Simulation for Timing of the Influenza Vaccination in prepration for an Epidemic
Munetaka Maekawa, Isao Kamae- Studies on the Design of a Regular Check List of Medical equipment for Early Recovery after Disasters
Yutaka Kawaguchi, Hidemune Naitou, Bunji matuyama, Yasushi Okanishi
- Report on the Shizuoka prefecture hospital disaster plan questionaire
Katsunori Aoki, Atsuto Yoshino
- The present condition of prolonged Afghan refugees
Masaki Kaneda , Osamu Kunii
- Japanese Red Cross Society's disaster relief activities for the disaster of the torrential rain and flood in Japan, 1998
Nobuyuki Suzuki MD , Mutuhiko Ouwaki , Toshiharu Makishima MD
Otohiko Hori , Yutaka Tanaka
- Artificial ventilation using bellows compressed by foot
Nobuo Fuke , Kazuyuki Serata , Takashi Maeda
- Information Transmission through the Internet for the Preparedness against Venomous Snakes in the Aftermath of Cambodian Flood in 1997
Ochi G. , Shirakawa Y. , Asahi S. , Toriba M. ,Akira Sekikawa , Ronald E. LaPorte
- A Report : the Mission of Japan Medical Team for Disaster Relief of Colombia Earthquake in Jan 1999.
Norimasa Seo, MD.
- Mortality and Morbidity Among Rwandan Refugees Repatriated from Zaire, November, 1996
1,Simulation for Timing of the Influenza Vaccination in prepration for an Epidemic
Munetaka Maekawa, Isao Kamae
Division of Health Informatics and Sciences Kobe University Research Center for Urban Safety and Security
Abstract
An influenza epidemic is of major public health concern. On January 17, 1995, Kobe experienced the Great Hanshin-Awaji Earthquake with a great number of victims and much damage, which produced confusion in the influenza surveillance system. We conducted a decision analysis based on the decision-tree model as to whether the emergency vaccination for influenza should or should not be performed in terms of maximizing life expectancy against the risk caused by the vaccination. As a result, we theoretically formulated the decision level at which the benefit of the vaccination overcomes its risk. The resulting mathematical formula will be helpful to decision makers in establishing as to when the influenza vaccination should be performed in the high-risk groups under the disaster of the particular circumstances where surveillance data suggest that the influenza epidemic is likely to become serious. Computer simulations based on the records of the Great Hanshin-Awaji Earthquake made possible the numerically analyzed formula to determine the optimal time for a population-based vaccination.
Keywords : Enterohemorrhagic E. coli, O157, Vero toxin, Hemolytic uremic syndrome, Disaster food poisoning
Yutaka Kawaguchi, Hidemune Naitou, Bunji matuyama, Yasushi Okanishi
Hiroshima International University, Kounann Hospital, Kounann Hospital, Laboratory of Urban Safety Planning
ABSTRACT
The purpose of this paper is to create a check list that medical staff can use daily for checking medical equipment in order to prepare for the quick recovery of diagnostic function when a disaster occurs, and to prove the usefulness of the check list.
A research group was organized, consisting mainly of staff at hospitals and corporations that had taken an active part in the medical activities and the recovery of medical equipment at the area of the Hanshin Earthquake of 1995 in Japan.
First, based on the experiences of the Kobe Earthquake, the research group determined what conditions hospitals should meet and what medical equipment was necessary in order to cope with the situation in a disaster. After consulting the manufacturers, the minimum operating requirments for each equipment were established and a regular check list was designed for the medical staff. The list was reviewed by the hospitals designated for disasters. We arrived at the conclusion that both the check list and the checking method were very useful in such hospitals and that they could be used as a reference for further disaster planning.
Keywords : disaster, Diagnostic Function, Medical equipment, Regular Check list.
3,Report on the Shizuoka prefecture hospital disaster plan questionaire
Katsunori Aoki, Atsuto Yoshino*
Department of Emergency Medicine, Hamamatsu University School of Medicine,
Department of General Medicine*, Hamamatsu Medical Center
ABSTRACT
In order to verify preparedness for the Tokai Earthquake which is expected to occur after several years to several decades, a qu**-estionaire about the hospital disaster plan was sent to 29 hospitals in Shizuoka prefecture over 3 consecutive years (1996-1998).
The results were as follows;
1.Use of a wireless telephone which covers a local area or the total area of the prefecture is not routine.
2.Two third of the facilities can not endure suspension of the water supply for over 24 hours.
3.Less than half of the facilities have a list of private telephone number within the hospital network.
4.About eighty percent of the facilities do not have a capacity to accept 500 or more injured persons.
