November 17, 2017
During Typhoon Haiyan in the Philippines in 2013, a nurse on the Medical Team teaches origami to children between medical examinations
Nakajima Yasushi, right, works in an area affected by the Great East Japan Earthquake
"Through my experiences as a member of Japan Disaster Relief Team, I knew that coordinating with local agencies in the disaster affected area is the most important thing."
Nakajima Yasushi, deputy director of the Tokyo Metropolitan Hiroo Hospital Emergency Care Center, who did medical work in areas affected by the Great East Japan Earthquake in March 2011, had this to say during that disaster.
Dr. Nakajima joined the JDR Team twice, for the 2008 Sichuan earthquake in China and the 2011 earthquake in Christchurch, New Zealand. During the 2011 Great East Japan Earthquake, he provided medical examinations to disaster victims in tsunami affected area in Miyagi prefecture, as a member of Disaster Medical Assistance Team (DMAT). At the same time, he supervised multiple medical assistance teams that rushed to the city and coordinated with local medical agencies and others.
DMAT was formed in 2005 as a "group of specially trained and readily mobilized medical professionals available to respond to a disaster on short notice." It is based on the lessons of the 1995 Great Hanshin-Awaji Earthquake. In case of a disaster, DMAT will respond based on agreements with, or according to disaster responce plans of various prefectures in Japan. Its activities are serving an on-site or off-site headquarters function, wide-area medical transport/evacuation, hospital support, regional medical transport and on-site clinical care.
It is a separate organization from the JDR Team, which provides assistance in response to natural disasters overseas, but many JDR registered members are registered to DMAT. This creates a virtuous circle: Members share their experiences of emergency response both overseas and in Japan.
The standardized report form proposed by JICA and others and created by the World Health Organization
In February 2017, the World Health Organization created a standard for the data* on medical care during disasters that should be submitted to the health authorities of disaster-struck countries. When there is a standard for information submitted by many emergency medical teams, it is easier for the health authorities of disaster-struck countries to grasp the overall situation, including what kind of medical needs exist where. Doctors registered with the JDR Medical Team proposed unifying the data format and led the discussion.
The idea came from assistance work done after Typhoon Haiyan in the Philippines in 2013. The JDR Medical Team sent to provide support suggested to the various emergency medical teams working in the affected areas that they use the report form of the Philippines Department of Health. This proposal was accepted and the results were positive. Japan then adopted the format for domestic disasters, and used it for the first time in the Kumamoto earthquakes in April 2016.
In ASEAN, medical assistance when natural disasters strike is a priority issue in the health sector. However, member states have different capacities to provide medical assistance during disasters and there is no organized regional cooperation structure. In this context, JICA has been cooperating with Thailand's National Institute for Emergency Medicine and the Ministry of Public Health, Thailand, since 2016 to implement the Project for Strengthening the ASEAN Regional Capacity on Disaster Health Management (ARCH Project). ARCH's aims are strengthening coordination among emergency medical teams of ASEAN member states and training emergency medical team personnel.
One part of the background of the project is the group training course "Seminar on Emergency/Disaster Medicine," which JICA conducted for 20 years from 1988 to 2008. The course, which trained emergency/disaster medicine experts and built a network among them, was given to 207 people from 53 countries. Trainees from Thailand who took the course established their own DMAT based on Japan's DMAT in 2008.
Joint training with medical teams from various countries of ASEAN
In tsunami-struck Miyagi prefecture, a Mongolian rescue team searches for missing persons
Registered JDR Medical Team experts also participate in this project, provide professional advice and conduct joint training with various ASEAN countries.
After the 2011 Great East Japan Earthquake, China, Mongolia, Indonesia and other countries JICA had assisted sent a succession of rescue teams to Japan to help.
"Rescue work had to be suspended frequently because of aftershocks. But the rescue and safety management techniques we'd learned from Japanese experts proved useful at the disaster site." That's according to an instructor from the Earthquake Emergency Aid Center of China's Earthquake Administration who was involved in the search and rescue efforts in Ofunato, Iwate prefecture.
There was a major earthquake in Mexico in September 2017. At the site of a destroyed apartment building, the JDR Search and Rescue Team searched for victims along with teams from the U.S. and Israel. In times of disaster, disaster relief teams use their accumulated experiences and relationships to rescue many people around the world.
*A minimum data set, or MDS. It is a collection of 46 pieces of information required to be reported to health authorities in the disaster affected country as a daily report. Emergency medical teams working in disaster affected areas take the data from patients' medical files.