This is Chapter 1 in a newly published textbook entitled "Case Studies in Public Health Preparedness and Response to Disasters" -- "The Great East Japan Earthquake of March 11, 2011. This chapter describes what is probably the best example historically of what has come to be known as a "cascading crisis": earthquake, tsunami, with secondary nuclear reactor damage. http://www.jblearning.com/catalog/9781449645199/
Fukushima Disaster and its introduction, Fukushima accident , causes and their impacts on people , social life , economy , nature and our environment and their solutions
This is a PowerPoint Presentation based strictly on Tsunami.
Here one can find the following details about Tsunami:
Definition of Tsunami
Major Causes of Tsunami
Pictures Related to Tsunami
Analytical and Statistical information
And other more useful details .
So Hope you like it
Thankyou
Fukushima Disaster and its introduction, Fukushima accident , causes and their impacts on people , social life , economy , nature and our environment and their solutions
This is a PowerPoint Presentation based strictly on Tsunami.
Here one can find the following details about Tsunami:
Definition of Tsunami
Major Causes of Tsunami
Pictures Related to Tsunami
Analytical and Statistical information
And other more useful details .
So Hope you like it
Thankyou
POWERPOINT Summary PART II of the 2012 Atlantic hurricane and tropical storm season
The prolonged recovery from Hurricane Sandy is continuing to take a mental and physical toll on residents of the East Coast who are still cleaning up flood, fire, and wind damage.
Powerpoint presentation courtesy of Dr Walter Hays, Global Alliance for Disaster Reduction
Mitigation and adaptation strategies for coping with the potential adverse effects of global climate change. If the predictions are right, we will be living with the effects of global climate change for the rest of our lives. Presentation courtesy of Dr. Walter Hays, Global Alliance for Disaster Reduction.
IN THIS TOPIC I HAVE MENTIONED WHAT IS EARTHQUAKE AND ITS EFFECTS , CAUSES.
SOME PRECAUTIONS FOR THE PEOPLE.AND SOME MAJOR EARTHQUAKES IN INDIA.
HOPE ALL OF U LIKE IT
Study of earthquake hazards or disaster Jahangir Alam
Earthquake Hazards
Definition of Hazard
Liquefaction
Ground Shaking
Ground Displacement
Flooding
Tsunami
Fire
Types of Hazard
Natural Hazards as Earthquakes
What Are Earthquake Hazards?
Ground Shaking:
this paper tells about reasons for earthquakes, how the earthquakes happen,earthquake effects on buildings,how the buildings are respond to the earthquakes and design methods to be fallowed while designing a structure to resist earthquakes
Particulate matter is a mixture of very small solids and liquid droplets that float in the air. Some particles come from a specific source (such as a burning candle), while others form as a result of complicated chemical reactions. While much is known about the health effects of exposure to particulate matter outdoors, the effects of indoor exposure are less well-understood. However, indoor exposure to particulate matter is gaining attention as a potential source of adverse health effects.
Two drivers stand out in this analysis because of their potentially large and negative effect on disaster risk, and the low associated uncer tainty of their future trends: global environmental change and demographic change. But others stand out for a different reason: while they have the potential to greatly increase disaster risk, there is also potential for effective policy action to achieve risk reduction. Urbanisation provides the clearest example: unmanaged growth of cities, par ticularly those in low elevation coastal zones, would leave millions in extremely vulnerable situations, but there will be oppor tunities for policy makers to intervene to increase resilience in urban areas. Other drivers, for example globalisation, have extremely complex interactions with disaster risk, but must nonetheless be considered. In this lecture I will discuss the impact of each of the eight drivers on disaster risk is considered.
The objective of this study is to evaluate the seismic hazard at the northwestern Egypt using the probabilistic seismic hazard assessment approach. The Probabilistic approach was carried out based on a recent data set to take into account the historic seismicity and updated instrumental seismicity. A homogenous earthquake catalogue was compiled and a proposed seismic sources model was presented. The doubly-truncated exponential model was adopted for calculations of the recurrence parameters. Ground-motion prediction equations that recently recommended by experts and developed based upon..
A powerful 7.5 magnitude earthquake rocked parts of South Asia on 26 October 2015. It was centred near Jurm in northeast Afghanistan, 250 kilometres (160 miles) from the capital Kabul and at a depth of 213.5 kilometres, the US Geological Survey said. (AFP, 26 Oct 2015) Pakistan's confirmed death toll so far stands at 272, with more than 1,900 people injured and nearly 14,000 homes damaged, though the spokesman said the NDMA was still in the process of estimating a final toll. (AFP, 28 Oct 2015) In Afghanistan, Assessment reports indicate 117 deaths, 544 people injured, 12,794 homes damaged and 7,384 houses destroyed. Furthermore, 136,967 people are still in need of humanitarian assistance, of which 131,345 people have received some form of assistance so far date. More than 51,000 people were affected in Badakhshan alone, where property damage was most extensive. The earthquake claimed the most lives and caused the most casualties in Kunar and Nangarhar provinces. Access remains the most significant challenge in providing assistance to people in need and is an issue reaching at least 194 villages affected by the earthquake.
A torrential rain event during the first full week of March 2016 featuring over two feet of record March rain in the South unleashed major river flooding, rising to historic levels in some areas. Add flooding along the Gulf Coast, and the disaster became a triple assault. In all, 400 homes flooded in Mississippi. Three people were killed in Louisiana, the governor said. In one case, a driver died when floodwater swept his vehicle off a road in Bienville Parish, the Governor's Office of Homeland Security and Emergency Preparedness said. The two others died in Ouachita Parish, according to the Louisiana Department of Health and Hospitals.