5.Most hospitals respect the prefectural policy that each hospital must accept inpatients calculated as the number of regular beds multplied by 0.7 .
6.Transport of patients to unaffected hospitals would possibly be difficult because hospitals with heliports are quite rare.
7.Improvement of the interhospital network is necessary for the disater relief coordination program in Shizuoka prefecture.
Keywords : disaster plan, Tokai earthquake, disaster preparedness, information system for emergency medicine
Masaki Kaneda* , Osamu Kunii**
*Department of Orthopedics. St.Marianna University Toyoko Hospital
**Department of Community Environment Science. National Institute of Public Center
ABSTRACT
Prolongation of Afghan war has given birth to 2,600,000 refugees.
The Japanese goverment has formed HUREX (Humanitarian Relief Experts) on the basis of the PKO law. With this as an opportunity, we investigated the actual situation of Afghan refugees in Pakistan and Iran. A great difference in the health environment, health education health manegement in the refugee camps was found between the two coutries.
On the Pakistan side, the aids from the goverment, UN organizations and NGO were functioning effectively.
The living environment there appeared to be close to a passing mark.
On the Iranian side, however, the living environment was hard to the refugees partly because of the activities of NGO being not approved.
The future problem of Afghan refugees is repatriation of refugees after peace. This involves major problems such as improvement of medical environment in Afghan proper and health management of the refugees on repatriation. And international aids are needed to deal with these problems.
The HUREX as one of the Japanese aids should positively take part in the rehabilitaion of Afghanistan.
Keywords : Afghan refugees, Health management, Repatriation, Japanes aids.
Nobuyuki Suzuki MD* Mutuhiko Ouwaki* Toshiharu Makishima MD**
Otohiko Hori*** Yutaka Tanaka***
*Nagoya Daini Red Cross Hospital
**Japanese Red Cross Medical Center (Tokyo)
***Japanese Red Cross Headquaters
ABSTRACT
Disaster relief programme has been one of the Japanese Red Cross Society's (JRCS) fundamental activities since the JRCS dispatched the first medical relief team to assist the victims suffered from Mt. Bandai eruption in 1888. After the Great Kanto earthquake (1923), the JRCS demonstrated its strength in disaster relief for the Unzen-Fugen volcanic eruption (1991), the Hokkaido South West Sea earthquake (1993), the Great Hanshin-Awaji earthquake (1995) and the torrential rain and flood caused typhoons in 1998, which brought more than 800 casualties as well as massive damage to the infrastructure.
Through the relief activities in 1998, the JRCS used its new disaster response system which was re-established after the Great Hanshin Awaji earthquake, deviding Japan into six blocks and allowing the chapters in the each regional block to response the disaster by their own decision without any appeal from the chapter in the affected area. Six major relief activities in 1998 were carried out quickly and efficiently.
Keywords : Japanese Red Cross society(JRCS), disaster relief operations, disaster mecical relief team, disaster of torretial
Nobuo Fuke*, Kazuyuki Serata**, Takashi Maeda**
*Intensive Care Center, Teikyo University Ichihara Hospital
**Deaprtment of Anesthesia, Showa University Fujigaoka Hospital
ABSTRACT
In critical situation like an acute phase of a disaster, artificial ventilation may be needed for a patient with respiratory failure. Practical problems at that situation include lack of electricity, lack of oxygen supply, lack of manpower and so on. Traditional bag-and-mask system is useful in that situation, however it is not always easy to maintain patient's airway and tightness of the mask by one hand.
The authors have successfully applied the bellows to ventilate an anesthetized patient through an anesthesia machine by compressing them by foot. Ventilation by foot makes it possible for an operator to proceed other resuscitative maneuvers while ventialting a patient. This method is also applicable without an anesthesia machine so far as an inspiratory / expiratory one-way valve exists in the system. The authors have developed two prototypes. By connecting the bellows with disposable plastic corrugated tubes, T-connector, and an one-way valve, artificial ventilation is possible and supplemental oxygen is inducible in the system.
Using the bellows is by no measns a new idea. In 1899 American surgeon Rudolph Matas introduced how to intubate and how to ventilate a patient with "Fell-O'Dwyer apparatus" which was a ventilator using the bellows as a flow generator, and an operators thumb as a valve.
In conclusion ventilation by foot is a choice of respiratory support in critical situation. The author's prototypes are successfully used and gives an operator free hands to do other procedures.
