Author: Karim Moutchou
Institution: Medical Student, Fez Faculty of Medicine and Pharmacy
Editors: Akihiko Ozaki M.D., Yuki Senoo
In the previous two articles about my visit to Japan, "My clinical exchange experience in Japan" and "Visit to Fukushima Prefecture," I detailed some of what I learned during my trip, which was organized by the Medical Governance Research Institute (MEGRI). After the visit, I was very motivated to share my experience with my colleagues in my hometown, Fez.
Seminar about my experience in Fukushima:
Fifteen students from different grades were selected to attend the seminar. Following short introductions of myself and the medical students, I presented a general overview of the MEGRI group and its history of activities, as well as its missions related to the Fukushima incident.
I explained the concept of emergency medicine, a subject that is rarely and insufficiently treated and thought about in Moroccan medical schools. Our country has suffered from only a few national natural disasters in the past few decades, mainly earthquakes. The two biggest ones were around 6.5 on the Richter scale. However, students and doctors are not familiar with natural disasters involving nuclear power plant accidents, as the country has never had a nuclear plant or incident. Therefore, nuclear irradiation in itself is a strange concept for most citizens.
To advance the conversation and to correct misconceptions regarding nuclear power plant accidents, I asked the attendees what they knew about Fukushima. I found out that because of the geographic distance between Morocco and Japan, students did not have clear ideas about what had happened in Fukushima. Although some of them said it was a tsunami or earthquake, others suggested that it was a nuclear accident, and none of them knew that the event involved the combination of all the three catastrophes. For this reason, I explained the chain of events that started on the 11th of March of 2011, and I stated that the region is still suffering these events’ consequences. These consequences include rumors and disinformation disseminated around the world, as well as an increased rate of chronic lifestyle-related diseases today.
Summary of the visit:
I divided the presentation into two parts:
The first part was about my two observerships at Juntendo University Hospital and Kobe Medical Hospital. I developed surgical experience in the urology department of the former hospital. Students were impressed by how advanced medical treatments are practiced in Japan. This is because the department was using surgical techniques and tools that have yet to be introduced to Moroccan hospitals.
In Kobe, I had an observership in the cardiology department. In Morocco, people suffer from the lack of cardiology centers and doctors. In fact, our country has only five public hospitals with heart catheterise laboratories. They cover more than 700,000 kms of land and more than 32 million people. In addition, rheumatic fever is still a very serious and common epidemic, with tens of thousands of new cases cropping up every year. Cardiology centers are overwhelmed, and cardiologists have more patients and low-quality work conditions in comparison with international standards.
On the other hand, there are 893 hospitals with cardiology centers in Japan. Considering the large population size in Japan, which is four times greater than the population in Morocco, this is an eye-opening number of hospitals with high-standard cardiology centers.
After this, we took some time to discuss as a group of future doctors what Morocco's health care system could learn from the Japanese health care system. Most of the audience of students agreed that it is not fair to compare the two systems due to the huge differences in their economies, histories, genetics, and cultures. However, they also acknowledged that there are many lessons to learn from Japan, particularly regarding disaster medicine, elderly care, and the introduction of high-technology tools. Our country has been historically dependent on France in many aspects due to decades of colonization. Medicine is practiced in French, and this makes it difficult for students and doctors to open up more about East Asian medicine.
More details about this first part of my trip can be found in this article.
The second part of the presentation was more focused on the Fukushima incident. As I mentioned earlier, Morocco is not familiar with natural disasters. The students were very interested in knowing how Japan had reacted to this massive disaster. The pictures I showed were devastating, and everyone felt sympathy for the victims of the disaster. I went through the details of what I had learned from Dr. Masahiro Kami and the health care professionals working at Jyoban Hospital in Iwaki City, Fukushima. I also distributed the articles and Dr.Tsubokura's booklet about nuclear irradiation.
I explained the actions taken by the government and nongovernmental organizations in the immediate and long terms to help those who were affected by the disaster. I also explained how some of the actions were helpful, whereas others caused more harm than help. I listed the scientific studies I went through, as well as the current situation as I observed it when I visited the region. I also transmitted some fundamental principles I received from health care professionals.
Most of the information I provided in the presentation was new to the Moroccan students. They were interested in knowing in more detail about the evacuation plan that was implemented for various demographic populations, such as newborns, pregnant women, the elderly, persons suffering from chronic diseases, and patients who were in intensive care units at that moment.
Students were also interested in whether the region is still not habitable and if people can eat seafood or local vegetables and fruits in Fukushima. There were also questions about the psychological and physical development of children there as well.
I provide more information on this part of my visit in my second article.
After I finished the second part of the presentation, we started a discussion on what we can learn from the Fukushima disaster and the countermeasures taken in Japan to help our country. The students were divided into small groups of three or four; each group had to present what they had discussed in the group to the other groups.
The presentation of the first group was on evaluations and a comparison of emergency preparedness between Morocco and Japan. In Japan, the government, researchers, and physicians have been studying the long-term and short-term impacts of the Fukushima nuclear power plant accident on the population’s health, and they seem to keep updating the country's emergency preparedness plans as well as international guidelines. These novel actions were not taken in Morocco after the earthquake occurred in 2004, which hit the northern region and killed and injured thousands. The number of deaths and injuries was disproportionate to the magnitude of the earthquake, which was less than 6.3. The students concluded that the unpreparedness of physicians is one of the reasons why many people lost their lives. Sadly, research and national investigation regarding emergency responses are rarely documented in Morocco; therefore, our country is at risk of repeating the same errors.
The second group discussed whether our country’s emergency preparedness plan is sufficient for having a nuclear power plant, which is under contemplation. Currently, Moroccan physicians are not taught how to treat people with nuclear injuries. Students claimed that considering that a minor accident can cause more damage to a third-world country compared with a developed country, medical education should be updated in case the country opens a nuclear plant. In addition, what happened in the Fukushima disaster should be studied in depth at universities.
The third group presented that Fukushima is a good example that illustrates the significant importance of the reinforcement of emergency medicine in our country. Morocco is located between Europe and Africa, limited by the Mediterranean and the Atlantic seas, and it is the home of the Atlas Mountains and the African Sahara. This puts Morocco in the middle of climate change’s consequences, as the cold mountains and the desert suffer from extreme weather events. Also, mass immigration is happening from the African to the European continent through Morocco. This makes the country at risk of desertification, heat strokes, a shortage of water and food, tsunamis, and infectious diseases. Because the country has several weaknesses, immediate actions are required to strengthen the country’s emergency medicine.
At the end:
Although distance and language barriers can make it hard to know a lot about Far East Asian countries, Morocco has a lot to learn from Japan. I am grateful to be one of the few who have had the splendid opportunity to experience and observe the medical system in Japan.
To make the most of my experience, I am committed to disseminating what I learned from my visit to Japan to my colleagues. Furthermore, I would like to keep encouraging others in Morocco to take similar steps to learn more from Japan's health care system and doctors.