After experiencing the 1995 Great Hanshin Awaji Earthquake, Government of Japan and Japanese Association for Disaster Medicine co-established the nation-wide disaster medical system including Disater Base Hospitals (DBH), Japan Disaster Medical Assistance Team (DMAT), Staging Care Unit (SCU) and Wide Area Transportation and Emergency Medical Information System (EMIS). After experiencing the 2011 Great East Japan Earthquake, many improvements were implemented as a "Building Back Better" for more efficient and tailored medical response. Apointment of Disaster Medical Coordinators (Egawa 2017), improved EMIS, Disaster Psychiatry Assistantce Team (DPAT), Japanease Rehabilitation Assistance Team (JRAT), Liaisons for hemodialysis, mother and child health, Disaster Health Emergency Assistance Team (DHEAT) and so on.
Because Japan is prone to many types of hazards, the society have tried many aspects of disaster risks reduction including the building code for seismic resistant structures. Houses and buildings endured the vigorous shake of GEJE and protected the people from the injury by the collapse. Tsunami, however, destructed the community, losing family members, jobs and critical infrastructures including hospitals and schools. People lost their food, water, clothes to change, daily drugs and essentials to live. Long-term living in the evacuation shelters affected the physical and mental health of the people. The following picture indicates the frequency and type of medical needs in Minamisanriku Town where all medical facilities were lost by the tsunami. Non-communicable disease (hypertension, pollinosis, diabeters) was the most frequent reason of visits followed by infectious disease (common cold, diarrhea), mental health issues (sleep disturbance, anxiety disorder, psychiatric disease) (Murakami 2018), trauma (minor injuries) and mother and child health issues (pregnant women, babies). (Suda 2019, Nakamura 2020)
Disaster medical system critically depends on the healthcare system of the country. The comparison of the INFORM Disaster Risk Index and the Life Expectancy (LE) of United Nations member states revealed that disaste risk and LE negatively correlate suggesting that improvement of life espectancy is also a countermeasure for the disaster risk (Egawa 2018).
Nakamura Y, Suda T, Murakami A, Sasaki H, Tsuji I, Sugawara Y, Nishizawa M, Hatsugai K, Egawa S. (2020) Sleep Disturbance of Evacuees in Minamisanriku Town after Great East Japan Earthquake: Risk Factors and Treatment. Tohoku J Exp Med. 2020;251(3):207-216. doi:10.1620/tjem.251.207
Sasaki H, Maruya H, Abe Y, Fujita M, Furukawa H, Fuda M, Kamei T, Yaegashi N, Tominaga T, Egawa S. (2020) Scoping Review of Hospital Business Continuity Plans to Validate the Improvement after the 2011 Great East Japan Earthquake and Tsunami. Sasaki H, Maruya H, Abe Y, Fujita M, Furukawa H, Fuda M, Kamei T, Yaegashi N, Tominaga T, Egawa S. Tohoku J Exp Med. 251(3): 147-159. doi: 10.1620/tjem.251.147.
Suda T, Murakami A, Nakamura Y, Sasaki H, Tsuji I, Sugawara Y, Hatsugai K, Nishizawa M, Egawa S. Medical Needs in Minamisanriku Town after the Great East Japan Earthquake. Tohoku J Exp Med. 2019 Jun; 248(2): 73-86. doi: 10.1620/tjem.248.73.
Egawa S, Jibiki Y, Sasaki D, Ono Y, Nakamura Y, Suda T, Sasaki H. The correlation between life expectancy and disaster risk. J Disaster Res 2018; 13(6): 1049-1061. http://doi.org/10.20965/jdr.2018.p1049 ;
Jones-Konneh TEC, Suda T, Sasaki H, Egawa S. Agent-Based Modeling and Simulation of Nosocomial Infection among Healthcare Workers during Ebola Virus Disease Outbreak in Sierra Leone. Tohoku J Exp Med, 2018; 245(4): 231-238. DOI https://doi.org/10.1620/tjem.245.231