Takashi Ukai
A.McDonald
Jun-ichi Hirabayashi
Isao Kamae, Naoki Oboshi , Kunio Kataoka
Koji Yamaguchi, Takeshi Oohara
Tatsuya Hayakawa , Miyuki Ishida , Izumi Matsubara , Tadami Akitaya , Nobuyoshi Kuniyasu , Toshiharu Endo , Yoshihiro Koshikawa
Katsuhiko Sugimoto , Toru Aruga , Masateru Shindo
Yasufumi Asai , Masamitsu Kaneko , Yasuhiro Yamamoto , Muneo Ohta , Tsutomu Korenaga , Tomohide Atsumi , Koji Sakane , Hideaki Ohi , Aiichiro Yamamoto , Tomoo Hirakawa
Yasushi Asari , Masaki Kaneda , Yasufumi Asai , Tatsue Yamazaki , Masanori Matsusaka , Hisayoshi Kondou , Yasuhiro Yamamoto
Hiroshi Enoki , Masahiro Kida , Katumi Asai
Yasuhiro Otomo , Hiroshi Henmi , Masato Honma , Junichi Inoue , Shunsuke Matsushima , Takahiro Shiozaki , Kenmei Kuramoto
Osamu Kunii , Shuzo Kanagawa , Iwao Yajima , Yoshiharu Hisamatsu
Kinugasa Tatsuya
Takashi Ukai , Shigenori Aoki
1,Review: Environmental Disasters
Takashi Ukai
Director,Hyougo Prefectural Nishinomiya Hospital
ABSTRACT
Near-exponential
explosion of human population and industrialization are the
primary causative factors in the environmental destruction and
pollution of the whole biosphere of the planet "earth".
Superimposed on this primary causative background are major
natural disasters such as cyclonic storms and floods,
earthquakes, tsunamis and volcanic eruptions. Man-made major
disaster s, war and conflict, nuclear and toxic chemical release
or indiscriminate disposal, and the abuse of earth or oceanic
resources may contribute to the wholes ale breakdown of the
subtle and vulnerable relationship between man and his
environment. Once the environmental destruction occurs, human
society in that area becomes more vulnerable to the next
disasters.
"Environmental disasters" may be defined as "events involving critical disturbance of the human/environmental ecosystem which affect human health or welfare ", and such kinds of disasters are becoming ever more prevalent and serious throughout the world today.
These environmental disasters often occur silently and covertly so that they a re difficult to recognize and therefore to avoid. Because of their insidious nature, such environmental disasters rarely attract the attention of mass media and therefore of the world. Where recognition is difficult or delayed, intervention and response are apt to be difficult and delayed; in consequence, the impact is both more severe and more extensive and environmental recovery or restoration much prolonged.
In spite of several enthusiastic global efforts to restrict indiscriminate disposal and the abuse of earth or oceanic resources, the future of this small planet earth is in a critical situation. Unless each of us, individually and collectively makes efforts to change our lifestyle, for example by limiting the abuse of fossil fuel resources, we will not be able to leave this planet in goo d health to our children, grandchildren and future generations.
2,Disasters and Disaster Preparedness in Jamaica
A.McDonald
Department of Surgery,University of the West Indies
ABSTRACT
Jamaica is a West
Indian island 600 Kms south of Florida. The island is prone to
disasters from hurricanes and earthquakes. Our most recent major
disaster was when hurricane Gilbert hit the island on September
12, 1988. Although only 45 lives were lost, there was extensive
damage to property and basic infrastructure. Damage amounted to
approximately US $4 billion. Resulting from the lessons learnt
from Gilbert, the island has developed a fairly good disaster
preparedness organization. There is a national disaster committee
chaired by the Prime Minister. The main agency for disaster
planning and management is the Office of Disaster Preparedness
and Emergency Management (ODPEM). This is responsible for
creating and maintaining contingency plans, promoting public
awareness, as well as monitoring and coordinating emergency
response.
This island is divided into 14 parish committees, each with a chairman. These are further subdivided into zonal or community based organizations, which are first responders. The main problems facing our disaster preparedness are lack of adequate communications and transportation equipment and deficient stores o f relief supplies.
3,Volcanic gas disaster in Japan
Jun-ichi Hirabayashi
Kusatsu-Shirane Volcano Observatory, Tokyo Institute of Technology
ABSTRACT
In 1997, three
volcanic gas accidents occurred around active volcanoes in Japan.