The 2016 Ecuador earthquake occurred on April 16 at 18:58:37 ECT with a moment magnitude of 7.8 and a maximum Mercalli intensity of VIII (Severe). The very large thrust earthquake was centered approximately 27 km (17 mi) from the towns of Muisne and Pedernales in a sparsely populated part of the country, and 170 km (110 mi) from the capital Quito, where it was felt strongly. Regions of Manta, Pedernales and Portoviejo accounted for over 75 percent of total casualties.[6] Manta's central commercial shopping district Tarqui, was completely destroyed. Widespread damage was caused across Manabi province, with structures hundreds of kilometres from the epicenter collapsing. At least 659 people were killed and 27,732 people injured. President Rafael Correa declared a state of emergency; 13,500 military personnel and police officers were dispatched for recovery operations.
The moderate-magnitude quake struck at 9:26 p.M. Thursday night at a depth of 11 kilometers (7 miles) in southern Japan near Kumamoto city on the island of Kyushu. The epicenter was 120 kilometers (74 miles) northeast of Kyushu Electric Power Company's Sendai nuclear plant, the only one operating in the country; no adverse consequences were reported.
Lesson: the knowledge and timing of anticipatory actions is vital
The Kathmandu Valley is densely populated with nearly 2.5 million people, and the quality of building construction is often poor. The epicenter of today's disaster was 80 kilometers (50 miles) northwest of the city, and had a depth of only 11 kilometers (7 miles), which is considered shallow in geological terms. This earthquake, the worst quake to hit Nepal (a poor South Asian nation) since 1934, collapsed buildings and houses, leveled centuries-old temples and triggered avalanches in the Himalayas. Presentation courtesy of Dr Walter Hays, Global Alliance for Disaster Reduction.
The Third UN World Conference on Disaster Risk Reduction was held from 14 to 18 March 2015 in Sendai City, Miyagi Prefecture, Japan. Several thousand participants attended, including at related events linked to the World Conference under the umbrella of building the resilience of nations and communities to disasters. The United Nations General Assembly Resolution for 2013 on International Strategy for Disaster Reduction states that the World Conference will result in a concise, focused, forward-looking, and action-oriented outcome document and will have the following objectives:
* To complete assessment and review of the implementation of the Hyogo Framework for Action;
* To consider the experience gained through the regional and national strategies/institutions and plans for disaster risk reduction and their recommendations as well as relevant regional agreements within the implementation of the Hyogo Framework of Action;
* To adopt a post-2015 framework for disaster risk reduction;
* To identify modalities of cooperation based on commitments to implement a post-2015 framework for disaster risk reduction;
* To determine modalities to periodically review the implementation of a post-2015 framework for disaster risk reduction.
Presentation courtesy of Dr Walter Hays, Global Alliance for Disaster Reduction
March 15, 2015: The second world conference on disaster risk reduction convened in Sendai, Japan will re-invigorate the historic global endeavor started in 1990 by the United Nations. Presentation courtesy of Dr Walter Hays, Global Alliance for Disaster Reduction
Popocatapatele and Colima, two of Mexico’s most active volcanoes, are acting up again. For now the eruptions are not considered to be dangerous and no evacuations have been ordered. But don’t forget that the world’s 1,498 other active volcanoes can erupt at anytime too. A re-eruption of any of these active volcanoes is likely to be very devastating, locally, regionally, and globally. Location and a large explosivity index (VEI) combine to make some volcanoes especially dangerous. Location refers to proximity to cities and other areas of high human population density. An eruption with large VEI at such locations is certain to be devastating to people, their property, their health, the community infra-structure, the environment, and the economy. Presentation courtesy of Dr Walter Hays, Global Alliance for Disaster Reduction.
INDIA IS BIG, DIVERSE, and CAPABLE. It is the seventh largest country, The second most populous country with human resources of over 1.2 billion people having cultural and religious diversity, The most populous democracy, with many well- educated and well-trained people, with high-tech and low-tech capabilities. On the downside, it is also a country with many living in poverty, with many living in non-earthquake-resistant housing, with cities and towns that are dependent upon non- earthquake-resistant infrastructure and critical facilities. India faces potential disasters each year from floods, earthquakes, and cyclones, some of which have triggered notable disasters in the past, and very recently. That will happen again, unless a paradigm shift occurs. Disaster resilience has become an urgent global goal in the 21st century as many Nations are experiencing disasters after a natural hazard strikes, and learning that their communities, institutions, and people do NOT yet have the capacity to be disaster resilient. Disaster resilience does not just happen; it is the result of decision-making for a national paradigm shift from the status quo to an improved “coping capacity” that enables the country to rebound quickly after a disaster. A paradigm shift towards earthquake disaster resilience is a three step process. Step 1: Integrate Past Experiences Into Books of Knowledge. Step 2: From Books of Knowledge to Innovative Educational Surges to Build Professional and Technical Capacit. Step 3: From Professional and Technical Capacity to Disaster Resilience. In summary, BOOKS OF KNOWLEDGE are are “TOOLS” to facilitate India’s continuing commitment to minimize the likely impacts of the inevitable future earthquake, thereby preventing another disaster
Disaster resilience, which is the capacity of a country to rebound quickly after the socioeconomic impacts of a disaster, requires decision-making for a national paradigm shift from the status quo. Disaster resilience has become an urgent global goal in the 21st century as many Nations are experiencing disasters after a natural hazard strikes, and learning that their communities, institutions, and people do NOT yet have the capacity to be disaster resilient. Presentation courtesy of Dr Walter Hays, Global Alliance for Disaster Reduction.
