasn’t just a panelist…

Page 9Fukushima Medical University…he also gave a major presentation. Mr. ANDOH was a shy Fukushima
native just finishing his second year of medical school when 3.11
happened. His sense of mission and purpose started to show in theYear 3 English Presentation Skills class that has been a part of ourcurriculum since 2009. After graduating in 2015, he did general training
at Japan’s National Center for Global Health and Medicine, and is now
specializing in hematology at the University of Tokyo.

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Pick a student at random, and you might expect random results, but
FMU does have systems in place to identify and develop the mostpromising students. One sentence from a recommendation letter
explains why Mr. Andoh was chosen for an IAEA conference.

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The following year, we had a panel composed entirely of students, fromJapan and from Mount Sinai Medical School in New York, with whom
FMU has had an exchange relationship for a number of years. Now, incontrast to the famous and highly distinguished session chairs on theright…

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Fukushima Medical University…we had a year 3 medical student from FMU chair a session withinternational speakers. The thinking is, yes, as a matter of protocol,
there should be a co-chair of similar rank to our guest speakers, but asa medical school, we can let the actual work be done by a student. Ms.
Saito did such a good job, FMU’S Professor Takenoshita – our newpresident, by the way – invited her to EmCee at a specialty conference
elsewhere in Japan.

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Another activity between FMU with IAEA was a “Train the Trainers”
workshop for medical physicists from around the world. Here they are,practicing under the watchful eyes of university presidents from years
past, who, as visionary as they were, probably couldn’t imagine any ofthis happening on our campus.

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After a long day wearing the uniform costumes of a radiation
emergency, our guests could change into unique costumes, reflecting
their cultural identities. This particular workshop, by the way, convened
during the holy month of Ramadan. FMU’s cafeteria has taken a big
step backward since then, but at least our banquet vendors do theirbest to accommodate different dietary practices, and clearly label
everything when they put on a buffet. We made sure that the banquet
buffet for this workshop during Ramadan was served right after sunset.

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Now let’s look at an example from our relationship with the International
Commission for Radiological Protection.

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ICRP started hosting Dialog Seminars from late 2011, engaging withcitizens affected by the nuclear accident. Their Dialog Initiative hascontinued since then. Let’s focus on an event from 2015.

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The 11th Dialogue on the Rehabilitation of Living Conditions after theFukushima Accident was subtitled, The Role of Measurements in
Regaining Control. Note that many organizations participate in theICRP Dialog Initiative, including Fukushima Medical University.

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At this Dialog Seminar, a group of students from the Super Science
Club of Fukushima High School made presentations, in particular, about
their D-Shuttle research project. The D-Shuttle is an electronic
dosimeter that records radiation exposure doses by the hour and day.

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Fukushima High School students got the cooperation of students atother high schools in Japan and around the world: Belarus, France, andPoland.

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Together, 216 students demonstrated background radiation levels
around Fukushima Prefecture that were in the same range as otherplaces around the world.

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As presenters, the students were poised and articulate, in front a live
international audience and in front of of video cameras.

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The students’ research was peer-reviewed and published in the Journalof Radiological Protection, with Prof. Hayano at the University of Tokyoserving as corresponding author. Our contribution was largely throughthe efforts of Dr. Makoto Miyazaki and Prof. Otsura Niwa.

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Next, the Korea Institute of Radiological and Medical Sciences.

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A delegation from KIRAMS visited FMU in 2014, and we held a joint
conference. They talked, we talked, just what you would expect.

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One difference was that we allowed medical students to host a banquet
for our guests at a small restaurant near campus. Maybe two FMU
faculty members were there, but this was really a student-organized
event. KIRAMS made some short presentations, FMU students madesome short presentations, and when it was time to eat, the student
stood up as a group, went to the kitchen, and brought out the dishes.
So well done, it was like watching synchronized swimming.

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In turn, we have been invited to Korea to participate in meetings, suchas this one in 2015, co-organized with WHO, and attended by people
from around the world…

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Fukushima Medical University…or this one, in 2016, co-organized with IAEA, again, with a very
international roster of participants.

