YALE/TULANE ESF-8 PLANNING AND RESPONSE PROGRAM SPECIAL REPORT
(JAPAN EARTHQUAKE AND TSUNAMI)
BACKGROUND
CURRENT SITUATION
GOVERNMENT OF JAPAN
JAPANESE RED CROSS
US RESPONSE
UN RESPONSE
OTHER ORGANIZATIONS
A 9.0 magnitude earthquake hit
Japan, unleashing a tsunami.
GOVERNMENT OF JAPAN
http://www.kantei.go.jp
INTERNATIONAL ORGANIZATIONS
RELIEFWEB
UNICEF
International Nuclear Safety Center
International Atomic Energy Agency
Global Disaster Alert and Coordination System
WHO
US GOVERNMENT ORGANIZATIONS
The Department of State
U.S Embassy in Japan
State Dept.'s DipNote on Twitter
State Dept. Background Note
U.S. Agency for International Development
OFDA
Library of Congress Country Study - Japan
CIA World Fact Book
The Department of Defense
Pacific Command
7th Fleet
Yokota Air Base, Japan
The Department of Homeland Security
HEALTH CONCERNS
HOSPITALS AND MED TEAMS
PSYCHOLOGICAL IMPACT
ELDERLY ISSUES
SHELTER
LOGISTICS & TRANSPORTATION
AS OF 1700 HRS EDT
5 APRIL 2011
KEY LINKS
The Department of Health and Human Services
Centers for Disease Control and Prevention
CDC- Tsunami
CDC-Earthquake
CDC-Radiation Emergencies
EPA
FEMA Blog
US Geological Survey
NOAA Center for Tsunami Research
NOAA Pacific Tsunami Warning Center
PORTALS AND RESOURCES
All Partners Access Network (APAN)
Japan Disaster Wiki
CATDAT and Earthquake Reports
GDACS
Center of Excellence – Disaster Management Humanitarian Assistance
Earthquake Research Institute, University of Tokyo
National Center for Disaster Medicine and Public Health
Google Crisis Resources
LIBRARY
National Medical Library – Japan Earthquake
Disaster Information Management Research Center
Radiation Emergency Medical Management
JAPAN EARTHQUAKE AND TSUNAMI
BACKGROUND
KEY FACTS
EARTHQUAKE AND TSUNAMI
•
On 11 Mar 2011 05:46 UTC, a 9.0 magnitude earthquake struck 400km north-east of Tokyo
off the coast of Japan, triggering a tsunami that flattened parts of the northeast coastline.
•
The earthquake’s hypocenter was 24.4 kilometers deep (shallow; most dangerous).The 9.0
magnitude makes it the fourth largest in the world since 1900 and the largest in Japan since
modern instrumental recordings began 130 years ago.
•
Researchers at the Yokohama National University and University of Tokyo say that the
tsunami reached as high as 29.6 m in Ofunato City, Iwate.
•
•
•
•
There were 7 tsunami waves over a 6 hour period after the earthquake. The first and the
largest tsunami was recorded 26 minutes after the earthquake.
•
4th strongest earthquake worldwide since 1900
•
Tsunami up to 30 meters high inundated 433,000 square kilometers
of land
•
492,000 people were evacuated
•
Fatalities : 12,344 - Missing : 15,237
•
20 International Search & Rescue teams from 15 countries
responded
•
17,000 homes and buildings destroyed, 138,000 damaged
Japan’s Geospatial Information Authority estimates that at least 443 square kilometers
(equivalent of 53,000 football fields or five times the size of Manhattan Island) of coastline
was inundated by seawater.
•
More than 119,000 emergency service personnel responded within 8
•
Estimated damages of $US 309 billion
In Fukushima and Miyagi, about 110 km of coastline was submerged and the water reached
5 km inland. Seawater has not receded in about 70% of the flooded areas. In Minami-soma,
Fukushima, seawater covering about 350 hectares is being pumped.
•
More than $951 million has been donated bilaterally
•
291 schools unable to start new year in April
days
The Japan Meteorological Agency (JMA) warns of potential, further aftershocks and
tsunami. On Mar 31, Iwate prefecture was hit by a 6.0-magnitude aftershock. The JMA says
the frequency of aftershocks is decreasing but that aftershocks over magnitude 7 are still
likely.
DEATH AND DESTRUCTION
•
Worst-affected areas are the prefectures (states) of Miyagi, Fukushima, Iwate, Yamagata,
Ibaraki, Chiba, Akita and Aomori. The tsunami caused severe damage along 600 km of
northeast coastal regions.
•
The population in these areas before the disaster was estimated at over 14.8 million people,
of which 1.6 million lived within 5 km of the coast. Areas near the coastal city of Sendai in
Miyagi prefecture were the hardest hit, and had a population of some 1 million people.
COE Update: 30 March 2011
US Geological Survey
NOAA Center for Tsunami Research
WHO-WPRO SitRep No. 23: 1 April 2011
OCHA SitRep No. 16: 1 April 2011
Alex Hofford)
SITUATION BY PREFECTURE
•
3,438 deaths and 4,560 missing
•
1,064 deaths and 4,741 missing
•
7,058 deaths and 7,159 missing
•
41,975 evacuees at 373 shelters
•
22,796 evacuees
•
70,020 evacuees currently in 550 shelters
•
42,400 households out of water
•
36,944 households out of electricity
• 118,000 households out of water
•
31,216 households out of electricity
•
37,000 households out of water.
• Sendai city disclosed its rehabilitation plan
•
7,775 households out of gas.
•
8,288 households out of gas
• 1,207 temporary shelters under construction,
another 1,195 to start on 5 Apr
•
Iwate Pref. decided to build 8,800 temporary
shelters starting on 19 Mar.
•
• Hanamaki Airport operates 24H since 17 Mar,
Kamaishi port reopened on 16 Mar, Ofunato
and Kuji open. Tohoku Express Way open to
all vehicles.
•
Evacuation advice within 30km is slowing
the relief operation
Number of evacuees is growing with the
evacuation advice
• Minamisanriku without any services, but
electricity will be available in early April
•
Sendai airport in recovery process
SEEDs Asia SitRep No 11: 1 April 2011
SITUATION
EMERGENCY RESPONSE
SHELTERS (continued)
•
JMA reports the weather has improved slightly in the Tohoku region, but lows remain
near freezing.
•
Improving the living conditions at the shelters in the worst affected areas is the
biggest priority; otherwise cases of cold and hygiene-related illnesses will
increase
•
The GoJ says the need for further international assistance is limited and any support
should be in accordance with the GoJ’s criteria. The GoJ welcomes financial
donations and asks Member States to donate through the Japanese Red Cross
(JRC). Countries, aid organizations, private individuals and private sector companies
have contributed and pledged US$951 million to the GoJ, Red Cross Societies,
international NGOs and other partners.
•
It is estimated that around 74,000 children remain displaced.
•
Priority needs are: fuel, prefabricated housing, clothing and medicine.
•
As rainfall increases in April and rainy season (starts in mid June) approaches in the
Tohoku region, the coastal areas of Iwate, Miyagi, Fukushima and Ibaraki are
preparing their early warning systems for flooding. The earthquake caused the land
to sink, and tsunamis damaged coastal embankments.
•
The vast majority of key infrastructure such as highways, ports and airports has been
restored and there have been improvements in electricity, gas and water supply, but
in the worst affected areas it could take some time before these vital services are up
and running. Most of sewage systems in the affected area are still not functioning.
POPULATION NEEDS OUSIDE THE SHELTER
•
It is still unknown how many people are living outside evacuation centers but
the number is large.
•
Many people who were originally living in evacuation centers have returned to
their homes despite damage and no utilities. They do not receive basic supplies
from the municipal authorities but are becoming the focus of attention by local
NGOs and volunteers.
RECOVERY OF REMAINS
•
On 1 April the Japan Self Defense Force and the US military launched a threeday joint operation to recover the bodies of people still unaccounted for in the
coastal areas of Miyagi, Iwate and Fukushima.
BUILDINGS - Latest assessments report that 16,950 homes and buildings were
destroyed and another 138,000 were damaged.
•
More than 11,734 people have died and 16,375 remain missing. 2,766 were
also reported injured.
ROADS AND TRANSPORTAION NETWORKS - At least 2,126 roads, 56 bridges and
26 railways have been destroyed. While key transport routes are open it is still
impossible to travel on many of the smaller roads and there are reports that some areas
remain cut-off from all assistance by road.
•
The operation does not include the 20 km exclusion zone around the
Fukushima Nuclear Power Plant where it is believed there could be a large
number of bodies. Many of the missing are feared to have drifted offshore.
•
A total of 18,000 Self Defense Force personnel and 7,000 US military
personnel will participate in this search on land, sea and from the air using 120
aircraft and 65 naval vessels.
•
Diving units from the Japan Coast Guard will also be deployed to search in
rivers and flooded areas.
•
Recovering the bodies of the missing is seen as an important step in helping
the country to move on.
SHELTERS
•
•
There are currently 170,500 displaced people living in 2,230 evacuation centers in 17
prefectures. The number of people in evacuation centers is decreasing slightly
whereas the number of evacuation centers has increased by 200 in the last two days.
That is because 174 have opened in Aomori Prefecture in the north.
WFP says it is ready to provide prefabricated housing to NGOs.
OCHA SitRep No. 16: 1 April 2011
WHO-WPRO SitRep No. 23: 1 April 2011
COE Update: 1 April 2011
USAID Fact Sheet #14: 31 March 2011
SITUATION
GAS AND FUEL
FOOD - The Emergency Disaster Response Headquarters reports that an estimated
14 million meals have been delivered to evacuation centers and hospitals in the
affected areas as of 1 April. Approximately 1.5 million meals were delivered on 30
and 31 March. In addition, approximately 3 million meals are in transit. The figure
does not include distribution of food items by municipalities, NGOs, private sector,
and Japan’s Self Defense Force.
WATER – As of 1 April, 87.9 per cent of water has been restored to buildings and
only 260,000 households in eight prefectures are still without running water. More
than 400 water supply companies will shortly deliver water to those without access
to tap water.
ELECTRICITY - As of 1 April, 96.3% of electricity has been restored in Tohoku,
leaving approximately 170,415 households without power. The Thai government is
sending a power-generating facility with two gas turbine generators to Japan to help
restore electricity supplies. The facility is capable of producing 240,000 kw of
electricity, enough for between 80,000-240,000 households. The equipment will be
set up at a TEPCO site and should be operational by August.
DEBRIS - In Miyagi prefecture, there is approximately 15 -18 million tons of debris,
which is roughly equivalent to 23 years worth of waste for the prefecture. The
prefecture only has the capacity to dispose of 0.8 million tons per year and officials
say it will take three years to remove all the debris, not including cars and boats.
