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A Society’s greatest test


A central part of Japan’s healthcare and emergency relief services, the Japanese Red Cross Society faces its nation’s greatest post-war crisis.

IT’S NIGHT TIME in what’s left of Otsuchi and it’s bitterly cold. With the temperature at minus 5 degrees Celsius, and no electricity or mobile phone coverage, this once-vibrant city is now almost completely dark.

The exceptions are the fires survivors have built from the timbers of shattered buildings, the light from a few relief centres and the searchlights of helicopters and rescue teams picking through twisted wreckage of once peaceful neighbourhoods.

Up until the afternoon of 11 March, this was a quiet and prosperous fishing town of 17,000 people built around one of the many small harbours along Japan’s north-east coast.

Today, Otsuchi is just one of several seaside towns being referred to by some media as a 'lost city'. More than half of the city’s population — as many as 10,000 people — perished or went missing after massive surges of ocean water crested the city’s 30-metre-high tsunami walls and smashed through downtown. The rampaging waters carried away people, cars, homes, schools, even factories and office buildings.

The devastation left behind was almost total. Only a few buildings remained amid a sea of wreckage. Here, and in other cities, media outlets referred to the aftermath as “apocalyptic.” A late-winter snowfall, mixed with ash from burning wreckage, draped the ruins with a layer of wet slippery snow that made relief efforts even more challenging.

The hardest hit were the elderly. “There are a lot of people with chronic conditions and today, it’s cold so some people have fallen ill,” says Takanori Watanabe, a Red Cross doctor from Himeji, in western Japan, who arrived in Otsuchi as part of a 12-person mobile medical team that ran daily clinics around the evacuation centres.

As similar scenarios played out in numerous coastal towns — including more populous cities such as Ishinomaki, Miyagi, Shendai, Shiogama — the scope of the earthquake and tsunami was quickly recognized as a national catastrophe. With the ongoing struggle to contain radiation at the crippled Fukushima nuclear power facility, the prime minister referred to this treble emergency as Japan’s greatest crisis since the Second World War.

Amid the extreme loss and grief, the people of Japan’s north-east coast were noted for their stoicism, poise and generosity. With fuel shortages and little food coming in to the few shops that remain open, people formed peacefully in long lines to get water or food or to make urgent phone calls to relatives. Others scavenged through the debris for packets of dried food.

A National Society responds

For the Japanese Red Cross Society (JRCS), the scale and varied nature of the crisis tested its robust resources and capacity. The 124-year-old National Society is well established with an annual turnover topping US$ 10 billion, a staff of 55,000 and roughly 2 million volunteers.

The JRCS is not only a key element of the national emergency response, it is an integral part of the country’s healthcare system, managing the nation’s donated blood supply and running more than 100 hospitals and nursing colleges. These are a few reasons why the National Society did not call for an international funding appeal though it did welcom donations (The JRCS received a total donation of 22.3 billion yen or 249 million swiss francs as of 20 March).

With a highly trained and professional staff and volunteer corps, the JRCS manages one of the largest international operations in the Movement and it also has experience with major domestic catastrophe (the 1995 Kobe earthquake, for example).

This combination of experience and dedication is embodied in volunteers such as Toda Kazuko, who drove 12 hours through the night from his home in Kobe to reach Otsuchi. Within hours of arriving, a tented clinic had sprung up and members of the team were treating patients in the evacuation centres. A veteran of the JRCS’s Haiti earthquake operation, Kazuko was completely focused on the job at hand.

“We have more than 700 staff deployed and in four days the next rotation comes in,” he says before having to leave abruptly as an elderly woman, shivering uncontrollably, is brought into the clinic on a stretcher.

Kazuku and his colleagues were among the 249 JRCS medical teams which fanned out across the length of the 400-kilometre-long disaster zone. Within 24 hours of the disaster striking, the JRCS had set up a network of emergency response units from which five-person teams, comprised of doctors and nurses, operate — moving out to different evacuation centres in nearby towns each day.

Each team included a trained psychosocial nurse, who allows survivors to voice their grief and anxieties, as well discuss practical concerns. The JRCS has 2,400 trained psychosocial nurses, and an eight-member specialist psychosocial team that had just returned from a mission in New Zealand, where they were helping survivors of the Christchurch earthquake.

The infirmary set up at Otsuchi high school, where about 700 people filled the floor space of the school’s gymnasium, only has two beds, one being used by an elderly woman who is barely conscious and the other by an old man attached to an I/V drip, who was badly dehydrated. Most of the patients at clinic were elderly and many had lost their regular medication in the disaster. 

