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Great East Japan Earthquake and Tsunami

Great East Japan Earthquake and Tsunam

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—Complete Record Document Covering from Relief Activities to Recovery Support—

—Complete Record Document Covering from Relief Activities to Recovery Support—


All figures, facts, etc., included in this document are a faithful translation of the Japanese version, which was published on November 29, 2013.In principle, this record document contains the results of operations carried out from the day of the earthquake and tsunami to December 31, 2012 (as of March 31, 2013 for figures related to the settlement of accounts).

On the Publication of the Record DocumentThe Great East Japan Earthquake and Tsunami（GEJET）caused tremendous damage, with a death toll of more than 15,000 lives. Local administrative agencies also suffered immense damage, leaving us completely unable to engage in disaster relief activities in response to their requests as we would normally do.Despite those circumstances, 55 of the Japanese Red Cross Society (JRCS) medical teams nationwide headed for the affected areas on the day of the disaster and immediately started relief activities. For the six subsequent months, JRCS put all its energy into carrying out the largest-ever relief activities. Not only did Red Cross Hospitals around the country provide medical relief, but the JRCS Blood Centers and Social Welfare Facilities also sent their personnel to the affected areas to provide support for the first time. The total number of personnel who participated in these activities exceeded 7,000. Many activities continued, meeting the needs of victims as they changed with the passage of time, and examples of these included psychosocial care, health counseling by nurses, and a wide range of services provided by JRCS volunteers and Red Cross Youth members from throughout the country as well as from the affected areas. Personnel at JRCS Headquarters struggled from day to day to provide logistical support for the dispatch of medical teams and received a large amount of Gienkin (cash grant scheme). We are proud that so many JRCS people joined forces in these activities, an experience unparalleled even in the history of JRCS. While we engaged in activities that befitted a Red Cross Society, there were many issues left for reconsideration since it was such a huge and unprecedented disaster. Our response to the accident at the nuclear power plant was not sufficient due to the lack of information and inadequate preparedness. We keenly realized the importance of independently assessing the situation without relying entirely on administrative agencies and swiftly establishing appropriate policies on how to respond to the situation. In particular, we received various opinions and critical comments from the nation about the fairness with which Gienkin were allocated and the speed with which they were delivered to the affected people. We are currently endeavoring to improve the way such Gienkin are allocated and delivered to the affected areas by sharing our experience of the problems involved with related organizations that receive contributions as well as with the national and local governments.The whole world paid attention to the recent disaster and up to now we have received Gienkin totaling over 320 billion yen, approximately three times the amount received after the Great Hanshin-Awaji Earthquake of 1995, and in addition 100 billion yen was contributed from overseas. In order to meet the expectations of people in Japan and abroad regarding JRCS and their trust, we must provide for dealing with emergencies in normal times and engrave this on our hearts. If a disaster of unheard-of dimensions caused many unexpected events, the response to such events would have to require an unexpected, enterprising spirit. This is exactly the role that Red Cross is expected to play.This document is intended to offer lessons for future improvements by faithfully recording all the activities of the JRCS after GEJET .I would like to take this opportunity to pray again for the souls of those who died in this earthquake and tsunami and express my deep sympathy with those who were stricken by the disaster. And I would like to conclude my comments on the publication of this document by thanking all of those who worked in the affected areas, supported the relief and recovery operation, and extended tremendous support.

　　November 29, 2013

Tadateru Konoe President Japanese Red Cross Society

Relief Activities of the Japanese Red Cross Society as seen in photographs

1

2011.3.11At 2:46 p.m. on March 11, 2011, a massive earthquake occurred registering a magnitude of 9.0 on the Richter scale whose epicenter was off the Sanriku coast.The Headquarters of the Japanese Red Cross Society (JRCS) immediately established a third-level relief regine under which it would engage in nationwide relief activities.

OTSUCHI, IWATE

The Headquarters of Disaster Control (HDC) at the Headquarters

2011.3.11

2

Preparations for Support ActivitiesImmediately after the earthquake occurred, JRCS started to prepare for relief and support and dispatched medical teams to the affected areas, FUKUSHIMA, MIYAGI and IWATE.It also sent relief supplies such as blankets, emergency kits and sleeping kits to the affected areas.

Personnel and volunteers loading boxes of blankets onto a 10-ton truck

Official ceremony to dispatch a medical team

A convoy of JRCS vehicles heading north on the New Tomei Expressway

3

An advance team of the Headquarters gained entry to the affected area

3

4

Emergency Relief activitiesEmergency Relief Self Defense Force (SDF) officials, Firefighters and Police officers from throughout the country also rushed to the affected areas to undertake emergency relief activities. JRCS worked with people from these disaster-response organizations on site to rescue the disaster victims.

A child rescued by a SDF official

A doctor watching the take-off and landing of a helicopter

5

Since the Ishinomaki Red Cross Hospital (RCHP), located in ISHINOMAKI, MIYAGI, was the only medical institution that escaped damage from the disaster in the Ishinomaki Medical Region, medical teams from around the country gathered there. In order to accommodate more patients, the hospital even used its lobby for medical care. It saved the lives of many victims.

A scene of the medical relief activity at the Ishinomaki RCHP immediately after the occurrence of the disaster

Medical teams gathered at the Ishinomaki RCHP

6

Medical Relief ActivitiesMedical teams dispatched from around the country established emergency-aid stations at the evacuation centers to provide medical care while coordinating with local HDC.In addition, they visited the homes of affected people to diagnose and treat the victims who lived there.

Traveling from shelter to shelter in the darkness with the aid of candle light to provide medical care

Visiting the Iwate Prefectural Takata High School to provide medical care

An emergency-aid station established at the Takata Municipal Daiichi Junior High School, IWATE

Relief activities associated with a temporary return to the caution zone designated after the nuclear power plant accident

A member of a medical team sorting out the sick and wounded in a triage process and SDF officials transporting the sick and wounded

7

A scene from an evacuation center in RIKUZENTAKATA, IWATE

Emergency kits (including items such as a radio, a hand towel, a tooth brush and detergent) delivered to evacuees at an evacuation center

8

Supported by VolunteersImmediately after the earthquake and tsunami, JRCS volunteers from around the country started to engage in relief activities within and outside the affected areas in an effort to help the victims. By March 2012, a total of over 170,000 volunteers had joined activities such as calls for donation, the preparation of hot meals, cleaning, and psychosocial care. The activities of these volunteers are still continuing.

Volunteers helping to remove mud from an affected store

A group of volunteers providing hot meals

99

Psychosocial Care SupportIn order to alleviate the psychosocial burden on the affected people as much as possible, JRCS nurses and volunteers visited evacuation centers and temporary housing. They not only listened to the troubles facing the victims, but also referred them to specialists as required. They also played the role of local public health nurses mainly through health counseling.

A JRCS volunteer on a visit to temporary housing regularly

JRCS nurses checking the health of victims at an evacuation center

10

Support from within the country and abroadNews of the damage from the tsunami spread quickly around the world. Immediately after the disaster, the circle of supporters spread throughout Japan and abroad and JRCS received not only individual donations, but also about 59.6 billion yen in donations from organizations such as the 100 Red Cross and Red Crescent Societies around the world.The Kuwaiti government provided five million barrels of crude oil free of charge. Some 40.1 billion yen, equivalent to its purchase price, was donated to JRCS, and these donations have been appropriated for the recovery operations in the three affected prefectures.

The official ceremony for the Kuwaiti government’s contribution of five million barrels of crude oil

Fund-raising campaign by volunteers

11

Overseas young people supporting TOHOKURepresentatives from Red Cross and Red Crescent Societies worldwide gathered to discuss how to use the donations collected.

Junior Red Cross Members of Fukushima advertising agricultural products from FUKUSHIMA and appealing for cooperation in collecting donations in TOKYO

12

Recovery OperationsJRCS not only provided emergency relief, but also worked to establish recovery operations in order to assist recovery in the affected areas. The main pillars of the recovery operations based on international donations were to support the rebuilding of the lives of the victims, to provide education and welfare services, and give direct medical care as well as to take measures to cope with the nuclear power plant accident, and JRCS always stayed close to the victims.

School bus taking children to and from their schoolsDonating a set of six electric household appliances

A whole body counter installed at the Fukushima RCHP©Nobuyuki Kobayashi

Victims enjoying Nordic walking together with Ms. Norika Fujiwara, a public-relations ambassador

©Ichigo Sugawara

A donated welfare vehicleA temporary clinic built to support the collapsed Shizugawa Public Hospital

13

Nagaya style rows of connected housing, a public housing built in SOMA, FUKUSHIMA

A temporary building of Naraha Municipal Aozora Child Care Center constructed within the campus of Meisei University in IWAKI, FUKUSHIMA

14

Ishinomaki Fishery Cooperative Association’s laver farm was restored using donation from overseas to purchase laver seedlings

An event held to commemorate the re-opening of the Onagawa Community Medical Center, which completed work on its repair using international donation

15

Indoor playground “Smile Parks,” which were installed to enable children in FUKUSHIMA to play to the full

Summer Camping in “a Cross Village Program”, which invited children in IWATE, MIYAGI and FUKISHIMA to HOKKAIDO

Introduction

　１．Overview of the earthquake …………………………………………………………………………2

　２．Damage ……………………………………………………………………………………………………4

　３．GEJET and the activities of the Japanese Red Cross Society 　　　(This section is omitted) 　 ………………………………………………………………………… 11

　４．Movement of the Honorary President and Honorary Vice Presidents ………………… 11

Chapter 1　Establishment of the Headquarters of Disaster Control (HDC)and Its Activities

　１．HDC at the Headquarters of the Japanese Red Cross Society (JRCS) ……………… 14

　２．The Iwate Chapter HDC …………………………………………………………………………… 24

　３．The Miyagi Chapter HDC …………………………………………………………………………… 27

　４．The Fukushima Chapter HDC ……………………………………………………………………… 31

　５．Other Chapters’ HDC ………………………………………………………………………………… 35

　６．Initiatives of the national and local governments as well as other related　　　organizations after the earthquake ……………………………………………………………… 39

Chapter 2　Provision of Medical Relief

　１．Mobilization of Medical Teams …………………………………………………………………… 42

　２．Activities of Chapters in All Prefectures Nationwide ……………………………………… 51

　３．Conditions of Hospitals in the Disaster-Stricken Areas ………………………………… 56

　４．Support from Blood Centers in the Disaster-Affected Areas and Nationwide ……… 78

　５．Various Activities Responding to Needs ……………………………………………………… 87

Chapter 3　Development of Disaster Relief Activities with Ishinomaki Red Cross Hospital (RCHP) as a Hub Hospital

　１．Damage due to the GEJET ………………………………………………………………………… 94

　２．Activities inside the Hospital ……………………………………………………………………… 97

　３．Joint Medical Team Activities in the Ishinomaki Area ………………………………… 109

　４．Approach from Before the Disaster ………………………………………………………… 115

　Contents　

Chapter 4　Response to the Fukushima Daiichi Nuclear Power Plant Accident

　１．Outline of the Accident ……………………………………………………………………………122

　２．JRCS Medical Services (Response to Radiation) …………………………………………124

　３．Medical Services for Temporary Access to a Restricted Area ………………………127

　４．Other Services ………………………………………………………………………………………129

Chapter 5　Psychosocial Care

　１．Development of the Psychosocial Care Program …………………………………………134

　２．Activities in the three Chapters in the affected areas …………………………………140

　３．Cooperation with local government bodies and other parties concerned …………144

Chapter 6　Distribution of Relief Supplies

　１．The Situation in the Headquarters ……………………………………………………………148

　２．Activities in the three chapters in the affected areas …………………………………156

　３．Other support status ………………………………………………………………………………163

　４．Status of support from overseas ………………………………………………………………163

Chapter 7　Red Cross Volunteer Activities

　１．Activities of the DRV center at the Headquarters ………………………………………168

　２．Activities of volunteers in the affected areas ……………………………………………172

　３．Volunteer activities at various Chapters ……………………………………………………179

Chapter 8　Recovery Assistance Program

　１．Organizational regime of the recovery assistance program ……………………………188

　２．Implementation regime of the recovery assistance programs ………………………192

　３．Actual achievements of the recovery assistance programs …………………………195

　４．Assistance from Kuwait …………………………………………………………………………211

　５．Accounting and audit ……………………………………………………………………………214

Chapter 9　Gienkin (Cash grant scheme)

　１．Gienkin ; Cash grant scheme ……………………………………………………………………220

　２．Handling of Gienkin …………………………………………………………………………………221

　３．Collection status of Gienkin ……………………………………………………………………222

　４．Transfer and distribution status of Gienkin …………………………………………………223

　５．Response system for the Gienkin ……………………………………………………………225

　６．Public relations activities and public opinion related to Gienkin ……………………228

　７．Discussion about the future methods of handling Gienkin ……………………………230

Chapter10　Relationship with the International Red Cross and Red Crescent Movement

　１．Liaison/coordination with the International Federation of Red Cross and Red Crescent 　　　 Societies (IFRC), the International Committee of the Red Cross (ICRC) and the National Red Cross and Red Crescent Society (NS) etc., in the initial response ……………………238

　２．Acceptance response to the declaration of relief ………………………………………244

　３．Tracing service activity …………………………………………………………………………249

　４．Response and accountability to donors ……………………………………………………251

　５．Holding of various meetings and conferences ……………………………………………255

　６．Implementation of the evaluation by the IFRC evaluation team ………………………263

Chapter 11　Public-Relations Activities

　１．Early response (From the day of the disaster to the end of March) …………………268

　２．Domestic PR activities ……………………………………………………………………………269

　３．Effective use of the mass media ………………………………………………………………273

　４．International public relations ……………………………………………………………………287

　５．Other PR activities …………………………………………………………………………………290

Chapter 12　Others (This section is omitted) ………………………………………294

Chapter 13　Summary of Disaster Relief Services for the GEJET

　１．Review (Examination) by Blocks ………………………………………………………………296

　２．Implementation of the “Overall Summary of the JRCS Disaster Relief Services for　　　the GEJET” …………………………………………………………………………………………297

　３．Reinforcement Plan of Medical Relief Equipment for strengthening institutional 　　　disaster preparedness ……………………………………………………………………………305

Chapter 14　Notes (This section is omitted) …………………………………………310

Afterword

How to operate DVD-ROMs

Introduction

2

Great East Japan Earthquake and Tsunami　Introduction

and western parts of the Pacific coast of HOKKAIDO; the coast along the Sea of Japan of AOMORI and its Pacific coast; IWATE, MIYAGI, FUKUSHIMA and IBARAKI; the KUJUKURI, SOTOBO, and UCHIBO regions of CHIBA; coasts along Tokyo Bay; the IZU

１． Overview of the earthquakeAt 2:46 p.m. on March 11, 2011, an earthquake occurred registering a magnitude of 9.0 on the Richter scale whose epicenter was off the Sanriku coast (38º06.2’ north latitude and 142º51.6’ east longitude, 24 km deep). The Japan Meteorological Agency called it the “2011 off the Pacific Coast of Tohoku Earthquake.” In accordance with its cabinet decision on April 1, the government called the disaster caused by the off the Pacific Coast of Tohoku Earthquake and the one that had resulted from the nuclear power plant accident following the “Great East Japan Earthquake and Tsunami（GEJET）”.GEJET is summarized as follows: (i) Time of occurrence2:46 p.m. on March 11, 2011

(vi) TsunamiThe tsunami that ensued from the earthquake made the damage from the disaster even more serious.By 6:00 p.m. on March 11, the Meteorological Agency observed a tsunami that reached the eastern, central,

(ii) EpicenterOff the Sanriku coast (38º06.2’ north latitude and 142º51.6’ east longitude)(iii) Depth of the epicenter24 kilometers(iv) Magnitude of the earthquake9.0(v) Intensity on the Japanese scale of zero to seven

measured at municipalities (5 lower or higher)The table below shows the maximum intensity observed in each prefecture and the points where it was observed.The maximum intensity observed was 7 as measured in KURIHARA, MIYAGI.An intensity of 5 lower or higher was observed in 17 prefectures, indicating that the earthquake caused damage to a wide range of areas in eastern Japan.

Introduction

Figure 0-1 Distribution of the Seismic Intensities of the Main Shock of GEJETIntensity 7 MIYAGI KURIHARA

Intensity 6 upper

FUKUSHIMA SHINCHI, NAMIE, FUTABA, OKUMA, TOMIOKA, NARAHA, KAGAMIISHI, NIHONMATSU, SUKAGAWA and SHIRAKAWA

IBARAKI HOKOTA, CHIKUSEI and KASAMATOCHIGI TAKANEZAWA, MOKA, UTSUNOMIYA and OTAWARA

Intensity 6 lower IWATE OSHU, ICHINOSEKI, HANAMAKI, YAHABA, TAKIZAWA, KAMAISHI and

OFUNATO

Intensity 5 upper

SAITAMA MIYASHIROGUNMA KIRYUCHIBA INZAI and NARITA

AOMORI OIRASE, HASHIKAMI, GONOHE, TOHOKU and HACHINOHEAKITA DAISEN and AKITA

YAMAGATA YONEZAWA, OBANAZAWA, NAKAYAMA and KAMINOYAMA

TOKYO NIIJIMA, EDOGAWA, ADACHI, ITABASHI, ARAKAWA, SUGINAMI, NAKANO, KOTO and CHIYODA

KANAGAWA NINOMIYA, SAMUKAWA, KAWASAKI and YOKOHAMA’s NAKA

Intensity 5 lower

NIIGATA MINAMIUONUMA and KARIWA

YAMANASHI FUJI KAWAGUCHIKO, YAMANAKAKO, FUJIGAWA, CHUO, KOSHU, YAMANASHI HOKUTO, FUEFUKI, MINAMI ALPS and KOFU

NAGANO NAGANO MINAMIMAKI and SAKUSHIZUOKA GOTEMBA

Source: This table has been created using data from the Meteorological Agency’s website.

3Great East Japan Earthquake and Tsunami

Introduction

and OGASAWARA Islands; SHIZUOKA; AICHI facing the open sea; the southern part of MIE; and WAKAYAMA TOKUSHIMA and KOCHI.

Later, however, it became clear that there were points where the maximum tsunami level had not been obtained mainly because the measurement facilities there had been damaged, leaving subsequent tidal waves unobserved.

Therefore, the Agency investigated the height of tsunami at these observation points from March 28 to April 2 using the traces of the tsunami and other types of evidence, and the height of tsunami thus estimated is as shown below.

Figure 0-2 Values Observed at Major Observation Points (as of 6:00 p.m. on March 11)First wave Largest wave

Area Date Time Wave type Height Date Time HeightSOMA FUKUSHIMA

March 11

2:55 p.m. Push 0.3 m

March 11

3:50 p.m. 7.3 m or moreOARAI IBARAKI 3:15 p.m. Push 1.8 m 4:52 p.m. 4.2 m or moreMIYAKO IWATE 2:48 p.m. Push 0.2 m 3:21 p.m. 4.0 m or moreKAMAISHI IWATE 2:45 p.m. Pull 0.1 m 3:21 p.m. 4.1 m or moreOFUNATO IWATE 2:46 p.m. Pull 0.2 m 3:15 p.m. 3.2 m or moreAYUKAWA, ISHINOMAKI MIYAGI 2:46 p.m. Push 0.1 m 3:20 p.m. 3.3 m or more

HANASAKI, NEMURO HOKKAIDO 3:34 p.m. Pull Slightly

higher 3:57 p.m. 2.8 m

URAKAWA HOKKAIDO 3:19 p.m. Pull 0.2 m 4:42 p.m. 2.7 mHACHINOHE AOMORI 3:22 p.m. Pull 0.8 m 4:51 p.m. 2.7 mTomakomai Higashi Port HOKKAIDO 3:40 p.m. Pull 0.2 m 4:17 p.m. 2.5 m

Source: This table has been created based on the Japan Meteorological Agency’s news release “The 2011 off the Pacific Coast of Tohoku Earthquake (Fourth Report).”

Figure 0-3　Values Observed at Major Observation Points

Observation points Height of the tsunami estimated from its traces and other types of evidence

Height of the largest tsunami based on tsunami recorders, etc.

HACHINOHE AOMORI 6.2 m 2.7 m or moreKuji Port IWATE 8.6 m -----MIYAKO IWATE 7.3 m 8.5 m or more*KAMAISHI IWATE 9.3 m 4.1 m or moreOFUNATO IWATE 11.8 m 8.0 m or more*AYUKAWA, ISHINOMAKI MIYAGI 7.7 m 7.6 m or more*

Sendai Port MIYAGI 7.2 m -----SOMA FUKUSHIMA 8.9 m 7.3 m or more* This table is based on quick reports issued in the form of tsunami information and the results of analysis of records collected at tsunami observation points at a later date (marked with an asterisk). Some of the observation facilities were heavily damaged, and due to the effects of such damage, these facilities might not have been able to observe the height of the tsunami properly.Source: This table has been created based on the Meteorological Agency’s press release “The height of the tsunami near tsunami observation points based on field surveys” (April 5, 2011).

[OTSUCHI, IWATE, which suffered devastating damage]

4


Figure 0-4 Damage Caused by GEJET, and the Measures Taken by the PoliceDisaster

types

Area

Dead persons

People missing

People injured Building damage Roads damage

Bridge damage

Landslides

Collapsed banks

Railways

damage

Seriously injured

Slightly

injured

Total

Com

pletely destroyed

Half

destroyed

Washed aw

ay

Totally destroyed by fire

Half destroyed by fire

Inundated above the ground floor level

Inundated below the ground floor level

Partially

damaged

Uninhabited houses damage

People People People People People Buildings Buildings Buildings Buildings Buildings Buildings Buildings Buildings Buildings Locations Locations Locations Locations LocationsHOKKAIDO 1 3 3 4 329 545 7 469

TO

HO

KU

AOMORI 3 1 24 85 109 308 701 958 1,363 2IWATE 4,671 1,195 202 19,199 5,037 15 1,761 323 8,741 4,909 30 4 6MIYAGI 9,529 1,359 4,140 85,315 151,736 135 15,475 12,894 224,262 26,603 390 12 51 45 26AKITA 4 8 12 3 3 9

YAMAGATA 2 8 21 29 37 80 21 29FUKUSHIMA 1,606 211 20 162 182 21,014 71,954 77 3 1,061 338 162,306 1,116 187 3 9

TOKYO 7 20 97 117 15 198 3 4,847 1,101 295 55 6

KA

NT

OIBARAKI 24 1 33 676 709 2,620 24,143 31 1,798 778 183,132 19,161 307 41TOCHIGI 4 7 127 134 260 2,109 72,018 295 257 40 2GUNMA 1 13 25 38 7 17,246 36 9

SAITAMA 6 36 42 24 199 1 1 1 1,800 33 160CHIBA 20 2 26 226 252 799 10,024 15 157 728 52,011 660 2,343 55 1

KANAGAWA 4 17 117 134 39 445 13 162 1 3NIIGATA 3 3 17 9

YAMANASHI 2 2 4NAGANO 1 1

SHIZUOKA 1 2 3 5 13 9

CHUBU

GIFU 1MIE 1 1 2 9

SHIKOKU

TOKUSHIMA 2 9

KOCHI 1 1 2 8

Total 15,872 2,769 6,114 129,591 266,231 281 20,587 15,629 727,810 55,753 4,200 116 208 45 29

* This data includes unconfirmed information.* The damage caused by GEJET includes that caused by aftershocks such as the one that occurred on April 7 and whose epicenter was off MIYAGI, as well as the subsequent ones that occurred in FUKUSHIMA’s Hamadori area on April 11 and 12, in the northeastern part of CHIBA on May 22, off FUKUSHIMA on July 25 and 31 and August 12 and 19, in the northern part of IBARAKI on September 10, off FUKUSHIMA on October 10, in the northern part of IBARAKI on November 20, 2011 and February 19, 2012, off IBARAKI on March 1, and off MIYAGI on June 18.Source: This table has been created based on the National Police Agency Emergency Disaster Countermeasures Headquarters’ news release “Damage caused by the 2011 off the Pacific Coast of Tohoku Earthquake and the Measures Taken by the Police” (October 31, 2012).

２． DamageThe massive earthquake and tsunami, which occurred on March 11, 2011, caused tremendous damage to the Pacific coast the Japanese archipelago from HOKKAIDO to SHIKOKU. According to the data collected by the National Police Agency, as of October 31, 2012, 19 months after the disaster, the toll of casualties was extremely high with 15,872 dead, 2,769 missing, and 6,114 injured. In particular, serious damage was caused in Iwate, Miyagi, and Fukushima Prefectures with most human loss of life accounted for by these three prefectures.According to the figures collected by the Reconstruction Agency, the number of earthquake-related deaths

1—

those who died for reasons such as health deterioration due to injuries suffered from the earthquake— was 2,303 nationally as of September 30, 2012. By age group, the number of those who died according to these circumstances at the age of 66 or older was 2,070, accounting for a majority of the earthquake-related deaths.

Meanwhile, as of October 31, 2012, the data collected by the National Police Agency on damage caused to buildings indicated that 129,591 buildings were totally destroyed and 266,231 half destroyed. In each of IBARAKI and CHIBA as well as IWATE, MIYAGI, and FUKUSHIMA, which suffered serious damage from the tsunami, the number of totally or half destroyed buildings reached tens of thousands to hundreds of thousands. Furthermore, if the number of buildings inundated below or above the ground floor level is included, a total of over 1.2 million buildings nationwide suffered a certain amount of damage.The damage caused to human lives and houses in the three prefectures (IWATE, MIYAGI, and FUKUSHIMA) in TOHOKU region and the northern part of the KANTO region was particularly serious, but a wide range of areas, including 22 prefectures nationwide, sustained damage from the disaster.

(1) According to the Reconstruction Agency’s news release “The number of deaths related to GEJET” issued on November 2, 2012, earthquake-related deaths are defined as those who died for reasons such as health deterioration due to injuries sustained from GEJET and to whom disaster condolence money was paid in accordance with the Act on Arrangements Such as Payment of Disaster Condolence Money (including those to whom such money has actually not been paid).


Introduction

Figure 0-5 Number of Deaths Related to GEJET (by Prefecture and by Age Group)as of September 30, 2012

Prefecture TotalBy age group

20 years old or less 21 years old or more and 65 years old or less 66 years old or more

National total 2,303 5 228 2,070IWATE 323 1 34 288MIYAGI 812 1 97 714

YAMAGATA 1 0 1 0FUKUSHIMA 1,121 0 90 1,031

IBARAKI 37 2 4 31SAITAMA 1 0 1 0

CHIBA 3 0 1 2TOKYO 1 1 0 0

KANAGAWA 1 0 0 1NAGANO 3 0 0 3

Source: This table has been created based on the Reconstruction Agency’s news release “The number of deaths related to GEJET” (November 2, 2012).

Figure 0-6 Trends in the Number of Evacuation Centers and Evacuees (Those Who Lived There) for GEJETDay of the earthquake

One week later

Two weeks later

Three weeks later

One month later

Two months later

Three months later

Four months later

Five months later

Six months later

Seven months later

Data collected by

the National Police A

gency

Number of evacuation centers

Figures in parentheses indicate the number of evacuation centers in the three prefectures (IWATE, MIYAGI, and FUKUSHIMA)

－ 2,182（1,874）

1,935（1,335）

2,214（1,240）

2,344（1,063）

2,417（897）

1,459（799）

-(536)

-(334)

-(112)

-(73)

Number of evacuees (*1)

Figures in parentheses indicate the number of evacuees in the three prefectures (IWATE, MIYAGI, and FUKUSHIMA)

20,499（1,198）

386,739（368,838）

246,190（216,963）

167.919（141,882）

147,536（124,450）

115,098（94,199）

88,361（67,073）－－－－

Data collected by

the Reconstruction Agency

Number of evacuees staying at evacuation centers (community centers, schools, etc.)

Figures in parentheses indicate the number of evacuation centers in the three prefectures (IWATE, MIYAGI, and FUKUSHIMA)

－－－－－－ 41,143（38,598）

17,798（16,138）

8,646（7,379）

3,439（2,468）

1,719（921）

Number of evacuees (*2)

Figures in parentheses indicate the number of evacuees in the three prefectures (IWATE, MIYAGI, and FUKUSHIMA)

－－－－－－ 101,640（75,215）

58,922（35,643）

42,744（20,659）

27,531（7,583）

21,899（3,432）

*1 The data collected by the National Police Agency focused on evacuees who stayed at community centers, schools, and other public facilities as well as Japanese inns and hotels.*2 The Reconstruction Agency collected data at (1) evacuation centers (such as community centers and schools), (2) inns and hotels, and (3) other places (such as the houses of relatives and friends).Source: This table has been created based on the Reconstruction Agency’s news release “Trends in the number of evacuation centers and those who lived there (A comparison between GEJET, the Great Hanshin-Awaji Earthquake, and the Chuetsu Earthquake)” (October 12, 2011).

GEJET forced hundreds of thousands of people to evacuate. According to the data collected by the National Police Agency, one week after the earthquake, the number of evacuation centers was 2,182, and that of evacuees reached 387,739. According to the

Reconstruction Agency, meanwhile, even seven months after the disaster, over 20,000 people had evacuated if those staying with relatives or friends were included (see Figure 0-6). According to the Reconstruction Agency’s subsequent

6


served by the Tohoku Electric Power Company and Tokyo Electric Power Company, and the power failure affected some 7.6 million households on the day of the earthquake alone.Subsequently, power supply gradually returned to normal, and the power cut ended in the areas served by Hokkaido Electric Power Company on March 12 and in the areas covered by Tokyo Electric Power on March 19. But the power failure continued in the areas served by Tohoku Electric Power, affecting tens of thousands of households. Except for areas such as those where the houses and other buildings had been swept away, the power supply was fully returned to normal in the service areas on June 18.

announcement (see 2 below), as of August 2, 2012, the number of evacuees nationwide (including those who lived in temporary houses, etc.) was about 343,000. Of this number, about 210 persons were staying at evacuation centers such as community centers and schools while the majority of evacuees nationwide led their lives in temporary houses or similar accommodation.The evacuees lived in more than 1,200 municipalities of 47 prefectures nationwide. In particular, not only did the three prefectures have a large number of evacuees staying there, but they also had a total of a little less than 70,000 persons who evacuated to or were otherwise staying at places outside their jurisdiction. Immediately after the earthquake occurred, the power supply was cut off in a wide range of areas, mostly those

The supply of city gas (general and community gas) was cut mainly in MIYAGI, FUKUSHIMA, and IBARAKI immediately after the occurrence of the earthquake on March 11, 2011, affecting a total of about 420,000 households. Eventually, the city gas supply had been returned to normal in all service areas by May 3, 2011, but at the end of March, about three weeks after the disaster, gas supply to some 300,000 households mainly in MIYAGI was still suspended.Water supply was also cut in a wide range of areas immediately after the earthquake. On March 13, 2011, two days after the earthquake, the water outage affected

over one million households. Later, the water supply gradually returned to normal, and by June 7, about three months after, it had returned to normal in all service areas except IWATE, MIYAGI, and FUKUSHIMA. And even in these three prefectures, which sustained heavy damage, the water outage ended in July to September except for some 45,000 households in areas where houses and other buildings had been washed away. Water supply was expected to return to normal, or new water supply systems were expected to be built, in the devastated areas of the three prefectures as reconstruction progressed in the future.

Figure 0-7 Recovery of Power Supply Services

Areas 2011March 11 March 12 March 13 March 14 March 31

Areas served by Hokkaido Electric Power

About 2,000 households(at 5:00 p.m.)

Power supply returned to normal




Areas served by Tohoku Electric Power

About 4.4 million households(at 9:00 p.m.)




About 170,000 households(at 10:00 a.m.)

Areas served by Tokyo Electric Power

3.18 million households(at 10:14 p.m.)





Source: This table has been created based on the Ministry of Economy, Trade and Industry (METI) Nuclear and Industrial Safety Agency’s “Earthquake damage information (7th, 16th, 21st, 23rd reports),” METI’s new release “The 2011 off the Pacific Coast of Tohoku Earthquake” (March 31, 2011), and METI Nuclear and Industrial Agency’s “Earthquake damage information (201st report),” issued on July 16, 2011.

(2) “Number of evacuees nationwide” announced by the Reconstruction Agency on August 8, 2012


Introduction

Figure 0-8 Recovery of City Gas ServicesNumber of households affected by the gas cutoff

General gas

City of Sendai Gas Bureau 268,398Shiogama Gas (SHIOGAMA) 9,290Kamaishi Gas (KAMAISHI) 5,613Joban Kyodo Gas (IWAKI) 5,627Tohoku Gas (SHIRAKAWA) 12Joban City Gas (IWAKI) 286Kesennuma City Gas (KESENNUMA) 927Ishinomaki Gas (ISHINOMAKI) 8,542

Community gas Miyagi Gas (SENDAI) 4,032Source: This table has been created based on the METI’s new release “The 2011 off the Pacific Coast of Tohoku Earthquake” (March 31, 2011), and METI Nuclear and Industrial Agency’s “Earthquake damage information (128th report),” issued on May 7, 2011.

Figure 0-9 Water Supply Cutoff and the Recovery of Water Supply Services (in Prefectures with 1,000 or More Affected Households)　　　　　　　　　　　　　　　

Prefectures2011

Period during which it was confirmed that the water supply was still cut only in areas where houses and other buildings had washed away (number of houses that had been washed away)

March 13 March 31 June 7

AOMORI About 1,800 householdsThe services had already

returned to normal - -

IWATE About 80,000 households About 50,000 households About 20,000 households → July 15, 2011 (21,116 houses)MIYAGI About 310,000 households About 130,000 households About 33,000 households → September 2, 2011 (21,482 houses)FUKUSHIMA About 190,000 households About 50,000 households About 6,000 households → September 2, 2011 (2,802 houses)

AKITA About 1,700 householdsThe services had already

returned to normalThe services had already

returned to normal -

YAMAGATA About 7,000 households 4 householdsThe services had already


IBARAKI About 470,000 households About 30,000 householdsThe services had already


TOCHIGI About 40,000 households About 590 householdsThe services had already


CHIBA About 300,000 households About 10,000 householdsThe services had already


NAGANO About 1,000 households About 250 householdsThe services had already


Source: This table was created based on the Ministry of Health, Labour and Welfare (MHLW)’s news release “Damage caused by and response to the 2011 off the Pacific Coast of Tohoku Earthquake (11th, 34th, 76th, 87th and 97th reports)” .

Figure 0-10　Areas Where Water Cutoff Continued as of March 2012 (Areas Where Houses and Other Buildings Had Been Washed Away) 　　　　　　　　　　

Prefectures

Number of households affected by the water outage(only areas where houses and other buildings had been washed away)

Municipalities, etc.