COMMUNICATIONS - As of 30 March: Some 118 927 telephone lines remain out of
service. (Some companies provide free "pay phone" and specially laid out
"payphone" in 16 prefectures). A reported 2 046 base stations of mobile companies
are not working. Some mobile companies provide free satellite phone, cell phone
and charger as well as disaster messaging services.
Gas supplies have been restored to roughly 32 per cent of households and 340,000
households remain without.
•
Because 4 out of 7 supply bases of liquefied petroleum (LP) gas are not operational,
the Ministry of Economy, Trade and Industry will release 40,000 tons from the
national reserve for the first time, beginning 4 April.
•
The fuel shortage remains a serious issue in the affected areas, exacerbated by a
limited number of operational fuel stations and increasing needs. The GoJ plans to
spend US$210 million (1.7 billion JPY) to procure tankers and install makeshift fuel
stations.
RADIATION CONTAMINATION
• Japan’s Chief Cabinet Secretary Yukio Edano said Friday that the evacuation of
residents within 20 km (12 miles) of the Fukushima Daiichi nuclear plant
(FDNPP) would be “long-term” as the crisis continues with no definite end in
sight. Around 78,000 people live in the mostly rural area.
• TEPCO conducted an analysis of soil, as part of monitoring activity of the
surrounding environment, at five sampling points in the premises of the FDNPP.
The soil samples on 21 and 22 March were analyzed and plutonium 238, 239 and
240 were detected. However, the concentration of plutonium does not threaten
human health.
•
EDUCATION – The academic year starts in April, but ~1,700 public schools (70%)
have been damaged in the three most affected prefectures. Many schools and
universities are still being used as evacuation centers. In the three worst affected
areas, approximately 1,700 (70 per cent) of public schools have been damaged, and
among them, 291 primary and junior high schools have so far no prospect of
resuming their classes.
OCHA SitRep No. 16: 1 April 2011
WHO-WPRO SitRep No. 23: 1 April 2011
•
COE Update: 1 April 2011
USAID Fact Sheet #14: 31 March 2011
The Japanese Ministry of Health, Labor and Welfare.(MHLW) reported:
- 98 of 111 samples of various vegetables, spinach and other leafy
vegetables, fruit (strawberry), seafood, various meats (beef, chicken and
pork) and unprocessed raw milk in eight prefectures (Chiba, Fukushima,
Gunma, Ibaraki, Kanagawa, Niigata, Tochigi, and Tokyo), showed I-131,
Cs134 and Cs-137 not detected or below regulation values set by the
Japanese authorities.
-
in Chiba, Fukushima, Ibaraki and Tochigi prefectures, the remaining 13 of
111 samples of spinach and other leafy vegetables, parsley and beef
exceeded I-131 and/or Cs-134 and Cs-137 regulation values.
SITUATION
HEALTH
•
Emergency medical needs have decreased, as a number of medical teams are now
active in the devastated sites. Focus is now turning towards care for the elderly,
where hypothermia due to cold temperatures continues to be an issue.
•
Tohoku University reports that pneumonia is increasing mong the elderly living in
evacuation centers in Miyagi. During 20 to 26 March, the University received 40
referrals from two local hospitals;10 times above the average.
•
Long term psychosocial support will be needed for survivors including emergency
workers. Preliminary key mental health areas identified are pediatric mental health
and survivor’s guilt. Continued assessment is necessary.
•
As of 26 March, 52 deaths in shelters have been reported, particularly among the
elderly.
CURRENT ASSESSMENT
NOTE: Assessment estimates are for the impacted areas. The overall infrastructure outside of the
affected areas remains strong.
G
R
A
Not a Major Concern
Currently
B
Generally
Ineffective
Working But
Inadequate
Non-Functional
Or Destroyed
Unknown
MEDICAL OPERATIONS AND PUBLIC HEALTH
DRINKING WATER
• Media reports indicate radiation has been confirmed in ground water below Unit 1 in
FDNPP
•
Radioactive elements detected in the tap water in Iitate Village, Fukushima
Prefecture have steadily decreased to a level acceptable for drinking. GoJ’s advice
for not consuming tap water was lifted on 1 April for most areas.
•
As of 2 April, most of the previously imposed drinking water restrictions have been
lifted. In one village in Fukushima prefecture, restrictions are still in place as a
precautionary measure by the local authority.
JAPAN
A
A
A
A
A
A
A
R
A
A
PUBLIC HEALTH
FOOD SAFETY
• On 31 March, radioactivity in 25 of 76 food samples exceeded the provisional
regulation values. Of the total 699 food samples that have been tested to date, 124
food samples from Chiba, Fukushima, Gunma, Ibaraki, Tochigi, Tokyo exceeded the
provisional regulation values.
•
•
Because of winter conditions, most cattle, pigs, and chickens are being kept indoors.
Animals are primarily fed on stored dried grass, silage and grain that has not been
contaminated by the releases from the Fukushima Daiichi NPP.
According to WHO, media report cesium has been found for the first time in meat
from Fukushima Prefecture.
OCHA SitRep No. 16: 1 April 2011
WHO-WPRO SitRep No. 23: 1 April 2011
IAEA Briefing on Fukushima Nuclear Accident 31 March 2011
AMDA Emergency Bulletin #12: Japan Earthquake and Tsunami 2 April 2011
JAPAN
R
A
A
R
R
A
A
R
OVERALL PH/MEDICAL ASSESSMENT
B
A
GOVERNMENT OF JAPAN RESPONSE
COORDINATION
• The GoJ’s Emergency Management agencies are leading the response
through the Emergency Response Team, headed by Prime Minister Naoto
Kan. The Chief Cabinet Secretary’s office is coordinating volunteers and
NGO’s through its Volunteer Coordination Unit.
• The Tokyo Metropolitan Government announced that it will deploy about
1,000 officials to Miyagi and Iwate to reinforce prefectural government
offices involved in emergency response. The Metropolitan Government is
planning to station at least 100 officers per day in the affected prefectures
from 2 April until at least mid May to provide non-emergency services and
manage evacuation centers.
• OCHA support to the GoJ Emergency Response Team ended 1 April.
• As rainfall begins to increase in April in the lead up to the rainy season, the
coastal areas of Iwate, Miyagi, Fukushima and Ibaraki are preparing to
tighten their early warning systems.
LIVELIHOODS - Over 22,700 people (18,201 in Miyagi, 3,282 in Iwate and
1,243 in Fukushima) have gone to local employment offices for jobs and
benefits. Prefectural governments say the roughly 800,000 displaced workers
should be given priority for construction and debris removal work.
SHELTER
• The number of shelters increased by 200 from 30 May – 1 April in efforts to
improve living/sanitary conditions for evacuees. However, consolidation
and movement from centers to temporary shelters will soon intensify, as
the GoJ seeks to reduce the number of evacuation centers to increase
sustainability and efficiency of assistance delivery. The GoJ is also
beginning to accommodate evacuees in public housing.
• Starting in May, GoJ will provide $1 million JPY ($10,000) to each family
who lost their homes.
HEALTH & MEDICAL CARE
• The MHLW has coordinated the deployment of doctors, pharmacists, social
workers, dentists, care managers, child welfare and psychological
specialists from various medical institutions. 142 teams, consisting of 640
members, are responding in Iwate, Miyagi and Fukushima.
WASH - As of 1 April, access to water had not been restored to approximately
260,000 households. A combined estimate of 98 sewage systems in Miyagi,
Iwate and Fukushima have been damaged, and the GoJ’s Ministry of Land,
Infrastructure, Transport &Tourism has deployed 210 professionals to repair the
sewer systems. The Emergency Disaster Response Headquarters reports that
approximately 5.5 million bottles of water have been delivered to evacuation
centers in the affected areas so far, with another 1 million in transit.
FOOD - The Emergency Disaster Response Headquarters reports that an
estimated 14 million meals have been delivered to evacuation centers and
hospitals in the affected areas to date. Approximately 1.5 million meals were
delivered on 30 and 31 March and 3 million means are in transit. The figure
does not include distribution of food items by municipalities, NGOs, private
sector, and Japan’s Self Defense Force.
AGRICULTURE - The Ministry of Agriculture, Forestry and Fisheries says
24,000 hectares out of 900,900 hectares of agricultural land in Iwate, Miyagi,
Fukushima, Ibaraki, Chiba and Aomori have been damaged by the tsunami. An
estimated 18,500 fishing vessels were reportedly damaged or lost. In the most
affected prefectures of Iwate, Miyagi and Fukushima, 87.9% of vessels were
significantly damaged. Agriculture & fisheries are among the biggest industries
in Japan and aid to these sectors will be critical in reconstruction of livelihoods.
EDUCATION – The GoJ seeks to vacate schools current serving as evacuation
centers prior to the beginning of the school year in April. The Prefecture of Iwate
and the Ministry of Education are considering establishing boarding schools for
children orphaned by the disaster.
FATALITY MANAGEMENT– A Japanese-US military operation is underway to
recover the bodies of those still missing. 18,000 of Japan’s Self Defense Force
personnel and diving units from the Japan Coast Guard will be deployed The
MHLW is supporting local government in the management of the dead.
NOTE: People who are able to live in their homes still require
assistance as they have no access to food, water and basic supplies.
These people are no longer receiving supplies from local authorities
but are becoming the focus of local NGO’s and volunteers.
WHO-WPRO SitRep No. 23: 1 April 2011
USAID Fact Sheet #14: 31 March 2011
OCHA SitRep No. 16: 1 April 2011
COE Update: 30 March 2011
JAPANESE RED CROSS SOCIETY
• The Japanese Red Cross Society (JRCS) continues to conduct relief operations in its
mandated role as auxiliary to the GoJ during disasters. They are providing medical relief,
psychosocial support (PSP), ongoing provision of full blood services, distributing relief
supplies, and are collecting voluntary donations.
• JRCS is concerned about the psychological well-being of the affected populations,
especially of children. They assigned trained psychosocial support providers (PSP) to
almost all deployed medical teams. The national society has 2,369 nurses trained to
provide PSP services. In addition, some PSP teams were deployed to conduct
assessments in the affected areas and support medical teams in conducting health
checks. There are shortages of medicine for the treatment of chronic medical conditions.
• The Japanese Red Cross Society has received a record $725 million from more than 1.1
million local donations.
• JRCS in-country capacity: 47 branches, each equipped with special equipment to with
nuclear, biological, or chemical disasters, 92 Red Cross hospitals, 66 Blood centers; 26
nursing colleges, 60,000 permanent staff (50,000 working for Red Cross hospitals), 495
deployable medical teams; 2 million registered volunteers.
• In order to reinforce and mobilize the network of volunteers,
volunteer centers have been established at the headquarters of
JRCS, and 4 branches in the affected prefectures.
• JRCS teams are also supporting local health facilities, and have
mobile clinics serving remote and hard-to-reach areas.