Three members of the Ground Self Defense Force lost their lives
due to CO2 gas at the flank of Hakkoda volcano, Aomori Prefecture
on 12 July. Four hikers died by H2S gas in the summit crater of
Adatara volcano, Fukushima Prefecture on 15 September. And two
tourists died by SO2 gas at rim of active crater of Aso volcano,
Kumamoto prefecture on 23 November. Volcanic gas disasters around
active volcanoes have occurred 27 times and 46 people lost their
lived by toxic gases since 1950 in Japan. Most of these gas
accidents were due to H2S gas.
Occurrence of volcanic gas disaster is mainly dominated by the configuration o f ground around fumarolic area and meterological conditions such as calm, cloudy, foggy weather and formation of an inversion layer.
Making gas-hazard map and selection of hazardous area by the minute surveillance of fumarolic area, setting of information board on volcanic gas disaster, and installation an autonomic alarm system by continuous monitoring of toxic gas are effective measures to prevent the occurrence of gas disaster. A previous knowledge of toxicity of volcanic gas and rescue technique are important to defend ourselves.
Keywords : Volcanic gas, gas disaster
4,Kobe University Research Center for Urban Safety and Security:The Foundation for Medical Research Division
Isao Kamae, M.D., Dr.P.H., Naoki Oboshi, D.M.D., Kunio Kataoka, Ph.D.
Kobe University Research Center for Urban Safety and Security
ABSTRACT
In 1996 Kobe
University established the Research Center for Urban Safety and
Security (RCUSS) in order to respond to the growing public
concerns about risk and safety which were seriously recognized at
the Hanshin-Awaji Great Earthquake in 1995. The RCUSS is designed
to be an interdisciplinary center with six divisions of research
concentration in city planning, city engineering, seismology,
health informatics and sciences, urban policy and management, and
information systems. Working in cooperation with Kobe University
School of Medicine, the division of Health Informatics and
Sciences in RCUSS is focusing on public health and medical
aspects of urban risk and safety which include risk analys is in
medicine, disaster epidemiology, information systems for medical
disaster response, medical technology assessment, medical
decision making under risk, crisis management for medical
professionals, and so on. These topics have bee n so recently
emerging in Japanese medical community that Kobe University is
expected to take the initiatives in such fields of research and
education at both the graduate and the undergraduate levels of
medical schools in Japan.
Keywords : Urban Safety, Disaster Medicine, Crisis Management, Medical Information System, Risk Analysis
5,The drill and operation manual for disasters in hospitals
Koji Yamaguchi, MD*
Takeshi Oohara, MD, PhD**
*Department of Surgery ,Yokosuka Kyosai Hospital
** Director, Yokosuka Kyosai Hospital
ABSTRACT
At the Yokosuka
Kyosai Hospital, the disaster relief drill, based on the disaster
operation manual, was performed. It was assumed that we had an
earthquake whose epicenter was directly below the hospital. We
reviewed the disaster relief plan at the hospital.
The Yokosuka Fire Department and Yokosuka citizen volunteers cooperated in transporting the victims. 65 people volunteered to act as disaster victim. The effectiveness of the procedures in the disaster operation manual was evaluated by the people assigned beforehand.
Five minutes after the earthquake, the injured flooded the hospital. First aid treatment was not performed and triage was not set up until after the disaster control center was established.
After the disaster control center was established, triage, transportation of t he injured, medical treatment, requests for additional support and other thing s were executed smoothly.
The disaster relief drill was not well prepared. We found that the present disaster operation manual is not effective unless the control center system (like a disaster control center) is established first.
It seems that evaluation of the disaster drill would be useful in measuring the effectiveness of the disaster relief activities.
Keywords : Disaster relief drill, Disaster operation manual, Disaster control center, Triage
6,The drill of the National Disaster Response Team of Japan (NDR) in1997 with realistic performance and make-ups of victims
Tatsuya Hayakawa*, Miyuki Ishida*, Izumi Matsubara*, Tadami Akitaya**, Nobuyoshi Kuniyasu**,
Toshiharu Endo** and Yoshihiro Koshikawa*3
*Sapporo City General Hospital, Departmet of Emergency and Critical Care Medicine
**Sapporo Fire Bureau, Emergency Section
*3Sapporo Fire Bureau, Research and Developemet Section
ABSTRACT
On July 29th
and 30th 1997, a drill for the National Disaster
Response Team of Japan(NDR) was conducted in Sapporo. In order to
make out the imaginative disaster condition as realistic as
possible in the context of the drill, the realistic performance
was much considered, especially in setting up the First Aid
Center as well as in the triage of the victims. The ambulance
workers played the parts of total number of 68 disaster victims
with both realistic performance and make-ups. In terms of saving
lives of the people, an immediate arrangement for the
well-functioned command system for disaster relief is sure to be
done with first priority, but it is also an important fact that
an appropriate triage and first aid by doctors, nurses, and
ambulance workers altogether facing to the victims is crucial in
that goal.