IWATE 21,161 households OFUNATO, RIKUZENTAKATA, KAMAISHI, OTSUCHI, MIYAKO, YAMADA, IWAIZUMI, TANOHATA, and NODA

MIYAGI 21,317 householdsSENDAI, KESENNUMA, ONAGAWA, IWANUMA, NATORI, WATARI, SHICHIGAHAMA, YAMAMOTO, Ishinomaki District Water Supply Authority (ISHINOMAKI and MATSUSHIMA), and MINAMISANRIKU

FUKUSHIMA 2,728 households

FUKUSHIMA, MINAMISOMA, IWAKI, Soma District Water Supply Corporation (SOMA and SHINCHI), Futaba District Water Supply Corporation (HIRONO area)* Apart of those area have suspended activities such as damage surveys for reasons such as evacuation orders.

Source: This table has been created based on the MHLW’s news release “Damage caused by and response to the 2011 off the Pacific Coast of Tohoku Earthquake (116th report)” (March 23, 2012).

8


The communications and broadcasting infrastructures sustained considerable damage immediately after the earthquake but had returned to normal by the end of April 2011. The Ministry of Internal Affairs and Communications (MIAC) provided affected

communication carriers and broadcasting stations with support such as lending satellite-based mobile phones and mobile communications equipment and distributing portable radios.

Figure 0-11 Recovery of Communications and Broadcasting Infrastructures

Communications infrastructure

Major damage caused

Fixed-line phones

As for fixed-line phones (subscriber and ISDN circuits), about 11,000 lines (maximum: about one million lines) could not be used immediately after the earthquake. →All exchanges for fixed-line phones (NTT East) had returned to normal by the end of April except for certain areas.

Mobile phones

Four mobile phone service providers stopped transmission at about 240 of their mobile base stations (maximum: about 14,800 stations).→In all communications areas, the mobile phone services had returned almost to the pre-earthquake level by the end of April except for certain areas.

Response

- A total of 1,109 satellite-based mobile phones were lent (931 for communications carriers and 178 for the MIAC).

- A total of 2,380 mobile communications devices were provided free of charge (985 for communications carriers and 1,395 for the MIAC).

- About 140 special public phones were installed by communications carriers and other organizations.

Broadcasting infrastructure

Major damage caused

- In MIYAGI, one of the 56 TV relay stations stopped transmission because it was damaged.　(This did not practically affect broadcasting services because houses and other buildings had been swept away in almost all of the areas covered by the damaged stations.)

Response

- At the request of 24 affected municipalities, the Ministry flexibly granted permission to set up temporary FM broadcasting stations (as of September 15).

- On April 1, the MIAC requested NHK and the Japan Commercial Broadcasters Association (JCBA) in writing to swiftly provide the nation with detailed, accurate information on the disaster.

- On March 11, the MIAC requested NHK, JCBA, and Tohoku’s radio stations orally to provide substantial information on the disaster.

- On March 16, at NHK’s request, the MIAC approved measures to exempt the payment of viewing fees, and on June 24, it expanded the scope of areas covered by these measures.

- With the cooperation of manufacturers, NHK installed 750 TV sets and 760 radio sets at evacuation centers. Over 40,000 radio sets from Panasonic, Sony, and other manufacturers were also provided through these centers.

- The MIAC distributed 10,000 portable radios to the affected areas.Source: This table has been created based on the MIAC’s announcement “The Ministry’s response to GEJET (as of 10:00 a.m. on August 28, 2012).”

In addition to the damage that the earthquake and tsunami caused directly, GEJET inflicted serious damage on transport networks in a wide range of areas due to the effects of the accident at the Fukushima Daiichi Nuclear Power Plant. Particularly in MIYAGI, the tsunami caused major damage to railways along the coastal areas and other means of transport, and even 18 months after the disaster, these transport facilities had not completely returned to normal. According to the Ministry of Land, Infrastructure, Transport and Tourism (MLIT), by November 5, 2012, about 20 months after the disaster, all roads (expressways and directly managed national highways), Shinkansen

lines, and airports had returned to normal whether they were used for disaster countermeasures or general purposes. At the same time, however, train services still remained totally or partially suspended on eight lines of JR East railways and the Sanriku Railway, except for the sectors (66.8 km) in the precautionary and other zones designated due to the nuclear power plant accident. The proportion of ports restored from HACHINOHE to KASHIMA was 80% with some of these ports requiring repair work for most of their facilities even though they are still usable. For other facilities, restrictions were placed on the maximum drafts or maximum vertical loads when they were in use.


Introduction

Figure 0-12 Damage Caused due to the Disaster Such as Damaged RoadsDamage caused by

the disasterPrefectures

Roads damaged Bridges damaged Landslides Collapsed banks Railways damaged

HOKKAIDO

TOHOKU

AOMORI 2IWATE 30 4 6MIYAGI 390 12 51 45 26AKITA 9YAMAGATA 21 29FUKUSHIMA 187 3 9

TOKYO 295 55 6

KANTO

IBARAKI 307 41TOCHIGI 257 40 2GUNMA 36 9SAITAMA 160CHIBA 2,343 55 1KANAGAWA 162 1 3NIIGATAYAMANASHINAGANOSHIZUOKA

CHUBU GIFU 1MIE

SHIKOKU TOKUSHIMAKOCHI

Total 4,200 116 208 45 29* The figures include unconfirmed information.* The damage caused by GEJET includes that caused by aftershocks such as the one that occurred on April 7 and whose epicenter was off MIYAGI, as well as the subsequent ones that occurred in FUKUSHIMA’s HAMADORI area on April 11 and 12, in the northeastern part of CHIBA on May 22, off FUKUSHIMA on July 25 and 31 and August 12 and 19, in the northern part of IBARAKI on September 10, off FUKUSHIMA on October 10, in the northern part of IBARAKI on November 20, 2011 and February 19, 2012, off IBARAKI on March 1, and off MIYAGI on June 18.Source: This table has been created based on the National Police Agency Emergency Disaster Countermeasures Headquarters’ news release “Damage caused by the 2011 off the Pacific Coast of Tohoku Earthquake and the Measures Taken by the Police” (August 1, 2012).

[A large vessel cast up on the shore in KAMAISHI, IWATE]

10


Figure 0-14 Trends in the Recovery of Transport FacilitiesLines, etc. Damage caused Road to recovery

[Roads]Expressways Tohoku Expressway Joban Expressway

- The 150-km embankment of the Joban Expressway between the Mito and Naka interchanges subsided with its road surface undulated.

- A total of 15 expressways were closed.

- As of February 6, 2012, there were no longer any closed expressways (excluding sectors in the planned evacuation zones).

Directly managed national roads National Route 4 National Route 45 National Route 6

- Girders of five bridges on National Route 45 running along the Pacific coast were washed away. Large portions of the embankment at the back of abutments were also swept away.

- National Routes 45 and 6 were widely inundated with water, and waste and other objects brought by the disaster were deposited on the roads.

- Irregularities such as differences in surface level and damaged joints occurred on roads such as National Routes 51 and 357.

- A total of 69 sectors along national roads were closed.

- Thanks to emergency recovery, all sectors of National Route 45 (478 km) had become passable by April 10, 2011, one month after the disaster.

- In mid-July 2011, temporary bridges for the Kesen Bridge and the Koizumi Bridge were completed, making all wide-area detours unnecessary.

- On February 3, 2012, National Route 45 came into service with one way open to traffic.

　With this resumption of its service, there were no longer any closed directly-managed national roads (excluding ones within the precaution zone designated after the nuclear power plant accident).

Roads managed by local governments

- Along the Pacific coast, a total of twelve bridges on roads managed by local governments fell down or were washed away for reasons such as the tsunami. In addition, there were various kinds of damage such as differences in levels, cracks, small collapses, and damaged bridges.

- A total of 102 sectors on national roads managed by prefectural governments, etc., were closed.

- As of February 6, 2012, two sectors of the roads managed by local governments were closed.

[Railways]Shinkansen Tohoku, Yamagata, Akita, Joetsu, Nagano, and Tokaido

- By 3:16 p.m. on March 11, 30 minutes after the occurrence of the earthquake, 90 railways operators, including JR companies (Shinkansen and old lines) as well as private and third-sector railway companies, had suspended the operation of 267 of their lines due to the damage caused by the disaster.

- The Tohoku Shinkansen was damaged at about 1,200 locations, and the damage caused included broken, leaned, or cracked electric poles (about 540 locations), cut power lines (about 470 locations), and damaged viaducts (about 100 locations).

- By November 5, 2012, all Tohoku, Akita, and Yamagata Shinkansen lines and 99% of the old track lines (on a working-kilometer basis) had returned to normal.

- The Tohoku Shinkansen resumed its services between Tokyo and Nasu-Shiobara on March 15 and between Shin-Aomori and Morioka on March 22. Then its services were resumed between Nasu-Shiobara and Fukushima on April 12, between Morioka and Ichinoseki on April 23, and between Fukushima and Sendai on April 24. Finally, with the completion of the restoration work between Sendai and Ichinoseki on April 29, the Tohoku Shinkansen resumed operation for all its sectors.

Old railroad lines - The major damage caused by the tsunami to seven lines (Hachinohe, Yamada, Ofunato, Kesennuma, Ishinomaki, Senseki, and Joban) included 23 railway stations washed away, about 60 kilometers of tracks washed away or buried by earth, and 101 bridge girders washed away or buried by earth. Old lines other than these seven were damaged at about 4,400 locations.

- There is still no expected period for the railways in the coastal areas to return to normal and resume operations.

- The operation of the Joban Line is still suspended between Hirono and Haranomachi and between Soma and Watari, including sectors located within 20 km of the Fukushima Daiichi Nuclear Power Plant where the nuclear power plant accident occurred.

[Airports] Sendai Airport Hanamaki Airport Fukushima Airport Ibaraki Airport

- Sendai, Hanamaki, Fukushima and Ibaraki Airports were hit by the earthquake.

- An intensity of 6 upper was observed at Sendai Airport, which was stricken by the tsunami about one hour after the earthquake. The airport was closed with its basic and air navigation facilities and terminal buildings heavily damaged.

- On March 15, at Sendai Airport, the operation of helicopters for relief activities was resumed, and airport restoration work began to facilitate the transport of relief supplies. On September 25, the full restoration of passenger terminal buildings was completed, bringing the airport into service.

- Fukushima, Hanamaki, and Ibaraki Airports continued operations even from the day of the disaster by restoring the control tower and terminal buildings temporarily as an emergency stopgap. At Ibaraki and Hanamaki Airports, commercial airline companies resumed operation of their scheduled flights on March 14 and March 17, respectively.

[Seaports] - All seaports along the Pacific coast from AOMORI’s HACHINOHE to IBARAKI’s KASHIMA were hit by the earthquake and tsunami. Breakwaters piers and other facilities were heavily damaged, causing all port functions to stop.

- As of February 29, 2012, 275 of the 373 public piers at 21 ports were usable, and as of November 5 of the same year, 306 were usable.

Source: This table has been created based on the MLIT’s record document “Record of GEJET: MLIT’s response to the disaster” (March 11, 2012) and MLIT’s report “Recovery of transport facilities” (as of 10:00 a.m. on November 5, 2012).

Figure 0-13 Recovery of the Transport NetworksThis figure is omitted.


Introduction

On March 17, one week after the occurrence of the earthquake, President Tadateru Konoe of JRCS, together with Vice President Yoshiharu Otsuka, visited the Imperial Palace to report to Their Majesties the Emperor and the Empress on the progress of disaster relief activities and other initiatives. Subsequently, as listed below, similar reports were submitted to other members of the Imperial Family as required. In addition, the same set of materials on the earthquake-related activities of the Society that had been presented to Their Majesties the Emperor and the Empress was also delivered to each of its Honorary Vice Presidents through a secretary of their households.

３． GEJET and the act iv it ies of the Japanese Red Cross Society

This section is omitted.

４． Movement of the Honorary President and Honorary Vice Presidents

Since its foundation, the Japanese Red Cross Society (JRCS) has developed while maintaining close ties with the Imperial Family as exemplified by the fact that it had members of the Imperial Family as its Honorary President and Honorary Vice Presidents. JRCS’s disaster relief activities began in 1888, when Mt. Bandai in FUKUSHIMA erupted. At the time, JRCS engaged in its first disaster relief activities on the orders of the then Her Majesty the Empress (later Empress Dowager Shoken).All members of the Imperial Family also worried about victims of GEJET, the most disastrous series of events that has ever been experienced. In particular, Their Majesties the Emperor and the Empress visited the affected areas many times on their own decision, encouraging many victims directly and addressing words of sympathy to them, and thanked those engage in disaster relief activities for their services.

These lectures were given as follows:March 17, 2011, 10:00 a.m. Emperor and the EmpressApril 6, 2011, 3:30 p.m. Akishinonomiya, Imperial

Prince Fumihito and Princess Kiko, as well as Princesses Mako and Kako

April 28, 2011, 4:30 p.m. Crown Prince and PrincessJuly 19, 2011, 2:00 p.m. EmpressJanuary 19, 2012, 11:30 a.m. Empress

Establishment of the Headquarters of Disaster Control (HDC) and Its Activities

Chapter 1

14

Great East Japan Earthquake and Tsunami　Chapter 1

1. HDC at the Headquarters of the Japanese Red Cross Society (JRCS)

(1) Establishment of its HDC systema. Response after the occurrence of the earthquakeAfter the earthquake occurred at 2:46 p.m. on March 11, 2011, HDC at the Headquarters for the off the Pacific Coast of Tohoku Earthquake was established as the Society’s second-level relief system at 3:00 p.m. Article 4 and Attachment 1 of the Guidelines for JRCS Headquarters Disaster Relief Systems (revised in March 2010) stipulate that a second-level relief system shall be established on the order of the Director General of the Disaster Management and Social Welfare Department in the following cases:

Furthermore, at 3:30 p.m., the second-level system was upgraded to the third-level one. Article 4 and Attachment 1 of the Guidelines quoted above provide that a third-level relief system shall be established on the order of the Director General of the Disaster Management and Social Welfare Department with the approval of the President in the cases listed below. In this case, the HDC at the Headquarters shall be led by the President.

The HDC at the Headquarters subsequent response is chronologically summarized as follows:

Figure 1-1 Major Moves of the HDC at the Headquarters and Other Organizations after the Occurrence of the Earthquake　　　　　　　　　　　　　　　　　　　　　

Date Major moves

3/11

(14:46) The earthquake occurred.(15:00) HDC at the Headquarters for the off the Pacific Coast of Tohoku Earthquake was established (second-level relief system), a response that was comparable to the level of Headquarters disaster relief drills (in 2009) based on the response plans for a Tokai earthquake.(15:00) Preparations for the early dispatch of personnel began.(15:30) Preparations for using Conference Room 201 for the operations team of the HDC at the Headquarters, and it was announced to the entire Headquarters building through the public addressing system that the Headquarters had shifted to a third-level system.(15:30) The Headquarters instructed the block representative chapters to send a report on damage to chapters under its jurisdiction to the Headquarters. It also instructed each chapter to dispatch medical teams to the Miyagi Chapter.(16:40) Six initial dispatch personnel were sent to the Miyagi Chapter (Director Iinuma of Ishinomaki Red Cross Hospital (RCHP) rode in the same car)(17:00) The operation team held its first meeting.(19:30) The first quick disaster relief report was compiled.The Headquarters worked with the International Committee of the Red Cross (ICRC) to set up the tracing services, the Restoring Family Links, which is a website to confirm the safety of people.Fifty-five medical teams from around the nation headed for the affected areas.The President was on a business trip to attend an official ceremony for the completion of the JRCS Wakayama Medical Center (Early morning on the following day, he returned to the Headquarters by air).

3/12(08:00) A six-member first contingent to investigate affected areas was additionally sent to the Miyagi Chapter.(12:00) HDC at the Headquarters held its first meeting.

3/13

(09:30) The President visited affected areas (3/13 to 14). The places visited included the Fukushima Chapter, the Miyagi prefectural government (to have a meeting with the Governor and gave a press conference), Ishinomaki RCHP, and first-aid stations and evacuation centers in MIYAGI and IWATE, and he was accompanied by a public-relations officer of the International Federation of Red Cross and Red Crescent Societies (IFRC) and a Reuters news reporter.After Mar. 13, in addition to personnel to support the Miyagi Chapter’s HDC, the Headquarters continued to dispatch Headquarters personnel to assist the Ishinomaki RCHP.

Chapter 1　Establishment of the Headquarters of Disaster Control (HDC) and Its Activities

- If a medium scale of damage is caused, and if the chapter in an affected area requires limited relief from organizations such as the Headquarters, blocks, or neighboring chapters

- If advisory for a Tokai earthquake is issued

- If a large scale of damage is caused, and if JRCS needs to engage in nationwide relief activities

- If a serious accident such as a nuclear or aircraft accident occurs

- If a wide-area, massive earthquake such as a Tokai earthquake occurs

- If a warning for a Tokai earthquake is issued

15

Chapter 1

　

Establishment of the H

eadquarters of Disaster C

ontrol (HD

C) and Its Activities


Date Major moves

3/13

The Headquarters notified its medical-team dispatch policy.Each block continued to dispatch personnel, who were accompanied by psychosocial care staff (whose working days were limited to three days or less, excluding travel time).(12:00) Two psychosocial care leaders were sent to ISHINOMAKI, MIYAGI.

3/14 The acceptance of Gienkin ※ began with their handling outsourced to external organizations.

3/15The disaster-response volunteer center was established (Conference Room 201 at the Headquarters).The Headquarters started to send personnel to support the Ishinomaki RCHP by chartered bus on the basis of a five-day shift.

3/16 A seven-member field investigation team with an IFRC representative as its leader headed for MIYAGI.3/17 Medical teams were set to survey the needs of evacuation centers (to IWATE from Mar. 17 to 31 and to MIYAGI from Mar. 17 to 29).

3/18Volunteer shuttle services between the Headquarters and the Miyagi Chapter began (and continued until May 7).By this day, over 100,000 donations were remitted to the JRCS account at the Japan Post Bank (6.653 billion yen).

3/20The safety of personnel at chapters and facilities, including the Ishinomaki RCHP, was confirmed.An investigation team was sent to MIYAGI to support broken-up families (Mar. 20 to 25).

3/22

The Vice-President visited the governors of affected prefectures, etc., at the Fukushima, Miyagi, and Iwate prefectural government offices (Mar. 22 to 24).The Headquarters assigned radiation support personnel (emergency medical advisors on exposure to radiation) to the Fukushima Chapter (Mar. 22 to Apr. 28).The Headquarters decided and notified which block should send medical teams and where.By this day, a total of 574,520 donations totaling 22.8 billion yen had been received (quick report).

3/23 (16:00) The President visited Deputy Disaster Management Minister Tatsuo Hirano to request him to approach the governors of the affected prefectures to promptly set up a joint committee to allocate Gienkin .

3/25 The Executive Director General for the Operations Sector went to the Fukushima Chapter to support safety measures (Mar. 25 to 28).

3/28A team dedicated to the handling of the donation from overseas was formed.The Miyagi Chapter established the HDC in the Ishinomaki RCHP.

3/29 By this day, a total of 1,128,434 donations totaling 59.4 billion yen had been received (quick report).

3/30 (14:00) Ms. Norika Fujiwara, a special public-relations ambassador, visited Headquarters, received explaining about the JRCS activities, presented the Gienkin and encouraging personnel at the HDC.

4/1 The national government decided to name the disaster the “Great East Japan Earthquake and Tsunami.”(GEJET)4/3 The Headquarters notified the dispatch of assistants to disaster medical coordinators as part of its relief operations in ISHINOMAKI, MIYAGI.

4/6 The Headquarters sent of the needs survey project team, three personnel, including the Operations Sector’s Medical Director from to MIYAGI (Apr. 6 to 9).

4/7The operation of volunteer shuttle buses between the Headquarters and the Miyagi Chapter began (and continued until Jun. 26).(23:32) A M7.4 earthquake whose epicenter was off MIYAGI occurred.

4/8The Headquarters dispatched a three-member caring team to RIKUZENTAKATA, IWATE, for a field survey (Apr. 8 to 10).(13:30) A committee to decide the percentage of Gienkin allocated held its meeting at the Ministry of Health, Labour and Welfare (MHLW), and the Director General of the Organizational Development Department attended it.

4/11 A team to survey the needs of the affected areas was sent to FUKUSHIMA (Apr. 11 to 15).

4/12Ms. Norika Fujiwara, a special public-relations ambassador visited ISHINOMAKI and HIGASHIMATSUSHIMA, MIYAGI (Apr. 12 to 13).A conference of the Director General of Japanese Red Cross Blood Centers (RCBC) nationwide was held.The Headquarters sent a team of engineers to install water supply equipment at the evacuation centers in ISHINOMAKI (Apr. 12 to 17).

4/13 The remittance of Gienkin to the affected prefectures began.

4/14Three politicians, including the President of the Liberal Democratic Party, visited the Headquarters. After being briefed on JRCS’s relief activities, they visited the HDC there.The first caring team was dispatched to RIKUZENTAKATA, IWATE (Apr. 14 to May 13).

4/20 The Federation of JRCS Hospital Directors held an extraordinary plenary session for activity reports on the GEJET.5/1 GEJET Recovery Task Force was established.5/9 The partnership meeting for GEJET (PNS Meeting) was convened.

5/30 The organization of the operations team was reduced with its office moved from Conference Room 201 to the Disaster Management and Social Welfare Department’s office on the fourth floor.

※Gienkin : It is donation which is distributed as cash to people in disaster area cash grant scheme.

16


b. Convocation of meetingsIn principle, the HDC held its daily regular meeting at 3:00 p.m., and the operations team did so at 1:00 p.m.The HDC consisted of the President, and the Director Generals of departments and offices. Members reported on the damage caused, the overall response to the disaster, JRCS’s relief activities, the actions

taken by departments and offices, and problems and the measures taken and determined relief operations policy, implementation procedures, and other important matters. A total of 34 meetings were held, and their agendas are as summarized below.

Figure 1-2　A Meetings Held by the HDC at the HeadquartersMeeting number

Date and time Major agenda

1 Mar. 12, 12:00 p.m.

Assessment of the conditions resulting from the disaster and reporting on the response of the operations team as well as departments and offices

2 Mar. 14, 1:00 p.m.

Decision on the early establishment of first-aid stations, psychosocial care centers, and volunteer centers in preparation for medium to long-term operations and on policy toward personnel support for the Ishinomaki RCHPDecision to temporarily cancel meetings of the Board of Governors and the Board of Representatives and allow the Boards to deliberate on matters by circulating documents

3 Mar. 15, 1:30 p.m.

Report by the President on his visit to the affected areas, and reports by the personnel initially dispatched by the Headquarters on their local activities

4 Mar. 16, 5:00 p.m.

Consideration of ways to procure and distribute relief supplies for evacuation centers and the decision to set up an evacuation center support team

5 Mar. 17 Reports by the personnel initially dispatched by the Headquarters on their local activitiesConsideration of measures to secure gasoline

6 Mar. 18 Activity reports by the first contingent that surveyed the affected areasConsideration as to how to handle Gienkin funds and donation from overseas

7 Mar. 22 Analysis of the current status of relief activities and their systemsConsideration of ways to step up public relations activities and countermeasures to deal with the nuclear accident

8 Mar. 23 Reports by the operations team as well as the departments and offices on their response

9 Mar. 24 Reports by the Headquarters’ medical coordinators on the current situationReport on its HDC organizational structure and safety systems in FUKUSHIMA

10 Mar. 25, 4:30 p.m.

Report by the Vice-President on support projects for the three affected prefectures (IWATE, MIYAGI, FUKUSHIMA)Report on the current situation based on surveys of the needs of the evacuation centers

11 Mar. 28, 11:00 a.m.

Consideration of the establishment of a team dedicated to the handling of donation from overseas Report on the organizational structure of the chapters’ HDC in the three affected prefectures

12 Mar. 29 Consideration of ways to use donation from overseas Report on the progress in the establishment of psychosocial care centers

13 Mar. 30 Revision of the structure for quick reports on disaster relief

14 Mar. 31 Consideration of safety measures for medical teams sent to FUKUSHIMAOverview of volunteer activities and the provision of relief supplies to evacuation centers, etc.

15 Apr. 1 Examination of ideas for the menu of JRCS program operations

16 Apr. 4, 3:30 p.m.

Updating the Headquarters’ website and making it more substantialReport on relief activities in the area of ISHINOMAKI, MIYAGI

17 Apr. 5, 3:30 p.m.

Analysis of JRCS’s response to donation from overseas and consideration of the ways to use themInstallation of a project team to survey the needs of the affected areas

18 Apr. 7, 3:30 p.m.

Consideration of draft business plans using donation from overseas as financial resourcesDecision on the implementation of projects to support aged persons requiring nursing care (caring team)Consideration of the policy on dispatching medical teams in the future

19 Apr. 8 Decision on dispatching personnel to support local public relations

20 Apr. 11Report on the handling of domestic Gienkin funds, such as their allocationReport by the needs survey team of MIYAGI Report on the progress in the projects of the team dedicated to the handling of donation from overseas

21 Apr. 12 Consideration of a plan to hold a PNS meeting for GEJET22 Apr. 13 Consideration of the policy on dispatching psychosocial care personnel

23 Apr. 14 Report on the dispatch of disaster-response volunteers and the handling of expressway tolls for Red Cross vehiclesReport on the production of a 14-minute special video on the GEJET

24 Apr. 15 Consideration of the needs for psychosocial careReport on the procurement and distribution of relief supplies

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Meeting number

Date and time Major agenda

25 Apr. 18, 3:30 p.m. Report by the team that surveyed the needs of FUKUSHIMA

26 Apr. 19 Report on the progress in the compilation of an interim summary report on the GEJET 27 Apr. 21 Interim summary report on the GEJET (supervisory, medical, psychosocial care, and volunteer teams)

28 Apr. 22 Interim summary report on the GEJET (information and logistics teams, the Medical Services Department, and the team dedicated to the handling of donation from overseas)

29 Apr. 25, 4:00 p.m.

Interim summary report on the GEJET (Planning and Public Relations Office, the Human Resources Department, and the Nursing Department)

30 Apr. 27 Interim summary report on the GEJET (Organizational Development Department, the General Affairs Department, the International Department, and the Blood Services Headquarters)

31 Apr. 28 Consideration of a plan to hold a PNS meeting for GEJETDecision on the implementation of programs at evacuation centers such as activities to express sympathy

32 Aug. 30, 1:00 p.m.

Summary of the relief activities that had thus far been carried outConsideration of long-term initiatives for radiation accidents

33 Oct. 17, 10:30 a.m. Consideration of issues to be addressed for the immediate future and improvement policies

34 Oct. 30, 10:30 a.m. Report on evaluations of the activities for the GEJET (third-party evaluations)

(Note) Meetings whose time is not mentioned were held at 3:00 p.m.

c. Organizational structure of the HDC at the Headquarters

The organizational chart for the Headquarters is as shown in Figure 1-3.In accordance with Part 5 Section 3 of the Guidelines for JRCS Headquarters Disaster Relief Systems, the Operations Team worked with Conference Room 201 as its base. Under the Administration Team, which supervised the Operations Team, five sub-teams were formed: Medical, Information, Disaster-Response Volunteer, Relief Supplies, and Psychosocial Care Teams.The Headquarters made the most of the experience gained through the Headquarters disaster relief drills (those carried out in accordance with the Tokai earthquake response plan) conducted in FY2009 to swiftly organize the Operations Team consisting mainly of personnel who had already experienced these drills.

The meeting of the Operations Team comprised the heads of its groups (administration, medical, information, disaster-response volunteer, relief supplies, and psychosocial) care and the Supervisory Directors of departments and offices and was presided over by the Director of the Disaster Manager Division.The first meeting of the Operations Team was convened at 5:00 p.m. on March 11, and following the decisions of the Headquarters, the Team’s subsequent meetings exchanged information on, coordinated, and considered the operations of the Operations Team as well as departments and offices.The Operations Team left Conference Room 201 at the end of May and moved to the office of the Disaster Management and Social Welfare Department on the fourth floor. It was disbanded at the end of August.

[Scene of the activities of the Operations Team of the HDC at the Headquarters established immediately after the earthquake (Conference Room 201)]

Figure 1-3 Organizational Structure of the HDC at the Headquarters(Unit: persons)

Team name Immediately after the earthquake occurred As of March 29 After April 1

Administration Team* 23 20 16Medical Team 8 11 10Information Team 36 17 17Disaster-response volunteer Team 6 6 5

Relief Supplies Team 21 13 9Psychosocial Care Team 5 6 4

Total 99 73 61(NOTE)* The Administraton Team does not include the Director General and Deputy Director General for the Disaster Management and Social Welfare Department.All figures include initially dispatched personnel and the chapters’ support personnel in the three affected prefectures.

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d. Handling of documentsThe Guidelines for the Handling of Documents at the JRCS HDC at the Headquarters for the off the Pacific Coast of Tohoku Earthquake, enforced on April 1, stipulate that all documents of the HDC at the Headquarters shall be approved as follows:

Documents on matters such as basic rel ief pol icy, the organization of the HDC at the Headquarters, and relief activities that are particularly important

Head of the Operations Team

Documents on matters handled by the HDCs Operations Team that are regular or minor

Head of the team or group in the Operations Team that is in charge

It was decided that the titles of documents created by the HDC at the Headquarters should be prefixed with the term Honsai and that the issuer of documents should be the Operations Team (or its head) or the head of the team or group in the Operations Team that was in charge according to the categories of decision-making authority listed above. In practice, however, many of the documents were issued by departments or offices depending on the situation, such as the need for giving priority to a swift response, and as a result, there was some confusion between the Headquarters and chapters/facilities at first because a reporting line was not unified at the Headquarters. In order to ensure proper document management, the

Headquarters decided to provide the Administration Team with a ledger of issued documents to record all documents created by the HDC at the Headquarters, and personnel appointed by the Head of the Operations Team managed these documents. It also decided that all documents created by the Headquarters should be stored for ten years excluding regular and minor ones.The flow of information and information sharing in the Operations Team was as shown below.

In order to ensure information sharing, personnel on day and night shifts took notes of matters to be taken over when they finished their work on their respective shifts and handed these notes over to those who took over the next shift and the Administration Team, which copied the notes and distributed copies to each team and group.

Information (Information Team)↓

Distribution (to teams and groups concerned) and information sharing (other teams and groups)

↓Response (each team and group)

↓Confirmation of the results of the response

(Administration Team)↓

Input of the results of the response (Information Team)

Figure 1-4 Organizational Chart of the HDC at the Headquarters

Deputy Head of the Headquarters (Vice-President)

Executive Director General for the Operations Sector, Executive Director General for the Administration Sector, and the Head of the Blood Services Headquarters

Head of the Operations Team (Director General for the Disaster Management and Social Welfare Department)

Administration Team

Group 1 Medical TeamGroup 2 Disaster-Response VolunteersGroup 3 Relief Supplies, etc.Group 4 Psychosocial Care

Chapters and facilities

Government agencies

Local governments

Disaster-response organizations

International organizations

Corporations and business firms

Local residents

Other

Directions, orders, replies, and reports

Directions, coordination, replies, and provision

Directions, requests, coordination, replies, and provision

Directions, orders, replies, reports, and coordination

Information Team Special Mission Team

Head of the Headquarters (President)

Local HDC

Headquarters medical teams

Dispatched personnel

Operations Team

Planning and Public Relations Office

General Affairs Department

Human Resources Department

Organizational Development Department

Compliance Office

Medical Services Department

Nursing Department

International Department

Blood Services Headquarters

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Despite these problems, these personnel played their role in the initial relief activities to a certain extent.

(b) Dispatch of the first contingent to survey the affected areas

In order to assess the situation in the affected areas and identify the needs of the Chapters in the three affected prefectures, a team of six personnel with the Deputy Director General in charge of disaster management as its leader visited the Miyagi, Iwate, and Fukushima Chapters and affected areas in these prefectures from March 12 to 16. At the Chapters, in addition to gathering information from the Chapters’ Secretaries General and other personnel, they gave advice on the policy for relief activities as required.

(c) President’s visit to affected areasThe President visited the affected areas for two days from March 13, two days after the earthquake occurred. He was accompanied by five persons: a Director from the International Department, an Assistant Director from the Secretarial Division, an IFRC public relations officer, a Reuters reporter, and a driver. On March 13, he headed for the Fukushima Chapter while listening to a radio broadcast reporting explosions at the Fukushima Daiichi Nuclear Power Station and was briefed by the Secretary General of the Chapter on the situation in the prefecture. Later, he headed for the Miyagi prefectural government (local HDC), where the Miyagi Chapter’s Secretary General reported to him on the situation in the prefecture. At the government office, he also had a meeting with the governor. After these meetings, the President gave a press conference at the correspondents’ club of the government office. On the evening of the day, he arrived at the Ishinomaki RCHP, where he participated in joint briefing sessions with its medical staff and encouraged all its staff and all members of the JRCS medical teams who had gathered there from around the nation. On March 14, he visited ISHINOMAKI and the vicinity and travelled northward along the coast. On his way, he went through the affected areas in RIKUZENTAKATA,

e. Dispatch of initial response, special missions, and other teams

(a) Dispatch of initial dispatch personnelAt 4:40 p.m. on the day of the earthquake, six initial dispatch personnel were sent to the Miyagi Chapter’s HDC.The dispatch period was six days until March 16. In general, chapters in the three affected areas take leadership in JRCS disaster relief activities, but if, due to the magnitude of the disaster, it is determined that it is difficult to respond to it through the chapters involved alone, or if the disaster requires a unified response as in public relations, the Headquarters is actively engaged in support and other operations. Therefore, these personnel were dispatched promptly in accordance with the Guidelines for Initial Dispatch of Headquarters Personnel at the Time of Disaster. The aim was to establish systems early so that the Chapters in the three affected prefectures could effectively engage in relief activities for the victims. To this end, these personnel worked to assist the Miyagi Chapter in setting up its HDC and ensure that the Headquarters fulfilled its functions smoothly.Their specific duties were as listed below.

The problems listed below emerged through the personnel’s activities.

medical teams dispatched.- Tasks (such as relief work, public relations, and volunteer centers) were assigned to each of the six initial personnel in advance, but did not correspond to the actual conditions at the Chapter’s HDC and its operational needs, preventing them from meeting such needs flexibly.

- Contact addresses and phone numbers at the Headquarters as well as matters to be notified to the Headquarters were not clear.

- There was confusion as to whether relief supplies should be addressed to the Miyagi Chapter or the Sendai RCHP.