• Media reports that the Ishinomaki Red Cross Hospital found that
sanitation and hygiene environment is deteriorating in 30 per cent
of the 314 evacuation centers that they have assessed in
Ishinomaki, Higashi-Matsushima and Onagawa in Miyagi
excrement disposal is a particular challenge.
• In response to damages caused to the Fukushima nuclear power
plant, the JRC remains prepared to support those evacuated from
the exclusion zone. All of the JRC branches (47) are equipped
with special equipment to cope with nuclear, biological or
chemical disasters.
• 346 domestic Emergency Response Units and medical teams of the Japanese Red Cross
Society (JRCS) have completed their mission as of 01 April, 27 remain in the three most
affected prefectures and 117 are on standby.
• A Family Links web site is operating in cooperation with ICRC (in Japanese, English,
Chinese, Korean, Portuguese, and Spanish). As of 28 March, 5,619 people have been
registered: http://www.familylinks.icrc.org/eng/familylinks-japan
• JRCS has also handed out more than 125,500 blankets, 26,100 emergency kits (including
radios, flashlights and other supplies), 11,000 sleeping kits (including pillows, camping
mats, ear plugs, etc.) and clothing to families in evacuation centers.
NOTE: Evacuees have been enduring bitterly cold weather with several sleet
and snow storms. These conditions have also hampered emergency relief
efforts. Priority needs are fuel, prefabricated houses, sanitation materials,
clothing, medicines and household appliances.
JRCS mobile medical team working in the high school
evacuation centre in Ostuchi. (p-JPN0139) (IFRC)
OCHA SitRep No. 16: 1 April 2011
COE Update: 1 April 2011
JRCS Emergency Relief 3: 23 March 2011
IFRC Info Bulletin 5: 28 March 2011
UNITED STATES RESPONSE
• The USAID team is working to manage the overall USG response
effort in Japan in coordination with the U.S. Embassy in Tokyo.
• The Disaster Assistance Response Team (DART) continues to engage at
three levels to determine any possible humanitarian needs in Japan:
nationally through Japan’s Ministry of Foreign Affairs, locally at the
prefecture level and in coordination with U.S. Forces-Japan, and through
Japanese civil society organizations.
• U.S. experts from the NRC, Department of Energy, Department of Health
and Human Services and the U.S. military are in place in Japan,
cooperating directly with Japanese authorities to help contain the damage
at the Fukushima Daiichi reactors. They are monitoring technical aspects
and engaging with Japanese officials on efforts to cool the reactors at
Fukushima, as well as regarding the health impacts of radiation.
•
U.S. Government officials are consulting with health experts and radiation
experts, in both the United States and Japan, and are continuously
monitoring tap water samples for radioactive iodine. In accordance with
guidelines that apply to water in the US, and based on analysis of tap
water samples for radioactive iodine on 24 March, the water in Tokyo is
safe for drinking.
•
27 March, DART staff participated in an assessment of Miyagi Prefecture,
with staff from OCHA, the U.N. World Food Program, and the GoJ. DART
staff noted concerns regarding adequate access to sanitation facilities in
evacuation centers; local officials reported plans to improve sanitation
conditions, such as setting up portable toilets.
•
USG Funding Announced and Committed as of 31 March 2011::
- USAID/OFDA Assistance =$6,825,286
- Department of Defense (DoD) Humanitarian Assistance = $63,051,000
- Total USAID and DoD Assistance for the Earthquake and Tsunami =
$69,876,286.
COE Update: 30 March 2011
U.S. Embassy Tokyo News Update: 29 March 2011
U.S. Embassy Tokyo News Update: 28 March 2011
MESSAGES FROM US EMBASSY – JAPAN
• 31 March, In response to the situation at the Fukushima Daiichi Nuclear
Power Plant, the United States Nuclear Regulatory Commission (NRC),
the Department of Energy, and other technical experts in the U.S.
Government have reviewed the scientific and technical information they
have collected from assets in country, as well as what the Government of
Japan has disseminated. Consistent with the NRC guidelines that would
apply to such a situation in the United States, we continue
recommending, as a precaution, that U.S. citizens within 50 miles (80
kilometers) of the Fukushima Daiichi Nuclear Power Plant evacuate the
area or take shelter indoors, if safe evacuation is not practical.
• March 29 Update from Ambassador Roos (Video Update)
• (Updated 31 March, 6 p.m. JST) The U.S. Embassy is continuing to make
potassium iodide (KI) available to U.S. citizens who have not been able to
obtain it from their physicians, employers, or other sources. It is not
recommend that anyone take KI at this time, as there can be side effects
from the drug. It should only be taken on the advice of emergency
management or public health officials, or your doctor. For more
information about KI, see this fact sheet from the Centers for Disease
Control, or contact your doctor.
USAID Fact Sheet #14: 31 March 2011
U.S. Embassy Tokyo News Update: 31 March 2011
U.S. Embassy Tokyo News Update: 31 March 2011
UNITED STATES RESPONSE
(DOD-OPERATION TOMODACHI)
Dubbed Operation Tomodachi -- Japanese for "friendship" -- U.S. military assets
mobilizing in the area include a wide range of equipment, air, sea, and ground capability
and expertise. Up to 2 April, the DOD has contributed the following items: 185 tons
food, 2,041,689 gallons water and 11,960 gallons fuel.
U.S. Air Force
• PACAF has generated 389 sorties moving 1,311 passengers and more than 3067.9 short
tons (6,135,800 lbs) of cargo in support of Japan Relief Efforts.
• Number of AF Personnel deployed in support of relief operations: 737
• Number of PACAF aircraft deployed in support of relief operations: 4
• Note: Distribution numbers have been adjusted to reflect only Operation Tomodachi
airlift missions.
U.S. Marines
• As of April 3, there are approximately 641Marines from III MEF/MCBJ in mainland Japan in
support of Operation Tomodachi.
Lance Cpl. Garrett Williams of the III Marine Expeditionary Force
clears debris April 1 in the tsunami-ravaged city of Noda, Chiba,
Japan. More than 80 sailors, Marines, airmen and civilians on
Misawa Air Base participated in cleanup operations here as part of
Operation Tomodachi. U.S. Marines
• As of April 3, 1st Marine Aircraft Wing units have flown 582 sorties, totaling 904 hours of
flight time while delivering more than 511,400 pounds of cargo in support of Operation
Tomodachi.
• Task Force Fuji and LTF 35 conducted bilateral training convoys to Manato Elementary
School for debris removal/clean up at Watanoha Elementary as part of Operation Field Day.
• U.S. Marines delivered 205 backpacks from the Camp Zama community backpack project.
• Sendai aviation school and runway “A” cleanup continues.
• Installation of shower units is ongoing at Aoba.
NOTE: A key project of the U.S. Air Force and U.S. Marines has been the reopening
of the Sendai airport, which has allowed extensive amounts of supplies to be
distributed to hard hit areas.
Marines and sailors with 31st Marine Expeditionary Unit,
work with Japanese locals and Japan Ground Self Defense
Force personal to clear a port in preparation for the landing
of a Navy Landing Craft Utility carrying supplies. U.S.
Marines
Joint Support Force Relief Update: 3 April 2011
UNITED STATES RESPONSE
7th FLEET
Dubbed Operation Tomodachi -- Japanese for "friendship" -- U.S. military
assets mobilizing in the area Seventh Fleet forces continued sustainment of life
efforts in support of Operation Tomodachi. Currently, 14 ships, 130 aircraft and
13,893 personnel are in the area of operation.
• Seventh Fleet forces continue support of Japan Self Defense Force in
Operation Tomodachi. Today’s focus of effort continues to be the search for
human remains off the coast of Tohoku and clean up and clearance
operations on the island of Oshima.
• Seventh Fleet ships, helicopters and aircraft are searching over 2,000
square miles of ocean in a concerted effort to find victims of the March 11
tsunami. USS Cowpens, USS Preble, USS Shiloh and USS Curtis D.
Wilbur are searching for remains in specific zones off the north east coast of
Honshu, with their helicopters, additional support helicopters from the USS
Ronald Reagan and one P-3 Orion aircraft providing aerial reconnaissance
support.
• Since Operation Tomodachi started, U.S. 7th Fleet forces have delivered
more than 260 tons of relief supplies to survivors of the tsunami and
earthquake in support of Japan Self Defense Force efforts.
• To date, 148 aerial reconnaissance and search sorties have been
conducted with more planned in the coming days.
• U.S. Navy barges containing 500,000 gallons of fresh water are moored at
the Fukushima Dai-Ichi nuclear plant, adding this resource to the fresh water
cooling efforts. Japanese authorities will use the fresh water to replace salt
water currently in some of the reactors.
NOTE: A video documenting the work of the Joint Support Force
relief efforts is available on YouTube.
• 187 Sailors and Marines from the USS Essex Amphibious Ready Group, the
31st Marine Expeditionary Unit supporting Japan Ground Self Defense
Forces began Operation “Field Day”, a clearing and clean up mission on the
remote island of Oshima off the coast of Kessennuma. The first location
slated for clean up is Uranohama harbor, the primary ferry harbor for
Oshima island, to allow ferry services to begin. Also, water testing
processes and specific locations to be tested were identified to determine
the safety of island drinking water.
• USNS Safeguard, and USS Tortuga, Mobile Diving and Salvage Unit 1,
Explosive Ordnance Disposal Mobile Unit 5 and Underwater Construction
Team 2 are also enroute to Oshima to assist in port clearance
operations. The island, which is dependent upon ferry service from the
mainland, has been largely isolated since March 11 when the tsunami
washed its ferries ashore.
• Cleaning and debris clearance has begun at Oshimatake Junior High
School in preparation to begin the new school year.
Marines assigned to the 31st Marine Expeditionary Unit depart the amphibious assault
ship USS Essex aboard a landing craft utility, assigned to Assault Craft Unit 1. Essex,
with the embarked 31st Marine Expeditionary Unit, is currently operating off the coast of
Kesennuma, in northeastern Japan, in support of Operation Tomodachi. U.S. Navy
Joint Support Force Relief Update: 3 April 2011
UNITED NATIONS RESPONSE
WORLD HEALTH ORGANIZATION-REGIONAL OFFICE FOR THE WESTERN
PACIFIC (WHO-WPRO) IN MANILA
• WPRO Situation room is on 24/7 operation to collect information and to monitor the
evolving events, in communication and coordination with MHLW (Ministry of
Health, Labor and Welfare of Japan), WHO Kobe Center, the WHO Headquarters
and partners.
UN OFFICE FOR THE COORDINATION OF HUMANITARIAN AFFAIRS (OCHA)
• According to OCHA, the GoJ says the need for further international assistance is
limited and any support should be in accordance with the GoJ’s criteria.
•
OCHA’s support to the GoJ’s emergency response ended on 1 April 2011.
