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Monday, July 18, 2011
Don't fall ill in a nuke crisis
The residents of Minami Soma, Fukushima Prefecture, are still being denied full medical services even though more than four months have passed since radiation leaks started from the nearby Tokyo Electric Power Co.'s Fukushima No. 1 nuclear power station in the aftermath of the March 11 earthquake and tsunami.
The primary reason for this denial is "buck passing" by the central and prefectural governments.
Shortly after the nuclear plant disaster, the central government instructed those living within 20 km of the plant to evacuate the area and those within 20 to 30 km to "stay home." This split the city of Minami Soma in two.
Many citizens were so frightened that they pushed the panic button and left the city, reducing its population from 70,000 to 10,000. Most of those remaining being bedridden elderly people.
Also fleeing the city were medical service workers; all but one of the five hospitals closed. Even at the one hospital, which is municipally run, the number of doctors dwindled from 14 to four, and only 84 of the 227 staff workers stayed on.
When it was discovered later that the level of radiation in the city was not as high as previously thought — apparently because of strong winds blowing from the mountains to the Pacific — many residents started returning home, bring the population back up to about 40,000.
The number of staff workers at the municipal hospital increased to 171 by the end of May and three other hospitals restarted to treat outpatients.
The trouble is that the hospitals did not admit patients. Even a seriously ill or injured person was not hospitalized and, therefore, had to be transported some 80 km over mountainous roads to the city of Fukushima, the prefecture's capital.
Between March 11 and April 27, the number of local residents reported suffering from brain vascular diseases numbered 47, but none of them was properly treated at a local hospital.
Why haven't local hospitals admit patients?
Their appeals to restart hospitalization have been turned down by both the health and welfare ministry and the Fukushima prefectural government. Both are simply passing the buck. The prefectural government says the decision against restarting hospitalization is in accordance with the ministry's policy, while the ministry asserts that it is a policy of the prefectural government.
Their reasoning is that they would have to be responsible for moving hospitalized patients to a safer place should another nuclear accident occur and that they would like to avoid such trouble. This is tantamount to the idea of abandoning the weak in the event of an emergency.
Even more surprising is the fact that neither the ministry nor the prefectural government has any legal authority to limit the number of hospital beds during natural calamities. So, bureaucrats of either the ministry or the prefectural government have rejected the restart of hospitalization amid ordinary citizens' ignorance of legal matters.
Before the disaster struck, there were 1,030 beds available for patients at the hospitals in Minami Soma. Even after the confusion from the disasters settled, only 10 beds at the municipal hospital and another hospital were made available. But even those who were lucky enough to be accepted in those beds were not allowed to stay longer than three days.
One hospital official has confided that he was repeatedly reprimanded by phone from the prefectural government every time the number of patients exceeded the permitted limit.
The failure of the Kan administration to review its arbitrary order for people living within a 30-km radius from the damaged nuclear plant to evacuate endangered many people. The arbitrarily drawn demarcation line made it increasingly difficult for ambulances carrying patients in critical condition to locate a hospital capable of or willing to accept them.
A number of cases have been reported in which patients died while being transported from a medical facility in Minami Soma to one outside the city. One observer says the health ministry and the prefectural government have imposed tight control on hospitalization in the area around the nuclear power plant in order to cover up their mismanagement.
Blame can also be placed on Fukushima Medical University. Instead of filling the posts vacated by doctors who fled after the disasters, the university helped them move to less contaminated areas.
All these phenomena have led citizens in the disaster-hit area to lament, "We have been abandoned by both the central and prefectural governments."
Newspaper publishers and TV stations have apparently hesitated to send reporters to the area for fear of being accused by their trade unions of exposing them to radioactive contamination. Thus information on the tragic and desperate conditions faced by local residents was not disseminated as it should have been.
A reporter of a nationwide vernacular newspaper is said to have interviewed a medical doctor not by visiting him at a hospital located near the nuclear plant but by having him travel to the city of Soma, which reputedly is not seriously contaminated. This physician thus sacrificed precious time that should have been spent looking after patients.
It also must be noted that Katsuyuki Haranaka, head of the Japan Medical Association, who is from the area, never made public mention of the medical-service problems in the area after the March 11 disasters. A large majority of medical institutions in the area are private corporations. Since income from inpatients account for 70 to 80 percent of their revenue, continued rigid restrictions on hospitalization could deal them a serious financial blow.
On June 21 the Fukushima prefectural government permitted hospitals in Minami Soma to admit up to 205 patients. This is a mere 20 percent of the pre-disaster level. Special beds for patients with chronic diseases still cannot be used.
If the current situation continues, all hospitals in the area will go bankrupt. With irresponsible attitudes prevailing in the public sector, not only citizens of Fukushima and the neighboring prefectures but also anyone living in this country could one day fall a victim to the haphazard policies of the government and "buck passing" among administrative agencies.
This is an abridged translation of an article from the July issue of Sentaku, a monthly magazine covering Japanese political, social and economic scenes.