This is the point to be considered when conducting the drill for any disaster in the most effective way. The planning and performance in realistic vein, therefore, come to be of great importance in this context. The first step, for example, is to put focus on the performance of the disaster victims under an emergency condition with careful consideration.
In the drill, the realistic performance of the victims made it possible to set up the excellent disaster environment imagined. The implied significance here is that the drill of this kind provided doctors, nurses, and ambulance workers with good experience of the realistic triage and first aid of the victims. On e of the opinions commonly proposed by those who had experienced the drill was the necessity of giving information and explanations concerning the triage or first aid by doctors, nurses or ambulance workers, which was not unfortunately fulfilled in the course of the drill because of time-shortages and so on. We should bear in mind that the same kind of situation can be seen in any real disaster.
Keywords : National Disaster Response Team of Japan, triage, first aid center, drill, realistic performance and make-ups
Katsuhiko Sugimoto MD, PhD*, Toru Aruga MD, PhD* and Masateru Shindo MD, PhD**
* Department of Emergency and Critical Care Medicine, Showa University, School of Medicine
**Department of Traumatology and Critical Care Medicine, Kitasato University, School of Medicine
ABSTRACT
In order to clarify
the state of the preparedness and planning for disasters o f
university hospital in Japan, the questionnaires were sent to all
of 131 University hospitals and it’s related facilities in Japan. And,
finally, we have received 87 (67%) answers. There were 47 (54%)
university hospitals and facilities which have prepared for
disasters, but many these hospital and facilities (78/87: 90.0%)
had found that their preparedness would not be sufficient for
disasters. The state of preparedness of these hospital and
facilities were com pared regarding to their experiences of
disasters, to their back ground (private of public) and to number
of beds. The hospitals and facilities which had experience of
disasters show a tendency to prepare for disasters comparing to
those had no experience about disasters. But, regarding to other
parameters including their back ground and number of beds, there
were no significant differences. The results from this inquiry by
questionnaires indicated that university hospitals and their
facilities had no sufficient planning and/or preparedness for
disasters.
The future revised effective preparedness which would be expanded from usual emergency medical systems should be planned for disasters, as soon as possible.
Keywords : Preparedness, Educational hospital, Emergency medicine
8,Activity of rescue dog in the disaster
Yasufumi Asai, Masamitsu Kaneko, Yasuhiro Yamamoto*, Muneo Ohta**, Tsutomu Korenaga*3 ,
Tomohide Atsumi*4, Koji Sakane*5, Hideaki Ohi*5, Aiichiro Yamamoto*5 and Tomoo Hirakawa*6
Department of Traumatology and Critical Care Medicine, Sapporo Medical University
* Nippon Medical College
** Osaka Prefectual Senri Critical Care Medical Center
*3 Nippon Volunteer Network Active in Disaster
*4 Kobe University
*5Japan International Cooperation Agency
*6the Ministry of Foreign Affairs
ABSTRACT
This paper is
intended to provide some information on the activity of the
rescue dog in Switzerland, Germany and Japan.
Within the Swiss Disaster Dog Association (SDDA) there is a permanent pool of 300 dog-handlers and 50 trained rescue dogs whose task is to search for victim s buried under the rubble after an earthquake. The SDDA has approximately 650 members throughout Switzerland. Since 1976, the SDDA has put these rescue tea ms into action both in Switzerland and abroad. Since 1982, several missions abroad under the auspices of the Swiss Rescue Chain have been dispatched. In Germany, Technishes Hilfswerk (THW) works in case of domestic disaster. SEEBA (Schnell Einsatz Einheit Bergung Ausland : Rapid Deployment Unit for Search and Rescue) consists of THW voluntary specialists who constantly undergo special training to prepare for rescue missions in foreign countries. It has rescue dogs which were dispatched in the Armenian Earthquake of 1988. The Japanese Rescue Dog Association was established as a voluntary group after the Great Hanshin-Awaji Earthquake in 1995. Other non-governmental organization also have rescue dogs. However there are many differences between these group in terms of efficiency and quality and jointly they should strive to achieve some nationally recognized standards for professional dog handler groups. They should also establish a much better communication network between themselves.