WORLD FOOD PROGRAMME (WFP)
• WFP this week started the construction of five mobile warehouses and four
prefabricated offices in Ishinomaki City in Miyagi Prefecture, which is estimated to
have the highest death toll among all affected municipalities, with 20,000 people in
evacuation centers. The warehouses and offices are for use by the city and various
Japanese relief organizations that are delivering supplies to people who have been
adversely affected by the disaster.
•
WPRO has been closely working with the National IHR Focal Point in Japan and
the WHO Headquarter to facilitate sharing of information through the IHR Event
Information Site (EIS) that is open to all the Member States.
•
WPRO has been providing regular situation reports, including situation updates
that have been posted on the WHO websites.
•
•
"Forward" planning is ongoing to identify direct and indirect health and other
impacts, expectations/concerns from the public/media, Member States,
international communications and partners, and to prepare for possible WHO
actions in responding to different scenarios.
WFP is planning to provide 20 mobile warehouses that will be used by the NGOs
Peace Boat and JEN.
•
WFP says it is ready to provide prefabricated housing to NGOs.
•
WHO reported some 142 medical teams, consisting of 640 members responding to
Iwate, Miyagi and Fukushima Prefecture from the National Hospital Institution,
JRCS, Japan Medical Association (JMA), etc. Additionally, there are 121 public
health teams, 20 mental health care teams to provide psychosocial support, 634
pharmacists and 256 nurses providing assistance to affected areas.
WFP is also working in Sendai in Miyagi Prefecture, where the agency will support
Japan Platform, a consortium of NGOs working closely together with the Japanese
Government and business community.
•
WFP is supporting the GoJ’s disaster response by the delivery of in-kind donations
received from overseas, and assessing the need for logistics hubs in some of the
other areas affected by the disaster across the stricken Tohoku region.
•
UN CHILDREN’S FUND (UNICEF)
• Working with local government, the Japan Committee for UNICEF has conducted a
rapid needs assessment on the ground to better support children.
•
In addition to the delivery of supplies, UNICEF relief workers have been working to
ensure the support needs of children are met. A needs assessment has been
conducted in collaboration with local governments. UNICEF workers are
beginning to increase efforts on education and psychological support for women
and children affected by the disaster.
•
Eight Japanese experts have been deployed from their posts around the world to
work with the Japan Committee.
UN HIGH COMMISSIONER FOR REFUGEES (UNHCR) - At the request of the GoJ,
UNHCR is providing 1,794 solar lanterns for Miyagi Prefecture. The GoJ has received
131 offers of assistance from countries as well as 33 offers from international
organizations. It has accepted relief items from 17 countries.
INTERNATIONAL ATOMIC ENERGY AGENCY (IAEA) The Joint FAO/IAEA Food
Safety Assessment Team has completed its mission and presented its report to the
Japanese Cabinet Office, Ministry of Foreign Affairs, Ministry of Health, Labor and
Welfare and the Ministry of Agriculture, Fisheries and Forestry on 31 March.
The Agency, in agreement with the Japanese government, will dispatch two reactor
experts to Japan. They will hold meetings with the Nuclear Safety Commission, NISA,
TEPCO and other Japanese counterparts from Monday 4 April 2011 onwards. The
objective of this visit is to exchange views with Japanese technical experts and to get
first-hand information about the current status of reactors at Fukushima Daiichi,
measures being taken and future plans to mitigate the accident.
COE-DMHA Update: 1 April 2011
WHO-WPRO SitRep No. 23: 1 April 2011
OCHA SitRep No. 16: 1 April 2011
UNICEF Press Rel: 23 March 2011
UNICEF Press Rel: 24 March 2011
WFP News Rel: 01 April 2011
OTHER ORGANIZATIONS OF INTEREST
• A network of NGO/volunteer organizations Japan Civil Network for Disaster Relief in
East Japan has been established in order to facilitate the communication and
exchange of information among the organizations working in Tohoku area to support
the survivors. A website has been created where readers have access in Japanese to
information on the activities each organization is carrying out. The aim of the network
is to coordinate the assistance provided in Tohoku area by the NGO/volunteer
organizations. (www.jpn-civil.net)
• The International NGOs which are requested to wait for the time being are strongly
advised to inform and consult with a Pref. Disaster Volunteer Center prior to the
commencement of their activities (communication to be made in Japanese language).
The Pref. DVC may advice the NGOs about needs, local DVCs, etc.
• The GoJ is identifying the needs and trying to match the offers with the identified needs
for efficient and effective delivery. As the transportation and storage capacity is still
limited, it is strongly recommended not to send any relief goods without coordination
with the GoJ or the local authorities.
• Due to the shortage of fuel and damage to infrastructure, international NGOs are
recommended to wait until the situation improves before commencing services (that
must be completely self-sustainable and coordinated with a local partner.)
INTERNATIONAL MEDICAL CORPS reports health care priorities are the vulnerable in
evacuation centers, those living at home, and mental health services for disaster
victims.
- IMC’s emergency response team is assessing the post-disaster needs of
isolated coastal villages in north Sendai that have yet to receive humanitarian
assistance. Information from assessments of evacuation centers has been
communicated to the Japan regional office of International Medical Corps to
facilitate coordination efforts.
- Fatigue, stress and insomnia are being reported among many evacuees, while
mental health and psychosocial support for children and adults is increasingly
recognized as a major priority in the response. IMC is looking at how to support
vulnerable displaced groups such as the elderly, single women, children and
those who chose to stay in their homes in damaged areas rather than going to
an evacuation center.
- IIMC’s assessments include: Minami-Sanriku, Kesennuma, Riken-Takata, East
Matsushima and areas north of Ishinomaki.
- Visited East Matsushima on 27 March 2011 and found cell phone service
operational and limited supplies available.
SAVE THE CHILDREN estimates that about 100,000 children have been
affected and 74,000 children remain displaced. As part of the relief
efforts, they have opened 12 Child Friendly Play Spaces. Save the
Children is also procuring 5500 back-to-school kits for primary students.
500 hygiene kits are ready for distribution at the Sendai warehouse.
ASSOCIATION FOR AID AND RELIEF (AAR) delivered prepared-food
pouches, toilet paper rolls, underwear, towels, and other necessary
hygiene items to evacuation centers in Miyagi, Iwate and Fukushima. AAR
also assisted a soup kitchen in Miyagi.
AMERICARES is airlifting an emergency shipment of medical aid that
contains:
• Antibiotics to treat 519 adults and children
• 630 course treatments of IV solutions
• Pain medicines to treat 480 people for one months
• 2,000 course treatments of anesthetics
• Sutures for as many as 2,510 procedures
• 859,458 units of bandages and wound dressings
• 11,460 masks
• 18,812 syringes
• An assortment of gloves, soap, hygiene kits, and flashlights
AmeriCares delivery of supplies to shelters in Miyagi (Americares).
OCHA SitRep No. 16: 1 April 2011
IMC: 29 March 2011
AmeriCares: 1 April 2011
JPF & JANIC 23 March 2011
OTHER ORGANIZATIONS OF INTEREST
• ASSOCIATION OF MEDICAL DOCTORS OF JAPAN (AMDA) ) has 108 relief
personnel working in the impacted area: 39 doctors, 20 nurses, 2 midwives, 1
assistant nurse, 3 pharmacists, 2 psychotherapists, 39 coordinators, 2 caseworkers
• AMDA and its partners have decided to launch a scholarship program for the disaster
programs. The scholarship is targeted to the high school students in the disasterstricken areas who wish to become a doctor in the future. Besides financial assistance
for three years, the scholarship aims to provide international cultural exchange
opportunities through support organizations.
• Emergency medical needs have decreased as a number of medical teams are now
active in devastated sites. Hence, along with the ongoing medical relief activities,
AMDA has begun shifting its target to the highly-demanded elderly nursing from 1 April.
AMDA is launching a nursing-assistance program that will send careworkers to
AMDA’s work site to work with existing teams; providing the elderly nursing care in
rotation.
• Iwate Prefecture (Kamaishi City and the town of Ohtsuchicho):
• Along with regular medical services, one of the AMDA doctors started to offer
acupuncture treatments at Ohtsuchi High School.
• Miyagi Prefecture (the town of Minamisanriku-cho):
• It is forseeable that due to the relocation of the residents (1,100 people) the number of
evacuees will decrease from now on. At the same time, the medical supplies have
been currently fulfilled.
• AMDA held a briefing session on norovirus in preparation to the the potential risk of
breakout as the sanitary condition in the shelter has been deteriorating due to the
prolonged evacuation life.
(Map) Seeds Sit Rep 11 : 1 April 2011
NOTE: All offers of assistance should continue to be directed to the
GoJ.
Photo: AMDA International
AMDA International Emergency Bulletin 13: 2 April 2011
OTHER ORGANIZATIONS OF INTEREST
RELIEF OPERATIONS BY JAPANESE HUMANITARIAN ORGANIZATIONS IN MAJOR AFFECTED CITIES
Seeds SitRep 11 : 1 April 2011
OTHER ORGANIZATIONS OF INTEREST
RELIEF OPERATIONS BY JAPANESE HUMANITARIAN ORGANIZATIONS IN MAJOR AFFECTED CITIES
Seeds SitRep 11 : 1 April 2011
HEALTH – CONCERNS
Communicable Diseases
Non-communicable Diseases
• There have been sporadic cases of influenza but no large
outbreaks. An internet-based ad-hoc syndromic surveillance system
has been developed by the Infectious Disease Surveillance Center,
National Institute of Infectious Diseases (http://www.syndromicsurveillance.net/hinanjo/index.html )
• Priority high-risk conditions for NCD management include
patients on dialysis, those with Type I Diabetes, those
requiring respiratory support or acute coronary care and
those post-organ transplant. Other priorities include patients
with diabetes mellitus, heart disease, asthma, cancer and
chronic lung disease.
• Influenza viruses were detected in Sendai and surrounding areas.
Based on a report, 21 out of 59 specimens were tested positive for
influenza A (21 were positive for H3N2 and 2 were positive for
pandemic influenza A (H1N1). Influenza rapid test kits were used at
an emergency center in Sendai for the period 12-21 March. Rapid
test was conducted for 335 out of 1,180 patients（28.3%). Results
are as follows: influenza A positive - 107(31.9%) and influenza B
positive - 5(1.5%).
• Influenza-like-illness activity is being monitored in elderly
populations due to their high risk status.
• There have been 2 cases of tetanus (one each from Miyagi and
Iwate prefectures) and 2 cases of legionella from Miyagi prefecture
(25 March). The diagnosis occurred between 17 and 21 March.
• A survey of sanitary situations in evacuation centers in Ishimaki,
Higashi, Matsushima and Onogawa. Around 40% (107/272) toilets
had sanitary-related problems.
• Acute gastroenteritis (50 cases of diarrhea and 20 of vomiting) and
UTI such as cystitis have been reported by media.
