Kenichi Murakami: What is Disaster Medicine?

June 14, 2024

Are you familiar with the term "disaster medicine"? On the website of the Japanese Association for Acute Medical Sciences, it is described as "medical care provided in a state where demand exceeds supply." Specifically, during a disaster, more people visit medical institutions than in normal times (increase in demand). On the other hand, because the medical institutions themselves are affected by the disaster, their clinical functions are reduced compared to normal times (decrease in supply). It is about how to provide medical care under such circumstances.

I work as a neurosurgeon at a hospital in Hakusan City, adjacent to Kanazawa City in Ishikawa Prefecture, but I am also a member of a DMAT (Disaster Medical Assistance Team) that operates during the acute phase of a disaster. On January 1, 2024, the Noto Peninsula Earthquake occurred with a maximum seismic intensity of 7. Consequently, from January 1 to mid-March, I was engaged in actual disaster medicine at the DMAT headquarters established within the Ishikawa Prefectural Government Office.

The mission of the DMAT this time was to confirm the damage status of medical and welfare facilities in the Noto region and provide necessary support. However, since the damage to buildings and water/sewage systems was extensive, we first had many inpatients and residents of medical and welfare facilities evacuate to the Kaga region or other prefectures. Afterward, we provided support to maintain the medical and welfare facilities. DMAT teams gathered from across the country, including Keio University Hospital, worked as local DMAT teams in the Noto region (please see the March issue of Mita-hyoron (official monthly journal published by Keio University Press)).

Meanwhile, at the DMAT headquarters in the Ishikawa Prefectural Government Office, we analyzed information sent from local DMAT teams, first calculated the number of evacuees, secured destinations and means of transportation, and carried out the actual evacuations. Subsequently, we procured necessary supplies (water, food, fuel, pharmaceuticals), services (bathing, laundry), and personnel (doctors, nurses, caregivers) to maintain medical and welfare facilities. Unlike in normal times, the organizations we consulted were diverse, including Ishikawa Prefecture, the Ministry of Health, Labour and Welfare, the Self-Defense Forces, industry groups, and NPOs.

What I understood from actually working this time is that disaster medicine means "creating a new medical system different from normal times in order to provide medical care during a disaster."

In present-day Japan, where a disaster could occur anytime and anywhere, I believe it is necessary for more people to learn about disaster medicine.