Friday, May 13, 2011

Care for Japan

SHARING THEIR EXERIENCES: From left, Hasegawa, Tom LaSalvia, associate director of the MGH Center for Global Health, Harris and Shiga

Fewer than 36 hours  after Japan suffered a devastating earthquake and tsunami on March 11, three MGH physicians were en route to the country to aid in relief efforts. Having spent two weeks working to help treat and carefor the victims, Takashi Shiga, MD, Kohei Hasegawa, MD, and N. Stuart Harris, MD, MFA, recently gathered in the O'Keeffe Auditorium to talk about their experiences in Japan. In conjunction with the MGH Department of Emergency Medicine and the MGH Center for Global Health, the three presented "MGH Responds: A 'Japanese Solution' to the Tsunami Disaster" on April 15. The three physicians shared firsthand accounts of serving with the Tokushukai Medical Assistance Team and offered their perspectives on the relief efforts.

Speaking first, Shiga, an MGH Emergency Department (ED) attending physician and Japanese native, outlined how the Japanese government's response to the disaster was born out of the 1995 earthquake in Kobe, during which relief efforts were slow and a lack of communication proved to be a major hurdle. Since then, the government has created a more effective mobilization plan and infrastructure, Shiga said. There is now an online system for tracking the capability of each hospital during an emergency event as well as countrywide helicopter evacuation plans and procedures. He added that the Japanese government recognized the need to send medical teams to the disaster site as soon as possible in order to receive accurate and timely assessment of the situation.

"If you wait in a disaster with no phone, no internet and likely no satellite phone, unless you get to the scene you will not get the right information," he said.

Hasegawa, a senior ED resident at MGH, also shared how he and his fellow physicians became involved with the relief efforts. Because the government intended the response to be led by the Japanese people, many non-Japanese relief agencies were sidelined. Since both Shiga and Hasegawa were Japanese nationals and Harris had spent considerable time in the country as an English teacher, they were able to join a small team organized by BWH radiologist Alisa Suzuki-Han, MD.

"Each member of our team had ties to Japan and was able to offer emergency medical, wilderness medicine, and linguistic and cultural experience," said Hasegawa.

Harris then discussed details of their work at Hashikami Junior High School in Kesennuma, which had been converted to a shelter for approximately 1,200 people. Upon arrival, the assistance team immediately set up an intake system within the shelter, taking vital signs and talking with displaced residents. Harris noted that, unlike other disasters, there was a relatively small range of injuries.

"In the initial response I was surprised that there was so little trauma," said Harris. "The vast majority of what we treated early on was really acute exacerbation of chronic disease."

After a 36-hour period of treating patients within the shelter, Harris and his team began working with the local visiting nurse associationto move further into the countryside and treat residents who hadnÕt relocated to the shelter. Harris, who is the director of the MGH Wilderness Medicine Fellowship, explained how wilderness medicine Ð practiced under austere and resource-limited conditions Ð can be useful in disaster situations.

Concluding his presentation, Harris shared photos of local residents, colleagues and disaster relief partners and reflected upon his experience.

"Kesennuma taught us that, even as our patients were profoundly grieving, they displayed more courage, compassion, playfulness, hospitality, good humor, persistence, pride and hope than we could have imagined."  

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