On January 29, 2015, a routine delivery of gas to a maternity hospital in Mexico City leads to a deadly explosion killing 4 and injuring dozens. The explosion occurred when a gas tanker was making a routine, early morning delivery of gas to the hospital kitchen, and gas started to leak. The tanker workers worked for 15 to 20 minutes to repair the leak while a large cloud of gas was forming, then exploded. Technologies for monitoring, forecasting, and warning are vital for becoming resilient. Presentation courtesy of Dr Walter Hays, Global Alliance for Disaster Reduction
Disasters are caused by single- or multiple-event natural hazards that, (for various reasons), cause extreme levels of mortality, morbidity, homelessness, joblessness, economic losses, or environmental impacts. The keys to resilience: 1) know the history of past disasters 2) be prepared 3) have a warning system 4) evacuate 5) learn from the experience
As we begin the year 2015, we must unfortunately recognize that it is well past the time to speed up the long-term recovery process for earthquakes (and tsunamis). The main insights from global earthquakes have consistently shown that being prepared includes pre-earthquake planning for post-earthquake recovery ("PEPPER"). Only about 110 of the 10 million earthquakes of all sizes that occur somewhere in the world each year are large enough and close enough to a community to cause a disaster, which creates a multitude of local and regional dilemmas about what to do, both before and after the quake, to shorten the recovery process. THE SOLUTION: PRE-EARTHQUAKE PLANNING FOR POST-EARTHQUAKE RECOVERY(PEPPER). “THE END GAME” FOR JAPAN AND SOUTHERN CALIFORNIA: Identification of the physical, social and economic consequences of a major earthquake in Tokai, Japan or Southern California will enable end users to identify what they can change now before the earthquake—to shorten recovery from the catastrophic impacts after the inevitable “big ones” occur, probably in the near future.
Floods occur somewhere in the world 10,000 times or more each year. With 2015’s spring floods only weeks away, it’s past time to speed up the long-term recovery process for floods. In 2008, after weeks of flooding through Iowa, Illinois, Missouri, Indiana and Wisconsin, the region faced billions of dollars in losses, threats of disease, and a long cleanup. Losses included millions of acres of prime farm land that are still requiring restoration and the rebuilding of large urban areas such as Cedar Rapids, Iowa which alone is estimated to have required at least $1 billion. However, the total direct and indirect losses may never be known. Flood waters during the summer of 2008 seeped into countless wells, affecting drinking water for thousands of homes and businesses across the region. Hazardous materials were also released into the flood waters that ultimately emptied into the Gulf of Mexico exacerbating what marine biologists call a “dead zone” – bodies of water so starved for oxygen that aquatic life can no longer be supported. Presentation courtesy of Dr Walter Hays, Global Alliance for Disaster Reduction.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
3. Case
The Great East Japan
Earthquake of
March 11, 2011
An example of the cascading
crisis: earthquake, tsunami,
with secondary nuclear
reactor damage
Eric K. Noji
1
45199_CH01_001-020.indd Page 3 30/04/13 4:53 PM f403 /202/JB00076/work/indd
4. BACKGROUND
All disasters have multiple causes; there is never a disaster that has only
one cause. On Friday, March 11, 2011, an earthquake that measured
between 8.9 and 9.0 on the Richter scale rocked Japan. The epicenter
of the earthquake was approximately 43 miles (69 kilometers) east of
the Oshika Peninsula of Tohoku. It triggered a 32-foot (10-meter) tsu-
nami that wiped out whole communities and caused explosions at two
Japanese nuclear power facilities. The tsunami and subsequent radiation
release devastated Japan, killing almost 16,000 people. This earth-
quake has been named the Tohoku earthquake, or the Great East Japan
Earthquake.
Japan’s social, technical, administrative, political, legal, health-
care, and economic systems were tested to their limits by the nature,
degree, and extent of the socioeconomic impacts of the earthquake
and tsunami, as well as by the possibility of a “nightmare nuclear
disaster.”1
THE SCIENCE OF EARTHQUAKES
The earth’s outermost layer consists of the crust and upper mantle, known
as the lithosphere. The lithosphere is divided into large rigid blocks, or
plates, that are floating on semifluid rock. Japan lies approximately 250
miles from where these tectonic plates are colliding at their convergent
borders, with one plate being dragged (subducted) beneath the other.2
Japan, part of the volcanic belt known as the Pacific Ring of Fire, is par-
ticularly susceptible to subduction-zone earthquakes. This belt surrounds
most of the Pacific Ocean and includes the western part of North and
South America. The oceanic crust underlying the Pacific Ocean is spread-
ing, and old crust is being subducted back into the earth’s interior along
the Ring of Fire. Because the oceanic crust rubs against the continental
crust, most of the world’s earthquakes happen in this setting.
On the day of the Tohoku earthquake, at 2:46 PM local time, at a
point approximately 20 miles (32 kilometers) below sea level and 80
miles (129 kilometers) east of Sendai Japan, there was a slip in part of
the subduction zone. The Philippine plate was subducted below the
North American plate at an angle of about 15 degrees. This resulted
in an earthquake, categorized as “great” on the Richter magnitude
scale,3
that ruptured a fault several hundred miles long, roughly par-
allel to the east coast of Japan.
4 THE GREAT EAST JAPAN EARTHQUAKE OF MARCH 11, 2011
45199_CH01_001-020.indd Page 4 30/04/13 4:53 PM f403 /202/JB00076/work/indd
5. THE SCIENCE OF TSUNAMIS
The word tsunami comes from the Japanese language and means
“giant wave.” It is a series of water waves caused by the displacement
of a large volume of a body of water, which can be triggered by earth-
quakes, volcanic eruptions, and the like. The tsunami wavelength is
much longer than normal sea waves, with a series of waves that can
reach heights of 40 to 50 feet (12 to 15 meters) and be hundreds of
miles long in large events.