- Partly because of poor communications, the personnel could not communicate closely with the

Providing support in three areas: relief, volunteers, and public relations(Relief)- Support in drawing up activity plans for the immediate future- Drawing up plans to dispatch medical teams- Liaison and coordination with the HDC at the Headquarters(Volunteers)- Gathering information on volunteer activities- Support in setting up the Chapter’s disaster-response volunteer center

- Liaison and coordination needed to encourage volunteer activities such as cooperation with Social Welfare Councils

(Public relations)- Gathering information and recording JRCS’s disaster relief activities and the conditions of affected areas, evacuation centers, and related organizations

- Communication of information inside and outside JRCS- Response to news gathering by the mass media

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centers. As a result, they provided ISHINOMAKI with cold weather protection gear (such as heating apparatuses, kerosene, winter clothes) and goods to protect them from infectious diseases (such as masks and disinfectants) and the town of WATARI with clothing.

＜FUKUSHIMA＞- Total number of personnel dispatched: 6 (up to Group 2)- Dispatch period: April 11 to 22- Summary of activities: In addition to the Fukushima Chapter’s HDC, they interviewed local government officials (KUNIMI, TOMIOKA, KAWAUCHI, IWAKI, and KORIYAMA) to identify goods needed at evacuation centers and temporary housing. In particular, some 1,800 evacuees lived at Big Palette Fukushima in KORIYAMA, and since this evacuation center was large, requiring certain sanitary measures, they provided support by meeting its requests for home appliances such as washing machines, driers, humidifiers, and vacuum cleaners.

f. Response to donation from overseas (a) Team dedicated to the handling of donation from

overseas in the Operations TeamOn March 28, a team dedicated to the handling of donations from overseas was formed in the Operations Team of the HDC at the Headquarters.This dedicated team was established to handle donations from overseas at the Headquarters because it was necessary to consider how to use the funds from Red Cross and Red Crescent Societies and similar organizations beyond the conventional framework while meeting the needs of the victims. The duties of the team were to:

(b) Project to survey needs in response to donation from overseas

The overseas fund team worked to take measures such as surveying and distributing goods needed by those living in temporary housing, but in order to further survey the needs of victims and identify them in more detail as their living situation at the

KESENNUMA, and other cities and visited first-aid stations in KAMAISHI and OTSUCHI, IWATE, where he encouraged all members of the medical teams. His visits to these places were immediately reported by the Reuters reporter to the rest of the world.

(d) Dispatch of personnel to survey the needs for relief supplies at the evacuation centers

A team of personnel was formed for each of the three affected prefectures to survey the needs for relief supplies at each evacuation center. The three teams visited there and surveyed such needs to help distribute relief supplies efficiently. The two specific tasks were to decide areas to be supported by JRCS with the prior consent of local governments, and to identify supplies needed by evacuation centers in those areas and request the HDC at the Headquarters to procure such supplies.

＜IWATE＞- Total number of personnel dispatched: 6 (up to Group 2)- Dispatch period: March 17 to 31- Summary of activities: They investigated six relief supplies centers in MIYAKO, YAMADA, OTSUCHI, KAMAISHI, OFUNATO, and RIKUZENTAKATA and distributed partitions, temporary toilets, and goods to support the lives of victims from the viewpoint of protecting privacy at evacuation centers.

＜MIYAGI＞- Total number of personnel dispatched: 4 (up to Group 2)- Dispatch period: March 17 to 29- Summary o f act iv i t ies : They v is i ted loca l governments (SHIOGAMA, TAGAJO, ISHINOMAKI, HIGASHIMATSUSHIMA, NATORI, WATARI, IWANUMA, and SHICHIGAHAMA) and evacuation centers in MIYAGI to hear from the local governments’ officials about the needs for relief supplies at evacuation

- Identify the needs of the victims- Draw up specific plans to utilize the funds- Coordinate with related administrative agencies (national

and local governments as well as local HDC)- Give directions to order goods, etc., and confirm their delivery

- Other tasks as required

[On March 14, the President saw the damage caused to OTSUCHI, IWATE, with his own eyes.]

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In addition, on May 1, the Promotion Conference for the GEJET Recovery Support Project with the President as its chairman was established to discuss and decide on support projects.

g. Summary of the activitiesIn April, one month after the establishment of the HDC at the Headquarters, each the Operations Team as well as each department and office reviewed the activities they had carried out, summarized problems and issues to be addressed, and put together an interim report summarizing a future response policy.In July, they reviewed the activities they had carried out again and summarized problems and issues to be addressed.

(2) Activities of the Operations Teama. Administration Team(a) Duties of the Administration TeamFour groups were formed under the Administration Team and performed the following duties:

Figure 1-5 Division of Duties in the Supervisory Team

Supervisory Group

- Operation and coordination of the meetings of the HDC at the Headquarters and the Operations Team

- Handling of projects shared by the Operation Team, departments, and offices

- Coordination of and decision of dispatch of personnel and organization of the work shifts

Coordination Group

- Handling of projects (communication slips) to be covered by the Administration Team

- Overall liaison and coordination with other groups

Dispatch Group

- Overall preparations for dispatch and support for personnel who had returned from the work, preparation of lists of personnel dispatched and their contact addresses, and securing accommodations for personnel who had returned from the work

- Collection of lists of personnel dispatched by other departments and teams and provision of information to personnel who were going to be dispatched and had already been dispatched

evacuation centers was becoming prolonged as well as to work actively to support the victims using overseas funds, it formed a four-member project team with the senior medical advisor as its leader.The team was sent to ISHINOMAKI, MIYAGI, from April 6 to 10, and the duties of the team were to:

As a result , it became clear that there were substantial needs in two respects. One was that the victims wanted medical support for them to continue and the sanitary environment to be improved as their living situation at the evacuation centers was becoming prolonged. The other was that they wanted ISHINOMAKI’s social welfare and medical systems to be restructured as the city sustained devastating damage. Based on the results of the survey, the team proposed to take the following measures:

(c) Establishment of a special missions office to support recovery from the GEJET and the meeting to promote projects to support recovery from the GEJET

In order to concentrate on projects to support recovery from the earthquake in a comprehensive manner using relief funds received from overseas Red Cross and Red Crescent Societies and similar organizations, “the Special Missions Office to Support Recovery from the GEJET” was established as a temporary organizational system based on the provisions of Article 3 of the Regulations for the JRCS Headquarters on May 1.The duties of the Special Missions Office were:

- Planning for and general coordination of support projects

- Coordination with related administrative agencies (national and local governments as well as HDC in affected area), related organizations, etc.

- Conclusion of contracts, directions to order goods, etc., and confirmation of their delivery, etc.

- Management of budget execution- Audits, reports on activities for overseas Red Cross and Red Crescent Societies, and financial reports

- Other support projects

- Install water tanks and simple faucets at the evacuation centers

- Install prefabricated buildings in the precincts of the Ishinomaki RCHP to provide an activity base

- Install a temporary municipal social welfare and medical center

- Restore the tertiary emergency medical system with the Ishinomaki RCHP as its core and enhance the functions of the Ishinomaki RCHP as a disaster relief core hospital

- Identify the needs of victims in more detail- Draw up plans to utilize the funds- Identify the needs of the Ishinomaki RCHP, related administrative agencies (national and local governments as well as HDC in affected area), and related organizations, and so forth

- Other tasks as required

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This system was used when medical teams from western Japan flew to HANEDA, YAMAGATA, and AKITA.

(d) Securing accommodations at the building of the Headquarters

Conference Rooms 501 (for men) and 301 (for women) at the Headquarters were always available for accommodations and were mainly used as a stopover point for medical teams from the Kyushu region. Medical teams using these facilities traveled from their place of origin to Tokyo by air and moved from the Headquarters to the affected area by their Red Cross vehicle. They also contacted the Operations Team at Conference Room 201 for information before they departed.

(e) Support for the Ishinomaki RCHPIn order to provide the Ishinomaki RCHP with personnel support, the Headquarters started to operate shuttle buses between the Headquarters and the hospital on March 15 .Personnel were dispatched by rotation. On Day 1 they left the Headquarters at 8:30 a.m. on the basis of five-nights-six-days shifts. They worked for five days. On Day 6 they left for Tokyo after they finished work, arriving at the Headquarters after 12:00 midnight. In order to meet the needs of the hospital, buses leaving the Headquarters carried as many daily necessities and relief supplies as they could.

(f) Lent vehiclesSince immediately after the earthquake, many vehicles had been required for disaster relief work, the dispatch of support personnel, public relations, and various other activities. At first, as the five vehicles (three people carriers, one van, and one

General Affairs Group

- Organization of work shifts and management of advance money for the Administration Team, and putting materials, whiteboards, and files in order

- Creation of documents to be taken over and the management of each team’s documents to be taken over

- Collection of information from each team and the provision of information to each team

(b) Free use of expresswaysImmediately after the earthquake, only vehicles to which a mark confirming that its holder was an emergency vehicle running for urgent purposes was issued were allowed to run on expressways, including closed sectors, free of charge, but after traffic restrictions were lifted, only vehicles engaged in disaster relief that had a certificate of a vehicle engaged in disaster dispatch, etc., issued by a local government were allowed to run on the expressways free of charge. For this reason, it was in fact difficult to have such certificates issued prior to relief activities, and in order to simplify administrative procedures, the Headquarters consulted with East Nippon Expressway Company. As a result, the Company considered JRCS as an organization similar to local governments and permitted it to issue such certificates in the name of its President or Chapter President so that Red Cross vehicles could use expressways free of charge.JRCS came to agreements with six expressway companies nationwide (East, Central, and West Nippon Expressway Companies, Metropolitan Expressway Company, Hanshin Expressway Company, and Honshu-Shikoku Bridge Expressway Company) on this system, which started on April 16. Later, JRCS applied for its extension for one month, and the system continued until the end of June. Records show that under this system, Red Cross vehicles used expressway free of charge a total of 1,664 times (523 for April, 776 for May, and 365 for June).

(c) Free flights for medical teamsFor one month from March 15 (March 14 for ANA) to April 15, airline companies provided a service of carrying free of charge individuals and members of organizations going to affected areas for recovery support who met certain requirements. A total of 6,558 JRCS personnel (991 times) used airlines (including Starflyer and Skynet Asia Airways), and 4,826 of them (745 times) used this system (1,248 persons (224 times) for JAL and 3,578 persons (521 times) for ANA).

[A scene from the ceremony held in the front garden of the Headquarters for the first group of personnel heading for the Ishinomaki RCHP]　　　　　　

　　　　　　　　　　　　

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less often, only on weekdays after April 16 and three times a week after May 12. After June 4, they were provided once a week.

(c) Gathering information from government agencies, etc., and its dissemination

The Information Team gathered the reports on the damage caused, infrastructure status, evacuation centers, traffic conditions, and so forth mainly through government agencies’ websites and the monitoring of radio messages and stored updated information.Based on the information collected, the Team updated the maps and quick reports on disaster relief posted in the center of Conference Room 201.In addition to gathering information on available facilities such as gas stations and accommodations by phone, it made a list of major evacuation centers and the routes to get there and provided such information to personnel dispatched by the Headquarters.Sources of information such as government agencies are as listed in Figure 1-7.

Figure 1-7　Sources of Information, Including Government Agencies

　 Information collected

Sources of information

Damage

Human casualties* Prime Minister’s Official ResidenceBuildings damaged*

Human casualties National Police AgencyBuildings damaged

Nuclear power stations (evacuation areas)*

Prime Minister’s Official Residence (Nuclear Emergency Response Headquarters)

Evacuation Fire and Disaster Management Agency

Infrastructures

Power failureTokyo Electric Power Company (TEPCO)**Tohoku Electric Power Company

Gas Japan Gas AssociationSubscriber phones, IP phones

Ministry of Internal Affairs and Communications

Water supply MHLW

Roads

Ministry of Land, Infrastructure, Transport and TourismEast Nippon Expressway Company

OtherMHLWMinistry of Internal Affairs and Communications

* Information from the mass media was also referred to.** TEPCO stopped information service one week after the earthquake because its information overlapped that provided by the Prime Minister’s Official Residence.

truck) owned by the Headquarters were not enough, the Headquarters utilized rental vehicles (up to eleven vehicles when it was busiest). Due to this plight, automobile sales companies offered to provide cars, and the Headquarters borrowed large vehicles meeting its needs that were suitable for the transport of personnel and goods.

Figure 1-6 Summary of Vehicles Lent

Company name Volkswagen Group Japan Co., Ltd. Jaguar Land Rover Japan Co., Ltd.

Number of vehicles lent Caravelle (three units) Discovery (two units)

Freelander (one unit)

Lending period

March 26 to August 25, 2011 (five months)

June 1, 2011 to March 31, 2012 (ten months)

Distance covered

86 ,949 km ( for three units combined)

45,734 km (for three units combined)

Uses

Relief activities and recovery programs in the three affected prefectures (shuttle service for disaster-response volunteers, needs surveys, meetings with affected municipalities, etc.)

Recovery programs in the three affected prefectures (needs surveys, meetings with affected municipalities, transport of blankets and other support supplies, accompaniment of representatives from overseas Red Cross and Red Crescent Societies during visits to the affected areas, etc.)

b. Information TeamThe duties of the Information Team are summarized as follows:

(a) Chronological organization of informationThe Information Team chronologically recorded the occurrence of the earthquake, the warnings and alarms issued, the meetings held, details of communication slips created, and so forth.

(b) Compilation of quick reports on disaster relief (1 or 2 staff members)

The Information Team gathered information at related places and compiled quick reports on disaster relief for internal and external use (website).In addition to posting these quick reports on the website through the Planning and Public Relations Office, the Team distributed them to all chapters via email, circulated printed versions within the Headquarters, put up 20 copies at the entrance hall on the first floor, and uploaded them onto the intranet.Immediately after the earthquake, quick reports were compiled twice a day, but later, at 12:00 noon each day. Afterwards, they were gradually compiled

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2. The Iwate Chapter HDC (1) The Actions Taken at the Time of the DisasterAbout 20 minutes after the disaster occurred, the Iwate Chapter confirmed the safety of facilities within its jurisdiction and established its HDC. Since communications and power supplies were cut off in the city of MORIOKA, the Chapter immediately dispatched two of its personnel to the Iwate prefectural government to collect information.In IWATE, since coastal areas sustained immense damage, the prefectural government’s HDC requested to use the heliport of the Morioka RCHP to convey sick and wounded persons, but at 6:37 p.m., the prefectural governments HDC decided to transport them to the Iwate Prefectural Fire-Fighting School in YAHABA, and the Chapter made preparations such as giving instructions to deploy Domestic Emergency Response Units (dERU). Informed that the sick and wounded could not be transported by helicopter on that day, however, it only made such preparations. On the morning of March 12, at the prefectural government’s request, the Chapter dispatched medical teams to the School in preparation for wide-area transport.At first, the Chapter gave instructions as to where medical teams should be dispatched and coordinated their dispatch, but at 7:00 p.m. on March 12, it left all decisions on the destination of the dispatch to the Morioka RCHP, which was suggesting that medical teams should be sent to coastal areas, and it was decided that later, the dispatch of medical teams should be coordinated not by the Chapter but by the hospital. Therefore, many medical teams, including those that had temporarily gathered at the Chapter, moved to the hospital, where they received instructions as to where they should go after they were briefed.On March 13, a HDC was established in KAMAISHI, and on March 15, one was set up in TONO, which served as a relay point for the affected coastal areas (The HDC in KAMAISHI was closed at the same time that the one was formed in TONO).

(d) Recording of the minutes of the meetingsThe Information Team announced the convening of the meetings of the Headquarters and the Operations Team, prepared materials for such meetings, and recorded their minutes.It also stored the meeting materials and uploaded them onto the Headquarters’ intranet for information sharing.

(e) Preparation of a list of medical teamsIt entered into Excel files lists of the names of the dispatched medical teams as reported by block representative chapters via facsimile and email, etc. and distributed the files to the local HDC, the chapters, and other parties concerned each day via email (at 8:00 a.m. until April 15).

(f) Collection, storage, and dissemination of documents, etc.The Team collected and stored documents and other materials created by other teams and departments/offices, and upon request, it distributed documents via email and facsimile.At 11:00 a.m. every day, it also provided the MHLW with information on the medical teams by sending via email a list of places to which they had been dispatched (prepared by the Medical Team). After April 16, it did so twice a week.

(g) Other dutiesIn addition to the foregoing, the Team performed the following duties:- Answering phone calls - Handling of mail received by the Headquarters

(confirming the contents of mail received by the Headquarters that sought relief or made disaster-related requests and transferring them or otherwise processing them as required.

[Inside the Iwate Chapter on the evening of the day of the earthquake][Map of the affected areas drawn up based on the information collected (Conference Room 201)]　　　　　　　　　　　　

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Figure 1-8 Major Movements of the Iwate Chapter’s HDC, Etc., after the Occurrence of the Earthquake

Date Time Description

3/11 2:46 p.m. The earthquake occurred (The power, water, and city gas supply to the Chapter was cut off, forcing it to respond to the disaster using lighting from a power generator).

3:08 p.m.The safety of Omeiso, JRCS Home for elderly, Morioka RCHP and the Iwate RCBC was confirmed.The Iwate Chapter HDC was established.The Chapter requested the Morioka RCHP to have two medical teams stand by.

3:20 p.m. Two chapter personnel were sent to the prefectural government’s HDC.

3:37 p.m. The Chapter requested the Morioka RCHP to make preparations for receiving patients as a disaster relief core hospital.

3:58 p.m. The Morioka RCHP completed preparations for medical teams.

4:05 p.m. The Chapter received a request from the Japan Disaster Medical Assistance Team (DMAT) to dispatch medical teams.

4:46 p.m. A hotline with the prefectural government’s HDC was set up.

5:02 p.m. The Chapter received the information that it appeared that the sick and wounded would be concentrated in inland areas because hospitals in the prefecture’s coastal areas had difficulty in receiving patients.

5:18 p.m. The Morioka RCHP’s heliport became usable.

6:30 p.m. The Chapter instructed the Morioka RCHP to set up dERUs at the Iwate Prefectural Fire-Fighting School.

6:37 p.m. The prefectural government’s HDC decided to transport patients in the prefecture’s coastal areas to the Fire-Fighting School by helicopter.

8:38 p.m. dERUs started to be set up.

9:25 p.m. The Headquarters confirmed with the Chapter as to how many medical teams it needed.

9:55 p.m. The Chapter requested the prefectural government to supply fuel oil.

11:10 p.m. The Emergency Medical Information System (E-MIS) became available for data entry.

3/12 5:19 a.m. The prefectural government’s HDC ordered JRCS to dispatch two medical teams, and the Chapter instructed two of its medical teams to go to the Iwate Prefectural Fire-Fighting School.

6:15 a.m. A disaster-response volunteer was dispatched to the Fire-Fighting School.

6:40 a.m. The Chapter and the Morioka RCHP became unable to send and receive email as the Internet access was interrupted.

8:10 a.m. The Musashino RCHP’s DMAT arrived at Iwate Medical University and headed for OFUNATO by land.

8:12 a.m. The Chapter strengthened the RCBC’s supply system (24 hours) and decided to cancel all its blood collecting plans for Mar. 12 and 13.

5:50 p.m. AKITA’s first medical team set up a first-aid station at Daiichi Junior High School in RIKUZENTAKATA (The DMAT retreated).

6:25 p.m. Power supply returned to normal.

6:31 p.m. Water supply returned to normal.

7:00 p.m.The Morioka RCHP suggested that it should dispatch medical teams to coastal areas. The Chapter responded that it had obtained approval from the prefectural government’s HDC for the dispatch of medical teams to coastal areas and that it would leave all decisions on the destination of the dispatch to the hospital.

8:15 p.m.The Headquarters told the Chapter that it had not received information on whether medical teams had arrived in the affected areas and how they were working. In response to these inquiries, the latter provided relevant information to the former.

3/13 1:50 p.m. The Chapter set up a local HDC in KAMAISHI.

3/14 3:00 p.m. The Chapter secured Tono Fukushi no Sato as a relay point for the affected coastal areas and a venue for its local HDC .

3/15 11:50 a.m. A local HDC was set up in TONO. (At the same time, the one in KAMAISHI was closed.)

3/16 3:00 p.m. A radio system was set up at the local HDC in TONO (with external antennas installed there).

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(4) Damage to the ChapterAt the Iwate Chapter, after the occurrence of the earthquake, power, water, and city gas supply was cut off, causing its personnel to secure only lighting through a power generator. Built in 1968, the building partly occupied by the Chapter did not have an aseismatic or seismically isolated structure and sustained damage such as broken window glass.Satellite-based mobile phones were mainly used as a means of communications. In MORIOKA, ordinary

NTT DoCoMo mobile phones also could get through relatively easily. Disaster priority phones remained unstable. JRCS’s business radio became unusable on the morning after the earthquake because a base station’s battery line was cut off (It also became unusable when an aftershock occurred on April 7).Essentially, JRCS’s business radio is not available in the entire prefecture because IWATE is large and has many mountains.

(2) Establishment of the HDCUnder its Head and Deputy Head as well as the Head of its administration team, the Iwate Chapter’s HDC consisted of four teams: general affairs and relief supplies, medical relief, psychosocial care, and Gienkin and volunteers. It also appointed personnel attached to the prefectural government’s HDC and set up a HDC. Immediately after the disaster, under this organizational system, it strove with all its resources to respond to the needs of the affected areas while obtaining support from the Headquarters.

The organizational structure chart for the Iwate Chapter HDC is as shown in Figure 1-9.

[A dERU set up at the Iwate Prefectural Fire-Fighting School]

Chapter President (Head of the HDC)

Secretary General (Deputy Head of the HDC)Hospital Director (attached to the HDC)

Director of the Operations Division (Head of the Administratoin Team)

Inside the HDC 5. Attached to the prefectural government’s HDC

6. Local HDC

1. General Affairs and Relief Supplies Team Director of the General Affairs Division

Deputy Director of the General Affairs Division2. Medical Relief Team

Director of the Operations Division (*)

3. Psychosocial Care teamDirector

4. 　　　　　 (donation) and Volunteer Team Director of the Organizational Development Division

Director of the RCBC (attached to the HDC)

Deputy Director of the Disaster Management DivisionDeputy Director of the Red Cross Membership Division

(*) Depending on factors such as the magnitude of the disaster, in addition to mobilizing more personnel from the Chapter, the Chapter HDC requests support from other chap-ters and additional personnel were assigned to its organization.

Gienkin

Figure 1-9 Organizational Structure of the Iwate Chapter HDC

(3) Reception of chapter support personnelThe Chapter received a total of 114 chapter support personnel.They were assigned mainly to the Iwate Chapter HDC, the HDC set up in TONO, and in KAMAISHI.A total of 22 personnel were dispatched to the Iwate Chapter HDC mainly from the Headquarters. A total of 68 personnel were dispatched from the Hokkaido Chapter to HDC in TONO, which was established as a base for relief work in RIKUZENTAKATA and other coastal cities. The HDC in KAMAISHI received a total 23 personnel from the Tochigi, Gunma, Niigata, and Yamanashi Chapters in the 2nd Block.

Figure 1-10 Number of Chapter Support Personnel by Destination of the Dispatch and Period of the DispatchPeriod of the dispatch

Destination of dispatch March April May June July August Total

Iwate Chapter HDC 11 7 4 - - - 22Iwate Chapter HDC (in TONO) - 13 18 22 15 - 68The 2nd Block Chapter HDC (SUZUKO, KAMAISHI) - 6 11 4 2 - 23Other places - - - 1 - - 1

Total 11 26 33 27 17 0 114Note 1: The periods of the dispatch are classified according to the day when the dispatch began.Note 2: As for the Iwate Chapter, ten of the eleven for March and three of the seven for April were sent from the Headquarters.

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Figure 1-11 Damage to the Iwate ChapterItem Damage Recovery

Building Broken window glass, etc.

Electricity 3/11: Due to power failure, only lighting from a power generator was available.

3/12: The service returned to normal.

City gas 3/11: No gas supply

Water supply 3/11: No water supply 3/12: The service returned to normal.

Mobile phone In MORIOKA, NTT DoCoMo mobile phones remained relatively usable.Disaster priority phone, satellite-based mobile phone, etc.

Satellite-based mobile phones were mainly used as disaster wire phones remained unstable.

JRCS’s business radio, etc. 3/12: JRCS’s business radio became unusable.

(5) Cooperation and liaison with local governments and other related organizations

In IWATE, emergency medical care was coordinated through DMAT in accordance with the prefectural government’s request starting from immediately after the earthquake. Since confusion in affected areas continued even after 48 hours passed, which is the period of time for which DMAT is originally intended to work, thus the prefectural government applied for an extended dispatch of DMAT, and as a result, medical teams, including JRCS’s, continued to work in the prefecture until March 19.On March 20, in order to meet medical relief needs at many evacuation centers set up in a wide range of areas, the prefectural government and five major support organizations, JRCS, Iwate Medical University, Iwate Medical Association, National Hospital Organization, and Iwate Prefecture Medical Service Bureau (prefectural hospitals), launched the Iwate Disaster Medical Support Network with Associate Professor Satoshi Takahashi of Iwate Medical University as its head. On March 22, the Network divided the prefecture into eight geographical areas and chose a principal organization that should take responsibility for coordination and other duties in each area. This made JRCS responsible mainly for RIKUZENTAKATA, KAMAISHI, and YAMADA (JRCS’s medical teams continued to work in other areas, too). The Network held a meeting daily to exchange information on medical needs and other subjects in each area, coordinated offers from medical teams nationwide, and ensured that there were neither gaps in medical resources among the areas nor overlaps in the activities. It also exchanged information with fire-fighters, police officers, and Self-Defense Force (SDF) officials who stood by at the prefectural government’s HDC. The participants from

JRCS were the Director of the Operations Division at the Chapter and the Chairman of the Morioka RCHP’s Emergency Medical and Disaster-response Committee, who served as a coordinator for JRCS medical teams in the prefecture. In principle, medical teams heading for the affected areas must be registered with the prefectural government, but this registration system was not thoroughgoing.

3. The Miyagi Chapter HDC(1) The Action Taken at the Time of the DisasterImmediately after the earthquake, s ince the consolidated government offices building partly occupied by the Miyagi Chapter sustained damage, the Miyagi Chapter establ ished HDC in the prefectural government too, and part of the personnel, including the Chapter Secretary General, moved to the prefectural government office building. Later, until March 22, the Chapter’s HDC operated with its functions divided between the branch in the prefectural government and the Chapter. All sorts of information were gathered in the prefectural government’s HDC and the SDF officials, police officers, and other parties concerned were stationed

［A scene from activities at the Fire-Fighting School］

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gas, and so forth. Goods saved for emergency were limited, requiring replenishment as needed. Another problem was how to secure food for hospitalized patients and hospital personnel.On the other hand, it was necessary to coordinate the destinations for the dispatch of medical teams heading northward to the affected areas. With communications disrupted, confusing information was flying around, and the damage in each area was unknown, there was no way of grasping the whole picture of the medical needs, and the Chapter asked medical teams heading for MIYAGI to move northward while confirming the medical needs of the coastal areas in the prefecture. As a result, these teams provided medical relief in municipalities such as NATORI, IWANUMA, and WATARI. In addition, dERUs were installed in front of the prefectural government office building to which many evacuees had rushed since the occurrence of the disaster, and at the same time, medical teams visited one evacuation center after another in SENDAI. Furthermore, medical teams that could serve as DMATs capable of wide-area transport were dispatched to the Ground SDF Camp Kasuminome in SENDAI.And other medical teams were instructed to head for the Ishinomaki RCHP. This was because it was determined that there should certainly be high medical needs as its buildings were not heavily damaged, making the hospital the only high-level medical institution that was functioning at that time while a wide area of the center of ISHINOMAKI where the municipal office was located had been inundated due to the tsunami and all other neighboring medical institutions were paralyzed.Subsequently, it was decided at a coordination meeting with health care workers in MIYAGI that all decisions on how to respond to medical needs should be left to the Ishinomaki area joint medical team based in the Ishinomaki RCHP. Meanwhile, it was decided that JRCS’s medical teams should withdraw from other areas.

there, and as a result, the Chapter could obtain information efficiently and liaised and coordinated with the parties concerned.Nonetheless, partly because the building where the Chapter was located sustained damage and a wide range of areas, particularly the three prefectures, were hit by the earthquake, the Miyagi Chapter could not function as a representative chapter for the 1st Block as a disaster activity base and consequently could not help but concentrate on disaster relief in MIYAGI.

At the Miyagi Chapter, a small number of personnel were being pressed to take many actions as they could not use PCs due to the power failure. Records of the day of the disaster are fragmentary with information on detailed movements of the Chapter HDC left unorganized. But according to the information received by the HDC at the Headquarters, at 3:35 p.m. the Fukushima Chapter informed the Headquarters that it had intercepted wireless communications between the Miyagi Chapter and the Ishinomaki RCHP, but it was at 4:50 p.m. that the Miyagi Chapter contacted the HDC at the Headquarters. Subsequent communications indicated that the Chapter was engaging in activities such as distributing relief supplies, confirming damage to hospitals, and gathering information on the needs of medical teams.Immediately after the earthquake, the top priority was given to maintaining the functions of the medical facilities and making effective use of the medical relief resources. Both the Sendai RCHP and the Ishinomaki RCHP requested the Miyagi Chapter to supply fuel oil within the day, and the Chapter managed to secure fuel oil by coordinating with the prefectural government and effectively using the procurement and logistic coordination capabilities of the prefectural government’s HDC. This also applied to food, water,

[The Miyagi Chapter HDC established in the prefectural government office building]　　　　　　　　　　　　　　　　　　　　　　　　

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Figure 1-12 Major Movements of the Miyagi Chapter HDC, Etc. after the Occurrence of the EarthquakeDate Time Description

3/11

2:46 p.m. The earthquake occurred.

3:35 p.m.

The Fukushima Chapter intercepted wireless communications between the Miyagi Chapter and the Ishinomaki RCHP. The Miyagi Chapter was confirming the damage that had been caused.

4:50 p.m. The Chapter contacted the Headquarters, providing information on the safety of personnel at the Ishinomaki RCHP.

9:30 p.m.

The Chapter contacted the Headquarters, saying that it needed 3,000 blankets; that all life lines had been disrupted; and that except for IP phones, fixed and satellite phones could get through.

10:05 p.m. The Chapter contacted the Headquarters, explaining about the conditions it faced and requesting relief supplies.

10:35 p.m. The Chapter instructed all medical teams currently heading for the Chapter to go to the Ishinomaki RCHP.

3/12

0:37 a.m.

The Yamagata Chapter contacted the Fukushima Chapter, saying that the life lines including the power supply of the Miyagi Chapter HDC had been paralyzed and that the Headquarters’ personnel had already joined the Miyagi Chapter.

8:50 a.m. The Chapter held preliminary discussions for its HDC in the prefectural government office building.

11:33 a.m.

The prefectural government requested JRCS to deploy all DMATs, including non-JRCS ones, but the Chapter left such deployment to the prefectural government’s medical coordination unit.

1:10 p.m.

The Chapter requested three medical teams to go to ISHINOMAKI (dERUs and 1 to 3 medical teams requested) and dERUs (Osaka) to be set up at the prefectural government office. It also planned to deploy dERUs in WATARI and requested three medical teams to head for IWANUMA. Medical teams from KYOTO and HIROSHIMA headed for ISHINOMAKI.

8:30 p.m.

The Ishinomaki RCHP informed the Chapter that it had not contacted all medical teams but that there were 40 to 50 evacuation centers and requested that at least 15 medical teams should be secured (for visits to evacuation centers and hospital support).

3/13

3:00 p.m.

The President arrived in SENDAI. Later, he met Internal Affairs and Communications Minister Yoshihiro Katayama, paid a courtesy call on the Governor, and gave a press conference.

6:10 p.m.

DMAT reported the Chapter the plan would change which is to withdraw on the morning of the following day to do so gradually.

10:25 p.m.

The Ishinomaki RCHP requested the Chapter to continuously send 20 medical teams a day (eight for hospital support and twelve for visits to evacuation centers) for the time being.

3/14

1:00 a.m.

The Chapter told medical teams working in FUKUSHIMA to head for the Ishinomaki RCHP because it could not guarantee safety due to the lack of information on the effects of radiation.

6:12 a.m.

DMAT in the prefectural government office requested the Chapter to install dERUs in the Ishinomaki Sports Park before 10:00 a.m. because disaster-prevention helicopters planned to start operations at 10:00 a.m., gather patients at the park by 3:00 p.m., and transport them to the Ground SDF’s Camp Kasuminome.

9:04 a.m. Transport of patients from ISHINOMAKI by disaster-prevention helicopters began.

10:40 a.m.

The Secretary General of the Tokyo Metropolitan Chapter informed the Miyagi Chapter that it had already coordinated with the parties concerned so that support personnel, who were currently being dispatched from the 2nd block’s Chiba Chapter, would be sent from the 3rd block next.

10:45 a.m. The Chapter was informed that dERUs had been set up at the Ground SDF’s Camp Kasuminome.

3/1511:25 a.m.

As a result of preliminary discussions with DMAT, it was decided that the triage team at KASUMINOME would retreat after the day’s work was over.

2:20 p.m.

In order to reduce the burden on the activities of the Ishinomaki RCHP, it was decided that first-aid stations should be installed at Hebita Junior High School and Senshu University (each dERU team).

3/16

11:30 a.m. The telephone and Internet lines returned to normal (cut off again at 12:40 p.m. but returned to normal at 2:00 p.m.).

3:00 p.m. Officials from the IFRC came to inspect the affected areas.

8:00 p.m.

A Staging Care Unit (SCU) operation conference was held at the prefectural government office. The SCU at the Ground SDF’s Camp Kasuminome retreated on March 16.

(2) Establishment of the HDCWith its small number of personnel assisted by the Headquarters and other chapters, under its Head and Deputy Head, the Miyagi Chapter’s initial HDC installed a supervisor each in one of its two organizations and in

the other, set up in the prefectural government office, and under each supervisor, it formed eight teams: relief coordination, relief supplies, volunteers, public relations, psychosocial care, recording, Gienkin , and communications.

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Figure 1-14 Number of Chapter Support Personnel by the Destination of the Dispatch and the Period of DispatchPeriod of the Dispatch

Destination of the dispatch March April May June July August Total

Miyagi Chapter 35 13 4 - - - 52Ishinomaki RCHP 12 12 4 4 5 - 37

Total 47 25 8 4 5 0 89Note 1: The periods of dispatch are classified according to the day when the dispatch began.Note 2: As for the Miyagi Chapter, 12 of the 35 for March, 4 of the 13 for April, and all of the 4 for May were sent from other chapters with the remainder dispatched from the Headquarters.

Figure 1-15 Damage to the Miyagi ChapterItem Damage Recovery, etc.

