Reflections on DMAT Deployment Activities for the 2024 Noto Peninsula Earthquake

2024/03/15

Image: Scenes from the disaster area

On January 1, 2024, all of Japan was shrouded in deep sorrow. The Noto Peninsula Earthquake, with a magnitude of 7.6 and a maximum seismic intensity of 7, claimed many lives in a short period. We would like to express our deepest sympathies to those affected by this immense disaster. While many victims are still forced to live under harsh conditions, we would like to report on the activities of the Keio University Hospital DMAT team. On January 11, our DMAT team was dispatched to the Noto Peninsula based on instructions from the Tokyo DMAT Coordination Headquarters. Keio University Hospital has a roster of 6 doctors, 4 nurses, and 2 logistics experts (commonly known as "Logi"), but for this mission, a team of 5 (1 doctor, 2 nurses, and 2 Logi) was formed to carry out a 9-day deployment until January 19.

DMAT stands for Disaster Medical Assistance Team, a mobile medical team trained to operate during the acute phase of a disaster. Regardless of their profession, all members have acquired the knowledge and skills necessary for self-sufficient living in disaster areas where lifelines are cut off, safety management during activities, and medical activities outside of hospitals. Doctors manage the health of team members and lead medical activities; nurses support medical activities and provide physical and mental care for victims; and Logi members handle long-distance driving and activity recording to ensure the team's mobility. While they usually perform different duties in their respective workplaces, they work together as a single team during disaster dispatch.

For the dispatch to the Noto Peninsula, we chose to travel by camper van, considering the severed lifelines and the long-term nature of the activity. Since bad roads and traffic jams were expected beyond Ishikawa Prefecture, particularly around Nanao City, we stayed overnight in Toyama Prefecture and drove toward the disaster area early on the morning of January 12. By this time, DMAT teams from across the country had already begun activities, but our team, along with those from Tokyo and Chiba, was instructed to gather in Wajima City on the northern side of the Noto Peninsula. The roads leading to Wajima and Suzu, which were particularly hard-hit, all pass through Anamizu Town at the base where the peninsula turns east. Upon reaching Anamizu, we saw many completely destroyed houses, and the roads became treacherous due to liquefaction and landslides. Furthermore, reaching the Wajima city center required crossing mountains, and it took about six hours to arrive at the Wajima City Health and Medical Coordination Headquarters (DMAT gathering point) inside the Wajima City Hall. During this time, we had already begun activities within the disaster area, such as eating emergency rations and using portable toilets while moving, which made us keenly feel the reality of lifelines being cut off even nearly two weeks after the earthquake.

In Wajima City, a vast number of houses and buildings had collapsed, almost all roads were cracked, and the area around the city hall was in an unsafe state due to liquefaction. We began activities immediately upon arrival to lighten the burden on the victims as much as possible. The Keio DMAT team leader was appointed as the Deputy Chief of the DMAT Activity Base Headquarters, and all team members were assigned roles in headquarters operations. We were in charge of the Welfare Facility Group, supporting welfare facilities and residents within the city. This proved to be a difficult support mission because Wajima's geography stretches east to west, and the roads from the Wajima district base to the Machino district in the east and the Monzen district in the west were easily blocked by snow.

There are two main types of support provided by DMAT teams to welfare facilities during disasters. The first is to ensure the safety of residents and staff by providing medical care and appropriate medical transport for the sick and injured while delivering relief supplies. This requires DMAT teams to visit the facilities, and we implemented this by directing up to 11 DMAT teams assigned to the Welfare Facility Group according to the geographical location and scale of the facilities. While the types and quantities of supplies requested by staff varied daily, we coordinated with the headquarters' logistics group, which managed the complex flow of relief goods in the disaster area, to ensure the health of residents and staff to the greatest extent possible. The conversations we had with the victims during these support activities remain deeply etched in my memory.

The other important support is facility evacuation. In disaster areas, even under harsh conditions unimaginable in normal times, a system of mutual aid naturally emerges among the local people. This spirit of helping one another is a source of pride praised by other countries, but sometimes these activities and actions reach a breaking point, like a taut string snapping. Even in the facilities we were responsible for, where all lifelines such as electricity, water, gas, and food were cut off, there was a strong will to keep persevering. However, if even one staff member falls ill, it becomes difficult to maintain the health and safety of the residents. DMAT members and facility staff consulted directly many times regarding the objective necessity of evacuation, and ultimately, most facilities reached the decision to evacuate. The evacuations were carried out successfully through cooperation between the Japan Self-Defense Forces and DMAT members.

On the seventh day of local activities, having grown accustomed to emergency rations and sleeping bags, we handed over our duties to a newly arrived DMAT team and began our journey home. For most members, this was their first disaster dispatch, but the fact that all members returned safely on the afternoon of January 19 is thanks to everyone who supported our activities. Furthermore, the DMAT team has resumed activities, including coordinating chronic phase medical support for the Noto Peninsula, which will continue in the future.