Not all earthquakes generate a tsunami. To cause a tsunami, the
precipitating event must result from an ocean-based earthquake
and must also change the level of (raise or lower) the sea floor. If
the level of the sea floor does not change, the earthquake will not
generate a surface wave. If the level of the sea floor goes up or down,
the earthquake generates a large water bulge, or water dimple, over
the area where the sea floor has moved. When an earthquake gener-
ates a water bulge, the water moves outward in all directions—just
like throwing a rock into a pond and watching it ripple. If this wave
encounters shallow water, it will slow down and increase in ampli-
tude, just as normal waves do at the shoreline. In other words, the
wave will grow. The more shallow the water becomes, the higher
the wave will be because all of the wave energy now builds wave
height. With heights totaling 10 feet (3 meters) or more, a tsunami
wave can overwhelm all low-lying structures when it strikes the
coastline.
Following an earthquake, some buildings are already weakened or
collapsed. Other buildings may be poorly constructed and are swept
away when the waves hit. All of the debris—cars, pieces of buildings,
shipping containers, boats, and the like—are carried along with the
rushing water, smashing into anything in their path.4
How powerful was the tsunami that followed the earthquake in
Japan? The tsunami following the Tohoku earthquake was 30 to
132 feet (10 to 40 meters) high. This wave was large and powerful
enough to devastate miles of Japan’s coast and inland.
THE SCIENCE OF NUCLEAR POWER
The facility producing nuclear power is similar to a coal-fired power
plant, except that the heat source is a nuclear fission reaction instead
of coal. In both types of plants, you need to make steam. Steam passes
The Science of Nuclear Power 5
45199_CH01_001-020.indd Page 5 30/04/13 4:53 PM f403 /202/JB00076/work/indd
6. through a turbine and the turbine spins a generator, which makes
electricity. Nuclear power plants are near bodies of water because
they need a method of cooling, and the ocean is a very convenient
source of large amounts of cool water.
How Nuclear Radiation Harms People
The type of nuclear radiation typically released from a damaged
nuclear power reactor involves gamma radiation. Gamma rays have
enough energy to break bonds between the nucleotides within
human DNA when they strike them. During normal day-to-day
living, our body can repair itself with enzymes that reattach the
nucleotides that break loose. However, larger-scale damage over-
whelms the repair mechanism, resulting in nucleotides being left
out or added, or sections of DNA may be inappropriately joined.
This may lead to altered protein synthesis and to the later develop-
ment of various types of cancer.5
Types of Radioactivity Released from
Damaged Reactors and Harm Caused
One common form of radioactivity released from damaged reac-
tors is radioactive iodine. The human body then concentrates this
radioactive iodine in the thyroid gland as it builds thyroid hor-
mones. This concentration of radioactivity leads to more damage
to the thyroid than to other areas of the body. Half of the radio-
activity decays in 8 days, so the buildup does not last a long time.
However, if a lot of radioactive iodine is released and blown over
crops, humans or animals eating those crops will take in the
iodine. Administering potassium iodide tablets helps block radio-
active uptake.
Following the reactor damage at Chernobyl in 1986, the incidence
of thyroid cancer rose up to 10 times in exposed children, the most
susceptible group. The World Health Organization has estimated
that up to 50,000 cases of thyroid cancer will be directly attributable
to the Chernobyl radiation leak.6
While it was believed that the dam-
aged reactors in Japan would not release the amount of iodine that
was released at Chernobyl, people living within several miles of the
reactor site were evacuated as a precaution.
6 THE GREAT EAST JAPAN EARTHQUAKE OF MARCH 11, 2011
45199_CH01_001-020.indd Page 6 30/04/13 4:53 PM f403 /202/JB00076/work/indd
7. JAPAN’S NUCLEAR CONCERNS IMMEDIATELY
FOLLOWING THE EARTHQUAKE
The Japanese nuclear power plants have backup generators to run
the cooling water pumps when the electricity grid goes down. Those
generators worked perfectly after the earthquake, but failed after the
tsunami. The plants also had surge walls constructed in the ocean to
protect the coastline in the event of a tsunami. However, the surge
walls were insufficient because the tsunami was so large.
The tsunami flooded the generators and the backup pumps for
the generators. When those backup pumps failed, pressure built
up inside the reactors, and hydrogen was produced due to the high
temperatures. The high hydrogen concentrations inside the reactors
resulted in multiple explosions. On March 15, 2011, 4 days after the
earthquake, there was a huge spike in radiation levels following a
new explosion and fire at the Fukushima Daiichi plant in Okuma,
Japan.
Fortunately, the problems surrounding the nuclear power plant
did not result in a true disaster, as the entire plant remained intact
following the massive earthquake. In a final measure to avert a
crisis, the authorities flooded the problematic reactors with sea-
water. The effects of this last-ditch effort were twofold: a chance
to avoid a nuclear meltdown and the destruction of the reactor.
Flooding a plant disables the reactor, and it can never be used
again. Although the authorities’ goal was to keep enough seawater
in the plant to avoid a meltdown, the end result was still uncer-
tain. There were plenty of reasons for concern, and a disaster could
have easily developed in the days, weeks, and months following
the earthquake.
