"JAPAN MARCH 2011 EARTHQUAKEAND TSUNAMI ATTACK ANDEFFECTS Table of ContentsIntroduction: ................................................................................................................................................. 2Evacuation after the attack: .......................................................................................................................... 4Respiratory Tract infections: ..................................................................................................................... 5Wound infections ...................................................................................................................................... 6Hypertension ............................................................................................................................................. 6Deep vein thrombosis (DVT) ..................................................................................................................... 6Gastrointestinal infections ........................................................................................................................ 7Psychological effect: ..................................................................................................................................... 7Medical services ............................................................................................................................................ 7Conclusion ..................................................................................................................................................... 8References: ................................................................................................................................................... 9 Introduction:On March 2011 the great east Japan earthquake attacked Japan at the Sanriku coast withmagnitude 9. The quake moved northeasters part of Japan by 2.4m closer to North America. Itwas recorded as the largest earthquake in history; the disaster was compounded with tsunami andnuclear power station accident in fukshima. The Iwate and Miyagi areas were also badlyaffected. The tsunami engulfed about 560sq km and destroyed almost all the coastal town andports. These regions were badly affected because it is made up of deep bays and inlets. The deathrate was estimated to be 15,799 and 4041 people were missing and over 295,000 buildings hadcollapsed.Out of the 11 reactors in fukshima 3 of them were affected due to the tsunami effect. The back- up generators were disabled due to which the reactors lost the ability to maintain proper coolingand water circulation functions. The electrical switchgear was also disabled. There was nofatality due to the radiation from the nuclear reactors (Acton J.M. & Hibbs M). The Fuginuma irrigation dam was ruptured during the quake it flooded the areas and washedaway homes in that area. The other banks were examined out of the 252 dams about 6embankment dams showed shallow cracks on their crests. Four dams in the Iwate region wascompletely damaged due to this about 1.5 million houses had lost water supplies. Electricity wasout as the nuclear reactors shut down after the tsunami attack.About 4.4 million houses losttheir electricity supply. Japan Aerospace Exploration Agency evacuated the space centre inIbaraki, the control room of the space centre was destroyed and was shut down. Gas and water were cut after the disaster and the normal means of communication was also lost.Public Transportation to the coastal areas was affected. After the attack the transportationbetween the city and the island was difficult as the roads and the railway lines were badlydamaged (Shibahara S).The rescue team from other cities was not able to reach the affected region due to the absence ofgasoline as the Cosmo Oil Company in Ichihara had caught fire due to the quake. It damaged allthe storage tanks and killed 6 people. It was extinguished after 10 days of the attack. Hence ittook about 4-5 hours for the ream to reach the region. The death rate was more due to drowningin sea water.The hospitals, health clinics in Iwate were completely destroyed by the tsunami attack. The localheath personnel were also affected due to which they were not able to help in the post-disasterresponse. Evacuation after the attack:After the nuclear plant attack the Japanese government issued evacuation for residents within 2miles of the distance of the plant. This was mainly to avoid health risks due to the radiation fromthe nuclear plant. The area was designated as the „high alert zone? (Akabayashi A, Hayashi Y).The evacuation started with two miles around the nuclear plant then it increased to twelve miles.The 101 evacuation centers in Iwate were hit by the tsunami wave. About 750 workers wereevacuated immediately after the explosion and about thousands of the citizens were shifted tosafe zones. Government checked for radiation exposures in the evacuation zone.The evacuationorder was given by the government as a precautionary measure as the plant might release someradioactive substance which may cause health problems to the residents. The radioactive hotspots were also found in other places of Japan which contaminated the food with cesiumradioactive substance making the lives of evacuees and the