OCHA SitRep No. 16: 1 April 2011
WHO-WPRO SitRep No. 23: 1 April 2011
NISA –News Release No.61: 29 March 2011
CDC - Hypothermia
• Patients with major NCD are particularly vulnerable to
exacerbations of their conditions. Factors contributing to this
include interruption of regular medical treatment, severe
situational stress and anxiety, overcrowding and reduced
living standards, shortages of water and regular food
supplies, degraded environmental conditions and physical
injuries.
• Tohoku University reports that cases of pneumonia among
the elderly living in evacuation centers in Miyagi are
increasing.
Hypothermia
• People continue to face cold temperatures with insufficient
heating. Hypothermia has been reported particularly among
the elderly population in the evacuation centers.
NOTE: Improving living conditions at shelters in the worst affected
areas is the biggest priority to prevent continued increase in
numbers of cold cases and hygiene-related illnesses.
INITIAL RISK ASSESSMENT OF INFECTIOUS DISEASE
Conducted by the National Institute of Infectious Diseases (NIID)
WHO – WPRO SitRep No. 21: 30 March 2011
DIARRHEA
HOW DOES A PERSON GET DIARRHEA?
WHAT CAUSES DIARRHEA?
•
•
•
Gastroenteritis means inflammation of the stomach and small and large intestines.
Viral gastroenteritis is an infection caused by a variety of viruses that results in
vomiting or diarrhea. Many different viruses can cause gastroenteritis, including
rotaviruses; noroviruses; adenoviruses, types 40 and 41; sapoviruses; and
astroviruses.
Diarrhea is the passage of loose or liquid stools more frequently than is normal for
the individual. It is primarily a symptom of gastrointestinal infection.
Diarrhea is a symptom of infection caused by a host of bacterial, viral and parasitic
organisms most of which can be spread by contaminated water. Depending on
the type of infection, the diarrhea may be watery (for example in cholera) or
passed with blood (in dysentery for example).
HOW DO YOU TREAT DIARRHEA?
• Diarrhea due to infection may last a few days, or several weeks, as in persistent
diarrhea. Severe diarrhea may be life threatening due to fluid loss in watery
diarrhea, particularly in infants and young children, the malnourished and people
with impaired immunity. Dehydration is the critical clinical issue.
• Key measures to treat diarrhea include:
- Giving more fluids than usual, including oral rehydration salts
- Continue feeding
- Consulting a health worker if there are any signs of dehydration or other
problems
- Acquiring adequate supplies for oral and intravenous rehydration in
affected regions before an outbreak occurs
NOTES:
• Confirmed cases of Acute Watery Diarrhea (AWD) and other
diarrheal diseases indicate that the sanitary conditions in the
evacuation centers are not sufficient.
• Early recognition of an outbreak and rapid implementation of control
measures is critical to limit the impact of an outbreak of AWD.
•
Transmission of acute watery diarrhea occurs through consumption of sewagecontaminated water or food, contact with contaminated environmental surfaces, or
direct person-to-person spread in conditions of poor hygiene.
•
It is more common when there is a shortage of clean water for drinking, cooking and
cleaning and basic hygiene
•
Water contaminated with human faeces for example from municipal sewage, septic
tanks and latrines is of special concern. Animal faeces also contain microorganisms
that can cause diarrhea.
•
Food is another major cause of diarrhea when it is prepared or stored in unhygienic
conditions. Water can contaminate food during irrigation, and fish and seafood from
polluted water may also contribute to the disease.
• Reported outbreaks of acute watery diarrhea (AWD) have been reported following
disasters involving flooding or encampments for displaced persons; more than
20,000 cases of AWD were reported after the earthquake in Pakistan in 2005.
WHAT ARE PRECAUTIONS FOR AVOIDING DIARRHEA?
• The most effective measures to prevent transmission of acute watery diarrhea
are provision of safe (chlorinated) water; safe water storage; appropriate disposal
of feces; and hand washing with soap after caring for patients, toileting, cleaning
other persons after toileting, or before preparing, serving, or eating food. I
• Key measures to reduce the number of cases of diarrhea include:
- Access to safe drinking water
- Improved sanitation
- Good personal and food hygiene
- Health education about how infections spread
CDC Pre-decision Brief: AWD and Cholera Haiti FEB 2010
CDC: Viral Gastroenteritis
WHO: Diarrhoea
WHO – WPRO SitRep No. 21: 30 March
TSUTSUGAMUSHI DISEASE
CURRENT SITUATION:
• National Institute of Infectious Disease Risk Assessment
updated March 24, 2001, rated tsutsugamushi disease a level
2 (medium risk) concern.
• The season for Tsutsugamushi is spring—early summer and
fall—early winter
• Risk of exposure may increase due to displacement and
inadequate shelter
TSUTSUGAMUSHIO DISEASE (ALSO KNOWN AS
SCRUB TYPHUS) IS AN ACUTE FEBRILE ILLNESS
CAUSED BY ORIENTIA TSUTSUGAMUSHI
According to the WHO SE Asia Regional Office:
Scrub typhus is difficult to recognize and diagnose because the symptoms
and signs of the illness are often non-specific. The non-specific presentation
and lack of the characteristic eschar in 40% patients makes the
misdiagnosis and underreporting of scrub typhus common.
CHARACTERISTIC FEATURES OF SCRUB TYPHUS
OUTBREAK
• Obvious association with certain types of terrain
• Marked localization of many cases within certain small foci
• Large percentage of susceptible people, who may be infected
simultaneously following exposure over relatively short periods
• Absence of a history of bites or attack by arthropods
Characteristic eschar in a patient (WHO)
TSUTSUGAMUSI IS A ZOONOTIC DISEASE
• Transmitted to humans and rodents
through the bite of an infected trombiculid
mite (or “chigger”).
• The mites are very small (0.2-0.4mm) and
not easily visible to the naked eye.
Chigger Mite
(WHO)
• The mites serve as both the vector and the
reservoir.
PREVENTION
• No vaccines or drugs are available to prevent infection.
• The best prevention is to minimize mite exposure: insect repellents,
protective clothing, and avoidance of vector-infested areas.
• These precautions are especially important for persons with underlying
conditions that may compromise their immune systems, as these
individuals may be more susceptible to severe disease.
Sources/Links:
CDC Yellow Book, Chapter 5: Rickettsial and Related Infections
FAQs: Scrub Typhus – WHO SE Asia Regional Office
WHO-WPRO SitRep No. 21: 30 March 2011
HEALTH – TUBERCULOSIS
GENERAL INFORMATION - Tuberculosis (TB) is a disease caused
by bacteria that are spread from person to person through the air. TB
usually affects the lungs, but it can also affect other parts of the body,
such as the brain, the kidneys, or the spine. A person with TB can die if
they do not get treatment.
WHAT ARE THE SYMPTOMS OF TB? The general symptoms of
TB disease include feelings of sickness or weakness, weight loss,
fever, and night sweats. The symptoms of TB disease of the lungs
also include coughing, chest pain, and the coughing up of blood.
Symptoms of TB disease in other parts of the body depend on the
area affected.
HOW IS TB SPREAD? TB germs are put into the air when a
person with TB disease of the lungs or throat coughs, sneezes,
speaks, or sings. These germs can stay in the air for several hours,
depending on the environment. Persons who breathe in the air
containing these TB germs can become infected; this is called latent
TB infection.
PREVENTION
• TB is a preventable disease, even in those who have been exposed
to an infected person. Skin testing (PPD) for TB is used in high risk
populations or in people who may have been exposed to TB, such
as health care workers.
• A positive skin test indicates TB exposure. Discuss preventive
therapy with your doctor. People who have been exposed to TB
should be skin tested immediately and have a follow-up test at a
later date, if the first test is negative.
TUBERCULOSIS (TB) SITUATION – JAPAN
•
Despite a decline after World War II, the rate of tuberculosis in Japan remains high.
Infection is heavily concentrated in the >60-year age group, and 82% of patients are
>40 years of age. The success rate for treatment of smear-positive patients is 78%.
Multidrug-resistant strains of Mycobacterium tuberculosis are rare.
•
Since the Earthquake and Tsunami the National Institute of infectious Diseases
(NID) has conducted an initial risk and identified a medium level of risk of TB for the
population and health care workers.
• Prompt treatment is extremely important in controlling the spread of
TB from those who have active TB.
OCHA Sit Rep 16: 1 April 2011
WHO-WPRO SitRep No. 21: 30 March 2011
WHO-WPRO SitRep No. 23: 1 April 2011
MONTHLY TB REPORT JAPAN 2011
CDC - Tuberculosis JATA TB Surveillance Center
HEALTH – HYPOTHERMIA
WHAT IS HYPPPPOTHERMIA
HYPOTHERMIA
AND THE ELDERLY
•
Hypothermia results when the body loses more heat than can be replaced
by increasing metabolism (through exercise) or by increasing warming
from external sources, such as a fire or the sun.
•
Wind increases heat loss, as does sitting or lying on a cold surface or
being immersed in water.
•
•
•
Sudden immersion in very cold water may cause fatal hypothermia in 5 to
15 minutes. However, a few people, mostly infants and young children,
have survived for as long as 1 hour completely submerged in ice water.
The shock can shut off all systems, essentially protecting the body.
Hypothermia may also occur after prolonged exposure in only moderately
cool water.
WHO IS AT RISK?
•
People at greatest risk are those who are lying immobile in a cold
environment—such as people who have had a stroke or a seizure or who
are unconscious from intoxication, a low blood sugar level, or an injury.
Because they are not moving, these people generate less heat and also are
unable to leave the cold environment. Such people are at risk of becoming
hypothermic even when the surrounding temperature may be only as cold
as 55 or 60° F (about 13 to 16° Celsius [C]).
•
The very young and the very old are at particular risk. People in these age
groups often do not compensate for cold as well as young adults and are
dependent on others to anticipate their needs and keep them warm.
•
Very old people quite often become hypothermic while indoors from sitting
immobile in a cold room for hours. Infants lose body heat rapidly and are
particularly susceptible to hypothermia.
•
Sometimes a disorder, such as a widespread infection or an under
functioning thyroid gland, causes or contributes to hypothermia.
.
HYPOTHERMIA AND THE ELDERLY
• Aging takes a toll on the body's ability to adapt to the cold. With
aging, the body becomes less efficient at shivering or at diverting
blood away from the surface of the body. Also, the layer of fat just
under the skin thins, so there is less insulation to prevent heat loss.
• The body's ability to produce heat is decreased by diseases that
commonly affect older people, such as hypothyroidism.
• The body's ability to retain heat is decreased by diseases such as
diabetes.
• A person who is less able to move around because of an injury or a
disease such as a stroke or arthritis is at a greater risk of dangerous
cooling, because the decreased movement generates less heatproducing muscle activity.
• Alcohol and certain drugs, such as antidepressants, increase the risk
as of hypothermia.