MEASURES OF EARTHQUAKE PREPAREDNESS
Japan has many measures in place to mitigate the damage caused by
earthquakes, which spared the population from a far worse outcome
following the Tohoku earthquake.3
These preparations include the
following:
• Warning people, to minimize loss of life. When an earthquake
occurs, it initially sends out waves that travel through the
earth, known as body waves. The fastest of these waves involve
Measures of Earthquake Preparedness 7
45199_CH01_001-020.indd Page 7 30/04/13 4:53 PM f403 /202/JB00076/work/indd
8. compression and are called P-waves or primary waves. Slightly
slower waves, known as S-waves or secondary waves, are very
destructive because they shake things from side to side. Because
there is a time difference in the arrival and detection of the
P-waves and the S-waves, once P-waves are detected, a warning
system sounds, escalators in Japan are stopped, trains come to a
halt, gas main valves are shut off, and people are encouraged to
seek protective cover. This warning sound provides as much as
a minute of warning time—enough to stop the trains and allow
people to protect themselves—before the more destructive sec-
ondary waves arrive. This warning system is reinforced with
regular drills.
• Emergency drills. From a young age, children are taught how to
protect themselves if an earthquake occurs so they are prepared
to take cover.
• Emergency rations. The Japanese people store emergency rations
in their homes, enough for a couple of days in the event that they
are without food or water for a period of time.
• Building codes. Houses and buildings are designed and built to sway
with the back-and-forth motion of earthquake waves. The idea is to
build things so that if the earthquake is very severe, rather than the
building collapsing (as it would if it were made of brick or concrete),
it will sway without breaking; if it sways too much, it will deform
and bend, but still give people time to get out.
PROTECTION AGAINST TSUNAMIS
Advance warning and vertical evacuation are the keys to surviving a
tsunami. Important life-saving principles include the following:
• Monitoring technologies and warning systems
• Knowing where, when, and why a tsunami occurs in order to
notify populations to evacuate
• Knowing when to evacuate and where to go before a tsunami
wave arrives
Japan has an extensive system of coastal barriers designed to pre-
vent high waves from flooding areas where large populations live.
Following the Tohoku earthquake, the resulting waves were higher
than the Japanese had expected, and water poured over the barri-
ers. As part of Japan’s early warning system, when a big earthquake
8 THE GREAT EAST JAPAN EARTHQUAKE OF MARCH 11, 2011
45199_CH01_001-020.indd Page 8 30/04/13 4:53 PM f403 /202/JB00076/work/indd
9. occurs, officials determine whether it might cause a tsunami. If they
think it will, they quickly alert the population. However, people have
to then be able to go somewhere safe (e.g., higher ground if they are
on land in low-lying areas; out to deeper water if they are in a boat).
If the warning time is too short, people will not have time to evacuate
to a safer area.
Evacuation for a tsunami is complicated both by the short time
between the earthquake and the arrival of the tsunami wave, and
by the damage and loss of function to buildings and infrastruc-
ture caused by the earthquake and its aftershock sequence (see
Figure 1-1). For those who choose not to evacuate or are unable
to evacuate, the odds for survival are lower. It is nearly impossible
to outrun or divert a 32-foot-high, debris-laden, ocean wave that
arrives with a high velocity (i.e., 20 miles per hour or faster) and
moves rapidly inland, covering 1 mile or more of land.
Causes of
damageTsunamis
Flooding
Inadequate resistance
of buildings
Vertical height of
wave runup
Inland distance of
wave runup
High velocity impact of
incoming waves
Inadequate horizontal
and vertical evacuation
Proximity to source
of tsunami
Figure 1-1
Causes of damage from a tsunami.
Protection Against Tsunamis 9
45199_CH01_001-020.indd Page 9 30/04/13 4:53 PM f403 /202/JB00076/work/indd
10. IMPACT OF CULTURE
The Japanese are an amazingly stoic and disciplined people. Japanese
culture has always emphasized the importance of gaman, which means
the ability to endure hardship with patience and without complaint.
Furthermore, the Japanese are well aware that they live in a country sub-
ject to frequent earthquakes and tsunamis. Each community in Japan has
developedemergencyprocedurestofollowintheeventofaserioustremor
or a tsunami. There are periodic drills for people to practice how best to
protect themselves in the event of a major earthquake or tsunami.
The Japanese are known as a people who are among the most dis-
ciplined and hard working in the world. They are used to rebuilding
their homes and communities, whether after earthquakes, tsuna-
mis, or the dropping of atomic bombs. The great earthquake in the
Tokyo area in 1923 claimed the lives of nearly 130,000 people. In
Yokohama, 90% of all homes were damaged or destroyed, while
350,000 homes in Tokyo met the same fate, leaving 60% of the city’s
population homeless. And the Japanese rebuilt. Because of their core
values and history, the Japanese people met this unbelievable catas-
trophe with a calm, disciplined response.
Despite these strengths, there were cultural stumbling blocks that
impaired acting decisively after the Tohoku earthquake. Japan’s own pre-
liminary investigation showed disagreement and confusion over who
should be making the final decisions. As evidenced following the Kobe
earthquake in 1995, this was partly cultural. The Japanese decision-mak-
ing process, which emphasizes group rather than individual decision
making, might have been a hindrance for dealing with an emergency
situation. It is difficult to quantify, but it seems that making multi-bil-
lion-dollar decisions such as these is more difficult to do promptly in the
Japanese culture than, for example, in the United States.7
EVENTS IN JAPAN
On March 11, 2011, a 9.0 earthquake with an epicenter approximately
80 miles east of Sendai, Japan, generated a tsunami that reached
heights of up to 132 feet (40 meters) and, in the Sendai area, traveled
up to 6 miles (9 kilometers) inland (see Figure 1-2). It was the fourth-
largest recorded quake.8
The earthquake and tsunami destroyed or damaged over 125,000
buildings, with almost 20,000 individuals killed or injured. In addi-
tion, the events caused several nuclear accidents, including the
10 THE GREAT EAST JAPAN EARTHQUAKE OF MARCH 11, 2011
45199_CH01_001-020.indd Page 10 30/04/13 4:53 PM f403 /202/JB00076/work/indd
11. ongoing level 7 meltdowns at the Fukushima nuclear power plant
complex. The earthquake and tsunami caused damage to much of
Japan’s infrastructure—destroying roads and railways, triggering
numerous fires, and collapsing a dam. Over 4 million households
were left without electricity, and 1.5 million were left without water.