Tired or sick, they lay on mattresses on the floor, swathed in blankets. Many shivered uncontrollably under blankets, suffering from hypothermia having been stranded in their homes without water or electricity.

One member of Watanabe’s team trained in psychological counselling sits in the corner, quietly comforting a teenage girl who is sobbing with her head in her hands. Everyone in Otsuchi has lost someone. A relative, a friend, a neighbour — the entire town has been affected. Helping people to overcome trauma is a major issue and teams of Red Cross counsellors are being deployed to combat the stress-related illnesses that are beginning to emerge.

Beacons of light

Amid the ruins, Japanese Red Cross hospitals were sources of hope and light — literally — in cities without power. The Red Cross hospital in Ishinomaki, for example, drew people in from miles around, many of whom simply find comfort in being able to sleep in a warm corridor with strangers. With all other local hospitals flooded or damaged, this hospital welcomed over a thousand patients from the surrounding area, and every inch of floor space is occupied with the sick and the wounded.

Most of the injured were brought by civil-defence helicopters and buses, while others managed to limp in or were carried through the doors. The trauma was evident, written on the pale faces of many who have seen loved ones swept to their death.

Takayaki Takahashi is a surgeon who leads one of the five mobile medical teams that operate out of the Ishinamaki hospital. He’s been on call for 48 hours straight. Each day he heads out with another doctor and three nurses to run clinics at the evacuation centres where thousands of people have been housed.

“Today we went to Miyato, which is only about 10 kilometres away by road, but the bridge from the mainland had been swept away,” he says. “We had to get there by helicopter. We treated 100 people and left three days' rations of food and water for 700 people who are sheltering in a school.”

Many of the wounded were burn victims whose homes caught fire when the diesel from sinking fishing boats ignited the mass of debris being carried inland by the tidal surge.

Some of the seriously injured taken to the hospital were people who were swept up in the tsunami and were brought in with internal injuries and severe wounds. Others were at risk from pneumonia having inhaled large quantities of contaminated sea water.

Hundreds of Red Cross medical staff from across the country have come in to work at the hospital on a four-day rotation from other hospitals across Japan. While morale was high, conditions were difficult. Medical supplies were running low, electrical power was cut off and there were problems finding fuel to run the hospital generator.

As this magazine went to press, search and rescue efforts turned towards recovering the mortal remains of those who had lost their lives. Official estimates had placed the number of confirmed dead at more than 8,000; the number of missing at 12,000. As the number of people missing following Japan’s earthquake continued to grow, the ICRC has supported JRCS efforts to provide information on missing loved ones through its Restoring Family Links programme and to identify mortal remains.

Attention was also focused on the Fukushima nuclear power station, where at press time, crews had been able to restore power, raising hopes that the situation would not worsen — though the plant continued to emit radioactive steam.

All 47 of the JRCS prefectural branches have trained nuclear decontamination teams and equipment, including special tents in which radioactive material can be washed off. The teams are designed to be mobilized in conjunction with the government’s specialist units. So far, there has been no request from the government to mobilize these teams, but they remain on standby.

With the support of government authorities, the JRCS is monitoring the situation in hospitals close to the exclusion zone, in case radiation levels rise and pose a risk to patients. Meanwhile volunteers have played a key role in caring for the thousands of people evacuated from the 20-kilometre exclusion zone surrounding the affected plants.

Despite the grim, compounding nature of this multiple disaster, many draw inspiration from the resilience of the Japanese people and their response to this national tragedy. And there are other reasons for hope: the generous international response will help in both relief and recovery stages. In addition, a regional early warning system developed after the 2004 Indian Ocean tsunami appears to have helped avert further loss of life as the tsunami spread throughout the south Pacific. 

By Patrick Fuller/IFRC in Japan and Malcolm Lucard in Geneva.

One week after the earthquake struck and tsunami surged through, a Japanese Red Cross volunteer surveys the damage to Otsuchi in Iwate prefecture.
Photo: ©Japanese Red Cross Society













Amid the ruins,
Red Cross
hospitals were
sources of hope
and light
— literally —
in cities















Many elderly people lived in the towns hardest hit by the tsunami. With their homes destroyed and electrical power cut, they were extremely vulnerable in the bitterly cold nights following the tragedy. Here a patient receives care at the Japanese Red Cross hospital in Ishinomaki.
Photo: ©Japanese Red Cross Society










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