other residents difficult.Evacuation centers were situated in cities away from the coastline and all the evacuees weregiven medical help and were checked for radioactive exposure. About 399 evacuation centre wasset up after two days of the disaster in Iwate prefecture and there were 54,299 evacueesaccommodated. These centers were closed in mid of August 2011. These evacuation centers lost basic necessities like power, drinking water and sanitationfacilities.Water for washing hands and for toilets was insufficient and the complete sewagesystem in Iwate was destroyed. More over the disaster was struck during the influenza season.Due to this the citizens faced infectious disease. Some of the diseases were:Respiratory Tract infections:People in Okinaga were reported with Pneumonia and were admitted in Miyagi cityHospital. About 82% of patients with pneumonia were aged 70 and more and out of that11 of them died with the condition. Certain of them had self acquired pneumonia (SAP)they were shifted from small clinics to Tohoku University Hospital (Suzuki M, Uwano C,Ohrui T, Ebihara T, Yamasaki M, Asamura T, Tomita N).Legionellosis infection was caused in infants and adults by the legionella species that waspresent in the tsunami water. The infection was combined with E.coli infection also.Influenza virus was also detected among the evacuees in Sendai region. Among 107patients Type A influenza virus was detected and only 5 patients were affected by type Bvirus other type of virus that was dominant was H3N2 subtype. The patients were givenpreseason vaccine against the influenza virus (Suzuki A, Okamoto M, Touma K,Kamigaki T, Oshitani H, Nakagawa H). The people in the evacuation centers suffered from measles which was highly contagious,they showed signs of fever and systemic eruptions. Wound infectionsTsunami had wounded a large number of civilians, the mortality rate was 18% killingolder people. They were wounded badly and died with infections caused due to thewounds. There incubation period was short. The other people who were wounded weretested with tetanus infection. None of them suffered from the infection. Others weredetected with lock jaws and muscular contractions. They were given vaccination fortetanus and immunization of the wounds.Hypertension Due to high stress, insufficient medication, lack of exercise and high salt content in thefood in the evacuation centers caused hypertension among the evacuees.Deep vein thrombosis (DVT) Evacuees suffered from deep vein thrombosis due to lack of exercise and lack of fluids.The thrombosis occurs in the vein in the legs. Causes pain, swelling and redness. It maylead to pulmonary thrombosis. Gastrointestinal infectionsAbout 31 evacuees aged 65 years and above suffered from acute gastrointestinalinfection. They also suffered from diarrhea and gastroenteritis due to contaminated waterand food. After 4 months of the disaster the residents were affected with food poisoningdue to the clostridium pathogen (Nomura K, Murai H, Nakahashi T, Mashiba S, WatohY, Takahashi T, Morimoto S).Psychological effect:Citizens in Iwate showed high prevalence of psychiatric disorders and also had high suicide rate.They suffered from psychological problems as most of them lost their family, friends, home,possessions and jobs. Clinicians call this condition as post-traumatic disorder (Kim Y, AkiyamaT).The nuclear blast had a different effect on the individuals. All of them were scared about nuclearradiations and health effects it thereby increased their stress levels. They were more scaredbecause they compared the blast to the blast in Hiroshima and Nagasaki which took them yearsto come out of the situation (Takahashi T, Iijima K, Kuzuya M, Hattori H, Yokono K, MorimotoS).Medical servicesAfter the attack in the Iwate region there were four hospitals set up and were designated asdisaster base hospitals which were mainly set up for the medical care of the affected people.Then about 128 medical assistance team was set up for engaging emergency medical care and transportation of patients from that region to the other medical care centers. The transportationwas through aircraft. This team also helped the civilians in evacuation from the affected region.After the local medical centers were opened the number of assistance team reduced. Theevacuees underwent a lot of tests to check for infectious diseases. Even after a lot of medicationand vaccination people suffered from diseases as the basic facilities like proper water and foodand proper sanitation were absent. The medical team tried their level best to keep the evacuationzone disease resistant (Christodouleas JP, Forrest RD, Ainsley CG, Tochner Z, Hahn SM,Glatstein E).Conclusion The earthquake was considered one of the biggest disasters on globe with a magnitude of 9.0. itwas compounded with tsunami and nuclear blast. This affected the normal lives of the civiliansnot having proper food, water, electricity for months. They also suffered from infectious disease.It was a challenge for the government to overcome the problems as the people had health issueand they were scared about the radiation. Teams were set up for medical aid and psychiatrics torecover them from the post-disaster trauma. It took them 6 months to come back to normal livesand the evacuation centers were closed. "