The earthquake moved the city of Honshu 1.4 miles to the east and
shifted the earth on its axis by approximately 7 inches.9
During the initial response, Japan’s Meteorological Agency issued
earthquake and tsunami warnings. It only took seconds for the earth-
quake’s P- and S-waves to do their damage. The tsunami reached
Sendai only 15 minutes following the earthquake. Devastation was
Yokohama
Pacific
Ocean
East Sea
Osaka
Kobe
Kyoto
Nagoya
Tokyo
Sendai
Sapporo
Fukushima
Hiroshima
Nagasaki
Epicenter
Figure 1-2
Map of Japan and epicenter of earthquake.
Source: Adapted from http://sertit.u-strasbg.fr/SITE_RMS/2011/05_rms_japan_2011/05_rms_
japan_ 2011.html
Events in Japan 11
45199_CH01_001-020.indd Page 11 30/04/13 4:53 PM f403 /202/JB00076/work/indd
12. widespread. The aftermath included a 300-second shaking from
the main shock and hundreds of powerful aftershocks, many at the
magnitude of a strong earthquake (see Figure 1-3). The magnitude of
this earthquake can be compared to the 1994 Northridge, California
earthquake or the 1995 Kobe, Japan earthquake, which each
had about 10 to 20 seconds of ground shaking. Coupled with the
Figure 1-3
Map showing intensity of shaking from earthquake on March 11, 2011.
Source: http://earthquake.usgs.gov/earthquakes/dyfi/events/us/b0001r57/us/index.html
Sendai
Utsunomiya
Yokosuka
Hamamatsu
224 responses in 57 cities (Max CDI = VII) 100 km
Intensity
Shaking
Damage
I
Not felt
None
II–III
Weak
None
IV
Light
None
V
Moderate
Very light
VI
Strong
Light
VII
Very
strong
Moderate
VII
Severe
Moderate/
heavy
VII
Violent
Heavy
X+
Extreme
Very
heavy
Tokyo
Takasaki
Koriyama
Iwaki
Akita
Sakata
Niigata
Toyama
Joetsu
Kushiro
City size
<10,000
10,000+
100,000+
2M+
Sapporo
Tomakomai
Muroran
Hakodate
Aomori
Hachinohe
12 THE GREAT EAST JAPAN EARTHQUAKE OF MARCH 11, 2011
45199_CH01_001-020.indd Page 12 01/05/13 8:48 PM f403 /202/JB00076/work/indd
13. tsunami, there was widespread damage to homes, buildings, essential
facilities, nuclear facilities, and critical lifelines (e.g., transportation
infrastructure). Together, the ground shaking and subsequent wave
caused major damage in northern Japan (see Figure 1-4).
The earthquake and the aftershocks triggered widespread fires,
including massive blazes at oil refineries. Four million households were
left without electricity. The subways and trains shut down for almost
2 months.4
This was all complicated by the damage to nuclear power
plants, the effects of which continued well into the recovery phase.
Some of the nuclear power plants in the region shut down automati-
cally, leading to an evacuation of several thousand people. All search,
rescue, and relief operations; evacuations; and international humanitar-
ian assistance efforts were conducted within the framework of possible
significant radiation release and nuclear meltdown resulting from the
fires and explosions at the Fukushima Daiichi nuclear facility. A week
after the earthquake and tsunami, Japanese efforts focused on the
pools used to store spent nuclear fuel, now dry or nearly so, because the
Figure 1-4
Aerial view of damage to Sukuiso, Japan.
Source: McCord D., U.S. Navy from the National Geophysical Data Center, National
Oceanic and Atmospheric Administration, U.S. Department of Commerce. Available
at: http://www.ngdc.noaa.gov/.
Events in Japan 13
45199_CH01_001-020.indd Page 13 30/04/13 4:53 PM f403 /202/JB00076/work/indd
14. consensus was that the dry rods could heat up and spew intense radia-
tion. Subsequently, radioactive contamination of soil, coastal waters,
and groundwater was detected, with radiation levels as high as 10,000
times the maximum government standards.
As a result of these developments, the U.S. Centers for Disease
Control and Prevention (CDC), Food and Drug Administration
(FDA), Environmental Protection Agency (EPA), and Customs and
Border Protection (CBP) issued informational updates in the follow-
ing areas:
• Screening procedures for elevated radiation levels for individu-
als returning from Japan
• Travel guidance for humanitarian volunteers
• Screening procedures for food products from Japan
• Environmental monitoring/potassium iodide
• Monitoring maritime and air traffic from Japan
RESPONSE
The major goal of the response was containment, especially to pre-
vent a meltdown at the Fukushima nuclear facility, where the normal
cooling system was compromised by the earthquake and tsunami. To
that end, emergency workers tried helicopter water drops, heavy-duty
fire trucks, and water cannons to cool down Japan’s dangerously over-
heated nuclear reactors and spent fuel pools.