Building Collapsed walls, etc.Elevator Suspended operationsElectricity 3/11: Power failure The service returned to normal at 7:40 a.m.Power generator fuel (fuel oil) 3/11: Around 10:30 p.m., the generator

stopped working due to lack of fuel oil. Unusable

Fuel (gasoline) Insufficient Support from contract gas stations and support teams

City gas Unusable 4/9: The service returned to normal.Water supply and sewage Only water left was in the rooftop tank 3/15: The service returned to normal at 3:00 p.m.Fixed phone Only analog lines were usable. The optical line returned to normal at

the same time as the electricity.Mobile phone Mobile phones could not get through easily.Disaster priority phone, satellite-based phone, etc.

Disaster priority phones and satellite-based phones were usable.

JRCS business radio, etc.Part of the JRCS business radio was usable (The Chapter’s base stations could only receive radio waves while its mobile stations remained usable).

Part of the radio system remained unusable in some buildings and other places (not connected in the prefectural government’s auditorium).

Internet Unusable (for reasons on the part of the provider)

MCA wireless JRCS did not use MCA radio.The system was effectively used between the prefectural government, medical associations, and major medical institutions.

Food (for the HDC) Insufficient Support from the Yamagata Chapter

(3) Reception of chapter support personnelInitial support personnel from the Tokyo Metropolitan Chapter joined the Miyagi Chapter on the night of the day of the earthquake, and those from the Saitama Chapter on the following day. Later, support personnel from other chapters and the Headquarters continued to join the Chapter until April.In addition to the provision of support for hospitals by job type and the dispatch of assistants to medical coordinators as later described in Chapter 3, the Headquarters sent support personnel to the local HDC set up at the Ishinomaki RCHP.

(4) Damage to the ChapterThe ground around the consolidated prefectural government offices building (separate from the main building) part of which was occupied by the Miyagi Chapter subsided, and the building was cracked in places, but there was no problem with using it. Immediately after the earthquake, the power supply

was cut off, forcing the Chapter to use an emergency power source, but by around 10:30 p.m. on the day of the earthquake, the power source became unusable as the Chapter ran out of fuel oil. For this reason, the Chapter also established its HDC in the prefectural government, which had no problem with its life lines. Thus it decided to respond to the disaster at these two locations.

Organizational Structure of the Miyagi Chapter HDC

Head of the HDC Secretary General

Deputy Head of the HDC Deputy Secretary General

Supervisor Director leading disaster response Supervisor Director of the Operations Division

Relief Coordination Team Coordination of medical teams, etc. Relief Supplies TeamCoordination with and delivery to organizations such as municipalities

Relief Supplies TeamDuties such as coordination with the Headquarters and prefectural and municipal governments

Volunteers TeamEstablishment and operation of the disaster-response volunteer center

Public Relations TeamGathering and communicating information mainly from/to public relations officers at the Headquarters

Psychosocial Care TeamCoordination of psychosocial care services

Recording Team Gienkin Reception of funds

Recording Team Recording events chronologically

Headquarters in the ChapterHeadquarters in the prefectural government office

Recording events chronologically

：

：

：

：

：

：

：

：

：

：

：

Team Gienkin

* The Chapter responded to the needs of the affected areas by establishing the function of its HDC at two locations

* It maintained the functions of its Headquarters by receiving support personnel from the Headquarters and other chapters.

Figure 1-13 Organizational Structure of the Miyagi Chapter HDC (Immediately after the Occurrence of the Earthquake)

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The Chapter used satellite-based and disaster priority phones for communications. JRCS business radio could not be used because radio waves could not be received in the prefectural government’s auditorium where the Chapter’s HDC was located. The Chapter’s base stations could only receive radio waves and could not transmit them. In-vehicle mobile stations were usable.The MCA wireless system, which had been deployed since the Iwate-Miyagi Nairiku Earthquake of 2008, was used between the prefectural government and local medical associations and major hospitals.

(5) Cooperation and liaison with local governments and other related organizations

In MIYAGI, DMATs were dispatched until March 16, and after March 17, they were replaced by medical teams. When DMATs worked, the supervisory DMAT gave instructions on matters such as where DMATs should be sent. On the other hand, disaster medical coordinators joined the prefectural government’s HDC, starting to gather information on medical institutions in the prefecture and coordinate activities such as the transport of patients. The disaster medical coordinator is the Miyagi prefectural government’s system, commissioned by the governor, to coordinate the parties concerned so that medical care and relief are provided swiftly and appropriately if a massive disaster occurs in the prefecture. In addition to the six coordinators who had already been commissioned, six new coordinators were commissioned after the earthquake. As of April 2013, there were twelve commissioned disaster medical coordinators. Commissioned by the respective medical regions in the prefecture, disaster medical coordinators coordinate medical service at the prefectural government’s HDC or affected areas when a disaster occurs. Dr. Tadashi Ishii of the Ishinomaki RCHP had been commissioned to work as such just before the earthquake, an arrangement that greatly helped him to serve as a supervisor of the Ishinomaki area joint medical team after the occurrence of the disaster.At the prefectural government, a meeting of the government’s related divisions, disaster medical coordinators, JRCS, SDF, medical associations, Tohoku University, National Hospital Organization and other parties concerned was convened to share information on and coordinate medical relief activities. The number of medical teams required for medical relief was adjusted mainly through the prefectural government, JRCS, medical associations and Tohoku University. Information on medical teams dispatched by prefectural

governments nationwide was put together by the Miyagi prefectural government for its sharing. Many medical teams were continuously sent to the Ishinomaki region, supervised by Dr. Ishii, a disaster medical coordinator, by other prefectural governments’ support teams, National Hospital Organization, Japan Medical Association Team (JMAT), and so forth under the leadership of JRCS.The Chapter HDC received a request from the Ishinomaki RCHP for the transport of the sick and wounded each day and coordinated the means of transport on a daily basis with senior officers of the SDF with whom the Chapter had established favorable relationships since before the earthquake.Thus the favorable relationships that had been built with other organizations during normal times worked effectively and were helpful at the time of the disaster.Except for those associated with the temporary return of residents to the off-limits area in FUKUSHIMA, medical relief activities continued until October 2011, when they were taken over by a temporary clinic set up in ISHINOMAKI’s OGATSU area--the place where medical relief teams worked until most recently.

4. The Fukushima Chapter HDC(1) The Action Taken at the Time of the DisasterThe Fukushima Chapter established a HDC immediately after the earthquake, at 2:50 p.m. Fixed and mobile phones could not be used, but there was no problem with its building. The Headquarters began to gather information and distribute relief supplies.The Chapter planned to gather information from municipalities and other organizations making the most of the prefectural government’s disaster-prevention system, but due to damage to the government’s building and communications lines, the system did not work immediately after the disaster. In addition, there was

[Personnel who coordinated the transport of the sick and wounded with other organizations at the prefectural government office]　　

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the power station, had medical teams working in SHINCHI temporarily move to SHIROISHI, MIYAGI, and those in MINAMISOMA and SOMA to KAWAMATA. After they moved to KAWAMATA, these medical teams provided medical care to many people who had evacuated by supporting hospitals and visiting evacuation centers. As medical teams continued to work in other areas, the Chapter received many inquiries about how to operate in emergency clinical settings exposed to radiation (such as the anxiety of team members about exposure to radiation and the risk of continuing to work near the power station). It consulted with Headquarters and the Fukushima prefectural government about the possibility of wearing protective clothing during medical relief activities, but with the opinions of the three parties left uncoordinated, the Chapter cancelled its requests for medical relief activities in the prefecture at 7:30 p.m. on March 13. Later, except for the activities of medical teams from the Yamagata Chapter on March 15 and 16, support from other chapters’ medical teams was temporarily suspended, and only the Fukushima Chapter’s medical teams continued to work. Subsequently, when relief activities were resumed, medical teams located their base in FUKUSHIMA and AIZUWAKAMATSU, visiting scattered evacuation centers for medical care.

conflicting information at the prefectural government’s HDC, and it was also difficult to obtain information on medical institutions from the personnel dispatched. The Chapter obtained information through TV and other media, and after the telephone lines returned to normal, it surveyed the needs of the affected areas by making phone calls to municipalities in HAMADORI, the eastern part of the prefecture which were likely to be directly hit by tsunami. As a result, at 4:45 a.m. on March 12, it requested the Headquarters to dispatch twelve medical teams (including one Fukushima team) to the prefecture. Since medical teams had already been dispatched from various chapters or were heading for affected areas without waiting for requests for support. The Fukushima Chapter gave instructions to medical teams who had arrived in the prefecture as to their specific destinations (such as SHINCHI) mainly through wireless system for professional use.Later, the information circulated that a serious accident had happened at a nuclear power station. As it did not have enough time to obtain knowledge of and equipment for radiation medicine as well as accurate information on the accident, the Chapter, which was not sure whether it could maintain the safety of medical teams working near

Figure 1-16　Major Movements of the Fukushima Chapter HDC, Etc. after the Occurrence of the EarthquakeDate Time Description

3/11

2:46 p.m. The earthquake occurred.2:50 p.m. The Fukushima Chapter HDC was established.2:50 p.m. The Chapter could get through to its counterpart in MIYAGI on the radio system.3:01 p.m. The Chapter established (wireless) communications with the Ishinomaki RCHP.3:20 p.m. A Cable No. 2 system was established with the Headquarters’ Disaster Management Division.

6:16 p.m. The Niigata Chapter requested the provision of information, but the Fukushima Chapter replied, “We, too, have not been able to assess the degree of damage caused to the prefecture.”

6:30 p.m. The Fukushima RCHP dispatched its DMAT to Fukushima Medical University.8:04 p.m. TV news reported that the Fukushima Daiichi Nuclear Power Station had automatically stopped its operation, declaring a nuclear emergency.

8:55 p.m. The Tokyo Metropolitan Chapter called the Fukushima Chapter to gather information, saying that it could not contact its medical teams. The latter asked the teams to provide their sender with information on their condition.

9:15 p.m. The Chapter received a phone call saying that the Fukushima RCHP DMAT planned to return to the hospital and head for the Minamisoma City Hospital after preparations were over.

9:55 p.m.TV news reported that Chief Cabinet Secretary Yukio Edano had urged local residents to evacuate because radiation might have leaked from the Fukushima Daiichi Nuclear Power Station’s Unit 2, and that evacuation orders were issued for those who lived within 3 km of the power station with those who lived within 10 km instructed to remain indoors.

10:05 p.m. The DMAT of the Fukushima RCHP returned to the hospital and stood by.11:45 p.m. The Fukushima RCHP’s DMAT arrived at the Minamisoma City Hospital.

3/12

2:00 a.m. The Ishinomaki RCHP requested the Chapter to provide oxygen, gas cylinders, and blankets in large quantities.

4:00 a.m.The Chapter contacted the Hamadori municipal HDC to find out how much damage had been caused and whether support such as medical relief teams was needed. Requests included two medical teams for the Iwaki Fire-Fighting Headquarters, one for MINAMISOMA, three for NAMIE, three for SHINCHI, and two to three for NARAHA.

4:12 a.m. The Chapter requested the HDC at the Headquarters to send eleven medical teams for support.4:45 a.m. The Chapter requested the HDC at the Headquarters to send twelve medical teams for support.

4:55 a.m.Personnel sent to the prefectural government’s HDC contacted the Chapter, saying, “Since five of the DMATs that had arrived in the prefecture have already been dispatched to the SOSO area, it is difficult to meet the Fukushima Chapter’s request for medical teams. Tell us how urgently the Chapter needs medical teams.”

5:40 a.m. A medical team from the Narita RCHP reported that its helicopter had arrived at Fukushima Airport.

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7:10 a.m. The Headquarters requested the Chapter to provide information, asking it about the prefectural government’s policy toward relief activities near the nuclear power station.

9:00 a.m. The Chapter received the information that an SCU had been installed at Fukushima Airport as a base to transport critically ill patients to other unaffected areas.

3/12 4:40 p.m. The Chapter instructed medical teams engaged in relief work in SHINCHI to move to SHIROISHI, MIYAGI, through the Niigata Chapter’s medical team.

4:50 p.m. The Chapter’s HDC in the prefectural government office directly instructed medical teams working in SOMA to move to KAWAMATA for relief work, and at the same time, the government declared a nuclear emergency.

10:20 p.m. The Kochi Chapter’s medical team inquired to the Fukushima Chapter about how to handle those exposed to radiation.

10:55 p.m. The Chapter inquired to a doctor at Fukushima Medical University, who advised it not to handle those exposed to radiation but to leave them to the national and prefectural governments. It instructed the Kochi and Okayama Chapters to return their medical teams.

11:30 p.m. The Shiga Chapter’s medical team contacted the Fukushima Chapter, saying that its members might have diagnosed and treated patients suspected of exposure to radiation.

9:05 a.m. Through the Headquarters, the Chapter requested medical teams departing from that time onward to bring protective clothing with them because it was expected that those suspected of exposure to radiation were scattered in various places.

10:20 a.m. The Fukushima RCHP’s DMAT, which was working at Fukushima Medical University, was requested to take over the duties of the prefectural government’s DMAT supervisory Headquarters.

10:45 a.m. The Chapter requested the HDC at the Headquarters to advise those who planned to come to help its relief activities to bring protective clothing with them for caution’s sake.

10:50 a.m. The Chapter HDC requested the HDC at the Headquarters for support personnel.

3/13 11:03 a.m. In response to the HDC at the Headquarter’s inquiry, the Chapter requested it to continue the dispatch of seven of the twelve medical teams currently at work (The remaining five were working in SHIROISHI).

12:45 p.m. The President visited the chapter.

5:45 p.m.

The Chapter held a meeting to consider how medical teams should work in the radioactive environment (Participants included the Chapter’s personnel and medical teams; the Niigata Chapter coordinators; and doctors, head nurses, and administrators from medical teams). It asked the Headquarters to determine whether JRCS should provide medical relief in the radioactive environment but did not receive a reply to the question. As it was unable to maintain the safety of medical teams in the radioactive environment, the Chapter canceled its request for relief and support activities under its jurisdiction. For further instructions, the medical teams contacted the chapters and hospitals that had dispatched them.

8:30 p.m. The Fukuoka and Saga Chapters’ medical teams, which had been scheduled to arrive in FUKUSHIMA, were redirected to ISHINOMAKI.

3/14 6:45 a.m. The Kagawa Chapter’s medical team left for ISHINOMAKI, followed by teams from the Hiroshima, Kochi, Ehime, and other Chapters.12:55 p.m. With the prefectural government’s HDC confused, the activities of medical teams in the prefecture were unknown as no information was obtainable.

3/15 1:30 p.m. The Yamagata Chapter’s medical team arrived.

3/16 2:50 p.m. The Chapter’s personnel left for the Azuma Gymnasium. They transported materials and installed a first-aid station there.3:40 p.m. The Chapter requested the Aizu RCBC to survey evacuation centers, including Aizu Tsurugajo Gymnasium.

(2) Establishment of the Fukushima Chapter HDCImmediately after the occurrence of the earthquake, the Fukushima Chapter set up six teams under its Head and Deputy Head.After April, it slightly reviewed its organizational structure.

(3) Reception of the Chapter support personnelOn the day of the earthquake, support personnel from the Niigata Chapter joined the Fukushima Chapter, and later, those from chapters, blood centers, and other JRCS organizations also continued to join the Fukushima Chapter. The activity bases for medical teams in the prefecture were divided into two cities: FUKUSHIMA and AIZUWAKAMATSU. For this reason, the Chapter sent coordinators to AIZUWAKAMATSU, and other chapters and organizations also assigned support personnel there. These support personnel were indispensable to the Chapter as it engaged in relief work at two locations though it had only a small number of personnel.

Figure 1-17 Organizational Structure of the 　　　 Fukushima Chapter HDC

＜Day of the earthquake to the end of March＞Head Hisao OtaDeputy Head Shinichiro Watabe

Relief and Information Team

(The names of team members are omitted.)

Relief Supplies TeamVolunteer TeamLogistic TeamGienkin TeamOrdinary Business Coordination Team

＜After April 1, 2011＞ Head Hisao Ota (Left the Chapter on July 20, 2012)

Masayuki Anabuki (after July 21, 2012)Deputy Head Director Saito

Recovery Support Promotion Team

(The names of team members are omitted.)

Medical Team Coordination TeamRelief Supplies TeamVolunteer TeamGienkin TeamOrdinary Business Coordination Team

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Figure 1-18 Number of Chapter Support Personnel by Destination of the Dispatch and Period of the DispatchPeriod of the dispatch

Destination of the dispatch March April May June July August Total

The Fukushima Chapter 29 50 17 - - - 96Fukushima Prefecture Aizu Health and Welfare Office - 4 1 8 - - 13AIZUWAKAMATSU - 2 2 - - - 4

Total 29 56 20 8 0 0 113Note: The periods of dispatch are classified according to the day when the dispatch began.

Network, which consisted of the government, Fukush ima Med ica l Un ivers i ty , Fukush ima Medical Association, and other organizations, to gather information on evacuation centers and local communities, ensure information sharing among the parties concerned, register and receive human resources in medical care, and coordinate the destinations of medical teams dispatched. The Network set up a general meeting to coordinate medical care related to the GEJET. The meeting comprised organizations such as the prefectural government, Fukushima Medical Association, Fukushima Medical University, Fukushima Dental Association, Fukushima Hospital Association, Fukushima Nursing Association, and Fukushima Pharmaceutical Association, and its purpose was to share information among its members. Meanwhile, the prefectural government requested medical teams to voluntarily submit completed medical support registration forms.The prefectural government divides the prefecture into seven livelihood zones, and in the northern part of the prefecture and in the Aizu area, JRCS’s

(4) Damage to the ChapterThe Fukushima Chapter occupied a relatively new, independent building, nor was the power supply cut off. Therefore, it also functioned as a base of assembly for medical teams.At the Fukushima Chapter, satellite-based mobile and disaster priority mobile phones could not get through easily, but JRCS’s business radio could get through easily though it was sometimes affected by weather conditions.

(5) Cooperation and liaison with related organizations such as local governments

In FUKUSHIMA, the dispatch of DMATs was extended to March 21. After March 22, medical relief was provided separately by various groups: medical teams requested by the prefectural government, JMATs served as the organization to contact, JRCS’s medical teams, and organizations the prefectural government did not know (including activities by medical associations in the prefecture). The Fukushima prefectural government launched the Fukushima Prefecture Disaster Medical Support

Figure 1-19 Damage to the Fukushima ChapterItem Damage Recovery

Building No particular problem for business Parts of the inner walls collapsed slightly, but this had no direct effects on the Chapter’s operations.

Electricity No problem

Power generator fuel (fuel oil) Not activated

Water supply Water supply was cut off for about one week.

The administrative agency continued to supply water, and about one week later, the water supply returned to normal.

Sewage No problems

Fixed phoneFixed-phones could not get through easily during the several days after the earthquake, but later the service returned to normal.

Mobile phone Same as above

Disaster priority phone, satellite-based mobile phone, etc.

Satellite-based and disaster priority mobile phones could not get through easily.

As time passed, mobile and other phones gradually came to get through.

JRCS’s business radio, etc. JRCS’s business radio could get through easily.

Starting immediately after the earthquake, JRCS’s business radio was very helpful in communicating and coordinating with medical teams.

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information by sending personnel to the prefectural government’s HDC, made preparations for medical teams, chapter support personnel, and the transport of blankets, and took other necessary measures.

Figure 1-20 The Aomori Chapter’s Activities 　　　　　　　　　Immediately after the Earthquake

Date Time Description3/11 2:46 p.m. The earthquake occurred.

3:03 p.m. The Aomori Chapter HDC was established.3:20 p.m. One officer was dispatched to the prefectural

government’s HDC for communication and coordination.

3:23 p.m. The Hachinohe RCHP put one medical team on standby.

5:00 p.m. The chapter transported blankets to HIGASHIDORI.

5:12 p.m. The Hokkaido Chapter requested the Aomori Chapter to dispatch one medical team to support the Miyagi Chapter.

6:10 p.m. The Hachinohe RCHP’s medical team was dispatched.

6:45 p.m. The Chapter support personnel were dispatched.3/12 00:30 a.m. The chapter instructed the Hachinohe RCHP’s

medical team to head for ISHINOMAKI.02:22 a.m. The Hachinohe RCHP’s medical team arrived at

the Ishinomaki RCHP, where it merged with the chapter support personnel.

＜Major activities＞In the prefecture, the Aomori Chapter engaged in the following activities:Visiting various places in HACHINOHE for care

Starting on the day after the earthquake occurred, the Hachinohe RCHP voluntarily organized teams of nurses to visit various places in the city.

・ Period: March 12 to 16 (five days)・ Total number of nurses mobilized: 244・ Number of patients tended to: 323

Distribution of relief supplies

From the day of the earthquake to the following day, the Chapter distributed 937 blankets to seven municipalit ies in the prefecture.

(2) IBARAKI a. The Action Taken at the Time of the DisasterAfter the earthquake occurred, the Ibaraki Chapter established HDC. While the Mito and Koga RCHPs made preparations to dispatch medical teams, the HDC gathered information on disaster-response volunteers and other matters. Later, medical teams from within and outside the prefecture were sent to the affected areas.

medical teams played a leading role in medical relief activities. The balance of supply of and demand for medical teams was also adjusted on an area-by-area basis, and the prefectural government’s HDC obtained information on each zone through health and welfare offices and adjusted the balance by requesting local governments, hospitals, and other organizations that offered to dispatch medical teams to do so if it received requests for the dispatch of such teams through health and welfare offices.Starting from immediately after the earthquake, the Fukushima Chapter sent personnel to the prefectural government’s HDC to cooperate with the Network mentioned above and the Fukushima Prefecture Emergency Radiation Exposure Medical Coordination Headquarters & Fukushima Prefecture DMAT Coordination Headquarters. It also cooperated with local health and welfare offices mainly by sending personnel to meetings held at the Northern Fukushima Health and Welfare Office to coordinate the dispatch of medical teams when engaging in relief activities in northern FUKUSHIMA and AIZU and by sending personnel to operate the Aizu Area Disaster Medical Care Coordination Headquarters, which was set up at the Aizu Health and Welfare Office.

5. Other Chapters’ HDCSections 2-4 above described the HDC in the major affected areas, but other Chapters’ HDC also responded to the disaster in their respective prefectures.

(1) AOMORIa. The Action Taken at the Time of the DisasterSoon after the earthquake occurred, the Aomori Chapter established its HDC, which gathered

[The Fukushima Chapter HDC (March 15)]

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Facility name Destination Dispatch periodYamanashi RCHP

HITACHINAKAMar. 12 to 13

Matsue RCHP Mar. 13 to 15Masuda RCHP Mar. 15 to 17Koga RCHP OARAI Mar. 11 to 13Koga RCHP Mar. 13 to 14Yamaguchi RCHP MITO Mar. 13 to 15Yamaguchi RCHP Mar. 15 to 17

c. Distribution of relief supplies Starting on the day of the earthquake, the Ibaraki Chapter delivered relief supplies stored in its warehouse and municipal governments to evacuation centers in various places of the prefecture.

Figure 1-23 List of spot to which Relief Supplies 　　　(Blankets) Were Distributed

Distribution destinations Number of blankets distributedMITO 100 HITACHI 1,000TSUCHIURA 20KOGA 500ISHIOKA 720RYUGASAKI 500SHIMOTSUMA 230TAKAHAGI 1,340KITAIBARAKI 1,980KASAMA 480TSUKUBA 20HITACHINAKA 3,340HITACHIOMIYA 500NAKA 300CHIKUSEI 800KASUMIGAURA 70SAKURAGAWA 50KAMISU 500NAMEGATA 500HOKOTA 1,000OARAI 1,220SHIROSATO 10DAIGO 270AMI 1,000Mito RCHP 700

Total 17,150

In addition to the foregoing, the HDC distributed 1,060 sets of daily necessities (such as towels, bars of soap, and tooth brushes) stored in the Chapter’s warehouse to five areas in the prefecture.

(3) TOCHIGIa. The Action Taken at the Time of the DisasterIn the Tochigi Chapter’s jurisdiction, the Otawara RCHP was heavily damaged, and medical teams from within and outside the prefecture were dispatched to the hospital.

Figure 1-21　Ibaraki Chapter’s Activities Immediately after the Earthquake (Chronological)


3/11

2:46 p.m. The earthquake occurred.2:50 p.m. The Ibaraki Chapter HDC was established.3:00 p.m. The Mito RCHP put medical teams on stand by.3:45 p.m. The Koga RCHP became ready for receiving patients.

6:07 p.m. The Koga RCHP sent personnel to JR Koga Station to gather information.

8:35 p.m. The HDC started to distribute disaster relief supplies such as blankets to the affected municipalities.

10:00 p.m.Disaster-response volunteer leaders started to work at the Kitaibaraki municipal office (to gather information).

11:20 p.m.Volunteer amateur radio operators started to work at the Kitaibaraki municipal office (to gather information).

3/12

1:05 a.m. The Koga RCHP’s medical team started to work at Oarai Minami Junior High School.

3:40 a.m. The Haga RCHP’s medical team started to work at the Kitaibaraki municipal office.

9:00 a.m. The Headquarters requested the Tokyo Metropolitan Chapter to dispatch a medical team for support.

10:00 a.m.As the Mito RCHP was unable to dispatch its medical team, the HDC requested the Koga RCHP to dispatch its second medical team.

10:30 a.m.Disaster-response volunteer leaders and area leaders gathered, starting activities such as bringing in relief supplies, and the Ibaraki Chapter volunteer center was set up.

12:03 p.m. The Headquarters requested the Tokyo Metropolitan Chapter to send 8,000 500-ml bottles of water.

12:30 p.m. The Yamanashi RCHP medical team arrived at the Chapter HDC.

3:50 p.m. The HDC requested Consumer Cooperative Union (Coop) to cooperate in transporting relief supplies.

10:40 p.m.The prefectural government informed the HDC that scheduled blackouts would begin on the following day

3/18 4:00 p.m. Medical relief activities in the prefecture ended.

b. Medical relief activities In addition to the Mito RCHP’s and the Koga RCHP’s medical teams, the HDC sent medical teams from the Tochigi, Tokyo, Yamanashi, Shimane and Yamaguchi Chapters to evacuation centers in various places of the prefecture, including OARAI in order to provide relief to evacuees. Medical relief activities in the prefecture ended on March 18.

Figure 1-22 Results of the Activities of the Medical Teams in IBARAKI　　　　　

(Seventy-eight doctors from 11 medical teams)Facility name Destination Dispatch period

Haga RCHP

KITAIBARAKI

Mar. 11 to 13, 2011Omori RCHP Mar. 13Yamanashi RCHP Mar. 15 to 17

Mito RCHP Mar. 17 to 18

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RCHP temporarily evacuated its patients to parking lots in front of its building and other places, and on the night of the day of the earthquake, it evacuated some of its patients to Otawara City’s and Otawara High School’s gymnasiums. And four DMATs (one of them was a team from the Ashikaga RCHP) gathered at the hospital.On March 12, hospital personnel cleaned up the wards that were in a mess and made preparations for health care and transported the evacuated patients back to the hospital by city buses and ambulances. All patients retreated from the evacuation centers within the day. On the night of the day, a medical team from the Yamada RCHP arrived in OTAWARA, and on the following day, it visited various places of OTAWARA and NASU to provide medical care.

c. Distribution of Relief SuppliesRelief goods were supplied to JRCS branches, facilities, and so forth in TOCHIGI.

Figure 1-25 Supply of Relief Goods to JRCS branches, Other Facilities in TOCHIGI　　　　　　　

RecipientNumber of blankets supplied

Number of emergency sets

(daily necessities) supplied

Number of bedding (futon) sets supplied

UTSUNOMIYA 20 － 7NIKKO － 54 －OYAMA 20 － 7MOKA 20 3 7YAITA 111 5 2SAKURA 151 5 14NASUKARASUYAMA 7 － 2SHIMOTSUKE 19 － 8MASHIKO 20 －－MOTEGI 7 3 －TAKANEZAWA 20 － 7NAKAGAWA 10 － 5NASU 10 － 3Tochigi prefectural government 10,000 －－

Otawara RCHP 255 1 5189 simple beds

(Note) Except for the Tochigi prefectural government and the Otawara RCHP, relief goods were supplied on a JRCS branches

(4) CHIBAa. The Action Taken at the Time of the DisasterImmed i a t e l y a f t e r t h e o c c u r r e n c e o f t h e earthquake, in an effort to provide rel ief to victims, the Chiba Chapter started to dispatch medical teams, first contingents, and dERUs to the Tohoku region, which it assumed had sustained

Figure 1-24 Tochigi Chapter’s Activities Immediately after the Earthquake (Chronological)


3/11

2:46 p.m.The earthquake occurred.An order for a third-level relief regime was issued (The Tochigi chapter HDC was established).

3:26 p.m. An order to dispatch members of DMAT was issued.

3:28 p.m.The Otawara RCHP reported the damage caused to its facilities by wireless. The damage, including water leaks, was immense.

4:02 p.m.

The Otawara RCHP informed the HDC that nobody was injured with little damage to its building. It also reported that in cooperation with the Otawara municipal government, it had evacuated its patients to a gymnasium in the city and requested 250 blankets and drinking water.

4:26 p.m.

The HDC confirmed with the Otawara RCHP as to whether it could dispatch its medical team. The hospital replied that it could not because it was fully occupied with the caring of its patients and there was no time for anything else.

4:32 p.m.Preparations for the transport of the Chapter’s supplies were completed. These supplies left for the Otawara RCHP.

5:13 p.m.

The Otawara RCHP informed the HDC of its condition: its functions stopped due to a water cutoff; new patients could not be accepted; preparations for transferring its patients to Otawara City’s and Otawara High School’s gymnasiums were under way; and all hospital staff members were joining forces in caring for its patients.

7:00 p.m.The Haga RCHP was evacuating its patients as its north building wards had become unusable. All critically ill patients were transferred to the south building.

7:36 p.m.At the prefectural government’s request, the Ashikaga RCHP dispatched a DMAT to the Otawara RCHP.

5:30 a.m.The Kyoto Chapter’s medical team took a nap at JRCS’s conference room (and left for the Morioka RCHP at 7:30 a.m.).

3/12 1:59 p.m.

The Headquarters requested the Otawara RCHP to receive a medical team from the Mie Chapter’s Yamada RCHP, and the Head of the Administrative Department at the hospital informed the Tochigi Chapter that the Hospital Director consented to its reception.

9:40 p.m. The HDC set up rest areas in the conference room and the lecture room so that 20 persons could take a nap.

3/13

8:10 a.m.

The Tokyo Metropolitan Chapter asked the Tochigi Chapter whether in terms of equipment and facilities, the latter could be used as a collection and distribution center for relief supplies in the months to come. The Chapter replied that it could if its vehicles were removed from the garage.

10:10 a.m.

The prefectural government’s disabilities and welfare division advised the Chapter’s Secretary General that its arena could be used from the day, adding that it would let other organizations cancel their reservations for the subsequent ten days or so.

b. Medical relief activities Two medical teams were dispatched to TOCHIGI: a DMAT sent by Ashikaga RCHP to the Otawara RCHP and a medical team from MIE’s Yamada RCHP.Since its building sustained damage, the Otawara

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Figure 1-27 Distribution of Relief Supplies from the Chiba Chapter 　　　　　 after the GEJET (Including Those Delivered outside

the Prefecture)　　　　　　　　　　　　　　　

Item Number of items distributed Recipients

Blankets 15,670

KATORI, NARITA, FUTTSU, TOGANE, CHOSHI, YOKOSHIBAHIKARI, KUJUKURI, SAMBU, ASAHI, KATSUURA, ISUMI, ONJUKU, MINAMIBOSO, ICHINOMIYA, SHIRAKO, NARASHINO, and Narita AirportMIYAGI

Set of daily necessities 2,120 CHOSHI and KUJUKURI

MIYAGIGauze sets 930 CHOSHI and SAMBU

Bath towels 1,010 NARITA, SAMBU, CHOSHI, KUJUKURI, and ISUMI

Bed sheets 700 ISUMI and SAMBUSleeping sets 1,000 MIYAGI

Emergency kits 366 ASAHI, ISUMI, MINAMIBOSOMIYAGI and FUKUSHIMA

(5) TOKYOOn the day of the earthquake, mainly due to the suspension of public transport services, there were over 3.5 million stranded people in TOKYO. Many public facilities provided lavatories and rest areas, and the Tokyo Metropolitan Chapter also opened its building to the stranded, distributed food and beverages to them in cooperation with volunteers, and provided road information and places for sleeping.At first, the Tokyo Metropolitan Chapter opened only its lobby on the first floor to help the stranded, but around at 5:00 p.m., in order to prevent confusion, it decided to receive them in its other facilities in the building. It let the stranded use lecture rooms on the second floor, an arrangement that continued until 10:00 a.m., when the last of the people who stayed there left. Over 2,000 people used the lavatories and other facilities, and about 120 stayed overnight.In addition, at the Shinjuku ward office’s request, the Chapter delivered relief supplies (Ritz crackers and drops) to Okubo Elementary School, where 150 to 160 evacuees had gathered, at 11:30 p.m. on the day of the earthquake. Moreover, at 0:10 a.m. on March 13, it sent volunteers (relief volunteers and Red Cross youth volunteers) to Okubo and Hanazono Elementary Schools and Nishiwaseda Junior High School. And after it guided the evacuees from Okubo Elementary School to Okubo Junior High School, the Chapter distributed blankets at the elementary school. It also installed aid stations along trunk roads in CHOFU on the night of March 11 and in KOKUBUNJI on the following morning. At these

immense damage.At the same time, at the request of the prefectural government and municipal ones, it urgently delivered blankets and other goods that it had stored to the affected areas in the prefecture with the cooperation of Chiba Coop (The Chiba Chapter has entered into an agreement with the Coop on the transport of goods at the time of a disaster). In addition, having obtained information on many stranded people, it sent a medical team each to Tokyo Disneyland and Narita Airport from the Narita RCHP in order to look after the sick there.

Figure 1-26　Chiba Chapter’s Activities Immediately 　　　　　　 after the Earthquake (Chronological)

Date Time Description3/11 2:46 p.m. The earthquake occurred.

3:00 p.m. The Chapter sent personnel to the prefectural government’s Fire-Fighting and Earthquake Disaster Prevention Division to obtain information.

3:15 p.m. The Chapter sent personnel to the Chiba Municipal government to obtain information.

3:15 p.m. The Chiba Chapter HDC was established.3:55 p.m. The HDC held its first meeting and decided

to request two medical teams to get ready for dispatch.

4:13 p.m. At the Narita RCHP, two medical teams completed preparations and waited for instructions.

5:25 p.m. The HDC requested the Coop in Chiba to transport relief supplies.

7:20 p.m. The HDC held its third meeting and confirmed the information that there were 40,000 to 50,000 evacuees at Tokyo Disneyland and 2,000 at the airport.

10:10 p.m. Four medical teams arrived at Narita Airport.3/12 0:58 a.m. Three medical teams arrived at Tokyo Disneyland.

