The Great East Japan Earthquake

 

I was talking with Dr. Uchiyama of Ishinomaki municipal hospital when the tremor broke out.  He called my clinic in Tokyo at around 2 pm on the 11th of March. We were about to discuss the chemotherapy of my uncle after his operation of stomach cancer when the quake began on the other side of the phone. He tried to continue even during the shaking. However, I realized the swing was extraordinary, when I felt the quake at my side. About 30 seconds after he said he felt the quake, he said we should stop talking because his room was about to be a mess.

 

After I hung up, the shaking became more intense and continued for an unbelievably long time. All medical charts on the shelf fell down. Computer monitors turned over. I felt that shaking continue on and off for more than ten minutes. One clerk became panicked and was twitching on the floor, but patients in the waiting room were calm and sat still. During that time, I was holding an ultrasonic machine beside my table. After the series of shaking the floor of the clinic became a complete mess with books and many things that had fallen from above. Though the electric power was still on, medical practice seemed impossible to continue because of the mess. The owner of the pharmaceutical shop adjacent to the clinic came to tell us that they couldn’t distribute medicine because the ceiling of their shop fell down. We apologized to patients and they left the clinic.

 

We heard on the radio that the earthquake occurred off-shore of Miyagi prefecture. I called my father in Ishinomaki City, a major port town in Miyagi prefecture. My mother was in her hemodialysis session in Senseki hospital, which was located near the coastal place in Ishinomaki city.  My father was in a home center store after he had taken my mother to the hospital by car. He told me on the phone that everything on the shelves in the home center fell down. He went back home just after that. As a result, this saved his life because there was a big tsunami and that area was widely covered by water. I called my father after a while, and he said that he couldn’t go back to the hospital because water blocked the road. After the conversation, telephone service became unavailable for many days. I worried about my mother in the hospital and brother who was working in a company that is also near the sea.

 

From the earthquake, all railways in Tokyo stopped. Many people were deprived of their means to go back home. Those who live within five or six stations walked home and others stayed in their offices, stations or restaurants. The next day, the trains, moved smoothly. However, on the following day, the government announced the conservation of electric power because both nuclear plants and thermal electric plants in eastern Japan had stopped. The rolling blackouts were enforced in the Kanto area. Many shops and offices had to be closed and the train stopped in many places. There were long queues of commuters in the morning at many stations.

 

 

 

Few days later, to help victims of tsunami, we arranged a medical team consisting of four doctors, four nurses, two pharmaceutical chemists and four clerks in Tama city in Tokyo where my clinic is located. Our caravan consisted of four vehicles with lots of medicines, water and food. We started from Tokyo to Ishinomaki city in Miyagi prefecture on the15th of March. The city was originally a town of fishing and seafood processing, especially whale. When I was young, I remember there was the odor of whale processing when I visited the town. After the whale catching was banned they invited a big paper factory. Ishinomaki city was populated with 160,000 people, and the main industry was fishing and the paper factory.

 

 

We all stayed at my parent’s house, which is located 10 kms from the disaster site, for one week. We were assigned to Higashi-matsushima city, where we visited evacuation camps to do medical treatment for refugees for one week. The place was all muddy. Rubble and drifted cars were all around the place. The first floor and the surroundings of the buildings for the refugee camp were filled with mud. The upper floors were very dusty and people living there were annoyed by constant coughing. People there have their own life and death stories 

 

One woman evacuated to a building of an elementary school but the water level got imminent and she had to move to a higher place, the gymnasium. When they were moving to the gym, a small boy near the woman was almost swept away by the flood. She pulled him up and brought him to the gym. However, the place was also flooded soon and they had to move to the upper area of the gym. The space was too small for the number of people so they had to keep standing for two days in wet clothes until the rescue came. The weather was also very tough for them. It was snowing outside and they had to stick together to keep warm.