SYMPTOMS
•
Initial symptoms include intense shivering and teeth chattering. As body
temperature falls further, shivering stops and movements become slow
and clumsy, reaction time is longer, thinking is blurred, and judgment is
impaired. These symptoms may develop so gradually that people,
including companions of the affected person, do not realize what is
happening. People may fall, wander off, or simply lie down to rest. When
shivering stops, people become more sluggish and slip into a coma. The
heart and breathing rates become slower and weaker. Eventually the heart
stops.
•
The lower the body temperature is, the higher the risk of death. Death may
occur at body temperatures below 88° F (about 31° C) but is most likely
to occur below 83° F (about 28° C).
HEALTH – HYPOTHERMIA
HYPOTHERMIA AND THE JAPAN EATHQUAKE AND TSUNAMISUNAMI
Environmental factors that likely contributed to the contributing to
the cases of hypothermia during the Japan Earthquake and
Tsunami were the:
- Temperatures of the sea water
- Air temperatures and the wind chill factors
- Inclimate weather
- Snow
- Freezing rain
•
The sea surface temperatures in the vicinity of Sendai around
the time of the tsunami were 9-10°C, or around 48-50°F.
•
In addition to the time of year, the waters are particularly cold
in the vicinity of Sendai due to its location on the northern side
of the Kuroshio Current, the North Pacific Subtropical Gyre's
analog of the Gulf Stream in the North Atlantic.
•
•
This strong western boundary current separates the very
warm, central gyre waters from those to the north. This is why
the ocean near Sendai is significantly colder than that around
Tokyo Bay, less than 400 km (~250 miles) to the south.
In the following days after the initial earthquake and tsunami,
the lack of adequate shelter and fuel shortages, electrical
outages, lack of clothing and blankets, all contributed to an
environment that produced hypothermia.
CURRENT SITUATION
• Hypothermia has been reported, particularly among the elderly
in evacuation centers, increasing their vulnerability.
• The temperature is dropping to minus 6 degrees Celsius
overnight and authorities in Miyagi Prefecture say the lack of
fuel means they cannot use heaters. 210,000 households
(516,600 people) do not have electricity and one million people
are without gas.
• The UN reports that it is unknown how many are living outside of
evacuation centers in affected areas as many who were in
shelters have chosen to return home even though they may not
have water or electricity.
•
In the northeast Tohoku region (Iwate, Miyagi and Fukushima
prefectures), the weather is sunny on 1 April, turning mostly
cloudy on 2 April. While the weather has improved, the lows
remain near freezing, with the temperature ranging from 1 to 16
degrees. Overall , the wind is blowing from the west.
Map generated from the AVHRR and
AMSR remote sensing instrument passes
on March 11, 2011 (Mike Bueti)
FUKUSHIMA - MEAN TEMPERATURES
MONTHLY MEAN DAILY MINIMUM TEMPERATURE
Year
2011
Mar
-0.6 C
Apr
2.1 C
MONTHLY MEAN DAILY MAXIMUM TEMPERATURE
2001
Japan Metrological Agency
9.3 C
13.3 C
http://www.data.jma.go.jp/obd/stats/data/en/normal/mrep.html
INJURY-RELATED INFECTION
BACKGROUND
• Skin protects the body from infection, however when individuals are injured through punctures,
scrapes, scratches, or tears of the skin, that protection is compromised & infection can occur leading
to serious health complications if untreated.
• As of 30 March the GoJ has reported 2,778 injuries with thousands more still unaccounted for.
•
Injury-Related (IR) Infections remain a serious concern. WHO reports IR infections likely endemic
in quake zone, with the potential for acute impact on population.
• Risk of IR Infections among rescue workers is HIGH.
EVALUATING SEVERITY OF WOUNDS (A SIMPLIFIED APPROACH)
RISK FACTORS ASSOCIATED WITH
INCREASED RISK OF INFECTION
• Wound Depth – the deeper the wound the more likely complications such as infection will occur
• Size of object – Larger or longer objects can penetrate deeper into tissue increasing risk of
infection.
• “Cleanliness” of Penetrating Object – Dirtier objects (including rust) are more likely to deposit
dirt & debris into wound increasing risk of infection.
SIGNS OF INFECTION
•
Older Age & individuals with chronic conditions including
diabetes & cancer.
•
Individuals with Immune system disorders & malnutrition.
•
Paralysis or other limited mobility.
•
Note: hospitalization may increase the risk for infection by
some antibiotic resistant organisms.
• Redness, warmth, tenderness & soreness
POTENTIAL COMPLICATIONS
ASSOCIATED WITH INFECTION
• Swelling or discharge from wound
• Fever
• Immediate Emergency Attention is needed if wound smells bad, discharge is thick &
brown/gray, tissue around wound discolors, or if swollen glands in armpits or groin can be felt.
JAMA PATIENT PAGE- Vol. 294, No. 16
WHO-WPRO SitRep No. 21: 30 March 2011
AMERICAN COLLEGE of FOOT & ANKLE SURGEONS
MEDICAL ASPECTS OF RADIATION INCIDENTS Handbook
•
Common complications range in severity and may include:
•
Death of surrounding tissue (muscle, connective tissue &
bone).
•
Spread of infection to the bloodstream & other organs.
•
Septic shock, organ failure, & death.
INJURY-RELATED INFECTION
TREATMENT OF INJURY-RELATED INFECTION
• Treatment depends on type of wound, degree of infection, & type of
bacteria responsible for infection.
• All wounds should be thoroughly cleaned, foreign objects should be
removed, and any pus drained.
INJURY-RELATED INFECTION & RADIATION EXPOSURE
• Radiation damage to cells occurs within microseconds of exposure.
• Cellular damage is generally most severe in rapidly reproducing cell types
including: stem cells and lymphocytes (a type of white blood cell that functions in
the immune system).
• Open wounds can allow radioactive contamination to enter the body.
• Laboratory tests may be required and are used to diagnose bacterial
wound infections , to identify the microorganism responsible for infection,
• Among individuals with high exposure to radiation, a condition called
and to determine susceptibility to specific antimicrobial agents.
Neutropenia is common. It is a condition in which white blood cell counts, an
important component of normal immune system function, is low. These
• Prescription antibiotics may be necessary to treat infection.
individuals are therefore at increased risk of injury related infection.
• ALWAYS finish antibiotics prescription even if infections seems to have
cleared up.
NOTES:
• Individuals contaminated by radioactive materials who have sustained injuries
requiring medical care should immediately receive all necessary and life-saving
actions, without regard to healthcare worker contamination.
• Living patients who have been exposed to radioactive contamination due not
pose an acute threat to health care providers.
• Injuries involving open wounds (including punctures,
abrasions, and lacerations) should be cleaned
thoroughly and covered with sterile bandages.
• Medical attention should be sought if there are signs of
infection.
WHO-WPRO SitRep No. 21: 30 March 2011
JAMA PATIENT PAGE- Vol. 294, No. 16
MEDICAL ASPECTS OF RADIATION INCIDENTS Handbook
NLLIC Easy Read Fact Sheet: Wound Care & Preventing Infection
The WHO considers
risk of injury related
infections to be
HIGH among rescue
workers
ACUTE RESPIRATORY INFECTION
WHAT IS ACUTE RESPIRATORY INFECTION?
MEASLES AND ARI
The disease burden for Acute Respiratory Infections (ARI) is
estimated at 94 037 000 DALYs (WHO, 2002 ) and 3.9 million
deaths (WHO, 2002 ). ARI are among the leading causes of
death in children under 5 years but diagnosis and attribution
are difficult and uncertain.
ARI is often associated with other life-threatening diseases
such as measles. A study reports 62% of all deaths are
attributable to ARI but most of these were associated with
measles. When measles deaths are excluded the proportion
falls to 24%.
In low-income countries, lower respiratory infections are the
leading cause of death worldwide, in high-income countries
they are the fourth main cause of death, and world-wide they
are the third cause of death with over 4 million deaths each
year according to the World Health Organization (WHO)
Measles is a highly contagious viral disease, which affects
mostly children. It is transmitted via droplets from the nose,
mouth or throat of infected persons. Initial symptoms, which
usually appear 8–12 days after infection, include high fever,
runny nose, bloodshot eyes, and tiny white spots on the inside
of the mouth. Several days later, a rash develops, starting on
the face and upper neck and gradually spreading downwards.
The main diseases that cause ARI are:
• Streptococcus pneumoniae
• Respiratory syncytial virus
• Parainfluenza virus type 3
• Influenza
HOW DOES ARI AFFECT CHILDREN?
About 20% of all deaths in children under 5 years are due to
Acute Lower Respiratory Infections (ALRIs - pneumonia,
bronchiolitis and bronchitis); 90% of these deaths are due to
pneumonia. Signs on an ARI are cough and difficulty
breathing. Young infants with fast breathing or chest indrawing
should be suspected to have serious bacterial infection.
Characteristics of Measles
There is no specific
treatment for measles
and most people
recover within 2–3 weeks.
However measles can
cause serious complications,
including blindness,
encephalitis, severe diarrhea,
ear infection and pneumonia.
The Measles, Mumps, and
Rubella vaccine (MMR) can
prevent infection.
Source: WHO Measles WHO Acute Respiratory Infections WHO Acute Respiratory Infections in Children WHO Leading Causes of Death
ACUTE RESPIRATORY DISEASE IN JAPAN
HOW COULD ARI AFFECT THE DISASTER?
Acute Respiratory Infection (ARI) is a significant threat
in shelters. Evacuees in the shelters are in close
proximity to each other and it is very easy for the
disease to spread. Hypothermia may amplify
respiratory illness, increasing the risk for those in
Japan who do not have proper shelter.
ARI AND THE JAPAN EARTHQUAKE
Doctors Without Borders/Médecins Sans Frontières
(MSF) has found respiratory illness in the crowded
living conditions found in the shelters. The elderly and
children are often more at risk for respiratory infection.
With Japan’s high population over the age of 65 it is
important to take preventative measures for reducing
the risk of disease.
Notes:
• Availability of appropriate medical equipment
(masks, alcohol wipes) and sanitary conditions are
part of an effective strategy to prevent the spread of
ARI
This image shows healthy people wearing masks to prevent
disease.
WHAT ARE PRECAUTIONS FOR ARI?
The following precautions should be used to
help prevent ARIs:
• Facemasks for both the healthy and the
sick
• Alcohol disinfectant easily available
• Increased hand washing
Source: Respiratory illness and hypothermia MSF
Respiratory Illness Elderly Respiratory Infection
HEALTH – HOSPITALS
• According to OCHA, hospitals providing emergency response services in the
three most affected prefectures are gradually building back capacity.
- Of the 33 major hospitals in these prefectures, 26 are now accepting
both inpatients and outpatients.
- Media reports that sufficient medical supplies are now reaching key
hospitals.
- The challenge is the onward distribution to a network of local hospitals
and clinics, which is being hampered by a lack of pharmacists.
.
• In the non-affected prefectures, there are over 390 public hospitals (about 3,400
available beds).
