Local Report: Japan’s Experience in Earthquake and Tsunami Disaster Can Be Used to Support Ukraine’s Displaced Population
This past March, the Japan International Cooperation Agency (JICA) dispatched a survey mission to neighboring Moldova to assist displaced people in Ukraine. Japan’s experience and expertise in overcoming numerous natural disasters, including the Great East Japan Earthquake, and especially the standardization method of disaster medical information introduced after the Kumamoto earthquake, are playing a major role in emergency disaster medical care in the region.
The current situation in neighboring Moldova, which is hosting displaced persons from Ukraine The four members of the First Assessment Team of JICA’s Emergency Humanitarian Assistance and Cooperation Needs Assessment in the Health and Medical Sector, which was dispatched to Moldova to provide assistance to displaced persons from Ukraine and neighboring countries, returned home on April 10 after 21 days of survey activities.
It has been about a month and a half since the Russian invasion of Ukraine began. The number of Ukrainians who have fled the ravages of war and left their homeland is said to be about 4.3 million (as of April 6). A report by a JICA survey team dispatched to neighboring Moldova reveals the current situation and the support needed.
Bordering southern Ukraine, Moldova has 2.64 million people living in a land the size of Kyushu. After the Russian invasion of Ukraine, nearly 400,000 Ukrainian refugees entered the country, and it is estimated that 90,000 to 100,000 of them are still in Moldova.
On February 26, two days after the invasion, JICA began to consider and coordinate the dispatch of a survey team, and on March 19, a six-member team headed by Professor Tatsuhiko Kubo, a public health specialist at Hiroshima University, left Japan for Moldova.
It is not easy for a country in turmoil due to displaced people to accept a survey team from another country, but JICA had built a relationship of trust with Moldova through its ongoing support in the agricultural and medical sectors, and the team was quickly accepted.
The survey team visited six northern cities, including the capital city of Kishinau and the Ukrainian border area, to inspect a basic hospital, a closed movie theater, and a shelter in a former university building. JICA had been cooperating in the medical field (improving medical services for cancer patients, providing medical equipment, etc.) since before the influx of refugees, and had some understanding of the local medical situation. This inspection focused on the aging of medical equipment, the shortage of human resources for maintenance, the shortage of medicines and other supplies, many of which had been procured from Ukraine, and the influx of displaced people with chronic diseases. In particular, the influx of refugees with chronic illnesses requiring advanced medical treatment, such as dialysis, cancer, and diabetes, has placed a heavy burden on the originally fragile medical system as a whole.
MDS, an international standard medical record “born in the Philippines and raised in Japan,” contributes to the speedy collection of medical information, and the issues it reveals. When a disaster or war occurs, medical teams and relief supplies gather from all over the world, but it is extremely difficult for the chaotic situation on the ground to accept and properly deploy assistance. The immediate consolidation and analysis of medical information necessary for this purpose, and the establishment of a system to centrally coordinate individual medical teams, were issues common to the world.
In 2011, during the Great East Japan Earthquake in Japan, emergency medical teams had to replace one another, which hampered the transfer of medical records to local medical services and the immediate identification of medical needs. Recognizing the need for uniform medical records and daily medical reports, the JDR medical team set out to develop a world-standard electronic medical record for disaster medicine.
In 2013, the JDR medical team that went to the Philippines to support the victims of Typhoon Yolanda faced the same challenges as in Japan. Using their previous experience, they proposed the use of SPEED, a locally-used disaster medical information gathering tool, to medical teams from around the world. The team’s contribution to identifying disease trends and coordinating the activities of each team was well received. After returning to Japan, Professor Kubo and his colleagues came up with the development of the Japanese version of J-SPEED, a standardized medical daily report for disaster medicine, using SPEED as a reference. The first implementation of J-SPEED in the 2016 Kumamoto earthquake brought about a significant change in the field of disaster medicine. The system quantified on a daily basis “where, what kind, and how many patients were treated,” and enabled timely provision of necessary support at that time. Based on these achievements in Kumamoto, a Minimum Data Set (MDS/Standardized Method for Disaster Medical Information) was developed based on J-SPEED in 2017, and was approved by WHO as an international standard.
MDS, “born in the Philippines and raised in Japan,” was adopted as an international standard based on Japan’s knowledge in the field of medical care in natural disasters, and its use was disseminated to international medical teams in Moldova at the initiative of the survey team, which revealed the medical needs and trends sought by the displaced population.
For example, it has become clear that there are more needs to deal with physical ailments and chronic illnesses caused by prolonged evacuation than direct trauma from the fighting. The fact that the percentage of adult males, who are supposed to be restricted from leaving the country, is higher than expected was a surprise to the doctors in charge at the Moldovan Ministry of Health. The fact that even adult males with chronic diseases or disabilities are allowed to leave the country has revealed the background to the exodus of many of them as displaced persons.
It is also becoming apparent that the number of evacuees requiring ongoing treatment is on the rise, although the number of daily treatments itself is decreasing. Referring to the data from the Kumamoto earthquake, those who are forced to continue living in evacuation centers are often economically disadvantaged and have pre-existing medical conditions, and there is a possibility that more cases of health conditions worsening due to prolonged evacuation will continue to increase.
Because of the incorporation of MDS, Moldova was able to capture such data quickly. Currently, they are considering introducing MDS in Poland and Ukraine, where there has been a large influx of displaced persons as in Moldova.
Different from natural disasters, the sadness is that it is caused by war, which is caused by people. Professor Kubo, who has been involved in emergency medical treatment due to natural disasters and has been deeply involved in the development of MDS since joining the medical team in the Philippines, described the difference between this activity and the previous one as follows: “The overwhelming difference is that it is caused by war, which is caused by people. The overwhelming difference is that it is caused by war, which means it is caused by people. In the case of natural disasters, there are moments when the city brightens up with the passage of time and the music on the radio makes you feel a sense of the future, but what the people of this country are worried about now is the further expansion of damage caused by the ongoing invasion. On the one hand, we feel the sadness of war and the instability of the future, which depends on the war situation.” On the other hand, he emphasized that Japan stands out in the world for its disaster medical technology and knowledge of health risk management, as it has faced and overcome emergency disaster medicine such as earthquakes and torrential rains, because the emergency medical care needed by evacuees remains the same regardless of whether the cause is war or natural disaster.
© Source JICA
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