Tae-Hwa Chun's Japan tsunami medical mission
In early April 2011, fellow Keiko Asao, M.D., M.P.H., Ph.D. and Tae-Hwa Chun, MD, PhD, both MEND Division endocrinologists, joined the effort to provide medical care to those in Japan affected by the earthquake and resulting tsunami that hit the country in March.
To read about Dr. Keiko Asao's experience, see: http://www.uofmhealth.org/News/Japan+medical+mission
Dr. Chun was part of a medical team organized by the Association of Medical Doctors of Asia (AMDA). Here is his account:
ANN ARBOR, April 15, 2011 — I took a bus that left Tokyo at 11 pm on April 3 and arrived at Sendai station at 5 am on April 4. From there, I took a taxi with another doctor to Minamisanriku-cho, which took 2.5 hours. We were sent to the Shizukawa elementary school, one of the major shelters in the town of Minamisanriku-cho in the Miyagi prefecture.
The town was completely washed away by the tsunami and the evacuees of the town had been enduring cruel conditions without any access to water or electricity for over three weeks. When I got there, the norovirus gastroenteritis infection was widespread, as the evacuees could not wash their hands with running water while sharing bathrooms without flushing water.
On the first day, I helped an Israeli medical team set up as a well-equipped clinic next to the largest shelter of the town, located at the Bayside Arena. Beginning on the second day, I engaged in the outpatient clinic at Shizukawa elementary school, and participated in the management of norovirus patients isolated in the different classrooms, in an effort to separate the infected from the healthy evacuees.
The outpatient clinic was a temporary one set up in the annex of the school gymnasium, where 400 people were crammed. Dr. Sasahara, a local doctor who used to practice in the region and whose clinic was destroyed by the tsumani, was wokring in the clinic 24/7 with the doctors of the AMDA. Nurses and pharmacists who used to work at Shizukawa hospital – the largest local hospital that became dysfunctional with the tsunami water filled up to the 4th floor - helped us at the outpatient clinic, while the AMDA nurses took care of the norovirus patients.
I also initiated the effort for the evacuees to reorganize bathrooms and sanitize the nearby floor with 2% bleach — which is higher than the usual concentration, as the norovirus is resistant to a bleach of lower concentration. Evacuees were encouraged to apply 70% ethanol gel or spray to their hands for at least one minute after using bathroom and before eating — longer than usual, as norovirus is more resistant than others. Drinking water and food were supplied by a Japanese self-defense army dispatched from Okinawa and volunteers from other groups; however, the food was nutritionally limited, which may have contributed to the decreased immunity of evacuees. In fact, there were a few cases of tuberculosis in elderly evacuees in the nearby area.
I stayed there from April 4 through April 8 before driving to Hanamaki airport to catch a flight on the morning of April 9. The school was rattled by the largest aftershock on April 7 around midnight. While we stayed in one of the classrooms, a few light bulbs dropped from the ceiling in the gymnasium and shattered on the floor. Luckily, nobody was injured — but the evacuees were frightened by the unexpected strength of the aftershock. The electricity was widely down in the Miyagi and Iwate prefectures on the following day, when we drove to Hanamaki airport.
I felt that my stay there was short and wanted to stay longer, to ensure that the outpatient clinic would run smoothly and that the norovirus infection would be confined. I also had a guilty feeling of being a visiting doctor, while the local doctor and nurses had to stay there and endure the hardships for months and years to come. However, I needed to come back to Ann Arbor to take care of my family with a small baby, resume my research activities, see scheduled patients, and attend a conference. Fortunately, I heard news that electricity was resumed in some parts of Minamisanriku-cho on April 15 and that the noroviral infection in the school had gone down to zero, after more water became available to improve hand hygiene.
Part of the mission might be similar to that required to help the evacuees of Hurricane Katrina that happened in US. We needed to take care of older patients with multiple chronic diseases without any medical or prescription records in their hands while facing the challenge of a norovirus outbreak due to the lack of hand hygiene.
On the last day of my stay, we managed to recruit a famous singer— Takeshi Kitayama to visit us and encourage the evacuees. His singing a song in gymnasium without a microphone (as we didn’t have electricity) and personally talking to each family gave mental relieves to the weary and depressed evacuees; they became joyous with his visit talking hope and patience.
I hope they will soon establish all the access to water, food, and electricity, and begin a better life in temporary housing dedicated to each family. The evacuees were very patient and kept their hope to rebuild their hometown, but their lives need to be eased as soon as possible by the accelerated efforts of the government and continuous help from people around the globe. We should not forget that there still are so many people enduring very cruel conditions with very poor lifelines.
I really appreciate that the University of Michigan continues to care for those who are suffering. I am very thankful to my wife, Mayumi Inoue, and my baby daughter who allowed me to be away more than a week to do the volunteering. Actually, the volunteering mentally helped me, rather than being anxious about the situation without seeing what’s really happening. I am very thankful for the opportunity to be part of the medical team.
— Tae-Hwa Chun, MD, PhD, Assistant Professor of Internal Medicine
Division of Metabolism, Endocrinology & Diabetes, University of Michigan Medical School