1:40 a.m. Personnel dispatched to URAYASU to gather information joined the Urayasu Municipal HDC

b. Distribution of Relief SuppliesThe amount of supplies distributed to the prefecture alone is unknown, but relief goods such as blankets, including those delivered to prefectures other than CHIBA, were distributed as follows:

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stations, volunteers helped stranded people mainly by providing road information and supplying drinking water.

(6) NAGANOa. Earthquake Situation Immediatly after the

Disaster OccuredAt 3:59 a.m. on March 12, 2011, an earthquake registering a magnitude of 6.7 on the Richter scale whose epicenter was TSUNAN occurred in northern NAGANO, and a seismic intensity 6 upper was registered in SAKAE and 5 lower at NOZAWAONSEN.The damage caused by this earthquake in the prefecture was as listed below.

Figure 1-28 Casualties and Damage to HousesCasualties Three persons died.

Twelve persons were slightly injured (ten in SAKAE, one in NOZAWAONSEN, and one in NAGANO).

Damage to houses

Thirty-three houses were totally destroyed in SAKAE and one in IIYAMA.A total of 169 houses were half destroyed in SAKAE.A total of 486 houses were partly destroyed in SAKAE, 14 in IIYAMA, and one in NOZAWAONSEN.

Figure 1-29 Evacuation (as of 2:00 p.m. on March 14)Number of evacuees

1,630 (from the entire village of SAKAE, excluding the AKIYAMA area)

Evacuation centers

Francaise Yusakae (home for elderly people requiring special care), Mitsukuri community center, Sakae village government office, Hokushin Elementary School, Kitanotenman hot spring resort, Sakae Junior High School cafeteria, and Tobu Elementary School

b. The Action Taken at the Time of the DisasterImmediately after the Northern Nagano Earthquake of March 12 occurred, the Nagano Chapter HDC was established and dispatched personnel to the affected areas. Meanwhile, the Azumino and Iiyama RCHP sent

[A lecture room on the second floor was provided as a lodging place]

medical teams to SAKAE, where the team members visited various places in the village for medical care. The team worked there from March 12 to 14.In SAKAE, the Chapter distributed 4,200 blankets, 210 sleeping sets, and 108 emergency kits.

Figure 1-30 Dispatch of Medical Teams, Etc.

Facility name Number of personnel Description Destination

Azumino RCHP 8 Medical team members

SAKAE

Iiyama RCHP 7

The Nagano Chapter 3 Personnel from the local HDC

5 Personnel to transport relief supplies

The Nagano Chapter’s medical team 2

Total 25

6. Initiatives of the national and local governments as well as other related organizations after the earthquake

(1) Central Disaster Management CouncilAfter the earthquake , the Centra l Disaster Management Council held its meetings at the Prime Minister’s Official Residence on April 27, October 11, and December 27, 2011, and on March 29 and September 6, 2012, and the JRCS President, a Council member, attended these five meetings.Taking into consideration the fact that the GEJET was of a far greater magnitude and caused far more serious damage than had been assumed, the Council established the Committee for Technical Investigation on Countermeasures for Earthquakes and Tsunamis to examine how disaster-prevention measures should be reviewed, including whether sufficient preparations had been made for disasters. Based on the final report of the committee, the Council set up Committee for Policy Planning on Disaster Management and reviewed the related legal systems such as the Disaster Countermeasures Basic Act as typified by the revision of the Basic Disaster Prevention Plan.

(2) Committee to Examine How Disaster Medical Care, Etc.

As it was recognized that disrupted life lines, lack of fuel, and other factors affected the diagnostic and therapeutic functions of some medical institutions as they responded to the GEJET, this Committee was established to further improve the disaster medical care system in the future as the government was

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(4) The Council for the Alleviation of Subterranean Urban Earthquake Commuter Distress

The Council for the Alleviation of Subterranean Urban Earthquake Commuter Dis tress was established in September 2011. In order to ensure that comprehensive measures would be taken through self-help, mutual help, and public help to cope with Council for the Alleviation of Subterranean Urban Earthquake Commuter Distress, it aimed to share information on the initiatives of the national and local governments as well as businesses and other organizations and examine cross-sectional issues that should be addressed through mutual cooperation and collaboration. Co-chaired by the Director General for Disaster Management at the Cabinet Office and the Vice Governor of Tokyo, the Council consisted of related government agencies, local governments, economic organizations, public means of transport, and so forth, and JRCS was represented by the Executive Director General for the Operations Sector. Based on the results of the verification of the effectiveness of measures taken to cope with stranded people after the GEJET, the Council considered the current specific initiatives and cooperative measures in various areas such as controlling number of people who try to return home simultaneously and securing temporary facilities to allow them to stay on. In September 2012, it put together a final report.

faced with issues to be addressed in disaster medical care, etc., including the necessity of building systems to support medical care, nursing care, and so forth over a period of several months.Cha ired by Prof . Yasuhiro Otomo of Tokyo Medical and Dental University Graduate School, the Committee consisted of representatives from medical organizations as well as municipalities and medical institutions in the affected areas. JRCS was represented by Dr. Masafumi Naito, Head of the Emergency and Critical Care Center at the Nagaoka RCHP and Mr. Daisuke Takakuwa, Director of the Procurement Division at the Musashino RCHP.The Committee held its first session at the MHLW on July 23, 2011, followed by three sessions in subsequent months. In October, it submitted a report on how disaster core hospitals should be, including their facilities and functions, and on medical care delivery systems at the time of disaster. The results of these examinations were reflected on the FY2011 supplementary budget related to recovery from the earthquake.

(3) Liaison Council to Support the Health of Victims

In order to support the health of victims of the GEJET, the Liaison Council to Support the Health of Victims, which comprised medical and nursing care organizations, was set up in April 2011. The Liaison Council was established under the government’s special response Headquarters to support the lives of victims, and at the Headquarters’ request for cooperation, it is engaged in initiatives required to (1) ensure the medium- to long-term dispatch of medical teams to the affected areas in order to meet their medical needs and (2) identify health needs in the affected areas, particularly in the evacuation centers, and maintain the health of the victims, including protection from infectious diseases.As of March 2012, it consisted of 18 medical organizations (34 groups), including the Japan Medical Association. JRCS had not participated in the council since its establishment, but determined that it was beneficial to cooperate with other medical organizations, including through information sharing, thus it sent Dr. Atsushi Katsumi, Head of the Emergency Department 2 at the Musashino RCHP, to serve on the council starting from its ninth session.

Provision of Medical Relief

Chapter 2

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1. Mobilization of Medical Teams(1) Policy of Dispatching Medical Teams and

their Initial Mobilizationa. Relief Services by the Japanese Red Cross Society (JRCS)The JRCS provides medical relief services as the prime activity of its disaster relief operations. To this end, the JRCS Headquarters and chapters organize medical teams consisting of registered medical team staff engaged in relief operations.In principle, a medical team consists of 6 staff (i.e., 1 doctor, 1 nurse leader, 2 nurses, and 2 administration staff). The number of care staff is likely to increase or decrease due to requirements for additional staff, including pharmacists, midwives, etc. The medical teams are dispatched for the following three purposes within the scope of their activities; i.e., medical aid, midwifery care, and cadaver processing. They also provide medical relief at makeshift aid stations while setting up a mobile clinic to provide medical care in the disaster-affected areas and disaster shelters, etc.

b. Initial Mobilization(a) Number of Medical Teams Initially MobilizedThe medical teams provided medical aid services at the disaster sites on and after March 11, the day the Great East Japan Earthquake and Tsunami (GEJET) occurred.55 initial medical teams were mobilized on March 11, including 22 JRCS Disaster Medical Assistance Teams (DMATs). The sites of services included IWATE with 11 teams, MIYAGI with 24 teams (the majority were assigned within the Ishinomaki limits), FUKUSHIMA with 7 teams, transferring from FUKUSHIMA to IWATE with 1 team, from MIYAGI to IWATE with 1 team, from FUKUSHIMA to MIYAGI with 4 teams, and

others with 7 teams (TOCHIGI with 1 team, IBARAKI with 4 teams, and CHIBA with 2 teams).

(b) Questionnaire Surveys of the Initial Medical TeamsA series of questionnaire surveys of the initial medical teams were carried out between August and September 2011. 49 teams responded to this survey. According to the survey results, the mobilization order was released mostly by the chapter that the respondent belonged to (65%), followed by the “sole discretion of the hospital” (25%). However, these respondents also selected other choices, while only 6% (3 teams) chose only the “sole discretion of the hospital”. On the other hand, a few respondents selected the chapters in the disaster-affected areas and Headquarters, which suggests that many of the teams seem to have decided on the mobilization according to the chapter or block representative chapter that they belonged to. Almost half of them knew their dispatch destination, etc., at the time of mobilization, and the remaining half started without knowing their destination.As for the role of the initial medical teams, 91% of respondents answered “it was highly significant to carry out the operations while collecting information”. Asked about the role or skills of the initial medical teams that should be improved in the future, many answered “to secure information communications equipment (49%)”, and “to define the line of communications (39%)”.

Chapter 2　Provision of Medical Relief

・ To provide medical and midwifery care services for disaster victims needing medical care ASAP, as well as cadaver processing (excluding temporary storage) in the disaster-affected areas.

・ To fill the void of medical care for local medical establishments undergoing a loss of functions due to the disaster.

・ To operate a mobile clinic to provide medical care, etc. and provide emotional support for the evacuees.

[Departure ceremony for the medical teams]


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edical Relief

Figure 2-1　Summary of the Initial Medical TeamsBlock /

Prefecture Facility Name Team Type No. of Staff Destination Prefecture Site of the Services

Headquarters JRCS Medical Center dERU-1 Team 14 MIYAGI Ishinomaki Red Cross Hospital (RCHP)Headquarters Medical Center DMAT-1 Team 5 FUKUSHIMA / MIYAGI Minamisoma Municipal General Hospital, Shinchi →Shiraishi

1 AOMORI Hachinohe RCHP Medical-1 Team 9 MIYAGI Ishinomaki RCHPIWATE Morioka RCHP dERU-1 Team 14 IWATE Yahaba Prefectural Fire AcademyMIYAGI Ishinomaki RCHP Medical-1 Team 5 MIYAGI ISHINOMAKIMIYAGI Ishinomaki RCHP Medical-1 Team 3 MIYAGI ISHINOMAKIMIYAGI Sendai RCHP Medical-1 Team 4 MIYAGI Sendai Medical CenterAkita Akita RCHP Medical-1 Team 8 MIYAGI / IWATE Information gathered at MIYAGI - IWATEFUKUSHIMA Fukushima RCHP DMAT-1 Team 5 FUKUSHIMA Minamisoma Municipal General Hospital

2 IBARAKI Furukawa RCHP Medical-1 Team 8 IBARAKI OARAITOCHIGI Ashikaga RCHP DMAT-1 Team 4 TOCHIGI Otawara RCHPTOCHIGI Haga RCHP Medical-1 Team 7 IBARAKI Kita-Ibaraki City OfficeTOCHIGI Haga RCHP DMAT-1 Team 5 MIYAGI Sendai Medical CenterTOCHIGI Ashikaga RCHP Medical-1 Team 7 MIYAGI Ishinomaki RCHP and shelters around the affected areaGUNMA Maebashi RCHP DMAT 1 Team 8 FUKUSHIMA Fukushima Medical UniversitySAITAMA Saitama RCHP DMAT-1 Team 6 MIYAGI Sendai Municipal Nanagou Elementary SchoolSAITAMA Fukaya RCHP DMAT-1 Team 6 MIYAGI Sendai Medical Center / Sendai City Municipal HospitalSAITAMA Fukaya RCHP Medical-1 Team 7 MIYAGI Ishinomaki RCHPCHIBA Narita RCHP Medical-1 Team 7 MIYAGI Ishinomaki RCHPCHIBA Narita RCHP Medical-3 Team 7 MIYAGI Tokyo DisneylandCHIBA Narita RCHP Medical-4 Team 7 CHIBA Narita AirportTOKYO Omori RCHP Medical-1 Team 7 IBARAKI KITA-IBARAKITOKYO Musashino RCHP DMAT 1 Team 7 FUKUSHIMA / IWATE Fukushima Medical University → Iwate Medical University → Iwate Prefectural Ofunato HospitalKANAGAWA Minato RCHP DMAT 1 Team 5 FUKUSHIMA Fukushima Prefectural Medical UniversityKANAGAWA Hatano RCHP DMAT 1 Team 8 MIYAGI Sendai Medical CenterKANAGAWA Minato RCHP Medical-3 Team 7 MIYAGI Ishinomaki RCHPNIIGATA Nagaoka RCHP Medical-1 Team 7 MIYAGI Ishinomaki RCHPNIIGATA Nagaoka RCHP DMAT-1 Team 7 FUKUSHIMA / MIYAGI Fukushima Prefectural Medical University →Shinchi →Shiraishi

3 TOYAMA Toyama RCHP DMAT 1 Team 6 MIYAGI Ishinomaki RCHPFUKUI Fukui RCHP DMAT-1 Team 8 MIYAGI Sendai Medical Center / Sendai Municipal Komatsushima Elementary SchoolFUKUI Fukui RCHP Medical-1 Team 7 IWATE MORIOKA, Rikuzentakata Daiichi Junior High SchoolYAMANASHI Yamanashi RCHP DMAT-1 Team 8 IBARAKI Hitachinaka Shiawase PlazaNAGANO Suwa RCHP DMAT-1 Team 6 IWATE Kamaishi Citizen HospitalNAGANO Nagano RCHP DMAT-1 Team 7 FUKUSHIMA Fukushima Prefectural Medical UniversityGIFU Gifu RCHP Medical-1 Team 8 IWATE Rikuzentakata Daiichi Junior High SchoolGIFU Takayama RCHP Medical-1 Team 8 IWATE Rikuzentakata Daiichi Junior High SchoolSHIZUOKA Shizuoka RCHP Medical-1 Team 12 IWATE KAMAISHI / OTSUCHI SHIZUOKA Hamamatsu RCHP Medical-1 Team 8 IWATE KAMAISHI / OTSUCHI AICHI Nagoya Daiichi RCHP Medical-1 Team 6 MIYAGI Shiraishi City Office / Ishinomaki RCHPAICHI Nagoya Daini RCHP DMAT-1 Team 5 IWATE Hanamaki Airport SCUAICHI Nagoya Daini RCHP Medical-1 Team 6 MIYAGI Shiraishi City Office / Ishinomaki RCHP

4 SHIGA Otsu RCHP DMAT-1 Team 6 FUKUSHIMA Fukushima AirportSHIGA Nagahama RCHP Medical-1 Team 8 FUKUSHIMA Hamanasu-kan, etc.KYOTO Kyoto Daiichi RCHP DMAT-1 Team 8 MIYAGI Around Ishinomaki RCHPOSAKA Osaka RCHP dERU-1 Team 15 MIYAGI In front of the MIYAGI Prefectural OfficeHYOGO Kobe RCHP dERU-1 Team 13 IWATE Suzuko Plaza First-Aid StationWAKAYAMA Wakayama RCHP Medical-1 Team 10 IWATE MIYAKO / YAMADA TOTTORI Tottori RCHP DMAT-1 Team 6 FUKUSHIMA Fukushima Airport

5 SHIMANE Matsue RCHP DMAT-1 Team 10 MIYAGI Ishinomaki RCHPSHIMANE Masuda RCHP DMAT-1 Team 5 IWATE Hanamaki AirportOKAYAMA Okayama RCHP Medical-1 Team 7 FUKUSHIMA Koseikai Kawamata HospitalHIROSHIMA Hiroshima Genbaku RCHP Medical-1 Team 9 MIYAGI Ishinomaki RCHPKAGAWA Takamatsu RCHP dERU-1 Team 14 FUKUSHIMA / MIYAGI Tamura City Gymnasium / Self Defence Force (SDF) Kasuminome Air FieldKOCHI Kochi RCHP Medical-1 Team 9 FUKUSHIMA / MIYAGI TAMURA / Ishinomaki RCHP

6 KUMAMOTO Kumamoto RCHP Medical-1 Team 10 MIYAGI Ishinomaki RCHP

44


Figure 2-2　Mobilization order to the initial 　　　　　　 medical teams (multiple answers)

Figure 2-5　Role and skills of the initial medical teams 　　that should improve in the future

(Multiple answers)　　　　　　

Figure 2-3　Destination of the initial medical 　　　　　　teams at the time of calling-out

Figure 2-4　Role of the Initial Medical Teams, etc.

20.4%

65.3%

24.5%

4.1%

8.2%

10.2%

16.3%

0.0%

0% 20% 40% 60% 80%

Block representativechapter

The Chapter

Judgment at the hospital’s own discretion

The Chapter in the disaster-affected area

Headquarters

IntegratedDMAT Headquarters

Others

DK

(n=49)

38.8%

18.4%

22.4%

18.4%

18.4%

49.0%

30.6%

16.3%

12.2%

32.7%

4.1%

12.2%

8.2%

2.0%

0.0%

0% 10% 20% 30% 40% 50% 60%

To clarify the reporting line on site

To cooperate with DMAT

To cooperate with local medical institutions

To provide safety equipment for the team members

To clarify the service criteria at Nuclear, biological and chemical (NBC) disasters (including nuclear accidents)

To secure information communications equipment

To liaise and coordinate with the related local organizations

To liaise and coordinate with the related JRCS staff

To understand / assess the situation of the evacuation shelters, etc.

To understand / assess information on the site / people requiring first aid after the initial service

To have skills/equipment for triage

Necessary medical tool to be secured

Patient transfer methods

Others

DK

(n=49)

Others22.9%

DK0.0%

(n=48）

Destination that the prefecture had instructed without any further specific information. 8.3%

Only instructed to head for the Tohoku District. 18.8%

The destination hospital or shelter, etc., had been instructed. 47.9%

Destination city / town / village had been instructed, although without any further specific information.2.1%

(n=44)

A few medical teams called out initially in order to collect information** 6.8%

First called out, although with insufficient information collected*90.9%

Others 2.3% DK　

0.0%

* It was highly significant for the teams to be called out to provide services while collecting information, although with insufficient information collected at that time.** A more desirable arrangement was to call out a few teams to collect information, and then to deploy more teams after collecting a certain amount of information.

c. Deployment of dERUJRCS owns 20 units of domestic Emergency Response Unit (dERU); 14 of which were used in GEJET. In addition, the Kumamoto Chapter also dispatched medical teams include large special vehicles for medical care (“Disaster Rescue”), wing box trucks carrying large tents and relief supplies, and crane trucks loaded with forklifts, etc.

d. Deployment of “Air Ambulances”On the day following the disaster, responding to a request from DMAT Headquarters, a Dohoku air ambulance was called out from Asahikawa RCHP to Hanamaki Airport, IWATE, the hub point for DMAT. The air ambulance from the same hospital transferred 10 patients, responding to requests for deployment from outside IWATE, including ISHINOMAKI (Municipal Hospital), SENDAI (Tohoku University Hospital), etc.In the morning of the same day, March 12, an air ambulance was dispatched by Maebashi RCHP, GUNMA to Fukushima Medical University Hospital, then further to Hanamaki Airport where the Staging Care Unit (SCU) was set up. The air ambulance from the same hospital served from March 12 to 15, providing intra-regional transfer service for 13 patients.


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In addition, the April 7 notification, stipulated that medical teams shall successfully submit their activity reports.

Figure 2-6　Form of the “Activity Report by JRCS 　　　　　　　　　Medical Teams for the Tohoku District-Off 　　　　　　　the Pacific Ocean Earthquake for FY2011”

Figure omitted

As the relief activities were expected to extend over a long period of time considering the magnitude of the disaster, JRCS explored the possibility of establishing, in addition to hospitals and disaster shelters, independent RC First Aid Stations at the hub points of the relief activities, similar to those established in the Great Hanshin Awaji Earthquake. The Society initially sought to establish a Station in Ishinomaki District, one of the hardest-hit areas, but never put it into practice because many medical teams and related entities other than JRCS joined forces to provide services. Since then, the First-Aid Station set up at Suzuko Plaza, KAMAISHI, IWATE has carried out this function.

f. Deployment of Medical CoordinatorsThe HDC at the Headquarters released a notice as of March 18, entitled “Dispatch of Medical Coordinators from the HDC at the Headquarter (Request)”, that Dr. Atsushi Katsumi of Musashino RCHP to be asked and deployed affected area as a medical coordinator for the medical team newly set up at the HDC.According to the notice released, the medical coordinator will play the following three roles.

The deployment was determined to start on March 18, 2011, .The medical coordinator communicated with local government authorities and medical professionals in the affected areas, ensuring liaison and coordination to provide advice and guidance with respect to medical services.On the other hand, local medical professionals in the affected areas, including Dr. Naohiko Kubo (Director of the HDC, Morioka RCHP, IWATE), Dr.

e. Announcement of the Policy and Outline of Medical Teams Deployment

(a) Policy for the deployment of medical teamsAfter the disaster , each chapter dispatched medical teams to the disaster affected areas at their own judgment and discretion. On March 13, the Headquarter of Disaster Control (HDC) at the Headquarters published a notice to the Block Representative Chapters (BRC), entitled, “Policy for the Future Dispatch of Medical Teams to the Pacific Coast of Tohoku Earthquake Disaster-Stricken Areas (Draft) with the following policy.

(b) Outline of the Deployment of Medical Teams As the means of communication was restored by March 18, HDC at the Headquarters released notifications, entitled, “Outline of the Dispatch of Medical Teams to the Pacific Coast of Tohoku Earthquake Disaster-Stricken Areas for FY2011” to require the medical teams to submit their activity reports, etc. The outline defined the following.

・To provide continuous deployment in order to ensure a nationwide medical service by block. For the time being, the teams served mainly in IWATE and MIYAGI (and FUKUSHIMA depending on local needs) which suffered serious damage.

・As long as they are available, counselors for psychosocial care staff will accompany the teams.

・The actual working days per unit shall not exceed 3 days (excluding the transfer).

・Each BRC shall send a list of its medical teams to the HDC of the three disaster-affected Chapters (IWATE, MIYAGI, FUKUSHIMA) as well as the HDC at the Headquarters upon the departure of such medical teams.

・Each medical team shall report their arrival to the Chapter HDCs in the three disaster-stricken prefectures upon arriving at the service sites.

・A half-day briefing shall be arranged to hand over duties by the medical teams returning to the Headquarters.

・Each medical team shall report the number of people it provided services to from 0:00 to 24:00 on the previous day to the Chapter HDC in the three affected prefectures by 20:00 the next day, using the form of the “Activity Report by JRCS Medical Teams for the Pacific Coast of Tohoku Earthquake for FY2011”.

・Each medical team shall report the time of departure from the local site to the HDC of three affected chapters at the end of the services and return to the Headquarters.

・The HDC of the three affected chapters shall provide periodical reports submitted by each medical team, reporting them to the HDC at the Headquarters by 22:00.

・ To liaise and coordinate with respect to the disaster-affected areas and medical needs

・ To request deployment and examine the details・ To provide guidance and advice on deployment

policy

46


to shelter to provide medical care and psychosocial support in the recovery period. In addition, each prefecture shall continue its current structure until the end of May.

Figure 2-8　Deployment system after AprilFigure omitted

The notice released on May 13, titled, “Future Policy to Dispatch JRCS Medical Teams to GEJET Disaster-Stricken Areas” laid out the direction to phase down their medical services in all three prefectures.

Figure 2-9　Deployment system after MayFigure omitted

The notice released on June 14, entitled “Policy to Dispatch JRCS Medical Teams to the GEJET Disaster-Stricken Areas after July”, indicated a plan for the withdrawal from some of the areas because of the decreasing need for their medical services.

Figure 2-10　Deployment system after JulyFigure omitted

The notice released on July 14, titled, “Policy to Dispatch JRCS Medical Teams to the GEJET Disaster-Stricken Areas after August”, was released to inform that more coordinated efforts shall be made to withdraw the teams from the disaster-stricken areas, except some of the areas.

Figure 2-11　Deployment system after AugustFigure omitted

The notice released on August 19, entitled “Activities by JRCS Medical Teams at the GEJET” announced the following information that Disaster Management and Social Welfare Department at the Headquarters shall be made responsible for the services.

Yoichi Watanabe (Assistant Director of Fukushima RCHP, FUKUSHIMA) and, Dr. Ishii (Director of the Medical Social Services Department, Ishinomaki RCHP, MIYAGI) played the role of such a medical coordinator for JRCS medical services.

(2) Number of Deployed Medical Teams a. Changes in the Number of Deployed Medical Teams (a) Deployment of Medical Teams by BlocksSubject to the notice released by the HDC at the Headquarters on March 15, entitled, “Medical Team Activities for the Tohoku Earthquake Disaster-Stricken Areas”, it was decided to continue the following scheme for medical teams at their destinations considering the deployment status of dERU.

Figure 2-7　Deployment status of dERU and 　 its subsequent deployment scheme

Deployment areas

Representative chapter

Chapter of affiliation In the future

IWATE 1B-IWATE4B-HYOGO

1B4B (HYOGO)

MIYAGI (excluding Ishinomaki HP)

2B-TOKYO 2B-SAITAMA 2B3B4B (OSAKA)

3B-AICHI4B-OSAKA

5B-KAGAWAIshinomaki RCHP

Headquarters6B-FUKUOKA 6B-KUMAMOTO 6B

FUKUSHIMAConsultation with BRC as necessary.

(Note) “B” stands for Block

On March 22, the destinations of the medical teams were reviewed and coordinated by block to ensure their continued services; specifically, as follows.

(b) Cutting down to smaller medical teamsThe notice released on April 8, entitled “Future Policy to Dispatch JRCS Medical Teams to GEJET Disaster-Stricken Areas”, announced the following deployment system considering the need for continued services by medical teams, mainly including traveling from shelter

・To IWATE, medical teams from the 1st, 2nd and 4th blocks will be dispatched.

・To MIYAGI, medical teams from the 3rd, 5th and 6th blocks will be dispatched.

・To FUKUSHIMA, medical teams will be dispatched from all blocks.


Chapter 2

　

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edical Relief

All medical teams deployment was arranged by the Headquarters and 47 Chapters. As for the 1st Blocks medical teams, in addition to the activities for affected areas within their own prefectures, the Hokkaido and Akita teams mainly served RIKUZEN-TAKATA, and the Yamagata team mainly served AIZU. Many teams from the 2nd Block served in KAMAISHI, ISHINOMAKI, the northern area of FUKUSHIMA and AIZU. The 4th block mainly provided services in YAMADA, IWATE; while the SHIGA and KYOTO teams were engaged in many activities in AIZU. The 3rd, 5th and 6th Blocks mainly served in ISHINOMAKI, MIYAGI. As mentioned in the previous paragraph, these characteristics were due to the reorganization of the destinations by Block on March 22.In addition to the JRCS, many medical teams from other organizations/institutions were also deployed in recovery from this disaster, including the Japan Medical Association and the Japan DMAT. Among these, the JRCS showed its presence by dispatching the largest number of staff of all entities. For example, according to a document released by the Ministry of Health, Labour and Welfare (MHLW) in 2011, the JRCS accounted for the majority with 6,541 individuals, of the total number of 12,115 medical staff deployed to the three affected prefectures.

b. Trends in the Number of Deployed TeamsAs mentioned above, 894 medical teams with 6,492 staff in total were deployed for about half a year until September. Even after this, medical operations continued in relation to the refugees’ temporary entry into the evacuation zone in response to the Fukushima Daiichi Nuclear Power Plant Accident. According to the breakdown of the number by destinations deployed, IWATE had 345 teams, MIYAGI had 383 teams, FUKUSHIMA had 136 teams, and others had 30 teams (including 7 teams deployed to the more than one prefecture in the affected area). As for the destinations cities, IWATE including RIKUZEN-TAKATA with 176 teams, KAMAISHI and OTSUCHI with 93 teams, MIYAKO and YAMADA with 56 teams, and MIYAGI including ISHINOMAKI and HIGASHIMATSUSHIMA with 358 teams accounted for the majority of the destinations. FUKUSHIMA, etc. had 71 teams and AIZU 54 teams.With regards to the breakdown by month, March, the disaster month, recorded the highest with 379 teams. The medical services provision other than for IWATE, MIYAGI and FUKUSHIMA were completed within March, phasing down to 257 teams for April, 142 teams for May, and 68 teams for June. The services were completed in May for YAMADA and June for KAMAISHI, and July for RIKUZEN-TAKATA in IWATE, and June for the entire FUKUSHIMA (however, the services in relation to temporary entry to the evacuation zone remained even after the withdrawal). The teams of Ishinomaki in MIYAGI, serving the longest, left in September.

IWATE- All of the medical services shall be completed as of July 30.

MIYAGI- Deployment of the medical teams from other blocks shall be completed by the end of July.

- At present, one medical team (3 staff consisting of a doctor, a nurse and a administration staff) of the Miyagi Chapter provides services at OGATSUCHO only 3 days a week.

- The team will be withdrawn upon completion of the temporary clinic established by Ishinomaki city government in September.

FUKUSHIMA- In August, the 2nd block and the Fukushima Chapter will serve refugees who make a temporary entry into the evacuation zone after the nuclear power plant accident.

- In September, the 1st block will mainly serve them in response to their request for medical services.

Figure 2-12　Trends in the number of deployed　　　　　　　　　　　 medical teams by month and destination

IWATEMIYAGIFUKUSHIMAOthersTotal

March1131785830

379

April110106410

257

May7248220

142

June3023150

68

July20800

28

August0

1200

12

September08008

Total34538313630

894

200

300

100

400

150

250

50

350

(Note 1) The date refers to the date of departure. (Note 2) Medical services provided in more than one area are

included in “Others”.

48


Figure 2-14　Medical support staff number from major 　　　　　　　　entities for1 month from the Disaster day

2,700

1,840

1,800

1,500

626

578

518

515

423

411

0 1,000 2,000 3,000

JRCS

Japan Federation of Democratic Medical Institution

Japan Medical Association

DMAT

Tokushukai Group andassociated organizations

Japanese Nursing Association

Japan Dental Association

Japan Pharmaceutical Association

National Hospital Organization

University School of Medicine

（Staff）

Source: Prepared from “Yomiuri Shimbun” (Newspapers) (morning edition of April 16, 2011)

Figure 2-13　Medical team staff number to the　　　three affected prefectures

(actual performance)

Nationwide 12,115 staffJRCS (percentage accounting for the entire nation)

6,541 staff (54.0%)

Source: Prepared from the document published by MHLW (September 30, 2011)

Figure 2-15　Number of dispatched JRCS Medical Teams by chapter and by destination (prefecture/area)

Destination

Headquarters/Chapter

IWATE MIYAGI FUKUSHIMAOthers TotalRIKUZEN-

TAKATAKAMAISHI, OTSUCHI

MIYAKO, YAMADA Others ISHINOMAKI Others

FUKUSHIMA, etc

AIZU Others

Headquarters 　　　 17 　　　 FUKUSHIMA / MIYAGI 1 18

The 1st Block

Hokkaido 29 8 　 1 　　　　　 HOKKAIDO 5 43Aomori 2 　　 1 3 　 5 　　　 11Iwate 89 　 3 5 　　　　　　 97Miyagi 　　　　 24 　1 　　　　 25Akita 42 　　　　　　　 MIYAGI / IWATE 1 43Yamagata 　　　　 1 　 1 24 　 YAMAGATA 1 27Fukushima 　　　　　　 32 　 6 　 38

The 2nd Block

Ibaraki 　 5 　　　　 1 2 　 IBARAKI　3 11Tochigi 　 7 　　 2 3 9 4 　 TOCHIGI 1 / IBARAKI 1 27Gunma 　 9 1 3 4 1 2 1 　　 21Saitama 　 8 1 　 5 5 　 1 　　 20Chiba 　 8 　　 9 　　　　 CHIBA 2 19Tokyo 　 18 　 1 8 1 1 　　 IBARAKI 1, FUKUSHIMA / IWATE 1 31Kanagawa 　 8 2 　 5 　1 6 1 1 　 24Niigata 　 2 　 5 1 2 2 　 FUKUSHIMA / MIYAGI 1 13

The 3rd Block

Toyama 　　　　 15 　　　　　 15Ishikawa 　　 3 5 　　　　　 8Fukui 7 　　 1 5 　1 　　　　 14Yamanashi 　 1 　　　　 5 　　 IBARAKI 2 8Nagano 　 1 　　 26 　 1 　　 NAGANO 2 30Gifu 6 　　　 10 　　　　　 16Shizuoka 　　8 　 10 　　　　　 18Aichi 　　　 1 30 2 　　　　 33Mie 　　　　 10 　　　　 TOCHIGI 1 11

The 4th Block

Shiga 　　 1 1 　　1 1 9 2 　 15Kyoto 　　 1 　 3 　　 10 　　 14Osaka 　　 11 　　　6 　　　　 17Hyogo 　 8 11 1 　　　　　　 20Nara 　　　 3 　　　　　　 3Wakayama 　　 13 　　　　　　 13

The

5th Block

Tottori 　 2 　　 5 　　　 1 　 8Shimane 　　　 1 12 　　　　 IBARAKI 2 15Okayama 1 　 4 　 6 　　　 1 　 12


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Provision of M

edical Relief

Destination

Headquarters/Chapter

IWATE MIYAGI FUKUSHIMAOthers TotalRIKUZEN-

TAKATAKAMAISHI, OTSUCHI

MIYAKO, YAMADA Others ISHINOMAKI Others

FUKUSHIMA, etc

AIZU Others

The 5th Block

Hiroshima 　　　　 13 　 1 　　　 14Yamaguchi 　　　　 9 　　　　 IBARAKI 2 11Tokushima 　　 5 1 6 　　　　　 12Kagawa 　　　　 11 1 　　　 FUKUSHIMA / MIYAGI 1 13Ehime 　　　　 10 　　　　 FUKUSHIMA / MIYAGI 1 11Kochi 　　　　 11 　　　　 FUKUSHIMA / MIYAGI 1 12

The 6th Block

Fukuoka 　　　　 15 　　　　　 15Saga 　　　　 6 　 1 　　　 7Nagasaki 　　　　 9 　　　　　 9Kumamoto 　　　　 25 　　　　　 25Oita 　　　　 8 1 1 　　　 10Miyazaki 　　　　 5 　 1 　　　 6Kagoshima 　　　　 4 　 1 　　　 5Okinawa 　　　　 6 　　　　　 6

Grouped by district 176 93 56 20 358 25 71 54 11 30 894Grouped by prefecture 　345 383 　136Source:“Report on JRCS Medical Services for the recovery from GEJET (September, 2011)　Data aggregated by the Disaster

Management and Social Welfare Department, JRCS Administration Sector (Note 1) Data shows the total number of departures aggregated by the end of September 2011 (Note 2) Services provided in some areas are included in “Others”. (Note 3) Data do not include the number of teams deployed in relation to the temporary entry into the evacuation zone after the

Fukushima Daiichi Nuclear Power Plant Accident.