Coordination at the National Level
Immediately after the earthquake and tsunami, the Japanese gov-
ernment began implementing its postdisaster response plans in a
highly charged environment with the constant threat of the possi-
bility of significant radiation release and a nuclear meltdown. The
fires and explosions in the Fukushima Daiichi nuclear facility and
radiation levels that were 1,000 times the normal levels created a
nightmare disaster response scenario for the government of Japan.
Approximately 140,000 people living within a 20-mile radius of the
plant were evacuated. The increased risk from radiation stymied
search and rescue operations, which were already operating beyond
the “golden window” where most lives can be saved, and slowed
humanitarian assistance.
14 THE GREAT EAST JAPAN EARTHQUAKE OF MARCH 11, 2011
45199_CH01_001-020.indd Page 14 30/04/13 4:53 PM f403 /202/JB00076/work/indd
15. Search and rescue operations—an international effort—were
organized within hours and continued for months. Approximately
50,000 members of Japan’s Self Defense Forces were mobilized
immediately to the hardest-hit areas. Tokushu Kyuunan Tai, the search
and rescue unit of the Japan Coast Guard, was dispatched to accelerate
search and rescue operations. The Japanese Red Cross dispatched 62
response teams within 24 hours of the earthquake.3
The teams were
primarily for medical relief and included 400 personnel—doctors,
nurses, and support staff—who worked from mobile medical clinics.
During the crisis, between 300,000 and 350,000 people were evac-
uated. The tsunami and earthquake knocked out power supplies in
addition to those supplied from the Fukushima power plant. Because
the tsunami hit in the winter months, there was an immediate need
to provide shelter against the cold and a need for clean water. There
was difficulty with the evacuations and difficulty finding food, shel-
ter, and especially water for those needing temporary housing (see
Figure 1-5). Shortages, closed roads, and lack of fuel made it nearly
impossible to meet survivors’ basic needs. The aid needed most was
provided by organizations such as the International Red Cross and
the International Medical Corps. They supplied food, clean water,
blankets, fuel, and medical supplies.10
During the response phase, responders worked to reduce sec-
ondary damage such as fires from broken gas lines and water
contamination from broken water lines. Teams were organized to
inspect the infrastructure of buildings and utilities. Through all of
this, first responders were tasked with utilizing critical information
to make rapid decisions in order to provide emergency assistance for
victims of the earthquake. As soon as people were available to assist
the first responders, the assignment of these personnel to various
tasks, such as search and rescue teams, began. Utilizing geographic
information systems (GIS), grid maps of collapsed buildings were
produced. Mapping data allowed emergency responders to identify
severely damaged areas; prioritize medical needs; map out areas that
would be suitable for the distribution of food, water, and supplies;
and locate emergency medical centers and emergency shelters.
International Humanitarian Assistance
In the recovery phase, Japan needed support in managing the incom-
ing offers of assistance and donations. The entire international
community participated in these efforts. Humanitarian assistance
was pledged or dispatched to Japan by many countries to mitigate the
Response 15
45199_CH01_001-020.indd Page 15 30/04/13 4:53 PM f403 /202/JB00076/work/indd
16. possibility of thousands of deaths and to provide specialized health
care in light of possible waterborne diseases, the effects of high radia-
tion levels, and a possible nuclear meltdown. Japan received offers of
assistance from 116 countries and 28 international organizations.11
Japan requested specific assistance from the United States, United
Kingdom, Australia, and New Zealand, in addition to requesting the
activation of the International Charter on Space and Major Disasters
for readily available use of satellite imagery of affected areas.
The U.S. Agency for International Development deployed search
and rescue missions at the request of the Japanese government.
Ninety medical teams from Médecins Sans Frontières arrived on
Sunday, March 14, and were deployed in the Miyagi prefecture. The
USS Ronald Reagan was dispatched immediately to Japan and, at the
request of the Japanese government, made helicopters available and
began assisting in urgent search and rescue missions. U.S. marines
were already stationed in the area and assisted in local search and
Figure 1-5
Rescuer following the earthquake/tsunami.
Source: NOAA/NGDC, Patrick Fuller, IFRC.
16 THE GREAT EAST JAPAN EARTHQUAKE OF MARCH 11, 2011
45199_CH01_001-020.indd Page 16 30/04/13 4:53 PM f403 /202/JB00076/work/indd
17. rescue missions. Teams from Germany and China also arrived that
Sunday to assist Japan’s recovery.
THE FUTURE
This case study on the Great East Japan Earthquake of March 11, 2011
focused on appropriate leadership knowledge and skills required for
effective performance during rapidly changing situations and crisis
events within and external to most organizations. Despite best-laid
plans, actual crises often require the ability to deal with the unex-
pected. Crisis events not only require flexibility, but also depend
heavily on effective delegation and well-planned resource logistics.
Health professionals planning or preparing for deployment to situ-
ations that are experiencing rapid change or crisis events need to be
especially careful when considering what skills they require.
Long-term recovery from this disaster will take many years.
Stakeholders must recognize the difference between meaningful
short-term recovery and the ultimate long-term goal. Long-term
recovery plans must consider the constraints of the predisaster social
situation, including baseline economic characteristics and political
conflicts that require the involvement of local people and political
structure as the key central stakeholders. Major effort will be needed
to rebuild schools, homes, hospitals, and roads; reestablish the sani-
tation infrastructure; recover from environmental damage; address
long-term healthcare needs; and provide preventive care.
The recovery phase may also be an opportunity for the growth
of policies that address pre-tsunami preparedness, such as enhanc-
ing the art and science of knowing when to evacuate and where to
go before a tsunami wave arrives. Key stakeholders in the recovery
include the people who are still homeless as a result of the earth-
quake and tsunami, the Japanese government, the organizations that
were supporting Japan’s efforts to disseminate aid to those people,
and lastly, the international markets who were invested in Japan’s
economy. While this disaster left thousands of people homeless, it
hit one of the most disaster-prepared countries in the world; Japan is
very much in control of the recovery efforts and is able to provide the
majority of necessary resources.