The main difference between Switzerland, Germany and Japan is that in Japan there is no official recognition of rescue dogs.
The other point is that the rescue dog plays an indispensable role for rescue activities in Switzerland and Germany. The Japanese Government should properly re-evaluate the function and usefulness of rescue dogs in disaster rescue work and provide financial support for their activities.
Keywords : Rescue dog, NGO, Volunteer, Swiss Disaster Dog Association, Technishes Hilfswerk
9,Evaluation of the activities of the Japan Medical Team for Disaster Relief in the aftermath of the 1996 Bangladesh tornado
Yasushi Asari* , **, Masaki Kaneda* , *3, Yasufumi Asai* , *4, Tatsue Yamazaki* , *5,
Masanori Matsusaka* , *6, Hisayoshi Kondou* , *7, Yasuhiro Yamamoto* , *7,
* Japan Association for International Disaster Scienec,
** Department of Critical Care and Emergency medicine, Kitasato University School of Medicine,
*3 Toyoko Hospital, St.Marianna University School of Medicine,
*4 Department of Traumatology and Critical Care Medicine, Sapporo Medical University School of Medicine,
*5 The Aoyama Tokyo Metroporitan Officers Hospital,
*6 Osaka Prefectural Daitoh Public Health Center,
*7 Department of Emergency Medicine,Nippon Medical School
ABSTRACT
The purpose of this
survey is to evaluate the activities of the Japan Medical Team
for Disaster Relief (JMTDR), which was dispatched in May 1996 to
offer assistance in the Bangladesh tornado disaster by the Japan
International Cooperation Agency with a view to improving and
strengthening disaster relief operations.
The Japanese Government dispatched JMTDR on May 17 and the activities of JMTDR started on the fifth day after the tornado struck. The sites of the activities of JMTDR were Tangail General Hospital and Mirikpur village in Tangail district, the most seriously affected area, where there was good access for the relief team, and to which severe cases were transferred from the disaster site.
JMTDR gave 955 patient-days of treatment in 2 weeks. Of the patients visiting the JMTDR outpatient clinic, 99% had multiple injuries due to flying corrugated iron sheets that had been used as roofs and walls. In 84%, the wounds were infected and needed not only debridement but also antibiotics for infection control.
There were 57 patients from Tangail district who were transferred from the disaster site and died in hospital. Before the activities of JMTDR began, that is, during the first 4 days after the Tornado, 46 of the 57 hospital deaths (8 0.7 per cent) had already died. The causes of death were: head injuries in 68 .4% of the cases, multiple injuries in 12.3%, pelvic and extremities injuries (8.8%), and shock (14.0%).
Seven per cent of the hospital deaths due to the tornado in Tangail district result from sepsis after wound infections, but no patients died of septicemia in the hospital during or after the activities of JMTDR in Tangail. In the follow-up survey of the affected people in Mirikpur village in Tangail district, the scars of the injured patients were noted but the wounds had completely healed by fifteen months after the tornado. Interviews of the authorities of Tangail district showed that they were of the opinion that the duration of the JMTDR activities was not sufficient, and that a second team should have been dispatched because of the extraordinary scale of the tornado and the large number of casualties. However the Team’s patient treatment was taken over by the local doctor without interruption, so that there was no problem of continuity.
A follow-up survey should be an integral part of this type of disaster relief effort. The information from this study was not available for the recovery an d assistance efforts in Bangladesh after the tornado disaster. However, JMTDR played an effective role in the medical management of this disaster while they were in Bangladesh.
Keywords : Evaluation, Disaster relief, Bangladesh tornado disaster, the Japan Disaster Relief Team
10,The joint drill for disaster by disaster prevention organization
Hiroshi Enoki, Masahiro Kida, Katumi Asai
Yokosuka Fire Department
ABSTRACT
In the Miura
Peninsula area, a train collision drill was conducted in order to
practice the rescue, first aid treatment and transportation of
disaster victims.
It was performed jointly by the Self-Defense Force, police, the
Doctors’ Association and the Fire Department.