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In every case, what we hear from KIRAMS and their international
guests is, “Can we train at FMU?”

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Indeed, we welcome visitors, such as this delegation in 2015 fromKorea Hydro and Nuclear Power…

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Fukushima Medical University…and this Korean delegation of mental health professionals in 2016.

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This year, we received a delegation of citizens from Manche, France, inour new International Conference Room. But the question remains,what about hands-on training?

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We definitely offer hands-on training in disaster and radiation medicine.
Organizer Dr. Kumagai is multilingual, and travels around the world
lecturing and teaching in English. Our challenge is that many trainees
only speak Japanese. So, next month, at our 25th Disaster Medicine –Radiation Exposure Course, as an experiment we’re pairing up our Dr.
Lyamzina – herself fluent in many European languages – with abiomedical engineer from Google in Tokyo, who wants to attend andsimultaneously translate between Japanese and English.

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On to UNSCEAR, whose representatives have come to FMU on
numerous occasions.

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And, for the past few years, we have been dispatching speakers toVienna for a satellite session on Fukushima that has been added to theannual UNSCEAR General Assembly.

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This year’s speakers from FMU are professors Yuliya Lyamzina andMichio Murakami, sharing the topic, “Risk analysis and perception after
the Fukushima Daiichi Nuclear Power Plant accident.”

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Last on the list, a trip that grew out of an invitation from America’s
Radiation Injury Treatment Network.

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Every couple of years, RITN convenes a meeting around Washington,DC.

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After FMU was invited to this RITN meeting, we built a bigger agenda tomake our travel dollars do more. Let me cover just 5 days of this trip.

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A lesson from colleagues at the Australian Red Cross is that Australia isso far from so many places that Australians routinely do as much as
possible when they go somewhere. They can even append vacation
days to professional travel, something that Japanese public servants
are careful not to do.

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There are other colleagues to thank for this travel schedule. On a 2012
trip to Minnesota, which included a blood donation, Dr. Jed Gorlin said,“Come early and come to lunch, there’s someone I want you to meet.”That someone was Cullen Case of the Radiation Injury Treatment
Network. He, in turn, organized an audience for me two days later, andthat set the stage for a future invitation to RITN’s national meeting.

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More appointments in Washington were arranged by Dr. Richard
BENJAMIN, Chief Medical Officer of American Red Cross Biomedical
Services, and Prof. Willy (Bill) FLEGEL, Medical Director of the NIH
Department of Transfusion Medicine. Previously, FMU’s Department ofBlood Transfusion and Transplantation Immunology helped welcome
these world-renowned specialists when they visited Japan.

Page 42Transfusion under Triple Threat

From a disaster preparedness article, I knew Victor CID at the National
Library of Medicine, and he added a meeting with other disaster
preparedness and emergency communications specialists on the NIH/
NLM campus.

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FMU’s Mr. Hideyuki MATSUI, who was on loan to us from the Ministryof Finance, previously worked at World Bank, and his connections
arranged our visit there. Prof. Jeffrey MCCULLOUGH has for many
years welcomed me to speak about Fukushima at the University ofMinnesota, including this time.

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So, here we are, Prof. Arifumi HASEGAWA and I, spending the morningand afternoon of July 13 at World Bank headquarters in Washington.

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The next morning, July 14, we were involved in an Advanced Hazmat
Life Support course that was scheduled just before the RITN meeting.

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RITN occupied the rest of July 14 and all of July 15.
ADDITIONAL NOTES:Radiation Injury Treatment Network (RITN) biennial meeting.
Lower left, NOLLET’s presentation, in progress.
Lower right, Prof. HASEGAWA in conversation with National Marrow
Donor Program (NMPD) Chief Medical Officer and University ofMinnesota Clinical Professor Dr. Dennis L. Confer, MD

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Fukushima Medical UniversityThe next day, we were on the campus shared by America’s National
Institutes of Health and National Library of Medicine.

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The morning of July 16 started with a tour of the NIH Department ofTransfusion Medicine.
ADDITIONAL NOTES:NIH Transfusion Medicine Fellow Dr. Kamille West (center) leads alaboratory tour for talented high school students who are spending 5weeks at NIH in a Science, Technology, Engineering, and Mathematics(STEM) education program.