(3) Number and Trends of Patients Receiving Servicesa. Total number and trends of patients receiving services According to the “Activity Report by JRCS Medical Teams” which was to be submitted by the medical teams every day, the number of patients treated by the medical teams amounted to 75,892 in total by August 31. March 20 saw the peak with 2,462 patients. As for the breakdown by month, the number phased down with 32,035 in March, 24,010 in April, 14,394 in May, and 180 in August.

Figure 2-16　Number and trends regarding 　　　　　　　　　patients treated by medical teams

32,025

24,010

14,394

3,9981,285 180

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

March April May June July August

（No. of patients）

b. Trends by age groupThe “Activity Report by JRCS Medical Teams” requires, for convenience, data input by age group as follows; infants (0-4 years of age), adults (5-74 years of age), and senior citizens (75 years of age or older). According to the survey results, infants accounted for 5.8%, adults for 72.7%, and senior citizens for 21.5%. In the three disaster-affected prefectures, infants accounted for 4.0%, adults for 83.1% and senior citizens for 12.9%, which shows a higher percentage of elderly people compared to their demographic percentage composition.

c. Trends by symptom severityIn regards to symptom severity, serious patients accounted for 0.2%, moderate for 3.7%, and mild for 96.0%; it was unique for the percentage of seriously injured victims to be so low in spite of the devastating damage from the disaster. Transformed time-series data shows a tendency for the percentage of mild cases to be higher.The breakdown by disease is characterized by many cases of “upper respiratory tract infections” (23.8%),

“high blood pressure” (19.7%) and “others” (33.3%). On the other hand, the proportion of “external injuries” was low, accounting for 4.7%, which was also only 5.1% even immediately after the March disaster. Transformed time-series data shows lower percentages for “upper respiratory tract infections”,

“external injuries” and “bowel movement disorders”, while “others” tended to increase.

50


(4) Coordination with Related Entities, etc.a. Information Sharing among Medical TeamsDue to the significant size and long duration of the deployed medical teams, and to many medical teams dispatched by organizations/entities other than JRCS for GEJET how to hand over and share information among the medical teams was particularly important. Coordination meetings were held among local medical professionals daily in many of the affected areas for information sharing among the medical teams, according to the notice by HDC at the Headquarters dated March 18, entitled “Activity Report by JRCS Medical Teams for the Tohoku District-off the Pacific Ocean Earthquake for FY2011" and medical records. Some local teams also used locally-specific reports prepared by Health Centers, etc. in ISHINOMAKI and KAMAISHI, etc., assessment sheets were used to record the state of hygiene, etc., of the disaster shelters.Staff members of the “National Workshop for Medical Teams (a.k.a.: JRCS DMAT Workshop)” organized since 2009 had their own mailing lists used in normal times, which they shared and used to exchange information since the disaster took place.

b. Withdrawal of Medical Teams and the CoordinationWith regards to the withdrawal of medical teams, Section 3.1 of Article 3 of the JRCS Disaster Prevention

It is characteristic that medical services for GEJET were related to more cases of chronic diseases than external injuries directly caused by the disaster. In other words, disaster victims who were unable to receive the medical services from their primary care physicians that had been available before the disaster and came to see the medical teams. In this context, many respondents may have chosen “others” (other than those we determined as a category), and the percentage seemingly increased over the course of the time.

Figure 2-19　Percentage of patients receiving 　 the services by month

and by disease　　

29.4%

26.4%

19.6%

17.3%

23.8%

19.9%

17.9%

20.9%

22.0%

19.7%

5.1%

4.4%

4.3%

5.7%

4.7%

4.4%

3.6%

4.6%

3.1%

3.9%

4.9%

3.6%

2.8%

2.6%

3.5%

8.6%8.6%

10.2%10.2%

12.9%12.9%

12.5%12.5%

10.9%10.9%

27.8%

33.9%

34.9%

36.7%

33.3%

0　　20%　40%　60%　80%　100%

March

April

May

June - August

Total

Upper respiratory tract infections

High blood pressure

External injuries

Stress symptoms

Bowel movement disorders

Other diseases

Others

(Note) “Other diseases” include the following: pneumonia, asthma, abdominal pain, cardiovascular disease, cerebrovascular disorder, low back pain, neuralgia, obstetrics and gynecology diseases (delivery).Figure 2-18　Percentage of patients receiving the 　　　

　　　　　　services by month and by severity group

0.2%

0.2%

0.2%

0.2%

0.2%

7.4%

2.4%

1.8%

3.3%

3.7%

92.4%

97.3%

98.0%

96.4%

96.0%

0% 20% 40% 60% 80% 100%

March

April

May

June - August

Total

Severe Moderate Mild

Figure 2-17　Percentage of patients receiving the services by month and by age group

4.2%

3.2%

4.3%

5.8%

5.8%

4.0%

71.7%

75.2%

71.9%

72.7%

72.7%

83.1%

24.1%24.1%

21.6%21.6%

23.9%23.9%

21.5%21.5%

21.5%21.5%

12.9%12.9%

0% 20% 40% 60% 80% 100%

March

April

May

June - August

Total

Reference: Population

Infants Adults Senior citizens

(Note 1) Age unknown group is not included. (Note 2) Infants are aged 0 - 4; adults 5-74, senior citizens 75 or over.(Note 3) The percentage is based on the populations of IWATE, MIYAGI,

and FUKUSHIMA (National Census, as of October 1, 2010).


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Plan provides that “Head of the Chapter in a disaster-affected zone shall, considering the recovery status of medical functions within the area, decide when to withdraw its medical teams after completion of the services based on discussions with the local government, local medical associations, etc."As mentioned above, the HDC at the Headquarters reported on the status of medical services and the policy of each district after the disaster and updated it almost every month. Based upon these reports the Chapter made a decision as to when to withdraw from each district based on discussions with the related organizations, including local Medical Associations, Health Centers, etc.

2. Activities of Chapters in All Prefectures Nationwide

(1) Overview of Support Servicesa. Deployment of Support Staff from the HeadquartersIn addition to the medical teams, 465 staff members in total were deployed from the Headquarters to support the activities of the Chapters in the three disaster-

affected prefectures for the term March – September.Among the staff, 98 chapter support members were engaged in supporting the Chapter HDC, conducting surveys on the needs of the evacuees in disaster shelters, etc.Another 367 staff members were also deployed in the disaster-affected regions for the purposes of promoting public relations, providing reconstruction support and psychosocial care, etc., and other related activities. According to the breakdown of prefectures, MIYAGI was ranked 1st with 208 staff, followed by IWATE with 202 staff and FUKUSHIMA with 120 staff.

b. Deployment of Support Staff from the ChaptersChapters other than those in the disaster-stricken areas also deployed 235 support staff in total in order to support services for the three prefectures for the March – July term. On a prefectural basis, 101 staff went to IWATE, 20 to MIYAGI, 113 to FUKUSHIMA and 1 to YAMAGATA.

Figure 2-20　Number of Staff Deployed from the HeadquartersMarch April May June July August September Total

Chapter support

By prefecture

IWATE　 Chapter HDC 10 3 - - - - - 13Surveys on the needs of evacuees in disaster shelters 4 - - - - - - 4

MIYAGIChapter HDC 23 9 - - - - - 32Chapter HDC at ISHINOMAKI * 12 12 4 4 5 - - 37Surveys on the needs of evacuees in disaster shelters 4 - - - - - - 4

FUKUSHIMA Chapter advisors 3 - - - - - - 3Survey on the needs - 5 - - - - - 5

Total (Overlapping** excluded) 56 29 4 4 5 0 0 98

Others

By service/activitySite visits (accompanying overseas RCRC, etc.) 11 5 10 - - - 4 30Public Relations Staff 10 23 16 4 7 - - 60Reconstruction assistance, overseas support projects

Full-time team for donation from overseas - 24 40 - - - - 64Others - 4 - 29 24 3 1 61

Psychosocial care 4 28 - - - 2 - 34Care management - 9 7 3 - - - 19Blood Service 16 8 - - - - - 24Others 11 13 10 22 12 5 2 75

Total 52 114 83 58 43 10 7 367

March April May June July August September Total By prefecture ***

IWATE 34 63 57 29 14 4 1 202MIYAGI 52 47 53 26 27 3 - 208FUKUSHIMA 23 21 40 16 10 4 6 120Others - - 6 5 2 1 - 14

Total 108 143 87 62 48 10 7 465* Medical teams deployed Ishinomaki RCHP before establishing the Local HDC of the Ishinomaki Chapter included.** Three staff deployed to each of the MIYAGI Chapter HDC and HDCs in affected area included.*** The figures shown in “By prefecture” do not add up to the total because, when the same staff were dispatched to several prefectures,

it was counted as a dispatch by each prefecture.

(Number. of staff)

(Number. of staff)

52


Figure 2-21　Number of staff deployed by chapterThe terms of the deployment

Destination March April May June July Total

IWA

TE

Iwate Chapter 1 4 4 - - 9Iwate Chapter HDC (TONO) - 13 18 22 15 682nd Block Local HDC (SUZUKO, KAMAISHI) - 6 11 4 2 23Others - - - 1 - 1

Subtotal 1 23 33 27 17 101MIYAGI

Miyagi Chapter 12 4 4 - - 20

FUK

USH

IMA

Fukushima Chapter 29 50 17 - - 96Aizu Ward Public Health and Welfare Office, FUKUSHIMA - 4 1 8 - 13

AIZU WAKAMATSU - 2 2 - - 4Subtotal 29 56 20 8 0 113YAMAGATA

Yamagata Blood Center 1 - - - - 1

Total 43 83 57 35 17 235Note: The terms of the deployment were categorized by that on the starting day of the service.

(Number of Staff)

c. Support to Ishinomaki RCHPMany medical teams from throughout the nation, including JRCS, took part in supporting Ishinomaki RCHP and Ishinomaki Joint Medical Teams that served areas around a hospital as the hub point. For example, 3,633 medical teams in total (including 1,011 JRC medical teams: 357 teams in actual performance) were deployed with 1,501 HDC staff in total (including 206 doctors) and 4,874 in-hospital support staff in total (including 1,477 doctors).

(2) Logistic Support Activities by Chapters　Roads, railroads, airports, harbors, etc., in the disaster-affected areas suffered tremendous damage, with a long way to go before their recovery. For one and a half months until the whole line was opened to traffic on the Tohoku Shinkansen (April 29), medical team members, psychosocial support staff, etc., in remote areas handed over their duties at airports (Akita, Yamagata, Hanamaki, etc.) that were free from the after effects of the disaster, and the Tochigi Chapter played a role as a hub station, etc. For approximately one month from the impact phase of the disaster (until April 15), the medical team members, etc., were able to move to the hub airports free of charge thanks to the full support of All Nippon Airways, Japan Airlines, etc.Logistical support services were provided for the medical teams gathering from throughout the nation

Figure 2-22　Support situation in ISHINOMAKI

Category Size

Ishinomaki Joint Medical Team

Medical teams (total number in service)

Medical service teams gathering from throughout the nation 3,633 teams

Including JRCS teams 1,101 teams* Number of medical teams in actual performance 357 teams

HDC staff

Doctors (Disaster Response Medical Assistant Coordinator),

42 staff (206 staff)

Nurses, clerical staff (including volunteers)

287 staff (1,295 staff)

Total 329 staff (1,501 staff)

Category Size

Ishinomaki RCHP

In-hospital support

Doctors 147 staff (1,477 staff)

Nurses, Midwives (Assistance in hospital wards, triage services, area support, and support at nursing school)

421 staff (2,426 staff)

Pharmacists 107 staff (839 staff)

Clinical engineers 20 staff (132 staff)

Administration staff / volunteers ※

Total 695staff（4,874staff）

Note 1: The numerical figure in parenthesis in the bottom row of each box represents the total number of active staff.

Note 2: Those other than JRCS teams and doctors are included in the number of medical teams and HDC doctors.

Note 3:* The number of “deployed administration staff / volunteers” is included in the Ishinomaki Joint Medical Team.


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b. Departure stand-by place for medical teams provided by the Niigata Chapter

As with the Tochigi Chapter, the Niigata Chapter also provided temporary accommodation for those who have arrived at night and were awaiting departure on location.

c. Logistical Support Activities by the Yamagata ChapterAdjacent to the three prefectures seriously damaged by the disaster, the Yamagata Chapter decided to provide medical care services mainly including logistical support, while carrying out liaising and coordinating duties with the Chapters in these three disaster-affected prefectures.In the first place, many medical teams headed for the disaster-affected areas by way of YAMAGATA, adjacent to these disaster-affected areas and serving as a hub point for logistical and personnel transfer services. The Yamagata Chapter arranged accommodation and refueled vehicles for the medical teams. It also provided refueling service for the medical teams dropping into the Yamagata Chapter due to lack of gas even on their way from the disaster areas to home.In the second place, the Yamagata Chapter arranged accommodation for 19 medical teams from 4 Chapters in total. Because many of the medical teams left for the disaster-affected areas early in the morning when a regular breakfast service was not available, the Chapter staff prepared light meals, such as rice balls, etc., with the cooperation of the lodging services.In the third place, as a mountain area covered with some compacted snow even in March borders YAMAGATA and MIYAGI, the Chapter staff helped attach tire chains to the vehicles owned by medical teams who were not used to driving on snow-covered roads.

d. Securing Airport Parking Lots by the Akita ChapterSome medical team staff coming from the western part of Japan moved to Akita Airport via air, and then to their destination sites by road using vehicles that the previous teams had left at the airport parking lots. Due to an arrangement made by the Akita Chapter, these vehicles were allowed to be stationed at the airport parking lots for free. And this information dated March 15 was disseminated to the chapters nationwide via HDC at the Headquarters.On March 16, they faxed maps of the free parking

at the Chapters of the prefectures adjacent to the three disaster-stricken area.

a. Transfer station for medical teams set up by the Tochigi Chapter

The Tochigi Chapter, situated at the southern entrance to the three disaster-affected prefectures, discussed the availability of logistical services for the medical teams, and decided to play the role of a

“transfer station” that allows liaison between the disaster-affected sites and the medical teams. The transfer station provided the following three services.

Temporary rest areas

Providing facilities for rest and meals for the medical team staff from throughout the nation when visiting and returning from the three disaster-affected prefectures.

Vehicle-keeping facility

The Tochigi Chapter kept the vehicles of medical teams from the western part of Japan so that they could access TOCHIGI via air and rail, and then use the vehicles in the disaster-stricken areas.

Courtesy bus service

To reduce the burden of transfers for the medical teams serving IWATE, Chapter staff and disaster-response volunteers drove a trailer bus to pick up and set down the medical team staff.

Figure 2-23　Performance of the transfer 　　　　　　　　　　　　　station services of the Tochigi Chapter

Availability of rooms for rest

As a transfer station, number of vehicles kept for medical services

March 210 staff 10April 24 staff 32May － 13June － 4July － 1Total 234 staff 60

Figure 2-24　The Tochigi Chapter’s large-sized 　　　　　　shuttle bus service for medical

team staff 　　　　　

Bus routesFrom the Tochigi Chapter to KAMAISHI

From KAMAISHI to the Tochigi Chapter

No. of times 8 times 8 timesNo. of staff transferred 168 staff 162 staffDrivers (in total)

Volunteers 10 staff 10 staffChapter staff 7 staff 7 staff

A variety of support services were provided by the disaster response volunteers and Red Cross Volunteers Corps (i.e., setting up comfortable beds for taking a rest, refueling vehicles at gas stations by hand, driving buses, etc.).

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c. The Kumamoto Chapter Deployment of Medical Teams Although a long way from the disaster-affected areas, the Kumamoto Chapter was engaged in the large-scale delivery of a substantial amount of equipment and supplies for medical care service in the disaster-affected areas. Medical teams-1 and -2 started on the disaster day on board special vehicles, etc. They traveled 1,600 km by land, taking approximately 40 hours to provide their medical services. The Teams-3 and -4 that started on the next day and 2 days later delivered many supplies using 10 ton trucks. Such delivery of relief supplies continued, amounting to 90 tons of supplies from KUMAMOTO.

lots at Akita Airport as well as of gas stations for emergency vehicles in AKITA to the HDC at the Headquarters Information Teams to be shared with the Chapters nationwide.

(3) Other Services at First-Aid Stationsa. Major Activities at Primary First-Aid Stations:

RIKUZEN-TAKATA, IWATEJRCS medical teams arrived at RIKUZEN-TAKATA, IWATE, setting up the first-aid station in a disaster shelter at Rikuzen-Takata Daiichi Junior High School to launch medical operations. Since June 24, the first-aid station had been moved to a prefabricated house built on the grounds of the school to provide primary care services for local residents until it closed on July 29.

b. Setting up the First-aid Station House in KAMAISHI, IWATE

Medical services in the Kamaishi District, including KAMAISHI and OTSUCHI, were provided mainly at a first-aid station as a hub point set up in Suzuko Plaza, near Kamaishi Station.Initially air tents were set up; however, the tents were damaged by strong winds, thus it was difficult to maintain a medical care environment. On April 25, 2011, prefabricated houses were constructed free of charge through cooperation from the Tohoku Branch of Komatsu House Co. These prefabricated houses, acting as a hub point, functioned as first-aid stations and as “relaxation rooms” for psychosocial support and as the coordination headquarters, as well as storage space for medical equipment and materials.The 2nd block Chapters, serving these first-aid stations as a hub point, shared their responsibilities with the Chapters, including for logistics (accommodation and transportation for medical team staff), food procurement, etc., to enable the successful deployment of the medical teams. Since the recovery of local home delivery services, the goods and logistics management system (SPD)

1 of the Musashino RCHP enabled blanket

procurement and the smooth arrangement of medical equipment and materials, office supplies, etc., which saved the medical teams from bringing them in.

[First-aid center and a materials and apparatus set up in front of

Ishinomaki RCHP]　　　　　　　　　　　　　　　　　　　　

[Prefabricated houses set up at the Suzuko Plaza in KAMAISHI as a local

medical headquarters / station]

(1) Referring to “goods and logistics management systems” that control the flow of goods (logistics flow), trading (commercial flow) and information (information flow) using computer systems for logistics control, including the selection of articles used and consumed in the hospitals (mainly medical materials, including medical products, ME apparatus (Medical Engineering apparatus), office supplies and commodities, etc.), the setting up of procedures for procurement, purchasing, ordering, inventory, releasing, usage, consumption and supply, in order to ensure medical safety (i.e., traceability), cost reduction and control that contributed to improving and sustaining efficient hospital management.


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edical Relief

for all members of the team staff to be dispatched to remote areas on such a significant scale. Witnessing the devastating effects of the disaster before their very eyes, they say they have fully understood what is required to take responsibility as medical professionals, reaffirming their mission to rescue as many disaster victims as possible.

e. Medical Teams Posting Postcards Written by the affected people

People in some disaster stricken-areas completely lost their means of communication, including mail delivery. MIYAKOJIMA Shelter in HIGASHI MATSUSHIMA, MIYAGI, was in one of these areas. The only one bridge connecting the island and the mainland was damaged, and medical teams from Nagano RCHP were forced to reach the island by helicopter in late March.In such circumstances, the medical team members purchased as many postcards as possible at post offices they happened to drop by at on their way to the mission in YAMAGATA. They distributed one postcard per family in the disaster shelters in MIYAKOJIMA, and some 50 cards were collected and posted by the staff. All of the cards were telling their acquaintances inside and outside the prefecture that the senders were fine, and asking if the recipients were well.Although some zip codes were missing or unknown because they were living in shelters, the staff wished

d. Medical Teams Deployed by Chapters without RCHPAmong the chapters, Yamagata, Nara and Miyazaki do not have any Red Cross Hospital or Clinic in their area; they concluded an agreement so that they could serve as JRCS medical teams in cooperation with public hospitals in these prefectures in order to meet disaster relief needs.Uniquely enough, all the Chapters deployed medical teams for this disaster; even the chapters without a RCHP dispatched 36 medical teams in total.

Figure 2-26　Deployment of medical teams 　　　　　　　　　by the chapters without a RCHP

Figure omitted

The Miyazaki Chapter deployed 6 medical teams in total to ISHINOMAKI and FUKUSHIMA with the understanding and cooperation of Miyazaki University Hospital. It was the first time that such large-scale disaster relief operations were provided beyond prefectural borders.The Chapter had tried to establish communication with the university hospital (especially, the emergency department) by establishing a program of emergency drills and exercises, etc. the Director of the Hospital expressed his willingness the hospital’s personnel to contribute in the future deployment of a JRCS medical teams. The organized team was a mixed group consisting of hospital and chapter staff. It was the first experience

Figure 2-25　Outline of the initial medical teams from Kumamoto ChapterTeam-1 Team-2 Team-3 Team-4

Departure time 3/11 21:00 3/11　24:00 3/12　17:00 3/13　11:00

Arrival time 3/13 12:00 3/13　16:05 3/14　02:30 3/13　17:00

Organization of medical teams

Three doctors, three nurses, four management staff and others

Two doctors, three nurses, eight management staff and others

Two management staff and others

Zero staff (Material support)

Equipment One leading car (vehicle for communications and instructions) Two land cruisers

One special medical service vehicle, “Disaster Rescue” (large vehicle)Two large vehicles: crane trucks (equipped with forklifts, heavy industrial machinery, etc.), wing box trucks (ERU (emergency response units), beds, desks, wireless equipment, satellite phones), one doctor car

Five 10-ton vehicles (trucks), relief supplies, materials and apparatus including tents (water supply systems, water, tents, food, blankets, toilets with a purified water tank, shower room), and daily commodities.* Provided by transport companies.

One 10-ton vehicleRelief supplies

56


3. Conditions of Hospitals in the Disaster-Stricken Areas

(1) The Morioka RCHPa. Damage to Buildings and Lifelines and the

Progress of RestorationThe Morioka RCHP is a 438-bed, 566-staff Disaster Relief Core Hospital situated in the center of IWATE. Situated inland, about 100 km from the coast, MORIOKA (IWATE) suffered from disruption due to power outages but there was no collapse of buildings. Figure 2-27 shows the damage to hospital buildings and the progress of the restoration.

to “send them as soon as possible” and so checked and added the code numbers, and posted them in a nearby post box on their way back to the hospital. This demonstrates that the medical team staff even acted as messengers on behalf of disaster victims.

Figure 2-27　Damage to the Morioka RCHP and the progress of the restorationItems Damage Progress of the restoration

Buildings No damage to structuresDamage to building structural jointsWater leaking from water tanks

No problem for usePlanned to be repaired in FY2012

Electricity March 11: Switch to emergency power system due to the power outage

Restored at 16:10, March 12

Fuel for power generation (heavy oil)

As supplies had been unstable until the end of March, the local government procured them

Residual volume of 27,000 liters on March 11 Refueling 22,000 liters on March 12

Utility gas As aftershocks followed, the supply was stopped.

Resumed for use at 6:30, March 12

Water system In combination with a well in the site, water was pumped up and distributed using an in-house power generator.

Sewage system No damageFixed-line phonesCell phonesWireline phones for use in a disaster

Difficulty in communications due to the limits of the communication systemPriority telephone links in a disaster were available for use; however, there was no connection in the coastal zone at all.

Satellite-based mobile phones Satellite-based mobile phones brought by the medical teams were the only means of communication for people living in the coastal zone.

JRCS wireless system for professional use

The system was down around 5:00 AM on March 12 due to the lack of batteries at the transmission station.

When it will be restored is unknown

Medical gas (liquid oxygen) No damage 1,600 m3 refilled on March 18Medical gas (liquid nitrogen) No damageElevators Stopped in general at an intensity 4 or

higherManufacturer checking within hours after discontinuance in order to resume

building. Later on, they cancelled the day’s general outpatient consultations and surgical appointments in order to prepare for accepting the sick and wounded from the disaster-stricken areas and deploying dERU teams. The Iwate Chapter HDC instructed the

b. Actions Taken at the Time of the DisasterThe Morioka RCHP established a HDC within some minutes after the disaster occurred, while immediately collecting information on their patients’ whereabouts and safety, and the status of damage to the hospital


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deployment of dERU teams and organized a SCU at a prefectural firefighting school on March 11. In city-wide total darkness due to the power outage, many evacuees gathered outside the hospital with its “Red Cross” signboard lit up. However, the staff asked those other than the sick and injured to move to acceptable shelters based on information on the fast-changing situation obtained from Morioka local government. The next day on March 12, 2 medical teams with dERU were dispatched to the coastal zone at 6:00 in the morning on instructions from the Iwate Chapter. However, only 2 physicians flew to the area by helicopter. Following this, the Iwate Chapter also ordered the addition of SCU to the deployment, sending 57 JRCS staff including those from 3 teams (Gifu, Takayama and Fukui). On the day, they had only 8 sick and wounded patients transported by helicopter from the disaster stricken sites. Meanwhile, Akita Chapter Medical Team (Team-1) which had started services in RIKUZEN-TAKATA reported

“more manpower for the medical teams is needed”. Thus, the HDC deployed the Akita Chapter Medical Team (Team-2) and the Fukui Chapter Medical Team, recommending the prefecture to dispatch teams to the coastal areas by land. Combined with approval from the prefecture for their deployment to the coastal areas, the Iwate Chapter answered, “the hospitals will be authorized to decide their destination”.

Figure 2-28　Major Responses of the Morioka RCHP after the disasterDate Time Events3/11 14:46 Disaster occurred

14:50 HDC establishedIn-hospital damage status identified

15:00 Disaster damage status identified. No human suffering. In-house power generation used after a power outage. Elevator and central heating systems stopped functioning. Only portable X-ray available. TV not available. Internet not available.

15:00 Designating Disaster Response III regime (General outpatient service discontinued; medical teams organized; triage center established; beds for disaster victims secured; testing / surgery operations cancelled)

15:50 14 dERU team staff waiting completed16:00 Triage center setting up completed16:17 CPA patients were brought in. The medical team staff claimed that the “phone line cannot be

connected to the hospital”; thus transportation of the patients was allowed without reservation.17:01 The fire station requested to “be ready for helicopter transportation services to the hospital”; a

hospital ambulance was prepared for patient transportation.17:04 The Iwate Chapter instructed, “Hospitals in the coastal areas were not available for hospitalization.

No deployment of medical teams. Prepare for accepting the sick and injured from the disaster”.18:00 The elevator stopped functioning and staff carried emergency food to each floor18:25 The Iwate Chapter instructed the “deployment dERU to the Iwate Firefighting School and to

establish an SCU”19:30 Discussion about in-hospital nighttime shifts at the Headquarters meeting

However, there was no communication with the local government having jurisdiction over the coastal site, as well as almost no information required for the deployment.On March 13, the HDC instructed the SCU to continue their services, and the Medical Teams to secure safety, start operations after reporting to the local authorities, etc., and provide updates on the situation, etc., to hospitals using satellite-based mobile phones for the deployment services at the coastal sites. As the Akita Chapter Medical Team requested “replacement teams” on the previous day, 2 teams from GIFU (Gifu, Takayama) were deployed to RIKUZEN-TAKATA. Due to the information that the bridge connected to Shin Sennin Hill had collapsed, three teams from HYOGO, SHIZUOKA were assigned to the southern prefectural coast, the Wakayama Team transferred from inland by road to serve in MIYAKO, and Nara Chapter Medical Team to KUJI. 2 teams (Ishikawa and Tokushima) following the previous teams were asked to join the Wakayama Team in MIYAKO in according to satellite phones from Wakayama and Nara Medical Teams. Figure 2-28 shows the progress in the situation over one week after the disaster.

58


Date Time Events3/11 21:00 The victims from MIYAKO visited the hospital. The staff checked the shelter locations in

MORIOKA, handing them a map. (Later on many patients visited us but we explained the situation at the front entrance of the hospital).

22:27 The Iwate Chapter told us that “there were no helicopters available until tomorrow morning”; dERU returned from the SCU and stood by in the hospital.

3/12 1:40 The Iwate Chapter requested the “SCU to accept dERU as soon as the dawn broke, and deployed three medical teams to the coastal areas by helicopter”.

1:48 The staff carried up newly hospitalized patients to the 5th floor on stretchers.6:00 dERU and 2 medical teams left for SCU.6:30 Gas and heating systems restored7:42 Two doctors (Dr. Kawamura and Dr. Shimatani) moved to the coastal areas from the SCU using an SDF helicopter.7:47 Reporting to the Iwate Chapter that DMAT arrived at the SCU. The Chapter replied, “SCU shall be

commanded by Nagano DMAT”. 8:00 A hospital HDC meeting was held. For the time being, it is expected to be held at 8:00 and 16:30 every day.10:01 Minami Fire Station requested the “acceptance of 140 moderately affected patients from RIKUZEN-

TAKATA”. We answered to accept “70 patients"→ After seeing them, we requested the City (shelters) to arrange vehicles available to bring them from their homes.

10:01 The Iwate Chapter instructed SCU to add 2 medical teams　→Deploying medical teams.12:10 We decided to discontinue general outpatient consultations after March 14 (Monday), sending out a

fax to the mass media.12:33 Morioka team reported, “No food available in the city stores”; the staff made rice balls with only salt

as a condiment (this service continued until March 27)14:20 Fukui RCHP returned to the hospital and starting traveling from shelter to shelter to provide

medical care in MORIOKA.15:01 The Iwate Chapter instructed the deployment of the Akita RCHP Team-2 to RIKUZEN-TAKATA15:42 The Akita RCHP Team-1 requested “another 2 teams”. We answered, “the Akita RCHP Team-2 is

on the way. The Fukui medical team is to be deployed”.16:10 Electricity restored.18:05 The Iwate Chapter instructed the deployment of replacement teams to RIKUZEN-TAKATA. We

decided to deploy 2 teams ( Gifu and Takayama) the next morning.18:05 The medical teams serving as SCUs reportedly returned with “8 patients transported by helicopter",

advising that the Iwate Chapter deploy vehicles to the coastal areas.18:40 The Iwate Chapter answered, “We authorize the deployment of medical teams to the coastal areas;

their destination shall be designated by the hospitals”.19:06 A joint meeting of the medical teams with regards to SCU service reports and deployment to the

coastal areas the next day.20:45 Accommodation requested for staff to serve at Hanamaki Airport; 100 staff members were to be accepted.20:50 19 patients visited for medical care from KESENNUMA, mainly complaining of hunger and fatigue

→We requested shelter at the Shinjo Water Purification Facility to provide meals to them. They were transported to the shelter after medical check-ups.

3/13 5:00 2 teams, Gifu and Takayama, headed to RIKUZEN-TAKATA for service.5:40 The Morioka team (17 staff) headed to the SCU at the Firefighting School for service.7:20 3 teams ( Kobe, Shizuoka and Hamamatsu) headed to KESEN for service.9:35 The SCU Morioka team requested additional medical teams; requested the Kanazawa medical team

for support.9:45 The Iwate prefectural Ofunato Hospital, IWATE, requested us to pick up premature infants and TPL (Threatens

Premature Labor) patients→We dispatched our doctors on board of our ambulance with incubator sets.11:40 The Shizuoka team: “SDF told us that they found no medical teams in KAMAISHI. It is accessible

by road, so we are going to head for KAMAISHI with SDF”. 11:45 From the Wakayama team: “8,000 evacuees from MIYAKO, no other medical teams” → the

Kanazawa team joined forces to serve in MIYAKO14:46 From the Nara; “No medical teams needed in KUJI; we are heading for NODA”.14:50 From the Wakayama team: “Many shelters accommodating 100 - 200 patients; no other medical

teams” →the Tokushima team changed its destination from KUJI to MIYAKO.16:15 From Nara team; “Many evacuees in Noda Village. Few injured. Many request medicines for chronic

diseases, and unrest and insomnia. No cell phone service available regardless of the carrier. Satellite phones only”.

16:55 From the Iwate Chapter, “The Iwate Prefectural HDC ordered to withdraw from SCU”


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Date Time Events3/13 18:55 From Iwate Prefectural Ofunato Hospital an ambulance arrived with Dr. Kawamura and Dr.

Shimatani on board19:20 The Morioka team dismantled the dERU and returned. 44 accepted for today.20:37 The Iwate Chapter requested accommodation for DMAT; available for up to 100 staff.

3/14 0:20 Kobe, Shizuoka and Hamamatsu teams returned to the hospitals, reporting the situation in KAMAISHI and OTSUCHI. Many patients requested medicines in regular use and there is a scarcity of drugs.Late night meals, Hitsumi (vegetable soup with noodles) and rice balls, were served at soup kitchens set up.

0:45 Situation in MIYAKO was reported using a satellite phone from the Wakayama team. Joining the Kanazawa and Tokushima teams, we took a rest inside junior high school classrooms. At 5:30 a.m. a meeting was held among the city officials of MIYAKO, Firefighters, SDF, DMAT and JRCS medical teams. There were few surgical cases; many cases needing oral medicines were reported.

6:10 Kobe, Shizuoka and Hamamatsu teams supplied pharmaceuticals, etc., leaving for KAMAISHI.7:20 Responding to an inquiry from the Firefighting Headquarters, “accommodation available for 100 in-

patients. No general outpatient practice available for today to focus on disaster victims”9:22 A deluge of patients with appointments. We explained that no service would be available in order to

respond to disaster victims. 9:40 There was an explosion on the underground floor of Nakasan Department Store. Twelve injured in

total, including one with a red tag and one with a yellow tag, were accommodated.10:51 The Iwate Prefectural HDC informed reflected waves → Provided information to the medical teams in the coastal zones.15:17 The Iwate Chapter instructed to “deploy 2 Morioka Teams to RIKUZEN-TAKATA for 3 days and

2 nights from tomorrow” → We answered, “now 24 hours into the operation; the teams will replace the local team and stay there 2 days and 1 night”

16:30 The hospital HDC meeting. Two teams will be deployed to RIKUZEN-TAKATA from tomorrow. We’ll accept no general outpatients but disaster victims tomorrow as well.

17:35 Receiving an inquiry from the Director of Hachinohe RCHP. We shared information on RCHP medical team activities in IWATE, including Nara’s team at NODA in the northern part of IWATE.

3/15 0:05 Kobe, Shizuoka and Hamamatsu teams returned to the hospital. After refilling pharmaceuticals, stoma materials, etc., they headed for KAMAISHI at 5:55.

6:20 Two Morioka medical teams headed for RIKUZEN-TAKATA8:00 The Hospital HDC meeting. We’ll accept no general outpatients but only disaster victims tomorrow as well.11:40 From Morioka medical teams, “The local manpower is insufficient for some districts due to traveling

from shelter to shelter to provide medical care. Also running out of drugs for chronic diseases”→ We requested Okayama team to supply pharmaceuticals and deploy manpower.