• 690 elderly people and people with disabilities in evacuation centers have been
moved to special facilities (e.g. nursing homes). Standby beds have been
prepared in special facilities : 35,557 beds for elderly, 8,756 beds for people
with disabilities, 7,148 beds for children with disabilities. Additionally, 919 beds
are available in shelters.
A father holds his daughter as she is screened for radiation
exposure. Photo: Kyodo News/AP
• The Ministry of Health, Labor and Welfare, in cooperation with the Japan
Association of Dialysis Physicians, requested prefecture and city governments
to set up a system for accepting dialysis patients outside of affected areas.
SITUATION OF HOSPITALS DESIGNATED IN DISASTER (31 MARCH):
No. of hospitals capable of
receiving patients for
hospitalization
No. of hospitals
capable of receiving
patients for check up
Miyagi (14 hospitals)
12
11
Fukushima (8 hospitals)
7
7
Iwate (11 hospitals)
8
8
OCHA SitRep No. 16: 1 April 2011
WHO-WPRO SitRep No. 23: 1 April 2011
An elderly patient gestures thanks to her staff after being hand-fed at the
Senen General Hospital in Miyagi Prefecture. Photo: Mark Baker/AP
HEALTH – MEDICAL TEAMS
•
The MHLW has coordinated the deployment of doctors, pharmacists, social
workers, dentists, care managers, child welfare and psychological care
specialists to Iwate, Miyagi, and Fukushima. Japan Red Cross Society
teams, Japan Medical Association teams, and teams from All Japan Hospital
Association are also operational in the affected areas.
•
142 teams, consisting of 640 members are responding to Iwate, Miyagi and
Fukushima from the National Hospital Institution, Japan Red Cross Society,
Japan Medical Association, etc.
•
634 pharmacists are deployed to Miyagi (427), Fukushima (144), Iwate (59),
Ibaragi (3) by the Japan Pharmaceutical Association and Japanese Society
of Hospital Pharmacists.
•
The Japanese Nursing Association has dispatched 256 nurses to Iwate (27),
Fukushima (2) and Miyagi (49). 30 Nurses have been mobilized to Iwate and
Miyagi.
•
1 dentist, 1 dental hygienist and 1 driver for a round clinic will be dispatched
to Iwate from 31 March to 14 April.
•
Some 280 caregivers (home helpers) for elderly people and people with
disabilities are in Iwate (89), Miyagi (98) and Fukushima (93). 8,126
caregivers are on standby.
PUBLIC HEALTH CARE TEAMS DEPLOYED TO EVACUATION
CENTERS AND PUBLIC HEALTH CENTERS AS OF 29 MARCH
NUMBER OF TEAMS
Responding
111
LOCATION
Iwate(37), Miyagi(50)+Sendai city(21), Fukushima(3)
Mobilizing
1
Sendai city (1)
Standby
9
Iwate (2), Fukushima (5), Miyagi (2)
Total
121
OCHA SitRep No. 16: 1 April 2011
SEEDS SitRep #10: 29 March 2011
Iwate (39), Miyagi (52)+Sendai City(22), Fukushima(8)
COE Update: 30 March 2011
WHO-WPRO SitRep No. 23: 1 April 2011
• Some 121 public health teams have been deployed to evacuation
centers and public health centers in Fukushima, Iwate, Sendai and
Miyagi. An additional 10 teams have been mobilized or on standby
for health-related services.
• As of 31 March, a total of 20 mental care teams of 95 members
have been deployed to support Iwate (7), Miyagi (10), Sendai City
(2) and Fukushima (1). Some 17 pediatric mental care providers
have been dispatched by Ministry of Health, Labor and Welfare to
Iwate, and 396 pediatric psychological care providers are on
standby
• Local medical associations have reported out of 231 hospitals in
Iwate, Fukushima and Miyagi, 121 (52%) are unable to accept new
patients, and 33 (14%) are unable to accept any patients due to lack
of resources, including staff.
•
22 “Kokoro no kea” (“Care of the Heart [for mental wellbing]” )
teams (106 workers) are working on the ground in Iwate, Miyagi,
Sendai city, and Fukushima).
• Various free telephone and email consultation services have been
set up for mental health and psychological support.
• Regarding identified non-communicable disease needs, facilities for
supporting dialysis and rheumatism patients, and telephone
consultation services for cardiologists, have been put in place.
Some 270 bags of dialysis liquid and 2,000 dialyzers have been
delivered to Miyagi Prefecture.
• MSF medical teams continue to work in evacuation centers in
Minami Sanriku in Miyagi, and have started to support a Japanese
doctor in the town of Taro in Iwate prefecture. MSF reports the main
activity continues to be consultations with elderly patients suffering
from chronic diseases.
HEALTH – PSYCHOLOGICAL IMPACTS
Psychosocial support to disaster victims is important to reduce morbidity, disability, and social problems. Those delivering psychosocial support
services need to be familiar with victims’ culture and way of life.
• A survey on mental health issues in Iwate Prefecture found that around
60% of the 73 shelters investigated had patients who needed immediate
psychosocial support.
• The MHLW has prepared a mental care guidebook that is being distributed
to affected municipalities; a website has been set up to provide information
for counselors and teachers.
• 17 pediatric mental health care providers have been dispatched by MHWL
to Iwate, and 396 pediatric psychological care providers are on standby.
• The GoJ has also deployed 23 psychosocial support teams, as the specific
area becomes an increasing need.
• Based on the identified mental health and psychosocial needs, several
response activities have been coordinated. Official government
information indicate that, as of 29 March, 22 "Kokoro no kea" ("Care of the
Heart [for mental wellbeing]") teams (106 workers) are working on the
ground (7 in Iwate, 11 in Miyagi [3 in Sendai city], and 1 in Fukushima).
Some 17 pediatric mental health care providers have been dispatched by
the Ministry of Health, Labor and Welfare (MHLW) to Iwate (as of 31
March).
NOTE:
• As response and recovery operations continue, the need for
long term medical and psychological support will increase for
pre-existing conditions as well as those caused by the disaster.
• A long-term strategy will be required to support these
conditions as well as to transition response assets into the
recovering infrastructure as appropriate.
IFRC Information Bulletin No.5: 28 March 2011
WHO-WPRO SitRep No 21: 30 March 2011
COE-DMHA Update: 1 April 2011
WHO-WPRO SitRep No. 23: 1 April 2011
COE-DMHA Update: 30 March 2011
• The Japanese Red Cross Society (JRCS) says the disaster has
psychologically affected children. The National Society has 2,369 nurses
who are trained and ready to provided PSP services. In addition, some
PSP teams were deployed to conduct assessments in the affected
areas, as well as to provide support.
• MSF plans to support a team of 6 psychologists, from the Japanese
Society of Certified Clinical Psychologists, who will treat victims of the
disaster.
• Currently, it is difficult to make complete estimates of the disaster impact
on mental health. Rapid surveys are being prepared/sent to Japan to
identify mental health needs. Preliminary key mental health areas
identified are pediatric mental health and survivor's guilt. Based on
evolving situation on the ground, continued assessment is necessary
• Coordination meeting of relevant MHPSS NGO agencies will be called in
the second week of April in Sendai. This meeting is planned to be called
by the government, the Ministry of Health, Ministry of Social Welfare, and
others
• As of 30 March, 22 mental health care teams with 166 members have
been deployed to provide psychosocial support to Iwate, Miyagi, Sendai
City and Fukushima.
• According to the WHO as of March 31, a total of 20 mental health care
teams (95 members) have been deployed to provide psychosocial
healthcare to affected areas, including Iwate, Miyagi, Sendai City and
Fukushima. (WHO, April 1)
ELDERY ISSUES
Japan is one of the oldest countries in the world. About 23 percent of Japan's
127 million people are age 65 or over
In the coastal areas struck by the tsunami, that number rises to nearly 30
percent. The elderly are particularly vulnerable to disruptions in food, water,
medical services, and regular schedules of essential medication. They are also
highly susceptible to hypothermia and pneumonia—significant risks due to
heating interruptions and blanket shortages in some shelters and hospitals.
People on their
wheelchairs rest at an
evacuation center in
Kesennuma, Miyagi
Prefecture in northern
Japan, after an
earthquake and tsunami
struck the area,
(REUTERS/Kyodo)
Those remaining in their homes are faced with no electricity, shortages of fuel
and kerosene, and are struggling to run heaters and cook hot meals.
With less resilience and weakened immune systems, the elderly are at a much
higher risk than others to falling ill. Japanese Red Cross medical teams have
been treating the elderly for hypothermia and infectious diseases such as
influenza.
There were 15 out of 170 elderly who died within one week after evacuation.
Social welfare facilities have identified accommodation facilities for at
least 35,000 elderly.
Around 280 caregivers for the elderly and people with disabilities are
responding in Iwate, Miyagi and Fukushima. Another 8,126 caregivers are
on standby.
The Association of Medical Doctors of Asia (AMDA) has begun shifting
its target to the highly-demanded elderly nursing from Apr. 1st.
According to the WHO, as of 31 March, beds in special facilities have
been prepared for standby. Around 35,557 beds for the elderly have
been prepared.
An elderly woman cries in the devastated town of
Rikuzentakata in Iwate prefecture.
OCHA SitRep No. 16: 1 April 2011
AMDA SitRep No. 12: 2 April 2011
COE-DMHA Update: 1 April 2011
CSIS 31 March 2011
WHO-WPRO SitRep No. 23: 1 April 2011
NOTE:
• The elderly are particularly vulnerable to illness due
to preexisting chronic diseases, weakened immune
systems, and susceptibility to infectious diseases.
• Cases of pneumonia, influenza & hypothermia among
the elderly are increasing.
SHELTER AND EVACUATION
• 245,508 people are displaced and/or evacuated and there are currently
170,500 displaced people living in 2,230 evacuation centres in 17
prefectures mostly in the north of Japan. In Miyagi, Iwate and Fukushima,
146,628 evacuees are living in some 1,245 evacuation centers
• The number of people in evacuation centers is decreasing slightly whereas
the number of evacuation centers has increased by 200 in the last two days,
as174 have opened in Aomori Prefecture in the north. Improving the living
conditions at the shelters in the worst affected areas is the biggest priority,
otherwise there will continue to be an increase in the number of cases of
cold and hygiene-related illnesses.
• In Tokyo prefecture, 600 families have been allocated vacant public housing
units on March 31 free of charge, for a period of 6 months.
• Starting in May, the GoJ will provide US$10,000 (1 million JPY) to each
family who lost their homes.
• OCHA reports that there are still significant humanitarian needs that are not
being met because of coordination and logistical issues. The biggest
concern is the extremely poor sanitation conditions at the evacuation
centers. Local media has also reported that hospitals in the areas are
reporting a steady increase in cases of nausea, gastroenteritis, and diarrhea
which is evidence that sanitary conditions are deteriorating in the centers.
