Be Prepared! — Lessons learned from the Great East Japan Earthquake and tsunami disaster
Be Prepared! — Lessons learned from the Great East Japan Earthquake and tsunami disaster
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做好准备！——从东日本大地震和海啸灾难中汲取的教训
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发表时间：
2013
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影响因子：
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通讯作者：
N. Uehara
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作者：
N. Uehara
灾害流行病学的先驱Michael Lechat将自然灾害定义为“生态破坏超过了受灾社区的适应能力”。灾害的影响是由自然现象的破坏力和人类应对它的能力决定的。防灾科学一直关注建筑和土木工程等问题，主要投资于物理预防；相比之下，公共卫生科学关注的是备灾，其目的是提供有效的应对措施，以减少灾害直接或间接造成的可避免的死亡、痛苦和残疾。2011年3月11日东日本大地震后，我作为宫城县政府公共卫生部门的医疗协调员和顾问，被分配到灾难应对和卫生救援活动中。我负责位于县政府大楼16层的卫生救援行动支持办公室，在那里工作了2个月。然后，我自愿在东北大学的办公室继续担任同样的职务，直到同年8月。我从这些经历中学到的主要教训是，在灾后情况下，没有事先准备的事情是很难做的。传统的灾难应对计划和手册严重依赖于地震中的大规模伤亡管理，但我们这次面临的海啸造成的如此严重和广泛的灾难是没有预料到的。根据1995年阪神浅地地震的教训所准备的，实际上在一定程度上得到了实施，如灾难医疗援助小组（DMAT）计划、精神护理小组和对继续透析治疗的支持。但是，在县一级和国家一级还没有制订其他保健救济行动，甚至没有制订灾害保健管理的协调制度。在如此混乱的情况下，要发起和执行既没有计划也没有事先准备的行动是极其困难的。尽管如此，身为灾难受害者的医生、护士、公共卫生护士和其他文职工作人员努力帮助其他幸存者。此外，来自日本各地的许多卫生专业人员自愿赶到灾区，参加为受灾人民提供的卫生救援活动。福岛核电站事故辐射造成的危险在当时引起了相当大的关注；因此，选择在东北地区的当地灾区实地工作，必须要有很大的勇气和决心。我也非常感谢那些从海外提供帮助和鼓励的同行们。与此同时，我感到遗憾的是，如果我们事先做好了更好的准备，他们的热情就会更有效地影响到受影响的人，并可能减少可避免的死亡和痛苦。我真诚地希望，我们从这次灾难中吸取的教训将用于改善日本和其他国家的卫生备灾工作。做好准备!——从东日本大地震和海啸灾难中吸取的教训
Michael Lechat, a pioneer of disaster epidemiology, defined natural disasters as “ecological disruptions exceeding the adjustment capacity of the affected community.”1 The impact of a disaster is determined by the destructive power of the natural phenomenon and the human capability to cope with it. The science of disaster prevention has been concerned with issues such as architecture and civil engineering, mainly investing in physical prevention; in contrast, public health science is concerned with disaster preparedness, which is meant to provide effective responses in order to reduce the avoidable death, suffering, and disability directly or indirectly caused by a disaster. In the aftermath of the Great East Japan Earthquake on March 11, 2011, I was assigned to help with disaster response and health relief activities as a medical coordinator and advisor for the Public Health Department of the Miyagi Prefectural Government. I was in charge of the Support Office for Health Relief Operations, located on the 16th floor of the prefectural government building, where I served for 2 months. Then, I voluntarily continued the same function at my office in Tohoku University until August of the same year. The primary lesson I learned through these experiences was that in post-disaster situations, it is very hard to do what has not been prepared for in advance. Conventional disaster response plans and manuals lean heavily on mass-casualty management in earthquakes, but such a severe and extensive disaster—one caused by the tsunami that we faced this time—was not anticipated. What had been prepared, based on the lessons of the Han-Shin Awaji Earthquake in 1995, were actually implemented to some degree, such as the Disaster Medical Assistance Team (DMAT) program, mental care teams, and support for continuation of dialysis treatment. However, other health relief operations, or even a coordination system for disaster health management, had not been prepared at the prefectural and national levels. It was extremely difficult to initiate and implement what were neither planned nor prepared for in advance in the midst of such a chaotic situation. Nonetheless, physicians, nurses, public health nurses, and other civil workers who themselves were disaster victims fought hard to help other survivors. Also, many health professionals from all over Japan voluntarily rushed to the disaster areas to join in the health relief activities for the affected people. The danger due to the radiation from the Fukushima nuclear plant accident was of considerable concern at the time; therefore, choosing to be on the ground at local disaster sites in the Tohoku region must have taken much courage and determination. I am also deeply grateful to our peers who provided aid and heartening encouragement from overseas. At the same time, I regret that, if we had been better prepared in advance, their enthusiasm would have reached the affected people more effectively, and could have reduced avoidable death and the pain. I sincerely hope that the lessons we learned from this disaster will be used for the improvement of health disaster preparedness in Japan as well as in other countries. Be Prepared! — Lessons learned from the Great East Japan Earthquake and tsunami disaster