An international aid organization operating in 35 countries, Project HOPE sent a survey team of three doctors on March 26 to Miyagi prefecture, at the request of the Japanese ambassador to the United States, ahead of the organization’s April 5 announcement seeking volunteer medical personnel wishing to assist in the recovery effort.
The team visited Minamisanriku, Motoyoshi and Kesennuma in the Miyagi prefecture in the Tohoku region of Honshu Island. “This is a city of probably 10,000 that really isn’t any more,” said Michael Brennan, an ophthalmologist and Project HOPE volunteer who led the assessment of Minamisanriku, a village of more than 19,000 from which local news outlet Xinhua reported that as many as 9,500 people were missing.
“Washed way up in the valley, is the city. It used to be down around the coastal plain,” Brennan said. “So the fishing boats, the small boats, the fishing shacks and some of the small enterprise shops were all washed almost a mile up into the valley or valleys that lead to this harbor. Then you start down and you see the harbor area and it’s just sort of bare, other than a lot of rubble. There’s no structure except a couple of concrete buildings.”
Those who heard the tsunami warning siren and were able to escape to the bluffs above the town survived. Brennan noted that there were many children, now orphaned, and elderly in the shelters, schools and community centers on the bluffs above town. “They’re clean. They’re well organized. There’s no commotion,” he said. “I’ve been to Haiti four times this last year, and it’s absolutely the opposite of Haiti. Everything is in good order. There’s food, there’s water, there’s port-a-potties, and they get along with each other it appears.”
Brennan said survivors sustained few physical injuries, and he predicted there wouldn’t be any serious public health issues such as food- or water-borne viral or bacterial infections given the Japanese health-conscious culture. His main concerns for the survivors were treating the emotional stress of the disaster and helping those who were living with chronic health problems before the earthquake and tsunami struck.
“In terms of supplies, they don’t really need that,” he said, “They don’t need orthopedic surgeons like they did in Haiti to fix compressive extremity injuries or head injuries. They need psychiatry because they’ve got orphans and elderly who don’t have the backbone of the family.”
An early estimate said 60 percent of Japan’s shelters reported an immediate need for mental health support. Brennan said it was probably higher. In addition to seeing signs of emotional distress in survivors, especially as they checked the rolls of dead and missing for family members and loved ones, Brennan also noted signs of stress in medical volunteers caring for survivors. “They need relief because two weeks there and it’s sort of hard to take because you’re seeing families finding out that they just lost the father or mother,” he said. “There were nurses crying, and the staff was starting to break down because of the turmoil.”
Brennan noted that there was an estimated quarter million evacuees in shelters at the beginning of his visit, but said the number is decreasing by 10,000 to 20,000 per day as Japanese officials make an effort to return survivors to their communities.
He advised Project HOPE to base physical and occupational therapy and mental health practitioners in Sendai from which they can make day trips to communities that need solace and support.
Project HOPE issued a call for medical personnel April 5, requesting specialties — including internal medicine, family practice, pediatrics and psychiatry in addition to certified health physicists and radiation safety officers — to assist with medical issues arising from the continuing nuclear spill at the Fukushima Daiichi nuclear power plant. The call, put out to the organization’s database of 8,000 volunteers, also included a request for personnel who speak Japanese.
In addition to surveying affected regions, the team met with Japanese officials and secured an agreement with the Ministry of Foreign Affairs for physicians to enter the country and practice medicine, excluding surgery, without a Japanese medical license for a limited time in collaboration with local doctors. Brennan said this model would provide for better continuity of care.
The Project HOPE team also worked on establishing links between the American Medical Association (AMA) and its Japanese counterpart. Brennan said the number of doctors and tons of medical supplies provided are not always the priorities. “Sometimes your colleagues just need to have a consultant,” he said. “So the JMA and AMA connection should be very valuable for them, because there is the possibility that there could be greater medical concern if there is a further nuclear disaster.”