• The shortage of fuel is still an issue and as soon as it is readily available it is
expected that people in shelters will move out of the centers and into nonaffected areas. Fuel is being provided to evacuation centers by freight train
and tankers from areas both north and south of the affected Tohoku region.
• While basic needs for food, water, toiletries and medicines are being met the
situation is serious and more sustainable solutions are being sought. In
addition, there are still thousands more that are living in their cars and who
have returned to their homes even though there is no electricity or water.
These people do not receive basic supplies from the municipal authorities
but are becoming the focus of attention by local NGOs and volunteers.
•
Authorities are trying to consolidate the number of evacuation centers and
move people into bigger shelters in order to provide a more efficient and
sustainable way of providing assistance. They also need to empty the 345
schools currently serving as evacuation centers in time for the academic
year, which begins in April.
• The Tokyo Metropolitan Government announced it will deploy 1,000 officials
to Miyagi and Iwate from 2 April until at least mid May to help manage
evacuation centers.
The Socioeconomic Effects of the 2011 Tohoku Earthquake - Daniell, Vervaeck, Wenzel - CATDAT
OCHA SitRep No. 16: 1 April 2011
WHO-WPRO SitRep No. 23: 1 April 2011
COE-DMHA Update: 1 April
2011IFRC Info Bulletin: 28 March
SHELTER AND EVACUATION
• The evacuees have established managing committees in the evacuation
centers to assist with distribution of food and relief items, cleaning, water
supply, and allocation of individual living spaces. A municipal official acts
as the liaison between the committees and the municipality. This practice
of self-management will continue when the evacuees are relocated to
planned housing. The GoJ wants to keep people from the same
evacuation centers together so bonds formed since the earthquake can
be maintained.
• Save the Children, reports that it estimates around 74,000 children remain
displaced and that it plans to open 12 Child Friendly Spaces so far to
assist those displaced children. They also are procuring 5,500 back-toschool kits for primary students who have lost everything, and have
completed putting together 500 hygiene kits based at the Sendai
warehouse for distribution.
• Hypothermia has been reported particularly among the elderly population
in the evacuation centers.
• For the thousands of people who are living in their homes without electricity
and water, there is no access to basic supplies unless they are able to receive
it from one of the bigger evacuation centers.
• The local municipality for Minamisanriku-town in Miyagi Prefecture has plans
to relocate some of its evacuees to other prefectures due to poor sanitation
conditions in the evacuation centers and to allow children and the elderly to
have better access to basic services. But a recent survey indicated that around
2/3 are not willing to move. The municipality planned to relocate evacuees to
seven towns but a large number of evacuees prefer to remain where they are
as many of them are still looking for family members. Many evacuees have
been moved several times. This is taking a toll on the evacuees, especially
the elderly.
• Majority of evacuation centers reported availability of three meals a day.
• Japan’s Chief Cabinet Secretary Yukio Edano said evacuation of residents
within 20 km of Fukushima nuclear plant would be “long-term.” Around 78,000
people lived in the mostly rural area, while another 62,000 lie within the 20-30
km radius. (CNN, BBC, Reuters)
• At least 20,000 foreign nationals have left Japan since the disaster - over
9,000 Chinese, 2,000 Australians, and 2,000 French citizens have left Japan,
while more than 7,400 members of families of US military in Japan were also
evacuated.
NOTE:
• The transition of evacuees from shelters into planned housing
will support the improvement of the health concerns associated
with mass sheltering, including some psychological concerns.
• The number of evacuees is reportedly growing with new
pressures mounting on the government to expand the 20km
evacuation zone surrounding the Fukushima power plants.
Residents living between 20 and 30 km from the wrecked Fukushima No. 1
nuclear power plant were urged to evacuate. AP Photo.
IFRC Info Bulletin: 28 March 2011
OCHA SitRep No. 16: 1 April 2011COE-DMHA Update: 1 April 2011
SEEDS ASIA SitRep No. 11: 1 April 2011
WHO-WPRO SitRep No. 23: 1 April 2011
SHELTER AND EVACUATION
• The Special Task Force for Livelihood Support of the Affected Population
says 40,500 government apartments and 19,500 public housing units are
available for displaced families, making a total of approximately 60,000
apartments. Among them, 42,145 are immediately available. 70,409
evacuee families are currently living in evacuation centers.
• The Ministry of Land, Infrastructure and Transportation says that only 8% of
the land needed for the construction of temporary shelters has been
secured. The construction of temporary shelter is underway but far below
the number requested by prefectures. The GoJ plans to have 30,000 houses
built in the next two months. So far, land has been allocated for only 2,645
shelters.
• A lack of clean water for evacuees’ personal hygiene is posing public health
risks in some evacuation centers. Media reports that the Ishinomaki Red
Cross Hospital found that sanitation and hygiene environment is
deteriorating in 30 per cent of the 314 evacuation centers that they have
assessed in Ishinomaki, Higashi-Matsushima and Onagawa in Miyagi.
Excrete disposal is a particular challenge. The local social welfare office is
conducting a training on drainage work and maintenance of toilets.
• Ministries such as the Ministry of Defense have provided bathing services to
1.2 million people so far. For evacuees, not being able to wash regularly or
change their clothes is a particular hardship.
•
Rikuzentakata is the first municipality in the earthquake/tsunami area to
start the registration process. The media is reporting mixed feelings
towards the registration as while evacuees are keen to leave the
evacuation centers where access to basic services is extremely limited,
they are also concerned about remaining in the areas destroyed by the
tsunami. At least 8,800 temporary housing units will be built in the
prefecture.
• An association of landlords, the Zenjyu Association, has established a
system to help landlords across the country offer vacant apartments at a
discounted rent to the people affected by the disaster. 418,000 vacant
apartments have been offered so far. Also, The Ministry of Agriculture,
Forestry and Fisheries is looking at available accommodation in Japan’s
fishing and farming villages as the population in these villages has been
steadily decreasing over the years. The Ministry is collecting detailed
information from local municipalities in order to make an allocation plan.
• Local authorities are facing difficulties in finding suitable land, as the
coastal area in Tohoku is mountainous, making it difficult to find flat land,
and a large part has been damaged by the tsunami. The Ministry is also
considering purchasing material for the construction of temporary shelters
from abroad, if they have the same cost, size and design specifications as
Japan. After the 1995 Kobe earthquake, 3,300 temporary shelters were
imported, as they could not all be procured in-country.
• Iwate Prefecture announced that they are increasing the number of
temporary shelters from 8,800 to 18,000, to cover 40,000 to 50,000 people.
Miyagi Prefecture has announced that construction of 1,195 shelters will
start on April 5 in 11 towns and cities.
Elderly people in the
high school evacuation
centre in Otsuchi.
Photo: IFRC
OCHA SitRep No. 16: 1 April 2011
WHO-WPRO SitRep No. 23: 1 April 2011
COE-DMHA Update: 1 April 2011
IFRC Info Bulletin: 28 March 2011
LOGISTICS AND TRANSPORTATION
LOGISTICS
TRANSPORTATION
• The shortage of fuel is the biggest obstacle to delivering relief supplies and
keeping people warm. Up to 700 tanker trucks have been mobilized from other
parts of the country to ease the situation. Because 4 out of 7 supply bases of
liquefied petroleum (LP) gas are not operational, the Ministry of Economy,
Trade and Industry will release 40,000 tons from the national reserve for the
first time from 4 April.
The Ministry of Land, Infrastructure and Transport reports that 99% of highways and
main roads have been repaired, excluding those near the Fukushima Nuclear
Power Plant. Traffic on some main thoroughfares such as the Tohoku expressway
has increased to 1.3 times traffic before the quake due to the large number of
emergency vehicles.
• Although 88% of gasoline, diesel and kerosene shipments have resumed to
Tohoku region, there is still a serious fuel shortage. The areas surrounding the
Fukushima Power Plants are also receiving emergency fuel.
ROADS: As of 1 April, 2,126 damaged roads have been reported from 11
prefectures (Aomori, Miyagi, Yamagata, Akita, Tokyo, Ibaragi, Tochigi, Saitama,
Gunma, Chiba and Iwate). There were reports of 56 damaged bridges in four
prefectures. Although almost all main roads have been cleared, many local and
residential roads are still impassable due to debris. More than 37,200 vehicles are
now passing through the Tohoku Expressway per day, which is 1.3 times more
traffic than before the disaster struck.
• The number of fuel stations operating is still limited and needs have increased
due to the disruption in public transport and increased number of emergency
vehicles. There are long lines and the public is restricted to 20 liters of fuel a
day. The GoJ says it will spend US$209.9 million (JPY1.7 billion) to solve the
emergency fuel shortage.
• Disruption in supply chain sources many of which were concentrated in the
east as well as significant shifts in demand patterns had an impact on the
supply of certain essential items such as bottled water and fuel.
AIRPORTS:13 airports in the affected areas are open for scheduled and chartered
flights. Sendai Airport is open 24-hours for humanitarian flights, but has inadequate
warehousing for relief needs. The World Food Programme (WFP) has been asked
to assist in improving warehousing. 71% of domestic flights have resumed in
Japanese airports.
• The GoJ says 11,257,000 liters of fuel have been delivered to the affected
areas to date. Another 29,000 liters is in transit. Approximately 1 million liters
arrived on 28 March.
SEA PORTS:15 of 15 ports in the affected area are usable. (multipurpose piers are
partly available (Excluding Aomori Port).
• GoJ has made progress in establishing the supply chain of petroleum to the
Tohoku region, securing a supply of 22,000 kiloliters per day. The areas
surrounding the Fukushima Power Plants are also receiving emergency fuel.
RAILWAY LINES: Railway lines are still under repair. As of 1 April, 26 railways
have been reported as destroyed. Railway service has resumed for 62% of bullet
trains and 60% of local trains. The interim assessment of the East Japan Railway
Company has assessed half of the total railway tracks and found that 23 train
stations and 22km worth of railway tracks have been completely washed away in
the region. According to NHK, the Tohoku bullet train is expected to resume full
service in late April. The route runs through affected regions, and repair work will
take more than a month, but the line sustained minor damage.
• The Japan Medical Association started to ship insulin to affected sites but
there has been difficulty in reaching the affected areas because of bad road
conditions and lack of fuel. Relief items are being delivered on foot in some
places.
• A logistics concept of operations to strengthen and enhance JRCS logistics
capacity has been shared with the National Society but has yet to be
discussed in detail. A more detailed plan of action is currently being
developed, including enhancing logistics infrastructure, information flows,
creating a logistics hub, shipping by sea/air options and increasing
warehouses in the field.
OCHA SitRep No. 16: 1 April 2011
WHO-WPRO SitRep No. 21: 30 March 2011
IFRC Info Bulletin No.5: 28 March 2011
MLIT 2011 Earthquake Outline 36th Report: 28 March 2011