An earthquake of magnitude 7.5 has struck Western Japan, triggering tsunami warnings in the country. People living in vulnerable areas have been urged to evacuate. The earthquake and its many aftershocks translate to a potential for many deaths, injuries, and missing people due to the disruption of local infrastructure. The earthquake struck in the Noto Peninsula of Ishikawa Prefecture, on Japan’s main island, Honshu, according to the United States Geological Survey. There have been numerous reports of injuries, deaths, people without power as well as people trapped in buildings.
“When there is an earthquake, you never know about what will happen in the next hours and days. I have experienced a bad earthquake in Japan before, but never one with multiple earthquakes and this one appears to be worse and so scary,” says Miho Furusawa, a native of Japan whose parents and sister still live in Japan.
Definition Of Disaster
A disaster occurs when a natural or human-made hazard negatively affects an area or region. It typically overwhelms the local response system. The impact of a disaster is dependent on the vulnerability to the hazard.
Vulnerability can be measured by vaccination rates, type of dwelling, quality of construction, overcrowding and population density, barriers to evacuation and the population’s overall health prior to the disaster. Resource-poor regions tend to be disproportionately vulnerable to disasters. In the case of Ishikawa, it has a population density of 705 per square mile and GDP of $43.8B.
Some challenges to expect include lack of access to medications, limited access to advanced laboratory and other diagnostics, extremes of temperature, food shortage, uncertain living conditions, and personal safety. Personal safety can become a concern because there may be temporary disruption of law enforcement infrastructure.
Types of Disasters
Disasters can be broken down into two general types. Human-influenced disasters include nuclear disasters, terrorist attacks, war and other forms of armed conflict. Natural disasters include Tsunamis, tornados, earthquakes and volcanic eruptions. Bear in mind that the argument has been made that many types of natural disasters are human-influenced, given the impact that human beings have on the environment.
Both natural and human-influenced disasters tend to occur unexpectedly, so the casualties may present for medical care before the medical community has been fully informed of the nature and scope of the disaster.
Disaster Life Cycle
To fully understand the approach to disaster medicine response, it is vital to understand the disaster life cycle. This includes Preparation, response, recovery and mitigation.
Preparation
The level of preparedness can help limit the level of destruction caused by the disaster. This could include making sure people are vaccinated against diseases like tetanus. People may be stuck under rubble for days, with open wounds providing easy access to microbes.
It is also important to identify human and material resources that can be used in disaster response. Having an evacuation plan in place is essential, and having more than one route to evacuate can be helpful since many people may be trying to evacuate simultaneously.
It is also helpful to have a way to inform people about the need to evacuate. This system should be periodically tested to ensure there is no communication breakdown when you need it most. Families and businesses may also consider how they will communicate during the disaster. Having a meeting point in case of separation could be helpful, but remember that the meeting point may not be a safe place depending on what areas were impacted by the disaster.
Response
When the actual disaster occurs, it is time to mount the response. In this stage of the disaster life cycle, it is essential to allocate human and material resources and clarify to the community how they are to evacuate. During this phase, people may start presenting to hospitals and clinics with injuries. Additionally, search and rescue teams may be deployed to search for missing people, some of whom may be trapped under collapsed structures. If there are a large number of injuries, then a triage system will be employed to determine which patients are getting care and what type of care can be provided. This is often when volunteers from other communities may arrive to provide support, particularly since local medical professionals may be injured or trapped.
There are typically three types of cases local medical providers can expect after a disaster such as this earthquake. They can expect health events triggered by the disaster and worsening of chronic disease triggered by the stress of the disaster. Medical providers can expect to see medical conditions that reflect the background disease in the community.
The casualties from a disaster may present for medical care before the medical community has been fully informed of the nature and scope of the disaster. Disasters tend to have a rapid scale-up of services followed by a return to pre-disaster levels of service.
Recovery
After the immediate threat of the disaster has passed, there is a transition to the long-term recovery of the community that was impacted by the disaster. A plan will be made to rehabilitate the community. Volunteers may still provide support at this stage. This goes from being a disaster response to humanitarian support. Behavioral health services to support the mental health impact of the disaster is keenly important. Mental health support should be provided for the medical teams and the patients who have been impacted by the disaster.
Mitigation
Following the recovery, the transition is now to mitigation. In this stage of the disaster life cycle, it is important to go over lessons learned and explore ways to decrease the chances of a disaster recurring. In this stage, taking measures to decrease the region’s vulnerability to the most recent and future disasters is also important. Having a solid disaster response plan for the next disaster can have a tremendous impact on reducing the loss of life and property after a natural or human-influenced disaster has occurred. Many models call mitigation the first step of disaster response because mitigation plays a significant role in preparing for the next disaster.
Events surrounding this earthquake in Japan are still unfolding. Numerous aftershocks have been reported, and more aftershocks are expected in the coming days. The major earthquake in Japan from 2011 triggered a massive Tsunami and a major nuclear accident at the Fukushima Daiichi power plant. So far, there has been no mention of damage to nuclear power plants.
It is important to be mindful that the disaster may also impact the medical team members from Ishikawa, so outside support may be needed. It is best to follow the guidance of the local and national government and the team on the ground before rushing in to volunteer. They will better understand what volunteer services are needed, if any. The earthquake’s impact will become more evident in the coming days, and opportunities to volunteer and support may be more apparent.