A man spent one night on the 2nd floor of his house with water in the floor and walked through the water to the camp with bare feet on the following day. There was lots of debris including pieces of glass and he injured his soles very badly. He has diabetes and was using insulin. When we found him in the camp, the injuries were infected and he had not used insulin for a week. We had to send him to the Ishinomaki Red Cross Hospital, the only big hospital that survived after the disaster, to bring him under medication

 

Abandoned cars in the school playground

 

 

The 1st floor of a refugee camp

 

 

Our activity; Pharmacists (left) did a great job. They gave over-the-counter drugs adding to my prescription

 

Ishinomaki Red Cross Hospital; the corridor was turned into an emergency room
Ishinomaki Red Cross Hospital; the corridor was turned into an emergency room

 

Ishinomaki Red Cross Hospital is located four kilometers from the sea and barely escaped the flood. The hospital functioned as the center of salvation of this area. Members of medical teams from many other cities in Japan were staying there.  They camped out on the floor or in a tent outside of the hospital and were dispatched to the afflicted areas.

 

I met Dr. Uchiyama there. His hospital was near the shore and was abandoned at the time. After the earthquake, he began a gastrectomy and he had to stop the operation and bring the patient to the upper floor of the hospital when the tsunami came. He said that the water came up to the 3rd floor of his hospital and he barely escaped himself.  

 

We worked for the refugees for a week. During the period, electricity and water became available at my parent’s house, but still the evacuation camp had no water and electricity when we left the town.

 

 

After one month, I visited Ishinomaki again. The town was recovering from the flood

 

gradually. Many volunteers were working. They were removing gravel and mud from the roads and houses. A few shops had opened for business already. The road to a Hiyoriyama Park, which is located 56m above sea level, became accessible. From the park, I could get a land view of the tsunami disaster. Many people came to the place to bow and pray for the deceased people and family.

 

 

View from Hiyoriyama Park. The white building near the bridge is the Ishinomaki Municipal Hospital

 

 

Street of Ishinomaki City. A volunteer was walking. A famous cartoonist who made Cyborg 009 came from this city. The red statue is one of the story’s characters.

 

 

After Ishinomaki city, I visited Shizugawa town in Minamisanriku-cho. The place was totally devastated by the tsunami. Even the place along the river several kilometers from the sea was washed out and most houses were destroyed. The main town was also totally destroyed. There was a car on top of a 3-story building. The tsunami must have been very high at this place. Shizugawa Public Hospital consisted of two buildings. Patients and medical staff who escaped to the 5th floor of the west wing survived. Many patients, most of them were bed-ridden, could not be moved to the top of the west wing and died. It seems that all the people who stayed in the buildings around the area were taken by the tsunami.

 

 

Shizugawa Public Hospital (east wing); the whole building was swallowed. Only those who escaped to the west wing (to the left) survived.

 

 

The red iron skeleton was the disaster countermeasure office of this town. Staff alerted the people to evacuate this area from the building. Many of the staff went up to the roof of the building but the tsunami swallowed them.

 

 

Land view of Shizugawa town. The whole town was taken by the tsunami.

 

 

Shizugawa town; the tsunami was very high and fast. This place was not close to the shore.

 

A drifted ship in Kesennuma city
A drifted ship in Kesennuma city

 

I took a road along the sea to go to Kesennuma city. All towns in lower places near the sea along the road were destroyed. The railroad has also destroyed in many places and still was left unrepaired.

 

Kessennuma city was not as badly devastated as Shizugawa town. The main industry is fisheries and its processed foods with a population of 73,000. Many buildings remained, and the town was recovering. A big ship was swept on the harbor by the tsunami. My wife’s parents were living there. Their house was located on a hill and was not flooded but their shop, a stamp shop, was flooded by the tsunami. They said that they could not continue the business because all machines and materials were damaged by the flood.  After the tsunami, many frozen fish were scattered all over the area. Lately, they gave out a putrid odor all over the area. After the earthquake, my parents-in-law rushed to their house because they worried about their grandson who was in their house, which saved their lives. They could not go back to their shop because there were many people who were trying to rush to town to get their family. My parents-in-law said, many of them were washed away by the tsunami.

 

A barren view of Rikuzentakata city. This land was filled with houses before the tsunami.
A barren view of Rikuzentakata city. This land was filled with houses before the tsunami.