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Around noon, Prof. Hasegawa and I gave lectures.
ADDITIONAL NOTES:
Special guest lecture hosted by the Department of Transfusion
Medicine, advertised as follows:“Lessons from Fukushima: Viewpoint of a Front Line Physician” –Arifumi HASEGAWA, MD, PhD“From 9-11 to 3-11: A Look at Our Past with a View Toward the Future”– Kenneth E. NOLLET, MD, PhD
In addition to participants from the National Institutes of Health (NIH)
and National Library of Medicine (NLM), the following person also
attended:
Lauren K. Gibson, Project Manager
Office of Nuclear Reactor Regulation
United States Nuclear Regulatory Commission

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On the afternoon of July 16, we spent time with representatives of theNational Library of Medicine who are involved in emergency
preparedness. You might notice the recessed, side-mounted windowsof Building 38, a National Library of Medicine facility designed and built
during the cold war to withstand the force of an atomic bomb.
ADDITIONAL NOTES:Photograph, from left to right:
NLM SIS DIMRC Mr. Victor H. CID, Senior Computer Scientist
NLM SIS Ms. Gale DUTCHER, Deputy Division Director
FMU Prof. Arifumi HASEGAWANLM SIS DIMRC Ms. Stacy J. Arnesen, HeadOthers attending, not shown in photograph:
Stefan Jaeger, PhD; Les R. Folio, DO, MPH, Staff Clinician
Mr. Anthony Kraut, EmComm Volunteer, Mr. Lucas Folio, Student
NLM = National Library of Medicine
SIS = Specialized Information Services
DIMRC = Disaster Information Management Research Center

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For the evening of July 16, NIH’s Prof. Willy Flegel, an immigrant fromGermany, arranged a public meeting at Washington’s Goethe Institute.

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We spent the next day, morning and afternoon, at American Red CrossHeadquarters.
ADDITIONAL NOTES:Presentations with Q&A at American Red Cross (ARC) Headquarters
included representatives of ARC Disaster and Biomedical Service
groups, and nationwide teleconference participants.

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After our presentations on Fukushima – which were teleconferenced toRed Cross locations around the United States, we toured the American
Red Cross Disaster Operations Coordination Center.
ADDITIONAL NOTES:
Mr. Bill FitzGerald, Senior Advisor – Biomedical Preparedness, led atour of the American Red Cross Disaster Operations Coordination
Center (DOOC). Lower left photograph includes a female university
student on a 10-week internship in the DOOC.

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Fukushima Medical UniversityAfter that, Prof. Hasegawa was on his own for the first time in the US,
staying in Washington, while I made some visits in Minnesota. You
have the general idea, so let’s leave it at that…

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Fukushima Medical University…except to say that our visit to Washington resulted in reciprocal visits
to FMU later in July...

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Fukushima Medical University…and again in August.

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It’s all well and good to talk about disaster response with international
colleagues, but the real objective is to prepare for and respond to realdisasters. Dr. Hasegawa was among those from FMU who went toKumamoto, Japan, after their April, 2016 magnitude 7 earthquake. Like
going global, this is not a new idea. The Red Cross Nurse’s Creed that
we saw in Washington says it well: “Wherever disaster calls, there I
shall go. I ask not for whom, but only where I am needed.”

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To wrap up, my specialty is strict about conflict-of-interest disclosures.
In brief, I am a public servant on a salary, who tries to make up for thatby doing a little editing and writing on the side.

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Also, various organizations have supported my travel to discuss
personal experience and facts about 3.11. But my opinions are not forsale, so people who don’t like what I think don’t invite me anywhere.
Always follow the money, but, yes, if there is a conflict of interest…

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Fukushima Medical University…maybe I’m just in this gig for the food. Fukushima is a great place toeat well, maybe drink a little, and live.

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Thank you, IAEA, for the invitation to speak. Congratulations on 60
years promoting atoms for peace and development. Thank your forlistening.

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