The purpose of the drill was for these organizations to learn how
to coordinate effectively with each other during simulated
disaster relief operations. To make the drill realistic and
useful, it was decided that detailed step-by-step planning and
staging of first-aid stations would not be done prior to the
drill as was done in past drills. And we also decided to stagger
the arrival times of each organization at the scene.
The operation points for the injured are under study at our Fire
Department. We inspected the operation points, especially triage
and first aid operations during mass disasters. And also we
inspected the coordination abilities of those organizations on
the scene.
This time the drill was
effective in finding problems.
Keywords : Prevention organization, On site control center, Triage, Disaster relief drill
11,Swift and appropriate management in the treatment of a large number of severely traumatized cases in a disaster medical center ; New trial in a hospital disaster drill
Yasuhiro Otomo*, Hiroshi Henmi*, Masato Honma*, Junichi Inoue*, Shunsuke Matsushima*
Takahiro Shiozaki* and Kenmei Kuramoto**
National Hospital Tokyo Disaster Medical Center
*Department of Critical Care and Traumatology
**Department of Radiology
ABSTRACT
We had accomplished
an unique hospital disaster drill
(Settings of this drill)
(Results)
1) Gross treatment time; 19.6 +/- 11.1 (5-46) minutes
2) Net treatment time (gross treatment time + time for blood tests and radiological diagnosis); 67.2 +/- 26.4 (25-136) minutes
Failed in diagnosis; serious 3, significant 7, minor 1 Missed examination; indispensable 2, necessary 15 Failed in first aid; important, skipped 3; minor, skipped 9; unnecessary, 4 Failed in medication; important, missed 1; minor, missed 4; unnecessary, 0 5. The final estimated treatment time, including the addition of the penalty time, was calculated to be 105.1 +/- 40.1 (35 - 206) minutes. Seven cases took more than 120 minutes that was set up as a qualification for successful treatment.
(Discussion)
Even though accurate triage had been accomplished, if a large number of severely traumatized cases were transferred simultaneously to the hospital it would be extremely difficult to achieve swift and appropriate management for all cases. To achieve efficient management, unnecessary examinations should be avoided. However, too great an avoidance of examinations would result in mistakes in diagnosis, first aid or medication. In disaster settings, decisions in managing trauma patients are much more difficult compared with that in ordinary emergency settings. Experienced trauma surgeons may deliver better results; however, we still feel the necessity of establishing guidelines for managing trauma patients in disaster settings that we believe would be different from ordinary emergency settings.
Keywords : Hospital disaster training, post triage management, large number of disaster casualties
12,Role of Japan Disaster Relief(JDR) Medical Team in the 1997 Forest Fires Disaster in Indonesia
Osamu Kunii*, Shuzo Kanagawa*, Iwao Yajima**, Yoshiharu Hisamatsu*3
*Bureau of International Cooperation, International Medical Center of Japan
**Indonesia Environmental Management Center
*3Department of Community Environment Sciences, National Institute of Public Health
ABSTRACT
Japan Disaster
Relief(JDR) expert Teams, including fire-fighting, environmental
and medical experts, were sent to Indonesia and Malaysia in
September, 1997 where the haze derived from large-scale forest
fires in Kalimantan and Sumatra had covered. The medical experts
in Jambi, one of the most affected areas in Indonesia conducted
information gathering in health facilities, air quality
measurements and a community sample survey.
As a result, carbon monoxide and particulate matters less than 10 microns in diameter(PM10) reached ‘very unhealthful’ and ‘hazardous’ levels respectively in the Pollution Standard Index(PSI). Health effects by the haze were very remarkable, demonstrated by the increases of outpatients and inpatients with asthma and pneumonia, 99% incidence rate of perceived symptoms, mainly respiratory, in which the elderly were more severe.
Estimated by the model from previous epidemiological researches of air pollution, the crude mortality rate and the number of death would increase about 3 times and over 300,000 in the affected areas. However, health effects might be different between the haze derived from fossil fuel and biomass combustion in terms of the gradients of PM10 and the interaction of air pollutants. In addition, long-term health effects of the haze from forest fires are little known and further studies are needed.
With an increasing need against global environmental disasters, Japan should p lay an important role to assist disaster prevention and mitigation programs as well as emergency relief, making cooperation with various sectors both nation al and international.
