Japan: The Best of Care in the Worst of Times

Health care personnel in Japan used social media and emergency response planning to care for patients after the March 11 earthquake and tsunami. (Image: Sherwin McGehee/iStockphoto.com)

In the best circumstances, transporting 600 patients more than 100 miles for kidney dialysis is no easy feat. After a 9.0-magnitude earthquake and city-swallowing tsunami, it would seem nearly impossible. But health care personnel triumphed. The story is among several accounts in this week’s Lancet from physicians in Japan who mobilized to provide life-sustaining treatments after the March 11 disaster.

In Iwaki, Japan, a city just 25 miles from the crippled Fukushima Daiichi nuclear power plant, 600 patients needing dialysis left on chartered buses 6 days after the earthquake. They traveled 124 miles to Niigata, where health personnel had emergency procedures in place after enduring 2 major earthquakes since 2004.

Without the patients’ medical records, health care personnel in Niigata performed brief physical examinations and took short health histories. Patients who needed immediate care were taken directly to dialysis facilities. All patients’ pertinent medical information was recorded so that it could be shared among health care personnel.

“The transfer of 600 hemodialysis patients is an unprecedented event,” wrote Junichiro James Kazama, MD, PhD, and Ichiei Narita, MD, of Niigata University Medical and Dental Hospital.

In other areas, social media became important tools. When telephone networks failed, physicians at Keio University School of Medicine in Tokyo used Twitter to tell patients where they could obtain continuous-infusion prostacyclin for their pulmonary hypertension.

“‘Tweets’ immediately spread through patients’ networks, and consequently most could attend to their essential treatments,” wrote Yuichi Tamura, MD, and Keiichi Fukada, MD, PhD. One patient received prostacyclin via helicopter.

“Together, these efforts ensured that all patients on prostacyclin treatment received their required medication,” they added.

Additional accounts describe rapid-response efforts to address Japan’s traditionally weak primary care system as well as the need for more reliable data on harm to human health from radiation exposure.

Categories: Emergency Medicine, Public Health, Pulmonary Diseases