13:45 From SDF, “There’s an overflow at prefectural Ofunato Hospital, we need more information on Morioka RCHP” → We provided copies of the hospital’s brochure and answered, “medical care is available excluding serious burns and circulatory organ surgery cases”

13:52 The disaster in-patients claimed that they had “No money. Needed money” → Secretary General of the Iwate Chapter requested a financial institution to make arrangements.

17:55 The Iwate Chapter requested to “deploy dERU from the HDC of Iwate Chapter to the Firefighting school again” → Answer: “We have already started deployment of the medical teams to the coastal areas. Will you please discuss again if you really think you need them”.

20:10 The Date team Supervisor serving in KAMAISHI visited the hospital, claiming that they “cannot obtain antihypertensive drugs in KAMAISHI”; supplied from the Morioka RCHP.

23:25 Asking Iwate Chapter if Morioka RCHP should deploy a medical team, they answered, “Ofunato Hospital, IWATE, is functioning with support from DMAT” so that the RCHP don’t need to deploy it.

3/16 8:15 The hospital HDC meeting. We resumed accepting outpatients with appointments for medical services.

16:30 The Wakayama team arrived. Brought in Mt. Kitakami, the only person out of the crew of 3 vehicles had who experience in driving on snowy roads. At sunset it began sleeting in MORIOKA. Route 106 had a high risk of icy road conditions, we decided to have the cars driven by Morioka local government officer’s tomorrow morning.

17:30 From the Iwate Chapter: “manpower will become scarce tomorrow due to the replacement of teams in KAMAISHI” → One team was deployed from MORIOKA RCHP.

21:10 Fujisawa team leader, “it is necessary for MORIOKA RCHP medical teams to manage Red Cross relief activities in RIKUZEN-TAKATA”→Sugimura Surgery Director departed for RIKUZEN-TAKATA for the coordination on behalf of alternate chapter staff.

3/17 2:31 Mr. Sugimura, Director of the Iwate Chapter, “manpower becomes scarce at tomorrow night”→ A team serving in KAMAISHI was moved to RIKUZEN-TAKATA in the evening.

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Date Time Events3/17 7:33 Mr. Sugimura, Director, expected that the “Morioka teams will serve for 24 hours and replace the

local teams on the site.”→ OK. A 24-hour shift and replacement arrangement was established on site. 9:15 Mr. Sugimura requested that “send stoma and ostomy care products every day”→ Responding

individually, we will identify the brand for each patient and, until then, prepare the stocks at each shelter.

10:00 From the Facility Management Department: “No response about heavy oil supply from the manufacturer” →We requested Fuel Team at the Iwate prefectural HDC for mediation

10:54 From the Nara Chapter: “We are asking for the Aomori Chapter to transport us from Misawa Airport to NODA”

15:05 The Iwate Chapter reported, “the Local HDC was established at Tono Health and Welfare Village”16:30 At the Hospital HDC Meeting, it was reported: “118 staff requested accommodation inside the

hospital due to a lack of gas and difficulty in commuting”.Mr. Kubo, Chairperson of the HDC, requested Iwate Medical Association to provide information on prescribed drugs based on the data from medical fee receipts→ from the next day, March 18, the Social Insurance Medical Fee Payment Fund and the All Japan Federation of National Health Insurance Organizations established a contact service to refer to prescription drugs.

Figure 2-29　Main relief suppliesSupport supplies Quantity Support groups / supporter

Water 90 boxes Direction Co., AICHIWater (550 liters) One box Pepsi ColaMilk, labor and delivery products Individual in MORIOKAMilk 9 boxes Direction Co., Ltd, AICHI25 milk powder cans, 15 baby food meals Iwate Branch, Japanese Midwives AssociationAllergy-free curry for children Japan Pediatric SocietyAllergy-free meat sauce for children Japan Pediatric SocietyEggs 60 kg Koiwai FarmApples 5 boxes Morioka Yuai HospitalSweet buns 50 boxes Family MartBoiled rice packs 13 packs

Public Health and Welfare Dept., IWATE

Rice gruel in retort pouches 2 packsRetort curry 9 packsCanned barbecued chicken 3 casesCanned fruit 9 casesJelly 10 casesGlutinous rice 210 kg Takajo Elementary School, MIYAKONOJO, MIYAZAKIBiscuit 3,120 cans Daihatsu, IWATEDrugs (4 items) 1,000 tablets each Hirayama Clinic, KUMAMOTOKindary 3E (3 cases) 30 boxes

JRCS

Saline 1 liter (10 cases) 100 boxesDisopa 3.8 liters (4 cases) 2 boxesCidex 3.8 liters (4 cases) 1 boxHyporite 20Suppositories (PARACETA 100 mg/ 200 mg) for childrenA variety of concentrated fluid dietPulse oximeters 40 units Fukuda DenshiEchography systems 2 sets Toshiba Medical SystemsX-ray equipment for hospital rounds 1 set Shimazu CorporationPortable X-ray digital equipment 1 set Canon2 respirators 2 units Sawai Pharmaceutical

etc. provided various relief supplies, including food, sanitary, pharmaceutical products, medical equipment, etc.

c. Status of supplied items, medical appliances/equipment, etc.

After the disaster, in-house departments, medical institutions, private companies, local governments,


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Support supplies Quantity Support groups / supporter1 portable first aid monitor Sawai PharmaceuticalDefibrillator 1 unit Sawai PharmaceuticalNebulizer 10 units

Omron ColinElectrocardiograph equipment 3 unitsThermometer 1,000 setsInhaler 10 setsSphygmomanometer 20 setsBlood pressure notebooks 400 books PfizerBlood pressure notebooks 1,000 books OmronSalon Deluxe 60 sets Al- Care Co., Ltd.Adhesive plasters (expansion and contraction surgical tape) 5 boxes Al- Care Co., Ltd.

Elastic stockings 3 boxesThe Japanese Society on Clot Hemostasis, the Japanese Society of Phlebology, the Japanese Society of Pulmonary Embolism Research

Paper stretchers 100 pieces Fukuda DenshiCamp beds 30 units Paramount bed Stretchers 5 units Sawai PharmaceuticalPaper diapers 22 boxes Environmental and Life Dept., IWATEDiapers 66 boxes Direction, Co., Ltd. (AICHI)Diapers 70 packs Sawai Yakushido TempleMasks 1 box Kowa Co., Ltd.Masks 70 boxes Prefectural ChapterMasks Direction Co., Ltd. (AICHI)Towels 5 dozen Kyowa Hakko Co., Ltd.Towels 120 Kowa YakuhinTowels / Towel blankets Patients’ familyTissue boxes 12 boxes Kyowa Hakko Co., Ltd.Wet tissues 1 bag Kyowa Hakko Co., Ltd.5 shampoos, 15 soaps and others IWATE Chapter, Japanese Midwives Association

Battery cells 7 boxes Environment and Life Dept., IWATE Prefecture

Blue sheets 11 boxes

Direction Co., Ltd. (AICHI)Cassette cookers 19 boxesCassette cylinders 26 boxesClothes for cold weather 25 boxesSocks, boots, batteries, futons, etc.30 underwear shirts, 6 socks Iwate Chapter, Japanese Midwives AssociationRubber glove 1,000 boxes The Chinese GovernmentFloodlights 2 sets

Sawai Pharmaceutical

Loudspeakers 2 setsLarge heaters 2 unitsUniform vests for medical professionals in disasters 140 vestsAlfard HV 1 vehiclePortable toilets, notebook PCs, cameras, etc.

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Oji General Hospital 1

Wide area transfer (Shin Chitose)

Teine Keijinkai Hospital 1

Megumino Hospital 1

Sapporo Medical University Hospital 1

Tokyo Medical University Hospital 1

Wide area transfer (Haneda)

Showa University Hospital 1

Tokyo Metropolitan Hiroo Hospital 1

Tokyo Medical Center, National Hospital Organization 1

Omori Hospital, Toho University 1

JRCS Medical Center 1

Akita Kumiai General Hospital 1

Wide area transfer (Akita)

Nakamichi General Hospital, AKITA 1

Akita University Hospital 1

Research Institute for Brain and Blood Vessels-Akita 1

Akita RCHP 1

Akita Municipal General Hospital 1

Hanamaki City Gymnasium 1 HANAMAKI

Hanamaki Nahan shelter 1 HANAMAKINA 6 　

Total 191

e. Special notes on other responses to disaster control (a) Issuing external prescriptions by medical teamsMedical institutions in Kamaishi District (KAMAISHI and OTSUCHI) and RIKUZEN-TAKATA suffered from severe damage, and it was impossible for only local doctors to issue prescriptions for drugs that the disaster victims used daily. Therefore, the medical teams also in both districts issued external prescriptions.

(b) Obtaining information on prescription data for payments for medical services

The main medical need of the evacuees was for drugs they had taken every day; however, it was extremely difficult to issue prescriptions due to the lack of drug information on individual patients. In this context, on March 17, we requested the Prefecture Medical Association to provide data on medical fee receipts (prescription) data. From the next day, March 18, the

d. Accommodation Status of the Sick and Injured in the Disaster-Stricken Areas

The fo l lowing Figure 2 -30 and 31 show the accommodation status of the sick and wounded by Morioka RCHP and other surrounding medical facilities.

Figure 2-30　Secondary emergency hospitals in 　　　　　　　　　　　MORIOKA No. of patients accommodated

(March 11 – 17)

Secondary emergency hospitals in MORIOKA

Within IWATE (other than Morioka)

Outside IWATE

Total

Morioka RCHP 196 14 210Iwate Medical University Hospital 51 26 77

Iwate Prefectural Central Hospital 60 1 61

Morioka Yuai Hospital 41 17 58Kawakubo Hospital 26 10 36Morioka Municipal Hospital 13 0 13Tochinai Hospital 7 0 7Morioka Tsunagi Hot Spring Hospital 4 0 4

National Hospital Organization Morioka National Hospital 3 0 3

Total 401 68 469

Figure 2-31　Destinations of patients carried 　　　　　　by SCU at Hanamaki Airport

　　/ Firefighters School

Name of the Patient Accepting Facility

No. of patients accepted

Remarks

Morioka RCHP 44 MORIOKAIwate Prefectural Chubu Hospital 25 KITAKAMI

General Hanamaki Hospital 22 HANAMAKI

Iwate School of Medicine Fuzoku Hanamaki Hot Springs Hospital

20 HANAMAKI

Iwate Prefectural Central Hospital 12 MORIOKA

Iwate Medical University Hospital 11 MORIOKA

Kitakami Saiseikai Hospital 9 KITAKAMIIwate Prefectural Isawa Hospital 9 OSHU

Morioka Yuai Hospital 5 MORIOKAIwate Prefectural Towa Hospital 4 HANAMAKI

Morioka Municipal Hospital 2 MORIOKA

Morioka National Hospital 2 MORIOKA

Tochinai Hospital 2 MORIOKA


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advantage of.

(f) Brokerage at Disaster SheltersOn the night of disaster, in the total darkness that enfolded the whole town following the power outage, the evacuees gathered outside the hospital with its signboard, “Red Cross”, being lit up from the coastal sites and inside the city. In order to maintain our medical services, we had liaised with the Morioka local government, and referred those who did not have to be hospitalized to shelters set up in the city.

(g) Accommodation for DMAT staffOn March 12, responding to a request from the Chapter HDC for accommodation for DMAT staff serving at Hanamaki Airport SCU, Morioka RCHP accepted 100 staff by converting the chairs in the outpatient waiting room into beds for rest. The hospital also had a request on the following day, March 13, and accepted 100 staff.

(h) Procurement of Emergency VehiclesThe RCHP had only one ambulance vehicle for emergencies, which affected our relief activities. Thus, we asked the Morioka Red Cross Blood Center (RCBC) to rent us 2 emergency vehicles for medical services.

(i) Distribution of Relief SuppliesRelief supplies provided for disaster victims at Morioka RCHP were stored in the Disaster Relief Center (one basketball court in the gym), distributed to medical teams, etc., heading for the coastal areas.

(j) Health Counseling at the Disaster Shelters in MORIOKA

Medical Checkup Director, with public health nurses, visited the disaster shelter set up close to Morioka RCHP for the purpose of providing health care and counseling to disaster victims evacuating from the coastal areas in MORIOKA. They visited the shelter 41 times in total until the number of evacuees using the shelter was down to zero on June 27.

Health Insurance Claims Review and Reimbursement Services and the Nat ional Health Insurance Organization established a consultation desk that was able to provide information on the drugs that were being prescribed prior to the disaster.

(c) Brokerage of external prescription drugs in RIKUZEN-TAKATA

It was impossible to obtain medicines within RIKUZEN-TAKATA because all nine pharmacies in the city were affected by the disaster. Therefore, we established a system, through cooperation with Iwate Pharmaceutical Association, where JRCS medical teams could collect external prescription data issued in the city every day, and carry such data to Morioka RCHP. These prescribed drugs were also prepared at pharmacies in MORIOKA and delivered to medical institutions and disaster shelters in the city. In total, 5,329 external prescription documents were processed through brokerage until the pharmacies in the city resumed service on May 15.

(d) Nighttime Medical Service System in RIKUZEN- TAKATAAs the Prefectural Takata Hospital had totally collapsed, JRCS medical teams played a role in providing nighttime medical service in RIKUZEN-TAKATA from the next day of the disaster. As of March 16, 5 JRCS teams serving at First-Aid Stations set up in Takata Daiichi Junior High School were reportedly “uncontrollable”, and the Chairman of general surgery visited the site for coordination by proxy. Morioka RCHP, a local hospital, was in charge of the nighttime medical services every night. Medical teams also joined forces with the staff at nighttime, to replace local teams based on a 24-hour shift on site. This allowed JRCS medical teams serving in RIKUZEN-TAKATA to supply pharmaceutical products and medical materials to medical teams.

(e) Free Bus Program for Medical Checkup Service from RIKUZEN-TAKATA

In RIKUZEN-TAKATA, no medical institutions were available for disaster victims diagnosed as needing a more detailed medical check-up, who had no transportation means to outside the city either. Therefore, the prefectural HDC provided a shuttle bus a day service between RIKUZEN-TAKATA and Morioka RCHP on weekdays for free medical checkup services until May 6, which 302 patients in total took

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Figure 2-32 shows the status of the damage and restoration of the buildings, etc. YAKIYAMA saw relatively less damage, including the collapse of buildings.

(2) Sendai RCHPa. Damage and Restoration Status of Buildings and LifelinesSendai RCHP is a hospital with 400 beds and 554 staff, situated in the southwestern part of SENDAI and halfway up Yakiyama hill.

damage. A“medical treatment meeting”, a general meeting consisting of representatives of the hospital, was held nine times from March 15 to 28.Figure 2-33 shows the status of the response for about 1 week after the disaster occurred.

b. Response Status at the time of the DisasterSendai RCHP established a Hospital HDC some 10 minutes after the disaster took place, closing general outpatient services for the day to prepare for accepting disaster victims and maintaining lifelines for disaster control, etc. On March 12 it started accepting patients from DMAT, while deploying the medical teams to Ishinomaki RCHP which suffered tremendous

Figure 2-32　Damage and restoration status of Sendai RCHPItems Damage status Restoration status

Buildings

No damage to structuresDamage to old/new ridge jointsSprinkler damaged, water leaking during operations

Electricity 3/11: Following the power outage, switch to emergency power 3/14: Restored

Generator fuel (heavy oil) 3/11: 13,000 liters of residual oil3/12: Refueling 14,000 liters

City gas 3/11: Supply discontinued 3/31: Portable PG set up4/15: Restored

Waterworks 3/11: Damage to plumbing system in the site, city water pipes, water restrictions and saving

3/12: Starting water wagon services, repairs for plumbing at the site3/30: Water serviced restored

Sewerage system

3/11: Unavailable until the completion of plumbing checks (Portable restrooms to be used)3/30: Damage to the drainage system in the extensions to buildings

3/30: Drainage in the enlargement of the building repaired

Fixed-line phones (Relatively well connected in Sendai)Cell-phones 3/11: Non-connectedPriority telephone links in a disaster, satellite-based mobile phones

(Few satellite-based mobile phones)

JRCS wireless for business use, etc. (MCA radio was less well connected)

Medical gas (liquid oxygen) 3/13: 500 m3 refilled3/14: 3,000 m3 refilled

Medical gas (liquid nitrogen) 3/11: Damage to plumbing systems3/11: Repair work on the plumbing system completed 3/15: 3,000 m3 refilled


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etc., provided various relief supplies, including food, sanitary, pharmaceutical products, medical equipment, etc.

c. Status of Supplied Items, Medical Equipment / Apparatus, etc.

After the disaster, in-house departments, medical institutions, private companies, local governments,

Figure 2-33　Main activities by Sendai RCHP after the earthquake took placeDate Time Description3/11 14:46 Occurrence of the disaster

14:58 The Hospital HDC was established (Level 3 (Intensity 5 upper; hospital controllable for disaster management services)1st in-hospital broadcasting systemThree engineers confined in Clinical Pathology Department; no injury, escapingNo confinement in the elevator while evacuation.

15:10 Triage / treatment sections successfully set up.15:22 With the announcement to close general outpatient services, a new section was launched.

Functions confirmed between hub hospitals via EMIS input / MCA radio15:33 Sendai Firefighting Station requested to provide transport for the injured; answered to accept

some 50.Ready to serve meals prepared with food stocks in an emergency.

15:43 The HDC was moved to the Nursing Department.15:55 2nd in-hospital broadcasting announcement instructions to discontinue medical gases, suspend

water supplies, restricted restroom use.Not available for absorption from the central plumbing system; instruction to use a syringe pumps or portable electric evacuators

16:15 Portable toilets set up in the hospital wards, and simple toilets for outpatients.16:25 Major tsunami warning was received.

Some testing equipment was confirmed to be successfully functioning. Emergency surgery (cesarean operations) available in the operating room.

16:51 Administration staff deployed for inspection to confirm the damage status around the hospital.17:00 Data on in-hospital storage was successfully collected / evaluated.19:15 Reporting to the Sendai Environment Agency about the portable toilets set up; Water Department

about arrangements for water wagons.22:20 Accommodating 4 injured and pregnant women22:30 Connection with the Miyagi Chapter and Headquarters by phone for the first time23:15 Deploying Information Collection Team to DMAT Integrated Headquarters (Sendai Medical Center)Night Starting deployment of the teams travelling from shelter to shelter to provide medical care /

mobile clinic3/12 Morning Starting to accept patients from DMAT

Starting to request food procurement13:45 Requesting Ishinomaki RCHP to deploy medical teams14:30 Medical teams leaving for Ishinomaki RCHP

3/13 Morning A nearby hospital requested accommodation for patients needing dialysis facilities according to the unit3/14 Afternoon Absorption restored from the central piping system3/15 The 1st medical treatment meeting (general meeting consisting of representatives from each in-

hospital department) carried out every day until March 18.

Figure 2-34　Main relief suppliesRelief supplies, etc. Quantity Support group, supporter

Heavy oil A 14,000 L JRCS* AkitaGasoline 100L Shimizu CorporationFood (canned food, vegetables, packed rice, and confectionery) Osaka RCHP

Food (frozen vegetables, etc) Ecchuya Meal service CenterFood (frozen lunch boxes) 2,000 meals Joint Co., Ltd.

Food (no-wash rice) 150㎏ Health and Hygiene Division, Health and Welfare Department of Sendai

Food (rice) 320㎏ Ecchuya Meal service Center

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Relief supplies, etc. Quantity Support group, supporterFood (rice) 210㎏ Ground SDFFood (retort Chinese food rice porridge) JRCS

Packed rice 1,620 meals Medical Service Affairs Div., Health, Welfare and Environment Dept. of Miyagi

Packed rice 100 meals Koyo Co., Ltd.Food (rice ball) 2,000 Fukui RCHPRice balls 250 Akita RCHP

Rice balls 1,500Medical Service Affairs Division, Health, Welfare and Environment Department of Miyagi

Soup kitchen setsGomoku rice (assorted rice with meat and vegetables) 40 Aichi Chapter

Rice porridge 500 Aichi ChapterFood (bread) 9,225 Ashikaga RCHP

Food (bread) 320 boxesRestoration Support Section, Disaster Prevention Planning Bureau, Hyogo Planning and Public Life Department

Bread 2,000Medical Service Affairs Division, Health, Welfare and Environment Department of Miyagi

Sweet bun 1,000 Akita RCHPCanned bread (muffins, chocolate and panettone) 2,592 in total Aichi ChapterSteamed yakisoba (chow mein) 648 meals Taihaku Health and Welfare Center, SendaiCalorie Mate 540 Aichi ChapterCalorie Mate 1,500 Otsuka Pharmaceutical Co., Ltd.Food (frozen chicken breast and wings, pork sausages) 500 kg in total Andes, Asia

Food (curry roux) 40㎏ Ecchuya Lunch CenterFood (Sasakamaboko or bamboo-grass kamaboko) 10,000 pieces Abe Kamaboko-ten Co.Soup kitchen sets 100 brown alga sets Aichi ChapterSide dishes in a lunchbox 384 Aichi ChapterFruit and boiled beans cans 168 cans

Koyo Co., Ltd.Red snow crab 888 cansLight Flaked Tuna 624 cansPickles, deli, etc. 17 casesCheese Sendai Meal service Center

Candy cheese Health and Hygiene Section, Sendai Health and Welfare Bureau

Fruits Sendai Meal service Center

Kiyomi oranges 108㎏ Health and Hygiene Section, Sendai Health and Welfare Bureau

Oranges Health and Hygiene Section, Sendai Health and Welfare Bureau

Dry milk (Rakuraku Cube) 768 bags Meiji Co., Ltd.Dry milk (Hohoemi) 32 cans Meiji Co., Ltd.Dry milk (E Akachan, MA-1, Hagukumi) 44 cans in total Morinaga Milk Industry Co., Ltd.Dry milk (Sukoyaka, pm) 28 cans in total Bean Stalk Snow Co., Ltd.Various brands of baby food 96 bags Morinaga Milk Industry Co., Ltd.Various brands of baby food Bean Stalk Snow Co., Ltd.

Food (baby food) 7,500Restoration Support Section, Disaster Prevention Planning Bureau, Hyogo Planning and Public Life Department

Corn soup 360 bags Aichi ChapterCorn cream soup 1 kg x 18 packs Koyo Co., Ltd.Pumpkin soup 780 Aichi ChapterCarrot soup 870 Aichi Chapter


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Relief supplies, etc. Quantity Support group, supporter

Beverages (water, tea and sports drinks) 27,264 bottles

Restoration Support Section, Department Disaster Prevention Planning Bureau, Hyogo Planning and Public Life Department

Drink (drinking water) 106,890 bottles Costco Wholesale Snow Co., Ltd.Drink (drinking water) 8 boxes Tohoku Branch, Suntory Foods Co., Ltd.Drink (drinking water) 10t A STYLEDrinking water 55 boxes MIYAGI Children’s Hospital

Mineral water 1,020 bottles MIYAGI Health, Welfare and Environment Department Medical Service Affairs Division

Mineral water 330 bottles Aichi Chapter

Mineral water Health and Hygiene Division, Health and Welfare Department of Sendai

Crystal Geyser 500 mL X 1,980 Otsuka Pharmaceutical Co., Ltd.Milk 1,135 bottles Ashikaga RCHP

Pocari Sweat 500 mL x 1,392 bottles Otsuka Pharmaceutical Co., Ltd.

Yakult LT 525 YakultDaily necessities (blankets) 150 pieces Osaka RCHPDaily necessities (electric rice cookers) 2 units Osaka RCHP

Daily necessities (electric rice cookers) 2 units Health and Hygiene Division, Health and Welfare Department of Sendai

Daily necessities (polyethylene tanks) 444 sets


Daily necessities (bags of non-common use drinking water) others 1,000 pieces


Daily necessities (movable AV tables) 5 sets Audio Visual Communications Ltd.

Daily necessities (face towels) 300 Sendai Branch, Meiji Yasuda Life Insurance Company

Daily necessities (air cleaners) 18 units Bridge Industry Co., Ltd.Daily commodities (work gloves, toilet paper, towels, wet tissues) Kyowa Hakko Kirin Co., Ltd.

Disposable baby bottles 500 bottles Mita Rika Kogyo Co., Ltd.Underwear for neonates 1,000 pieces Silk Mulberry Co., Ltd.Sanitary materials (wet towels) 6 boxes JRCSSanitary materials (skin cleanliness cotton) 30 boxes Sendai Branch, Eisai Co., Ltd.

Sanitary materials (nursing bottle cleaner) 200 Restoration Support Section, Department Disaster Prevention Planning Bureau, Hyogo Planning and Public Life Department

Sanitary materials (paper diapers) others 297Restoration Support Section, Department Disaster Prevention Planning Bureau, Hyogo Planning and Public Life Department

Diapers 12 boxes Tohoku University HospitalSanitary materials (medical alcohol gel CB) 10,000 Cocokarafine GroupSanitary materials (masks) 7,500 pieces Sendai Branch, Hogy Medical Co., Ltd.Surgical masks Tohoku University HospitalSanitary materials (disposable gloves) 3,300 pieces Sendai Branch, Hogy Medical Co., Ltd.Baby wipes Tohoku University HospitalPharmaceutical products (saline) 100 boxes JRCS

Pharmaceutical products (saline) 2,000 boxes Medical Service Affairs Div., Health, Welfare and Environment Dept. of Miyagi

Pharmaceutical products (Tamiflu) 970C Fujimoto Hospital, IchiyukaiPharmaceutical products (Tamiflu Capsule 75) 440C Miyabi Pharmacy　Watanabe Cyozai Pharmacy

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Relief supplies, etc. Quantity Support group, supporterPharmaceutical products (Isodine Gargle) 200 Miyabi Pharmacy　Watanabe Cyozai PharmacyPharmaceutical products (Relenza) 156C Fujimoto Hospital, IchiyukaiMedical materials/equipment (crutches) 20 sets JRCSMedical materials / equipment (aluminum light weight crutches) 30 sets Hitsujigaoka Hospital, Yujinkai

Medical materials / equipment (digital automatic sphygmomanometer) 5 units Sendai Branch, Omron Colin Co., Ltd.

Medical materials / equipment (digital automatic sphygmomanometer) 100 sets Sendai Branch, Omron Health Care Co., Ltd.

Medical materials / equipment (electronic thermometers) 30 sets Sendai Branch, Omron Colin Co., Ltd.Medical materials / equipment (electronic thermometer) 200 sets Omron Health Care Co., Ltd.Medical equipment (X-ray equipment for rounds) 2 units Shimazu CorporationMedical equipment (ultrasonic diagnostic equipment) 2 units Toshiba Medical Systems Co., Ltd.

By age group, groups under 10 years and those above 61 years of age were characteristically higher. By disease, respiratory and digestive diseases, and other internal diseases exceeded 40% of the total.

d. Medical servicesFigure 2-35 shows the status of patients accepted at first-aid stations set up after the disaster. The number of patients peaked on March 13.

March 11 March 12 March 13 March 14

Others15%

Medicine prescription6%

Obstetrics and gynecology3% Surgical disease

(other than injury)10%

Surgical disease (other than injury)10%

Otherinternaldiseases12%

Otherinternaldiseases12%

Injury20%Injury20%

Hemodialysis4%

Digestive diseases (internal diseases)7%

Respiratory diseases (internal diseases)22%

0-10 years

11-20 years

21-30 year

31-40 years

41-50 years

51-60 years

61-70 years old

71-80 years

81-90 years

91 years or older

Unknown

Figure 2-35　Status of patients accepted at Sendai RCHP for in-hospital medical care

No. of patients visiting the hospital per day Percent of patients per disease

Number of patients visiting the hospital by age group


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f. Services outside the Sendai RCHPAlthough situated in the disaster-stricken area, Sendai RCHP deployed medical teams to Sendai Medical Center and Ishinomaki RCHP on the day and the day following the disaster, and to Ogatsu District from August to September. It also dispatched support staff for the Ishinomaki Joint Medical Team Headquarters, for pharmacist duties, as well as for medical services at MINAMI SOMA after the Fukushima Daiichi Nuclear Power Plant accident.

e. Working status of hospital staff and the damage situationImmediately after the earthquake took place, many staff on duty, as well as even those taking days off, voluntarily attended the hospital for service. None of the staff were injured or died after the disaster; however, some lost family members due to the tsunami.Many staff also stayed at the hospital overnight to provide services because their houses were damaged by the earthquake and tsunami, and in-hospital care was needed immediately after the disaster. It was also difficult to commute due to the lack of fuel.They also set up temporary nursery schools and rest spots so that they might feel secure in providing the services.

Figure 2-36　List of services provided outside the hospitalService

description Destination Deployment term Job title

Deployment of medical teams

Sendai Medical Center 3/11 Director of Pediatric Surgery, Nurse Manager, Administration staffIshinomaki RCHP 3/12-13 Director of the Medical Social Services Department, Deputy

Director of the First Orthopedics Department, Nurse manager, Nurses (2), Assistant Manager of the 2nd Radiation Technology, Administration staff (2)

Deployment of support staff from the Headquarters at Ishinomaki Area Joint Medical Team

ISHINOMAKI 3/25-284/12-174/21-246/8-12

Director of Pediatric Surgery

4/22-286/12-14

Director of Medical Social Services

3/25-283/30-4/14/4-64/28-305/65/21-225/28-29

Nurse Manager

4/8-125/1-25/9-10

Nurse Manager

4/16-205/16-185/22-245/29-31

Chief Nurse

4/1-44/6-84/25-285/7-85/19-20

Chief Nurse

Deployment of support staff from the Headquarters at Ishinomaki Area Joint Medical Team

ISHINOMAKI 4/12-165/11-135/25-27

Nurse

4/20-255/3-65/14-16

Nurse

3/25-28 Administration staffSupport for pharmacist duties

Ishinomaki RCHP 3/19-21 Section Manager of Formulations3/21-23 Pharmacist3/17-198/6-156/29-7/8

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the prefectural capital of FUKUSHIMA. Figure 2-37 shows damage to the hospital buildings and their restoration status. Fukushima suffered from almost no collapse, etc., of buildings.

(3) Fukushima RCHPa. Damage and Restoration Status of the Buildings

and LifelinesFukushima RCHP is a hospital with 359 beds and 482 staff, located in Fukushima Nakadori District that is

Service description Destination Deployment

term Job title

Deployment of Ogatsu, Ishinomaki medical teams

ISHINOMAKI 8/11-13 Director of Pediatric Surgery, Nurse, Administration Staff8/25-27 Director of Medical Examinations, Nurse, Medical

technologist (Administration Staff)9/1-3 Director of the Medical Social Services Department, Nurse,

Pharmacist9/15-16 Surgery Doctor, Nurse, Social Worker (Administration Staff)

Medical services after the Fukushima Daiichi Nuclear Power Plant accident

MINAMISOMA 10/21-23 Director of Pediatric Surgery, Nurse Management (2)12/15 Surgery doctor, Nurse Deputy Manager, Chief Nurse10/21-2312/15

Director of the Medical Social Service Department (Administration Staff)

Figure 2-37　Damage and Restoration Status of Fukushima RCHPItems Damage status Restoration status

Buildings No damage to the structuresDamage to the structural joints of the former main buildingCracks in the wall, distorted floorsElevated water tank damaged; boiler facilities partly damaged

Electrics 3/11: Switched to the emergency power system (in-house power generation) in the blackout

3/12: Restored in the evening

Gas 3/11: Supply disruption 3/12: RestoredWaterways 3/11: No breakage of the pipes on the premises

Municipal water outage (To examine the status of the piping breakage)Possible to save drinking water in the main building until the pipe system was examined.No use of water in the former building (used portable toilets, etc.) For water intake and savings

3/14: 20t water supplied by a Fukushima city water wagon3/15: Water services restored in the main building3/16: Water services restored in the former building

Fixed-line phones Paralyzed communication network (due to restrictions)

Cell phones Same as aboveWireline phones in times of a disaster, Satellite-based mobile phones

A few phone calls available during restrictions(Satellite-based mobile phones were not available)

JRCS wireless system for professional use

(No particular communication network problem in the Fukushima Chapter)

At the request of the Fukushima Chapter, Medical-1 Team was deployed to Minamisoma Hospital, which had suffered from significant damage.Starting on March 14, a general meeting was held for representatives from each in-hospital department and various reports and information on the availability of clinical services, disaster data, etc. were shared among them.Figure 2-38 shows the response status over about 1 week after the disaster occurred.

b. Response to the DisasterThe Fukushima RCHP set up the HDC in the 5th floor of the Administration Office of the main building about 20 minutes after the disaster took place. Subsequently, they stopped providing general outpatient services to prepare for accepting disaster victims and secure in-hospital lifelines against power outages, etc. At 18:30 on the same day DMAT was called out, heading for MINAMISOMA via the Integrated HDC at Fukushima Medical University. At 10:40 on March 12, the next day, patient information from DMAT was obtained.


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Figure 2-38　Main responses of Fukushima RCHP after the disaster occurredDay Time Description3/11 14:46 Disaster occurred

Evacuation Hospital guidance to outpatients, confirmation of damage status to inpatients15:05 Setting up the HDC

Closing outpatient services (except first aid practice); suspended some accountsProviding the first in-hospital broadcasting; confirmed the damage status of each department via extension telephoneNo confinement in the elevators

Evening Transfer of patients in the former building to the quake-resistant main building for temporary evacuationNutrition Department distributing temporary prepared food

17:00 Request for DMAT deployment18:30 Deploying DMAT (Fukushima Medical University → MINAMISOMA)

3/12 10:30 1st Medical Team, leaving for Minamisoma Municipal Hospital15:36 Hydrogen explosion took place in the building housing reactor 1 of the Fukushima Daiichi Nuclear Power Plant17:30 Fukushima Chapter ordered the Medical-1 Team to move (from MINAMISOMA to KAWAMATA)

After moving, started a medical care / mobile clinic from shelter to shelter.18:30 Electricity restored; requested Fukushima prefectural government to procure 20 t water wagon23:00 DMAT returned

3/13 7:00 DMAT left again11:30 Instructing to restrict the use of toilets due to the lack of water19:30 Fukushima Chapter informed, “drugs for 7 days available for purchase from Primary Medical Doctor

(PMD) without prescription”22:00 Fukushima RCHP DMAT returned

3/14 6:05 Requested to supply water and resume water services with 20 t water wagons from Municipal Waterworks Dept. 8:00 2nd Medical Team left

Based on instruction from the Fukushima Chapter, mobile clinic services traveling from shelter to shelter started (many refugees within a radius of 5 km from the Plant)Instructions from the Prefecture about how to treat patients suspected of being exposed to radiation.

8:30 First Medical Treatment Meeting (General meeting with representatives of each in-hospital department). Since then, negotiating with the Gasoline Stand contractor as for strategies to cope with fuel scarcities every day

“10 liters refueling available if a staff identification card of the Hospital is presented”; provided, however, it is “only when the residual amount is low”.