Keywords : Japan Disaster Relief Medical Team, Indonesia, Forest fires, Air pollution, Health effects
Kinugasa Tatsuya
Mitsubishi Kobe Hospital Surgical Division
ABSTRACT
Ever since countries
around the world began to make use of nuclear energy, radiation
accidents have occurred at various places. From 1944 to 1996,
there were about 400 radiation accidents world-wide, involving
nearly 134,000 people. Once radioactive substances flow out into
the environment after a radiation accident, residents in the
surrounding areas can be exposed and contaminated. In such a
case, the radiation accident may become a radiation disaster.
Five representative examples of radiation disasters are given
below. The first is the Bikini Atoll disaster (1954) caused by a
nuclear test. Native s of the Marshall islands and Japanese
fishermen were exposed and contaminated by fallout from the test.
Thyroid disease, including thyroid cancer, increase d
significantly among the natives.
The second case is the Windscale disaster (1957) caused by a fire in the react or. The main released radiation substances were 131I and 210Po. Consequently, milk control was done. Fortunately, the risk of thyroid and lung cancer was estimated to be very low by the National Radiological Protection Board (NRPB) of the United Kingdom (UK).
The third is the Three Mile Island (TMI) accident (1979) caused by a meltdown of a reactor. As the released radioactive substances were noble gases, they we re immediately diffused in the atmosphere. Consequently, the public was spared health risks. Unfortunately, because of a lot of misinformation by the mass media, the public was confused.
The fourth is the Chernobyl disaster (1986) caused by an explosion in a reactor. More than 130,000 people were evacuated or relocated. In this disaster, the necessity of psychological care for victims gained recognition. The fifth is the Goiania disaster in Brazil (1987).The main radioactive substance released was 137Cs. Four victims died of acute internal exposure. These examples show the danger of contamination. Therefore, when a radiation disaster occurs, we need to track immediately the movement of the released radioactive substances. In addition, timely decision-making on various matters is important to protect the public. These matters include 1) Control of access to site, 2) Shelter, 3) Evacuation, 4) Administration of stable iodine, 5) Personal decontamination, 6) Injury management, 7) Intervention in the food chain and drinking water supply, 8) Relocation, and 9) Decontamination of the structure and land surface.
Lessons learned from past radiation disasters include the immediate release of an explanation, in a manner the public can easily understand, about the radiation units, e.g., mSv, Bq, etc., and the release of sufficient information about the relationship between the radiation doses and health consequences as a result of contamination.
Of course, an emergency plan for radiation disaster should be prepared in advance. In addition, emergency staff should be required to take part in drills an d educated in various matters. For example, the administration of stable iodine, personal decontamination and injury management are commonly provided by medical support at radiation disasters.
Personal decontamination is important for victims who have been evacuated or relocated from contaminated areas. It consists of four steps. (1) The registration of victims for identification purposes. (2) An estimation of the contamination by taking surveys and assessing the degree of exposure.
(3) The implementation of personal decontamination measures and the evaluation of their effects.
(4) The provision of an explanation to victims about the outcome of a sequence of treatments and of short-term plans.
For some victims, e.g., those subjected to high dose exposure (whole body exposure of more than 250 mSv, or surface contamination of more than 40 Bq/cm2), transport to a regional main medical facility, after decontamination, should be envisaged.
In Japan, problems remain concerning emergency measures in the event of a radiation disaster. It is necessary to have drills based on realistic simulation programs. In addition, improvements must be made so that staff members may explain radiation units and health consequences after a radiation disaster. Finally, emergency plans for radiation disasters should include measures for mass treatment.
Keywords : Contamination, Radiation disaster, Emergency planning
14,Water Shortage in Ngara Camp, 1996, A Not-Quite Hypothetical Case-Study (from HELP'97)
Takashi Ukai* and Shigenori Aoki**
*Hyogo Prefectural Nishinomiya Hospital
**Fukuoka Tokusyukai Hospital
ABSTRACT
This text is a
translation into Japanese from a case-study exercise given at t
he HELP'97 course held in July at Hawaii with the permission of
Dr. Pierre Perrin of International Committee of the Red Cross and
Prof.F.M. Burkle of Hawaii University, Center of Excellence in
Disaster Management and Humanitarian Assistance. Readers are
recommended to read this text as if he/she is attending the
seminar and joining in the discussion of this case-study
exercise. Water shortage in refugee camps, its assessment and the
available countermeasures to cope with this problem are
discussed.
Keywords : Refugees, Displaced people, water shortage, water resources, cost benefit