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