 

Finally I visited Rikuzentakata city, which is ten kilometers north from Kesennuma city, with a population of 23,000. I had to take a long road to get to the city because the bridge to get into the city was destroyed. This city was also totally devastated by the tsunami. There was no sign of rebuilding in the city. People were still looking for corpses in the mud using long sticks. The beautiful shore had disappeared.  I used to take my children to this place. They played in the beach and park along it. I think nobody survived in this area even if they had tried to escape after the earthquake because the area of the tsunami is very wide and there are no hills around this place.  Even if they had climbed to the top of the buildings they could not survive. The water washed out whole buildings.  Windows of the 4th floor of buildings were destroyed and I thought people living in these buildings could not survive. The whole place was washed out. I don’t think they are going rebuild the city.  I believe nobody wants to live here with fear and remorse.

 

 

I was born in Ishinomaki city and raised there until I graduated from high school. I worked in Kesennuma city as a high school teacher and in Shiogama city as a doctor. So this coastal area in Miyagi prefecture is very familiar to me.

 

I studied helicobacter pylori infection under Professor Barry Marshall from April 2009 to September 2010. Before I went to Perth, I worked as a doctor for Miyagi prefecture. The local government dispatched doctors to remote areas of the prefecture. I worked for the local government, and the government gave me a one-year study period. I was supposed to work in a hospital in the remote area of Miyagi prefecture after I finished studying in Perth. However, when I asked the government to extend the studying period, they turned it down, and I had to quit the work.

 

If I hadn’t extended my study, I would have been working at a hospital in this area when the tsunami struck the place.

 

Ishinomaki Municipal Hospital had 5-story building. Patients, staff and the residents who were near the hospital could evacuate to the upper floor of the hospital. My mother was in her hemodialysis session in the 2nd floor in four-story building and could escape to the upper floor. In Shizugawa Public Hospital, the majority of patients were bed-ridden and medical staff could not bring all of them to the safe place, the 5th floor of the west wing. Sixty-seven out of 109 patients were taken by the tsunami and several medical staff died while they were moving patients to the 5th floor.

 

Ogatsu Public Hospital in Ishinomaki city was a 3-story building standing just in front of the ocean. All medical staff, including three doctors, and patients who tried to escape to the upper floor and roof of the building were taken by the tsunami.

 

I wonder if doctors have a right to escape leaving bed-ridden patients. It is impossible to take all the patients to the safe place within 20 minutes. There are lots of old-aged bed-ridden patients, especially in hospitals in rural areas. Elevators stop after a quake and most hospitals are understaffed.

 

Must doctors stay with bed-ridden patients sacrificing their own lives? The tsunami attack increases in a wave like fashion. Can doctors leave bed-ridden patients behind to save their own lives if possible? If a doctor leaves patients and survives, the public would blame the doctor and, in the worst case scenario, the doctor would be under litigation.

 

I think many staff in the Ogatsu Public Hospital were aware of the danger of staying in the hospital. The building of the hospital didn’t have not enough height to fend off the tsunami attack, but they might have felt guilty to leave bed-ridden patients behind and chose to stay.
I think in such emergencies, doctors as well as medical staff should leave the hospital with the patients who can move. Bed-ridden patients should be taken care of by the emergency medical rescue teams. Hence, as soon as the earthquake hits, the teams should rush to the hospital to bring them out from the dangerous place. There are many young medical staff and they should not be sacrificed. In Shizugawa Public Hospital, a 25 year-old nurse was killed while she was helping patients to move up to the safe area. Ethical discussion should be made for the behavior of medical staff when such an emergency event breaks out.

 

Hospitals should not be built in dangerous areas. In Shizugawa town and Ogatsu town, the main hospital was destroyed by the tsunami, which makes the salvation of the people very hard. They had to depend totally on aid from outside of the towns. In Kesennuma city and Ishinomaki city, fortunately the main hospital survived and the hospital functioned as the center of salvation.

 

Bed-redden patients should be taken care of in hospitals located in safe places. When patients are admitted to hospital, we should consider the safety of the hospital very carefully.

 


The back-grand picture is stromatite of Shark Bay in West Australia. This is a living fossil.

 

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