Disease structure of affected people of earthquake and tsunami disaster in Northwest Japan - Dr. Tamotsu Nakasa
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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
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Disease structure of affected people of earthquake and tsunami disaster in Northwest Japan - Dr. Tamotsu Nakasa
- 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