Death toll climbs and healthcare needs escalate in Japan

BMJ 2011; 342 doi: (Published 22 March 2011) Cite this as: BMJ 2011;342:d1859
  1. Peter Moszynski
  1. 1London

Bad weather continues to disrupt emergency relief operations in Japan and is compounding the misery of the hundreds of thousands of people who survived but lost their homes in the 11 March earthquake and tsunami in the northeast of the country.

The number of documented casualties continues to rise. As at 21 March 8649 deaths had been confirmed, 13 262 people are officially missing, and 2644 people are injured. The final death toll is expected to be above 20 000.

More than 350 000 evacuees continue to endure cold weather at 2131 evacuation centres while blankets and other desperately needed relief supplies start to arrive.

The government has established a special task force for livelihood support of the affected populations, which is responsible for ensuring that aid reaches the evacuation centres. It will coordinate with the newly established Disaster Volunteer Coordination Office. A separate task force has been set up to respond to the nuclear reactor crisis.

The United Nations Office for Coordination of Humanitarian Affairs says that about 10 000 people are leaving the evacuation centres for their homes each day as electricity is restored. But thousands more cannot go home “either because their homes were washed away by the tsunami [or were] levelled by the earthquake or they are evacuees from the area around the Fukushima power plant.”

Elderly and sick people in the evacuation centres “are becoming increasingly vulnerable as a result of the freezing weather, shortage of medicines, and limited water, sanitation and hygiene facilities,” the UN office warns. In addition, many evacuees, including children, have post-traumatic stress disorders. People with disabilities are also a concern.

Sadia Kaenzig, a spokeswoman for the International Federation of the Red Cross, told the BMJ that more than 30% of the population in the affected areas were elderly. The needs of these people are a major concern because many need treatments for chronic diseases, and a large number of them now have hypothermia and pneumonia.

She said that the situation “would have been far worse had Japan not had such excellent crisis preparedness.” The Japanese Red Cross Society is one of the world’s most active societies, with 60 000 permanent staff and more than two million trained volunteers. It has 500 emergency medical teams, of which 150 have already been deployed.

The government has 74 health teams working in the affected prefectures of Iwate, Miyagi, and Fukushima, and two teams specialising in radiation medicine are operating in Fukushima.

The Japan Medical Association has dispatched 20 teams, the All Japan Hospital Association and the Japan Association of Medical Care Corporations have jointly sent 12 teams, and the National Hospital Organization has sent an additional 16 medical teams.

As authorities continue to work to prevent further leaks of radiation from the damaged nuclear reactors, radioactive contamination has been detected in some milk, water, and vegetables, but the World Health Organization says that these are currently below levels that represent a health concern.

WHO emphasises that there is currently little risk to people further than 30 km from the damaged reactors and warns that “potassium iodide tablets are only recommended for people with very high exposure to radiation and should not be taken unless prescribed by a doctor.” It says that reports have already been received of overdoses and toxicity in people who are treating themselves because they are worried about the risk of exposure to radiation.


Cite this as: BMJ 2011;342:d1859