Health problems in disaster situations: Deaths, diseases and other problems caused by disasters themselves (Drowning, pneumonia, no electricity and water,etc） Problems induced by low function of health facilities including hospitals（Lack of health personnel, lack of supply of medicines and marerials, etc) Problems induced by low function of public health system and prolonged deteriorated consition(Interruption of immunization and MCH services, mental problems, sanitation, etc) This work was presented during the II Workshop on edical Anthropology in Rome, on October 14th - 15th 2011

1. Disease structure of affected people
of the earthquake and tsunami
disaster in Northwest Japan
Tamotsu Nakasa
NCGM
National Center for Global Health
and Medicine

2. Higashimatsushima City
Population：42,908
Affected people: 14,000
1,031 Died 395 missing
Shelters: 160-180
Sea water
invasion
（６５％）

3. Situation

4. Relief activities for Higashimatsusima City
by NCGM
3/11 3/17 3/21 4/1 7/1 9/30
Organization
NCGM
1st 2nd 3rd 4th-48th total 239 49th -53rd Total 31
Personnel Team Team Team Outreach medical services for shelters (MD, nurses etc)
Sendai MC Higashi-M.
Mental
Care
Mental
Care
Mental
Care
Mental
Care
24 Personnel
Team Team Team Team (MD, PSW etc)
Outreach medical Rebuilding support for Public
3/16 7/1
DMAT services for shelters Health Administration
Activities Higashi-M.
Household survey to affected houses
4672 (4/28-7/30)

5. Health problems in disaster situations
1. Deaths, diseases and other problems caused
by disasters themselves
(Drowning, pneumonia, no electricity and
water,etc）
2. Problems induced by low function of health
facilities including hospitals
（Lack of health personnel, lack of supply of
medicines and marerials, etc)
3. Problems induced by low function of public
health system and prolonged deteriorated
consition
(Interruption of immunization and MCH
services, mental problems, sanitation, etc)

6. What happened ?
• Few severe emergencies cases
• Lack of health personnel
• Destruction of hospitals and Interruption of
supplies
• No instruction from central and middle level local
government
• No information (No services
of portable telephones)
• High percentages of elderly
people

7. Number of patients at Emergency
department of Sendai Medical Center
3/11 3/12 3/13 3/14 3/15 Total
Severe 19 7 4 8 38
Middle 38 39 31 49 157
Light 31 58 69 81 239
Total 88 104 104 138 152 586
Admis
sion
26 47 28 42 41 184

8. One month later, shelters
（1）Chronic disease
（2）Hospitals nearby start
functioning
（3）Evacuees start to work and go
back to their homes

9. SHELTERS
Existing facilities
- Gymnasium of a school
- Public hall
- Temple

10. Public bath Toilet
Solar electricity

12. Number of patients by diseases from 3/22 to 5/10 in
Higashimatsuishima city URI
Upper respiratory infection
hypertention
hay fever/ allergic rhinitis
insomnia Allergic rhinitis Hypertension
others
trauma Insomnia
other respiratory diseases
diabetus mellitus/…
decubitus (bedsore)
eczema/ dermatitis
joint pains
other orthopedic diseases
lower respiratory infections
other cardiovascular diseases
ophthalmologic diseases
low back pain/ lumbago
constipation
gastroenterocolitis/…
urological diseases
bronnchial asthma
headache/ vertigo
otological diseases
other psychiatric diseases
oral and maxillofacial diseases
other gastroenterological diseases
gout/ hyperuricemia
abnormal lipid metabolism
schizophrenia
deep venous thrombosis
unknown
ischemic cardiac diseases
influenza
other exanthem
brain stroke/ apoplexy N:1446
paediatric diseases
obstetric diseases
0 50 100 150 200 250 300 350 400

14. 100%
10%
20%
30%
40%
60%
70%
80%
90%
0%
50%
3月22日
3月23日
3月24日
3月25日
3月26日
3月27日
3月28日
3月29日
3月30日
3月31日
4月1日
4月2日
4月3日
4月4日
4月5日
4月6日
10歳未満
4月7日
4月8日
Over 60 years
4月9日
65%
4月10日
10-19歳
4月11日
4月12日
4月13日
20-59歳
4月14日
4月15日
Number of Patients by age
4月16日
1% 2% 4%
4月17日
60歳以上
4月18日
Trend of aging groups
4月19日
4月20日
28%
4月21日
4月21日
年齢不明
4月22日
4月25日
4月26日
4月27日
4月28日
4月29日
20-59 years
2011/3/22-5/10
4月30日
5月2日
5月3日
5月4日
5月5日
5月6日
5月7日
5月9日
N:1446
5月10日

15. Household survey at affected areas in
the city of Higashimatsushima
• Study period : 4/28-7/28
• Interviewer: Public health nurse
• Total Number : Total Households 4,672
15,503 residents (About 40% of total households)
• Male:48% Female:52%
• Main Purpose is
- Indentify the persons who needs medical and
mental supports

16. Sea water invasion areas and damaged houses

17. Sea water invasion areas and houses

18. Number of the study

20. Coverage rate of the study

21. Hypertension

22. Rate of Hypertension by area
Akai
Omagari
Yamoto
Ono
Nobiru
Rate of
HTN
＜16%
16-17%
Miyato 18-20%
≧21%
Unstudied aress

23. Odds Ratio HTN vs Depression

24. Depression

25. Rate of Depression by area
Akai
Omagari
Yamoto
Ono
Nobiru
Rate of Depression
＜9%
9-10%
Miyato 10-11%
≧11%
Unstudied aress

26. Coughs

27. PTSD

28. Rate of PTSD by area
Akai
Omagari
Yamoto
Ono
Nobiru
Rate of PTSD
＜4%
4-5%
Miyato 5-6%
≧6%
Unstudied aress

29. Sea water invasion vs Depression

30. Damage of buildings vs Depression

31. Damage of buildings vs Depression

32. Sea water exposure vs PTSD

33. Sea water exposure vs coughs

34. Damage of buildings vs Depression

35. Rate of Diabetes by area
Akai
Omagari
Yamoto
Ono
Nobiru Rate of DM
＜4%
4-5%
≧5%
Miyato
Unstudied aress

36. Conclusion
• Main causes of diseases post disaster period are
URI(Upper respiratory
infection), Hypertension, Allergic rhinitis and
insomnia.
• The number of URI cases declined and the
percentages of hypertension and insomnia
increased after the first month.
• According to the household survey , some
persons who did not have hypertension began
suffering from it, and some showed signs of
depressive tendencies