The fallout from the Fukushima power plant and the disruption to
businesses affected stakeholders well beyond Japan’s borders. Japan
has the third-largest economy in the world. The closing of plants,
highways, and ports caused disruption of production and investment
The Future 17
45199_CH01_001-020.indd Page 17 30/04/13 4:53 PM f403 /202/JB00076/work/indd
18. flow that was felt worldwide. It was estimated that $287 billion in
market capital was wiped out when stocks dropped just after the
disaster. Japanese car manufacturers, electronics companies such as
Sony, and other global companies such as GlaxoSmithKline all shut
down due to the disaster. With so many lives at stake and the stabil-
ity of the global market at risk, Japan needed to quickly assess the
damage and begin the recovery process as efficiently as possible.
Returning to economic strength will require the same degree of
national will and sacrifice that produced the “Japanese economic
miracle” following the devastation of the Second World War. By 1945,
nearly half the surface area of all Japanese cities had been reduced to
rubble by American bombers. Still, the Japanese rebuilt their country
to become the number two economy in the world only 4 decades later.
In the Kobe earthquake of 1995, 5,000 people perished and more than
100,000 were left homeless. Today, Kobe is once again one of the loveli-
est and most prosperous cities in Japan. The Japanese will rebuild after
this latest catastrophe, as they have always done—with calm patience
and determination.
DISCUSSION QUESTIONS
1. Which competencies described in the Appendix does this case
demonstrate?
2. Describe two examples of ways of mitigating the impact of such
events using the following two preparedness strategies:
• Disaster Vulnerability Assessment
• Critical Infrastructure Protection of Health Care Delivery Systems
3. What is the difference between a tsunami and a tidal wave?
4. Give three examples of how you would lead when preparations are
insufficient and when core values are threatened? How would you
respond to unanticipated situations when time is of the essence,
and planned approaches do not work?
5. “Reputations are made or lost in crises” is a core observation from
almost all major past disasters. Please give three examples in
recent history of natural or human-generated disasters where this
was a particular outcome.
6. How might the nuclear reactor disaster have been prevented or
repaired more quickly with proper planning and tools and more
effective media relations? What is the meaning of the word
“Tomodachi”?
18 THE GREAT EAST JAPAN EARTHQUAKE OF MARCH 11, 2011
45199_CH01_001-020.indd Page 18 30/04/13 4:53 PM f403 /202/JB00076/work/indd
19. REFERENCES
1. Fuse A, Yokota HJ. Lessons learned from the Japan earthquake and tsunami,
2011. Nippon Med Sch. 2012;79(4):312–315.
2. Sample I. Nuclear scare grows with an orange flash and a violent blast: health
concerns as hydrogen explosion at Fukushima 1 nuclear power station
injures 11 and destroys containment building. The Guardian. March 14, 2011.
Available at: http://www.guardian.co.uk/world/2011/mar/14/fukushima
-nuclear-power-plant-japan. Accessed March 3, 2013.
3. Aramaki S, Ui Y. Japan. In: Thorpe RS, ed. Andesites: Orogenic Andesites and
Related Rocks. New York, NY: John Wiley & Sons; 1982:259–292.
4. Maegele M, Gregor S, Yuecei N, et al. One year ago not business as usual:
wound management, infection and psychoemotional control during ter-
tiary medical care following the 2004 tsunami disaster in southeast Asia.
Crit Care. 2006;10:1–9.
5. Ohnishi T. The disaster at Japan’s Fukushima Daiichi nuclear power plant
after the March 11, 2011 earthquake and tsunami, and the resulting spread
of radioisotope contamination. Radiat Res. 2012;177(1):1–14.
6. World Health Organization. CHERNOBYL at 25th anniversary: frequently
asked questions, April 2011. Available at: http://www.who.int/ionizing_
radiation/chernobyl/20110423_FAQs_Chernobyl.pdf. Accessed April 14,
2012.
7. Earthquake Engineering Research Institute. Learning from earthquakes:
the March 11, 2011, great east Japan (Tohoku) earthquake and tsunami—
societal dimensions. Oakland, CA: EERI; August 2011. Available at: http://
www.eqclearinghouse.org/2011-03-11-sendai/files/2011/03/Japan-SocSci-
Rpt-hirez-rev.pdf. Accessed March 22, 2013.
8. U.S. Geological Survey website. Japan: seismic hazard map. Available at:
http://earthquake.usgs.gov/earthquakes/world/japan/gshap.php. Accessed
March 3, 2013.
9. NOAA National Geophysical Data Center, World Data Service for
Geophysics. March 11, 2011 Japan earthquake and tsunami. Available at:
http://ngdc.noaa.gov/hazard/tsunami/pdf/2011_0311.pdf. Accessed March
2, 2013.
10. Sakai T. What have we learned from Japan’s major earthquake, tsunami and
nuclear incident? World Hosp Health Serv. 2011;47(4):10–12.
11. TheU.S.ArmyOfficeoftheSurgeonGeneral(OTSG).OperationTomodachi:
proceedings of the after action review—medical issues and recommenda-
tions. San Antonio, TX; July 29–30, 2011. Available at: http://omicsgroup.
org/journals/2167- 0374/2167-0374-2-108.php?aidϭ7466. Accessed March
20, 2013.
References 19
45199_CH01_001-020.indd Page 19 30/04/13 4:53 PM f403 /202/JB00076/work/indd