Key words : bellows, artificail, ventilation, anesthesia
Ochi G, MD*, Shirakawa Y, MD, PhD*, Asahi S, MD, PhD**, Toriba M, MD, PhD***,
Akira Sekikawa, MD, PhD**** and Ronald E. LaPorte, PhD****
ABSTRACT
We report a case in which the Global Health Disaster Network (GHDNet), an internet-mediated network for disaster relief, played an important role in the preparedness against venomous snake in the aftermath of Cambodian flood. On Aug. 6, 1997, a request was sent for venomous snake antiserums from the Government of Cambodia to the Western Pacific Regional Office in Cambodia, Emergency and Humanitarian Action (EHA), WHO. There had been serious flood in Cambodia and many snakebite cases were expected aftermath the flood. On Aug. 13, the EHA coordinator sent an e-mail to a GHDNet member to ask information about snakes in Cambodia. The member transmitted the mail to three mailing lists related to the GHDNet. Some mailing list members recommended to contact some institutes including Japan Snake Institute and the Serum Institute of India. Finally, in Aug. 18, antiserums for 100 persons were ordered to the Serum Institute of India, and were transported to Cambodia by air. On this occasion, prompt information exchange was essential to minimize the number of casualties by snakebite and the Internet proved to be quite helpful to connect specialists on an international scale.
Norimasa Seo, MD.
Team Leader and Medical Coordinator of the Mission, Professor of Anesthesia and Critical Care Medicine,Omiya Medical Center, Jichi Medical School
ABSTRACT
A powerful earthquake, magnitude 6.0, struck at 13:19 EST (18:19 GMT) of Jan 25 on Colombia's central region. According to this earthquake, at least 263 people killed and hundreds were injured reportedly at 18:00 EST. By the request of Government of Colombia, the Japan medical team for disaster relief was sent without break after the rescue team at noon on Jan 28 (Japan Time) by the mission of the Ministry of Foreign Affairs of Japan. The two disaster relief teams worked in ARMENIA, the capital of Quindio province, where the infrastructure, electricity, communication and transportation system were almost destroyed and public order was disturbed. The Japan medical team treated 1,355 of patients during 8 days stay in ARMENIA at three temporary constructed clinics.
This mission was characterized by early dispatch without accurate information where to perform medical care and stay at. The medical mission for this disaster relief was completed uneventfully and safely thanks to the united efforts of members of counter part, Japanese embassy staff, JICA, JOCV and native volunteers.
JICA: Japan International Cooperative Agency
JOCV: Japan Oversea Cooperative Volunteer
Keywords : disaster relief, earthquake, medical support
9, Mortality and Morbidity Among Rwandan Refugees Repatriated from Zaire, November, 1996
Nicholas Banatvala, MFPHM; Alison J. Roger, MFPHM; Alisa Denny, SRN; Johon P. Howarth, MRCGP
Prehospital and Disaster Medicine, 13(2): 93-97.1998.ABSTRACT
Introduction: Following renewed ethnic violence at the end of September 1996, conflict between Tsuti rebels and the Zairian army spread to North Kivu, Zaire where approximately 700,000 Rwandan Hutu refugees resided following the 1994 genocide. After a major rebel offensive against the camp's militia groups on 15 November, a massive movement of refugees towards Rwanda through Goma town, the capital of North Kivu, began. Massive population movement such as this are likely to be associated with substantial mortality and morbidity.
Objective: To study patterns of mortality, morbidity and health care associated with the Rwandan refugee population repatriation during November 1996.
Methods: This study observed the functioning of the health-care facilities in the Gisenyi District in Rwanda and the Goma District in Zaire, and surveyed mortality and morbidity among Rwandan refugees returning from Zaire to Rwanda. Patterns of mortality, morbidity and health care were measured mainly by mortality and health center consultation rates.
Results: Between 15 and 21 November 1996, 553,000 refugees returned to Rwanda and 4,530(8.2/1,000 refugees) consultations took place at the border dispensary (watery diarrhea, 6.3%, bloody diarrhea 1%). There were 129 (0.2/1,000) surgical admissions (72% soft tissue trauma) to the Gisenyi hospital in the subsequent two weeks. The average number of consultations from the 13 health centers during the same period was 500/day. Overall, the recorded death rate was 0.5/10,000 ( all associated with diarrhea). A total of 3,586 bodies were identified in the refugee camps and surrounding areas of Goma, almost all the result of trauma. Many had died in the weeks before the exodus. Health centers were overwhelmed and many of the deficiencies in provision of health care identified in 1994 again were evident.
Conclusions: Non-violent death rates were low, a reflection of the population's health status prior to migration and immunity acquired from the 1994 cholera outbreak. Health facilities were over stretched, principally because of depleted number of local, health-care workers associated with the 1994 genocide. Health-care facilities running parallel to the existing health-care system functioned most effectively.