Authors: Karim Moutchou
Institution: Medical Student, Fez Faculty of Medicine and Pharmacy
Editor: Akihiko Ozaki, M.D., Yuki Senoo
Students around the Arabic world are taught during high school geography classes that Japan is a unique East Asian country. At my school, the lessons about Japan always started and ended with the same sentences: “Japan is a country that faced and is still facing a lot of natural challenges. However, they are always overcoming these challenges and have grown powerful in their foreign relations.” The textbooks then explain in numbers the natural disasters that Japan has experienced every year, from earthquakes to massive tsunamis. After that subject, students are taught the current economic situation of Japan as an “economic superpower” and a member of the G7 club.
When I visited Japan, I had a chance to visit Fukushima Prefecture and observe natural disaster management programs. Coming from a naturally safe country where there have been only two major earthquakes in the last century, I was intrigued to visit the place where people experienced a disaster known worldwide.
Earthquake experiences in Morocco
Before I talk about my experience in Fukushima, I would like to introduce the history of earthquakes in Morocco. In the 70s, a major earthquake hit the city of Agadir in the South of Morocco. It was 6.7 on the international scale and entirely destroyed the city, causing dozens of thousands of deaths. You can easily recognize how destructive the earthquake was when you walk around the city because the streets appear new. It is the only major city without an old historical part in Morocco.
Three decades later, another major earthquake hit Morocco and was evaluated as a 6.3 in power. Thousands were killed and displaced in the northern city of Alhoceima; the aftermath of this disaster is still visible there now.
Interview with Dr. Tsubokura
I was interested in the triple disaster at Fukushima because it is the most recent and widely known major catastrophe that Japan has experienced, and also because there is a relatively large amount of data available on the internet, including articles published by major medical journals and international news media. Furthermore and most importantly, it involves many major problems at the same time: earthquakes, tsunamis, and health problems related to radiation exposure.
Before the field study, I had a chance to talk with Dr. Tsubokura, who is a medical doctor also conducting research in Fukushima about the evacuation process that took place there. A study conducted by Dr. Tsubokura’s team compared the survival rates of patients who were evacuated and of those who stayed in safe areas after the accident at TEPCO’s Fukushima Daiichi Nuclear Power Plant. Surprisingly, the study demonstrated that those who had remained in their hospitals or nursing homes in Fukushima had a higher survival rate than those who were evacuated. This conclusion goes against what most, if not all, the general and medical population would assume. It certainly calls into question the process of evacuation during disasters and the obligatory risk-benefit evaluation.
Visiting Joban Hospital In Fukushima
I visited Joban Hospital in Iwaki City, which is located 80 kms away from the nuclear plant. It must have been a distinctive experience for any doctor or paramedical staff to deal with the circumstances in a post-nuclear catastrophe, where there are no guidelines that can offer enough knowledge or ensure safety to anyone.
At Joban Hospital, many medical doctors and nurses were not only doing their best to prevent further radiation exposure, heal patients, and explain radiation exposure risks to residents; they were also doing a lot of medical research for evidence-based medicine to follow on their practices. Research done at the hospital on the nuclear disaster serves as an excellent database for all concerned countries in case a similar situation happens.
In order to surveil the radiation air dose, free radiation measurement centers were implemented in many areas in Iwaki City to provide residents a sense of comfort for living in the city. Furthermore, residents at any time can have quick tests to check their levels of internal radiation exposure, by personal choice or by employer request. Several hospitals in Iwaki City are equipped with a whole-body counter, which is a device used to scan the whole body for its internal radiation dose. Moreover, some hospitals have a machine called “baby-scan,” which is a special device designed to measure internal radiation dose for infants, whose bodies are much smaller and need more precise devices. One relieving finding from investigations conducted among 8360 infants in Iwaki City from April 2012 to December 2013 is that levels of radiation exposure with radioactive cesium exceeding 10Bq/kg were not detected in 99.9% of infants; radioactive cesium exceeding 10Bq/kg was detected in only one infant, who in one month had another scan that then showed below 10Bq/kg.
After the visit to Joban hospital, I also visited an institution for infants, which was opened to keep them healthy and well-educated while at the same time safe. Most of the infants were the children of hospital staff. I was amazed at how detailed and refined many of the considerations were for the safety of infants in this institution. Even without being outside, children were put in physical motion most of the time to prevent obesity; for a few years after the disaster, many people felt uncomfortable letting their children play outside. Special emotional and educational support is offered by specialized nursery teachers. A radiation measurement machine was placed in the playground of the kindergarten to keep track of the radiation air dose rates and indicate whether children in the area can safely play outside.
Impressions from Fukushima visit What I learned from this experience is that the medical community plays the most major role in the aftermath of natural disasters. Doctors in Fukushima Prefecture offer not only medical treatment but also scientific research to evaluate the health status of residents in the community. The constant evaluation of the short, medium, and long terms in the post-nuclear disaster field provides a lot of data that could support construction of countermeasures and guidelines, for both the area and countries worldwide.
Although my country is in a relatively safe area when it comes to natural disasters, we have so much to learn from the Japanese experience. Catastrophes by natural events are rare, but that doesn’t mean they’re impossible, which is why we need to reevaluate how we and other countries have dealt with them in the past. After visiting Fukushima, I strongly feel that Morocco should adapt international guidelines to our context and introduce the lessons from other countries’ natural disasters into our educational system, from primary school throughout to medical school.