11:01 Hydrogen explosion took place in the building housing reactor 3 of the Fukushima Daiichi Nuclear Power Plant14:00 Medical-2 Team received radiation measurements at the Fukushima Gender Equality Center

(NIHONMATSU) → No abnormality was detected for all the teams.16:30 Medical Team-3 left for Azuma General Gymnasium

The 2nd Medical Treatment Meeting (with representatives)Appointment for stable outpatients for the next day will be canceled to accept emergency patients

22:00 After the measurement of radiation exposure, Medical Team-3 returned3/15 8:30 The 3rd Medical Treatment Meeting (with representatives)

As the municipal water system was restored, it was decided this day to resume medical services for outpatients, although at a lower level. Prescriptive drug was delivered for at least a week for the present. Medical care expenses of 3,150 yen (healthcare services provided combining insurance-covered and non-covered services covering for the end of March) are not to be paid.

8:50 Medical Team-4 leaving for Azuma General Gymnasium16:30 The 4th Medical Treatment Meeting (with representatives)

Treating patients from the Soso District in the special care room due to the risk of radiation exposure3/16 7:45 Medical-5 Team leaving for Iwaki Municipal Junior High School Gymnasium, Big Palette Fukushima

8:30 The 5th Medical Treatment Meeting (with representatives)Instructions on how to respond to patients or suspected patients exposed to radiation Screening of those living within a radius of 20 km from the Fukushima Daiichi Nuclear Power Plant

15:00 The 6th Medical Team leaving for Azuma General Gymnasium16:30 6th Medical Treatment Meeting (with representatives)18:00 The team reported that about 35 patients from Futaba Hospital being transported to Azuma Gymnasium were in a very

serious condition (out of which, 3 died, 4 were urgently transported to the Fukushima RCHP and others to other clinics)3/17 0:30 Medical Team-6 returned

8:00 Medical Team-7 leaving for Azuma General Gymnasium 8:30 7th Medical Treatment Meeting (with representatives)

Briefing on how to respond to the explosions at the nuclear reactorsRequesting Fukushima Prefectural Kenhoku Public Health Center to provide iodine agents for disaster medical assistance team staffTo ensure indoor evacuation and sealing up of the hospital to prepare for another explosion, and discuss moving patients from the former building to the main building

16:30 The 8th Medical Treatment Meeting (with representatives)Obtained 250 tablets of potassium iodide from Fukushima government

3/18 8:30 The 9th Medical Treatment Meeting (with representatives)Ministry of Economy, Trade and Industry requiring oil supply businesses to refuel vehicles for emergencies preferentially (cooperation obtained for emergency vehicles of Fukushima RCHP by our Gasoline stand contractor)

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Figure 2-39　Main relief suppliesRelief supplies, etc. Quantity Support organization / supporter

Medical care / welfare apparatus

Inhalers 20 sets

Headquarters

Nebulizers 20 setsPortable electrocardiographs 10 setsElectronic sphygmomanometers 100 unitsToshiba’s portable ultrasound machines/Viamo 2 unitsNitrile gloves 500 boxesElectronic thermometers 3000 sets CitizenAstral lamps 1 unit Maquet JapanX-ray equipment for rounds 1 unit Shimazu CorporationPulse oximeter 30 units Konica MinoltaAutomatic resuscitators 1 unit City Medical AssociationWheelchairs 9 units Kirayaka Financial GroupBedside tables 132 units ToyovendingOver tables 63 units ToyovendingAir mattresses / Advan 2 sets MoltenMedical care mats 14 pieces Fukuda Denshi

Pharmaceutical products

Skin washing cream sprays 11 piecesJWOCMMulti-fix rolls (medical transparent

waterproofing film) 2 piecesWound treatment ointment 30 piecesWound protection, adhesive plaster system, agents for covering pressure sores 652 pieces JWOCM/ Japanese Society of Pressure UlcersTapes 1,008 pieces JWOCM/ Japanese Society of Pressure UlcersAntibacterial sanitization (bubble) 16 pieces Eisai JapanHaru-onpax 60 pieces Eisai JapanToromismile (2kg/700g) 2 bags each KoyoSurgical masks 2,038 boxes Koyo / Eisai Japan / Sumitomo 3M

Sanitary materials

Toothbrushes 16 pieces Eisai JapanAntibacterial cotton swabs 600pieces Eisai JapanHand gels 4,920 pieces Sumitomo 3MBaby wipes, wet towels for adults 340 bags KoyoUrine collecting pads for men/ paper underwear for adults 95 pieces Eisai JapanSanitary goods 2,396 bags Koyo / Eisai Japan

Food Beverages 418 boxes Koyo / Kyowa Hakko Kirin / Nestle Japan / Otsuka Pharmaceutical / Toyovending / Yakult

Foodstuffs (onions, carrots, potatoes, cabbage) 19 containers Suzusho greenDry milk 6 boxes Koyo / Morinaga Milk Industry / othersFood (cup noodles, CalorieMate) 1,138 boxes Koyo / Otsuka Pharmaceutical / Kyowa Hakko KirinFood (freshly baked bread, financier) 3,300 pieces

KoyoClothing / others Underwear, night clothes, T bandage 70 boxes

Deodorant 2,100 piecesUmbrella 294 piecesAlkaline AA batteries 600 piecesPlastic bags (45 liters, 90 liters) / shopping bags 2,400 pieces Koyo / Eisai Japan Box tissues, pocket tissues, wet tissue 756 pieces Eisai Japan / Kyowa Hakko KirinTowels 220 pieces Style heart / Kyowa Hakko Kirin

Gratuitous rental support Quantity Support organization / supporterMedical equipment

Sterrad plasma sterilizers 1 unit

J&J

Sterrad hydrogen peroxide cassettes 100S 1 caseIndicators (for inside CI) 1 boxIndicators (for outside CI) 1 boxIncubators 1 unitCyclesure 24 biological indicators 1 boxSterile packs 5 boxesDispensers with purification function 2 units TMC

medical equipment, etc., were provided from medical institutions, private corporations, local governments, etc.

c. Status of Relief Supplies, Medical Equipment, etc.After the disaster, various relief supplies including food, sanitary materials, pharmaceutical products,


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evacuate with their family. Those whose family members still stayed far apart due to the nuclear disaster commuted from rental housing from outside the Prefecture that they had evacuated to.　 (4) Otawara RCHP*Since July, 2012, the name was changed to “Nasu RCHP”.a. Restoration and Damage Status of Buildings and LifelinesOtawara RCHP is a hospital situated at the northern part of TOCHIGI. TOCHIGI, situated in the northern part of the Kanto Region, without any coastline on its border, suffered no Tsunami damage. However, the Disaster Relief Act applied to as many as 15 cities and towns (26 in total for the entire prefecture) with human suffering (4 deaths, 134 injuries) and house damage (260 houses totally destroyed, 2,109 houses half destroyed, 72,143 houses partially destroyed). This affected the restoration of lifelines and prolonged the duration of power and water outages, etc.Figure 2-41 shows the damage and restoration status of the hospital buildings, etc.

d. Medical ServicesFigure 2-40 shows the numbers of outpatients / in-patients of Fukushima RCHP over the 1 week after the disaster occurrence.

Figure 2-40　Number of outpatients / in-patients 　　　 of Fukushima RCHP per day

Outpatient services Hospitalization Service descriptionMarch 11 (Fri) 575 patients 281 patients General outpatient services

discontinued after the disaster took place at 14:46.

March 12 (Sat) 35 patients 250 patientsMarch 13 (Sun) 77 patients 250 patientsMarch 14 (Mon) 85 patients 216 patients General outpatient services

temporarily closed.March 15 (Tue) 92 patients 214 patients General outpatient services resumed,

although on a smaller scale.March 16 (Wed) 363 patients 223 patientsMarch 17 (Thu) 415 patients 230 patientsMarch 18 (Fri) 538 patients 240 patients

e. Working status of hospital staff and the damage situationNone of the staff were injured or died after the disaster; however, many had their houses half or partially destroyed.Some of our staff evacuated to distant places using their paid vacation until the situation of the nuclear accident settled down. In particular, some staff with a small child or children even retired in order to

Figure 2-41　Damage and restoration status of Otawara RCHPItem Damage status Restoration status

Building

Many cracks in the pillars and walls of the entire Building C (RC pillar structure)First floor tilted with the walls fallen D700 × H900 × W4500Water leakage due to damage to the pipes on the 2nd, 4th and 5th floors

3/11　No entry due to serious damage to Building C

Office of the Nutrition Section 150 mm gap 3/14　Recovery using tarpaulinsWall fallen in the Outpatient Section, on the 2nd floor of Building A D150 × H2500 × W4000

3/11　Prevention against falling of the construction scaffold bridge

Water leaking due to broken hot/cold water pipes at the 1st, 3rd, 4th, 5th Fl. of Building A

3/11　Repair water leaking from hot / cold water pipes

Water leaking due to broken water pipes around the toilets at the 1st floor of Building A 3/14　Repair to water pipes around the toilets

Corridor slope broken outside Building A side 3/18　Slope available for use after quick repairPartition broken and ceiling fallen in the Dialysis Room of the Central Ward 3/13　Partitions and ceilings repaired

50 mm gap between the ICU of Building B and the OP Room 3/14　Recovery using tarpaulinsAll joint covers fallen in the Emergency Ward Building 3/15　Covers restoredCeiling covers fallen in the Emergency Center; uneven floor surface at 50 mm in the central part of the floor 3/13　Slope installed as quickly repaired

No vehicle entry or exit available due to the uneven surface being 100 mm at the entrance / exit for ambulances Treating the slope with asphalt

All joints of both old and new buildings broken, or with uneven surface created 3/13、14　Quick repair

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evacuating from the affected region.There was a kitchen in the damaged building, which significantly affected the service of serving meals to patients. To cope with the situation, we provided a soup kitchen service and used the dining room for outpatients (deli or prepared food via an outsourcer). We eventually remodeled the warehouse into a kitchen.Figure 2-42 shows the disaster response status for about one week after the disaster took place.

b. Response Status at the time of the DisasterAt Otawara RCHP, with damage to the building and aftershocks, doctors and nurses carried out triage and guided the patients outside the hospital. They moved the patients having difficulty in moving outside the hospital to an earthquake-resistant building, allowed some mildly ill patients to go home, or evacuated them to public facilities by municipal bus with the cooperation of Otawara municipal government. The next day, March 12, they added beds in hospital wards still available for use in order to accept patients

Item Damage status Restoration status

Electricity3/11　No blackouts3/15〜24　Rolling blackouts; switch to emergency power generators

Fuel

3/11　Kerosene for heating was not available from nearby stands; one of the stands provided fuel by hand

3/11　Heavy fuel oil A 34,000 liters remaining3/11　Procuring 120 liters of kerosene for heating

3/15〜22　Medical Welfare Division of the Prefecture provided fuel stockpiles for emergencies and light fuel oil for generators

3/15　Refueling 550 liters of light oil3/17　Refueling 734 liters of light oil3/18　Refueling 256 liters of light oil3/22　Refueling 138 liters of light oil

Propane gas 3/11　Serious damage to Building C; not available for use3/11　Temporally installing propane gas devices; setting up portable PG in the three-multilevel car parking garage

Waterworks

3/11　Municipal water pipe broken 3/15　Municipal water piping restored3/11　Tap water not available due to serious impurities; switched to groundwater

3/20　Partially starting to use municipal water

3/11　Using broken water tank although water leaking 5/20　Repairing water leaking

Sewage system 3/11　Using broken pipes as they are in Building A 6/30　Restoration of sewerage system completed

3/11　Stopping the use of broken pipes in Building C 3/11　No entry to Building C

Steam 3/11　Stopping the use of broken boiler pipes 3/11　Restoration of steam pipes completed

Telephone 3/11　Fixed phone available intermittently3/11　Cell-phone interruption

JRCS wireless system

3/11　Trying to use cell phones, although only 3 units or so were available at nighttime due to few available battery chargers and a shortage of batteries

3/12　Some two devices available after charging with a battery

Medical gas 3/11　No damage to the plumbing and cylinders 3/11　50 cylinders (500ℓ) supplied

The exterior3/11　Vehicle traffic not available with an uneven surface of 150 mm at the front rotary 3/25　Repair work completed

3/11　Terribly uneven floor around Building C; only possible to walk 3/27　Repair work only partial

Figure 2-42　Major response at Otawara RCHP after the disasterDate Time Description3/11 14:46 Disaster took place (Northern part of TOCHIGI: intensity 6 upper)

14:50 Hospital HDC established. (Due to the risk of a building collapse, we instructed patients and their families and all staff to evacuate the building)

15:15 Temporarily evacuated inpatients able to walk to a parking lot (front, bank over the river).Inquired from each department in regard to the number of patients within the hospital, those hospitalized, and the damage status.


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Date Time Description3/11 15:30 Transferred seriously injured patients from the collapsed building to the emergency ward

Due to the significant degree of damage in the hospital ward, we secured temporary evacuation spots for inpatients and requested transportation vehicles (Otawara local government).Emergency food and other items were collected at the first floor entrance

16:00 As an evacuation place for mildly-injured patients, the City Gymnasium and Otawara Senior High School’s gymnasium were designated.Inputting EMIS and requesting DMATSoup kitchen and emergency food prepared (as the kitchen unavailable, hot meals were served by the Nutrition Section staff).

16:30 After triage, transferred the patients one by one by municipal bus (113 patients)Other patients with difficulty in walking were transferred by our two ambulance vehicles

16:55 No entry to Building C (due to a risk of collapse): 3/12 Results of the Imminent Risk Assessment18:00 Doctors, nurses and administration staff were placed at 2 points of the gymnasium for the night

shift.18:10 DMAT team of Dokkyo Medical College Hospital started services at the ICU, etc.20:10 DMAT Teams (2 teams) of Uenomiya Koga General Hospital started services at the gymnasiums22:25 DMAT team of Ashikaga RCHP arrived

3/12 06:05 Staff preparing breakfast for evacuees to the gymnasiums and inpatients (as the kitchen was unavailable, hot meals were prepared by the Nutrition Section staff)

07:30 Dokkyo Medical College Hospital informed us that they could accept some 50 inpatients (regardless of internal or surgical departments)

07:25 Two pharmacists were assigned to each gymnasium.07:45 Soup kitchen service completed. Serving meals to evacuating patients and inpatients.08:29 Patients on dialysis evacuating to the city gymnasium were transferred to clinics in the city

(accompanied by nurses)09:00 The general meeting started (with participants including government authorities, DMAT teams)

Otawara RCHP：Report about the patients, building status, etc.Government authorities : Report about damage status, etc., in the region.

09:45 Identifying the status of empty beds and adding beds at hospital wards available 10:25 Determining of ward allocation for the patients accommodated at our hospital (evacuating patients

to each gymnasium)10:55 Started to transfer patients one by one by municipal bus and ambulance car.

Ended at 15:30; withdrawal from the gymnasiums11:19 Started to transfer 14 serious patients to 4 facilities in the prefecture, including Dokkyo Medical

College Hospital (accompanied by DMAT Teams: by air ambulance / ambulance vehicle)16:30 Started general meeting (including government authorities and DMAT Teams)

*Determining of the future direction23:00 Two staff from the Mie Chapter and 6 medical team staff from Yamada RCHP arrived.

3/13 09:00 Started the general meeting.12:13 Transferred two serious patients to Saiseikai Utsunomiya Hospital (accompanied by Yamada RCHP

medical team staff)15:55 Medical teams from Yamada RCHP started medical services by traveling from shelter to shelter

22:35 Closed the service for the day16:00 The general meeting started.

* Confirmed patients about medical care and meal services from March 14, etc.22:25 Prefectural Medical Welfare Division answered questions about preparations for the planned

(rotating) power outage from March 1423:30 Briefed by Tokyo Electric Power Company (TEPCO) about the planned (rotation) power outage

schedule (hours)3/14 08:30 In-hospital liaison conference held (at 8:30 15:30) until March 193/16 17:00 Medical teams and administrative support staff deployed to Ishinomaki RCHP

18:00 Joint meeting with participants including prefectural and local government authorities, medical associations from each city, etc.2

(2) Discussion about medical services for those evacuating to disaster shelters (2 accommodations)

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provide our normal service menu due to the effect of the rolling power outage, we wrote prescriptions and test request sheets in handwriting during the blackout.From around March 16, people evacuating from FUKUSHIMA (radiation originating from the nuclear accident) increasingly visited us for medical care.

＜First Aid＞On the day of the disaster, we temporarily stopped providing emergency outpatient services, although 17 patients visited us until 21:00. They included 10 injury cases due to head banging, bone fracture, etc., 2 serious

d. Situation (Response) of Medical Service Functions, etc.

We evacuated the patients outside/inside the hospital immediately after the disaster took place. On the next day, all patients were accommodated inside the hospital, and the hospital wards were reorganized. From March 14, our general outpatient medical care restarted.　　＜Outpatient Service＞Our general outpatient consultations resumed on March 14. Although it was impossible for us to

materials, medical equipment, etc. were provided by local governments, medical institutions, local companies, JRCS Headquarters and Chapters, etc.

c. Status concerning supplied materials, medical equipment, etc.

Various relief supplies, including food and sanitary

Figure 2-43　Main relief suppliesSupport supplies, etc. Quantity Support groups / supporters

Rice (retort) 4,000 meals

OTAWARA

Rice (polished rice) 99 mealsMiso soup 1,158 mealsBowls 1,600 piecesPlates 4,000 piecesSpoons 2,000 piecesForks 1,000 piecesDisposable chopsticks 4,000 setsCups 1,000 piecesFlashlights 20 pieces Fire and Disaster Management Section of TochigiDry rice porridge 1,000 meals Fire and Disaster Management Section of TochigiWater (500 ml) 120 bottles Morinaga Milk IndustryDisposable paddles 4 sets Nihon KohdenBedside monitors 50 sets Nihon KohdenFood (biscuit) Tannobe Prefectural HDCRice porridge with plum 1,000 meals TOCHIGIJelly for deglutition 288 pieces

Ryoshoku Service Co., Ltd.Vegetable juice (100 ml) 25 packsWafers 5 bagsEgg rice crackers 1 bagCrackers for emergencies 1,260 meals TOCHIGIHamburgers 400 pieces MOS BURGERYogurt 1,000 pieces GlicoOrange juice 1,000 packs GlicoDisposable wood chopsticks 1,000 sets NikkaneRice (retort) 720 pieces Tochigi CO-OPSweet bun 23

PiaBread 4 loavesDisposable tablewareGasoline 20 liters Nasu Town OfficeBlankets 255 pieces

Tochigi ChapterCots 189 unitsFirst-aid kit 1 setFuton set 5 setsSimple toilets 300 units TOCHIGIMilk conditioning water Morinaga Milk Industry

Random order


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day inside the Otawara RCHP and, fortunately, our patients and staff managed to evacuate without anyone being injured.One of the factors that allowed us to provide evacuation guidance and stand-by outside the hospital relatively smoothly were our repeated disaster drills held on a relatively large-scale for the past 7 years. This helped every staff member to act voluntarily without direction, while assessing the the situation. The second factor is our determination, wisdom and leverage where every one of the staff members came together, considering the patients first to

“protect the patients”. Furthermore, it is essential to have the cooperation of the local government and the Medical Association on a daily basis. Cooperation carried out on daily basis helped alleviate the effects of the sudden disaster, which made the medical team staff determined to further develop this circle of cooperation and promote deployment.On March 14 the Tochigi Chapter requested Otawara RCHP to deploy medical teams, although the hospital put off responding to its request as the hospital had been being functioning insufficiently. On March 15 they again requested the hospital to deploy teams, and it made a decision to meet the request. One of the major factors that encouraged the hospital to make the decision was a conversation between staff members in the locker room in the morning, “Why don’t we rush into ISHINOMAKI to provide medical services?”, “We got enough support from others too. It will be all right if all of us come together”. When we approached some of the staff, asking, “will you be able to come and join forces for medical care at...” 2 out of 3 had been already been prepared to head for the area with their necessary belongings in their cars.

“This is the spirit of Otawara RCHP. It’s the time to rise to the occasion, playing our role as Red Cross hospital staff”, every member thought at this moment.Services provided by 79 staff in total included 10 team staff to Ishinomaki RCHP, Suzuko Plaza at IWATE, Azuma Sports Park in FUKUSHIMA from March 16 to July 27; 9 psychosocial care staff; 12 support staff to Ishinomaki RCHP (ER support, ward support, doctors, pharmacists, administration staff). This was the largest force among the 3 hospitals in TOCHIGI, providing long-term support.After the disaster this time, some staff claimed mental illness, and those missing their hospital ward

cases (2 patients with subarachnoid hemorrhage were transferred to the university hospital after the first aid treatment) being hospitalized [one with chronic respiratory failure of at-home oxygen therapy, and one with myocardial infarction (cardiac catheterization provided at midnight) ].Subsequently, we stopped, in principle, emergency outpatient services for one week although several patients visited us per shift , and a few were hospitalized.

＜Surgery＞On the disaster day, 4 patients in the hospital room managed to evacuate from there safely. From the next day, 2 rooms were made available providing only in-hospital emergency and C-section surgery for one week, and surgery appointments already made were rescheduled until after March 22.

＜Dialysis＞We deployed our nurses to nearby clinics and asked them to take care of our patients for 3 days from March 12. We resumed only maintenance dialysis therapy for patients needing it from March 15.

＜Hospital Ward＞On the disaster day, we closed 4 wards (180 beds unavailable). From the next day, March 22, and April 18, with the hospital resuming its functions, we reopened the wards that were closed and added another 100 beds to cope with the increasing number of patients.

＜Meal Service＞On the night of the disaster day, we served emergency food, sweet rolls and water. From the next morning to March 13 we were able to provide hot meals prepared at the soup kitchen. From March 14 meal service program started by outsourcing. From April 1, staple food was provided at the hospital (using a dining room for hospital staff and outpatients), and side dishes were procured from outside.All staff hoped to resume meal services as soon as possible, and remodeled the warehouse to construct a makeshift kitchen. From July 13, full meal services began at the hospital.

e. Medical service and Staff SupportThere were some 400 patients and staff on the disaster

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had a “feeling of loss”. There was a feeling of “guilt” because “I was not able to come to the hospital at the disaster time”, “I hurried to the hospital, leaving my child who said, “Don’t go!” And there was a feeling of

“fear” that “I might die with the patients together”. With these feelings some staff lost their mental stability, which resulted in the temporary retirement of 2 staff members, and the permanent retirement of 1 staff member.For psychosocial care:

In the above mentioned order, if necessary, a patient was referred to a psychiatrist through a clinical psychologist in a step by step process. When returning to work, we provided support with regards to the timing, work shift (no nighttime, no after work, shorter work hours).At this time all staff thought, “the new hospital building should have been constructed a year earlier!! We have no choice but to recover from the situation for another one and a half years”.Although the building became obsolete and vulnerable after this earthquake disaster, there was no human suffering, which allowed us to resume medical services from an early stage. This enabled cooperation by various people, including the staff, contracted staff, local people, OB / OG, volunteers, staff at the construction site (moving and newly constructing), and staff newly employed in April.

①Initially the clinical psychologist staff went around the ward and listened to the staff talking about their experience;

②A poster was put up to send a message from the Nursing Department, “What you are feeling now is normal”;

③Try to write down the feelings you had at the time (and it has now been compiled as a file)

④Personal interviews (superiors, clinical psychologists, etc.)

⑤People who had the same experience at the same place should come together to talk about how they felt about it

⑥Support for middle managers by the Liaison Clinical Nurse Consultants

4. Support from Blood Centers in the Disaster-Affected Areas and Nationwide

(1) Status of Blood Centers in the Disaster-Affected Areas

a. Damage Situation after the Disaster (i.e., lifelines, whereabouts of the victims, etc.)

Some local blood centers were also damaged by this disaster.The Miyagi Blood Center (BC) building experienced a main shock of intensity 6 upper where testing and formulating apparatus was moved, fallen or damaged, and pipework equipment, etc. was broken. Koriyama Supply Branch and Koriyama Blood Donation Room (BDR) buildings in FUKUSHIMA were also damaged, and the Haramachi Supply Branch was forced to withdraw after the Fukushima Daiichi Nuclear Power Plant accident.As for lifelines, power outages took place in some northeastern centers (except Fukushima BC). There was water outage in Miyagi and Fukushima BCs, and a lack of vehicle fuel throughout the region which caused a significant problem.Outside the Tohoku region, Omiya Station BDR of Saitama BC was unavailable for service due to water leakage from the plumbing system, while Yokohama Higashiguchi BDR of Kanagawa BC and Hitachi BDR of Ibaraki BC were unable to provide services due to broken blood collection devices, etc.

b. Situation of Blood Collection, Testing and Preparation (until Restored)

Figure 2-45 shows BC functions from immediately after the disaster to March 14.Originally, Miyagi BC had been a hub for five Tohoku BCs; Aomori, Akita, Iwate, Yamagata and Fukushima even before the disaster. Likewise, the preparation function of Iwate and Yamagata BCs had been concentrated in Miyagi BC.Miyagi BC suffering from a water outage stopped the services including testing and X-ray irradiation of blood components. It also stopped its testing and preparation services since it was unable to control the temperature after the municipal gas supply stopped, the need for revalidation for instrument gaps, and concerns about aftershocks, etc. In Fukushima BC, X-irradiation to blood products was not possible due to the suspension of water-supply.On the next following the disaster, it also put off providing blood collection services at all of Tohoku


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Figure 2-46　Restoration of the lifelines of Tohoku BCs 　　　 and resumed the dates of services

Restoration of lifelines

Resuming date to accept blood donation

Resuming date for testing and formulating drugs

Electiricity

Gasoline

Water service

Fixed facilities

Bloodmobile service

Testing

Preparation

AOMORI 3/12 －－ 3/133/14 ** 3/13HACHINOHE 3/12 －－ 3/14

IWATE 3/12 －－ 4/20 4/18 －－MIYAGI 3/12 3/27 3/22 4/18 5/1* 4/13 4/13AKITA 3/12 －－ 3/13 3/14 ** 3/13YAMAGATA 3/12 －－ 3/13 3/14 ** ***FUKUSHIMA －－ 3/18 4/18

5/1* － 4/18AIZU －－－ 4/25IWAKI － 3/14 4/8 4/26

* Resuming BC as soon as ready** Until the Miyagi Center reopens, blood collection and testing services

for Aomori and Akita will be carried out at the Tokyo BC, and for Yamagata at the Saitama BC.

*** Produced at the Niigata BC until the Miyagi BC reopens.

Figure 2-44　Damage situation of BCs at TOHOKU 3 prefectures (Immediately after the disaster - March 14)Iwate BC Miyagi BC Fukushima BC Aomori BC Akita BC Yamagata BC

Main shock intensity 5 upper Intensity 6 upper

5 upper 6 lower at Iwaki C 5 upper at Aizu C

4 (5 upper at Hachinohe C) 5 upper 4

Whereabouts of the staff

All staff identified on the night of 3/11

All staff identified in the morning of 3/14

All staff identified in the afternoon of 3/13


All staff identified on the night of 3/11.


Damage status of the main facilities

Nothing in particular

OA equipment fallen or damaged; testing equipment and pharmaceutical manufacturing apparatus fallen or damagedPlumbing system, etc. of the facility damaged

Damaged so that narrow boards anchored in ceilings are flakedKoriyama Supply Branch:Possibility of building collapseKoriyama BDRPossibility of collapse of the beam under the roofHara Supply Branch: withdrawn due to the nuclear plant accident

Hachinohe C:Land sinking on the premises

Nothing to be noted.

Nothing to be noted.

Electricity

In-house power generation →〇

In-house power generation →〇 ○ In-house power

generation →〇In-house power generation →〇

In-house power generation →〇Water supply

○ Water outage Water outage ○ ○ ○

Gas ○ Discontinued △→〇 ○ ○ △→〇

Fuel

Stock →insufficient

Stock → insufficient

Stock →insufficient Stock Stock Stock

→insufficientReference: Damage situation of BCs at other Tohoku 3 Prefectures (Immediately after the disaster - March 14) (Note)　 “×”: Functions, etc., discontinued, “△”: Functions, etc., partly discontinued, “〇”: Normal condition, “→”: Changes in the conditions

〔〕

Figure 2-45 BC function in the six Tohoku prefectures (from immediately after the disaster until March 14)Iwate BC Miyagi BC Fukushima BC Aomori BC Akita BC Yamagata BC

BDR × × × ×→○ ×→△ ×→○Blood × × × ×→○ ×→○ ×→○

Manufacturing function

Preparation Aggregation × × ×→○ ×→○ AggregationTest Aggregation × Aggregation Aggregation Aggregation Aggregation

(Note)　 “×”: Functions, etc., discontinued, “△”: Functions, etc., partly discontinued, “〇”: Normal condition, “→”: Changes in the conditions “△” of the Blood Donation Room (BDR) means some of the rooms currently discontinuing services due to the disaster.

BCs because: Miyagi BC, a hub for blood product preparing, was affected; there were plenty of blood product stocks nationwide; a higher priority was placed on identifying the damage situation and restoring the administrative functions; there was concern about aftershocks, etc.Aomori, Akita and Yamagata BCs resumed accepting blood donations from March 13. Iwate, Miyagi and Fukushima BCs suffered from significant damage and there was no idea as to when they could resume the service. In this context, the supply and demand was to be adjusted over a wider area.Subsequently, with the restoration of lifelines, each BC restarted services one by one as shown in Figure 2-46.

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(2) Support System of the Blood Service at Headquarters (BSH)

a. Precedent Service for Providing Supplies through the Wide-Area Supply-Demand System

We provided the service for supplies in advance as was planned to be introduced in the wide-area supply-demand system from April 2012. As a result, although it was quite difficult to continue blood donation acceptance / testing / preparation services, this supply-demand system allowed us to secure constant supplies, responding to medical demand from disaster-stricken sites based upon the nationwide support system. One of the main factors in the success of this operation was that, including the blood amount needed in the disaster stricken areas, blood was collected and processed in non-disaster stricken areas, transferred to TOKYO, and then delivered to the disaster areas every day using available transportation means. Specifically:

(a) Securing Replacement Facilities for Those in Disaster Areas for Testing / Preparation Services

After the disaster took place, BSH reviewed all substitute facilities for testing / preparation services, and the delivery and transportation routes for source blood components, samples for testing, and blood products to the substitute facilities.The samples for testing for Aomori and Akita BCs were delivered to the Tokyo BC via air, and those for Yamagata BC were delivered to the Saitama BC via land (through the Niigata BC).Aomori and Akita BCs could produce source blood components in-house, while those for Yamagata BC were delivered to Niigata BC by land transport.

(b) Securing an Appropriate Amount of StockBecause some BCs in the disaster areas found it difficult to accept blood donors, others increased their blood collection estimate by 20% more than usual for the service. In addition, they decided to maintain more stocks of red blood cell products than the optimum quantity of stocks in normal times in order to respond to medical demand nationwide, including from the disaster-stricken zones.The stock quantity of red blood cell products as of March 11 (6:00 AM), the disaster day, was 183% (corresponding to 5.5 days of normal use) of the optimum amount of stocks; thus, it was considered that a constant supply of the products would be

c. Medical Activities, etc. Engaged by BC Staff in Disaster-Stricken Prefectures

BCs in d isaster -h i t prefectures temporar i ly discontinued blood collection services, etc. after the disaster, and some of the staff were deployed to support medical services in the prefectures. Their specific services are shown below.Requested by Iwate Chapter, Iwate BC deployed 265 staff in total mainly to the coastal zone for the purpose of supporting medical relief services and conveying supplies to disaster shelters.

Figure 2-47　Main disaster-support services by　　　　　　　 Iwate BC (March 14 - April 17) and

　　　　　total number of staff deployedDestination and purpose

No. of staff deployed and the servicesAdministration staff Nurses

Tono HDC staff 51 staff (Acceptance of medical teams, etc.) －

Support to the Iwate Chapter

18 staff (Delivery of disaster supplies, etc.)

2 staff (Services as a medical team)

Support to the Iwate Chapter HDC 13 staff (Records, etc.) 8 staff (Testing, blood

collection, etc.)Support to Morioka RCHP － 173 staff (Blood collection,

hospital wards, etc.)

In response to a request from the Miyagi Chapter JRCS to support Ishinomaki Joint Medical Team that had provided services at Ishinomaki RCHP, a hub point, the Miyagi BC helped conveying supplies and other duties for the Team.At Fukushima BC nurses, traveled from shelter to shelter to provide medical care from March 25 to April 16, provided health counseling to 3,000 patients in total (10 disaster shelters).

[Conveying supplies using a bloodmobile]


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situation. Blood for platelet products was collected at BCs other than the Tokyo BC, delivered to the BCs of TOHOKU, and supplied to the medical institutions after adjustment for the supply and demand from local medical institutions.

Figure 2-49 Delivery and receipt status between the Blocks after the disaster

(Red cell products) 　　Figure omitted

Figure 2-50 Delivery and receipt status between 　　　the Blocks after the disaster

(Platelet products)　　　Figure omitted

(d) Review of the Supply Support SystemThe Sub-Committee on a Stable Blood Supply established in the BSH provided a support system to provide blood products for transfusion, i.e., updating the inventory status per product and blood type for the blocks and nationwide BCs every week, responding to changes in the supply status and medical demand, and reviewing the blood collection plan according to the above. As the blood centers in disaster areas resumed their blood collection functions, the Committee reviewed the first plan as needed, increasing/decreasing the amount until the end of May.

available for the time being. However, because the TOHOKU and KANTO regions had repeated aftershocks, which caused a danger to buildings, it was considered difficult for BDRs, etc., to receive platelet apheresis in a constant way. In this context, BSH instructed blood centers in non-disaster areas to focus more on procuring platelet apheresis for all blood types in their service for the entire day of March 12.With all these efforts, there was no trouble in securing or constantly supplying blood components in the three disaster-affected prefectures although they were forced to discontinue their own blood collection practice.

Figure 2-48　Trends in the optimum inventory rates of　　　　　　　 blood products (red blood cell products)

(as of 6:00 in the day)　　　(Unit:%)

Blocks

No. of blood donorsMarch y/y 3/11 3/21 3/31 4/11

400 mL of blood donation

Platelet apheresis

HOKKAIDO 107.0 119.0 154 263 194 203MIYAGI 61.7 39.0 175 172 157 177TOKYO 104.8 98.5 200 245 209 180AICHI 113.4 113.4 190 283 282 229OSAKA 114.5 108.4 180 262 246 192OKAYAMA 115.3 108.3 170 236 267 195FUKUOKA 131.4 119.9 167 371 397 200Total nationwide 109.5 102.1 183 263 249 195

From March 19, Blocks other than TOHOKU/KANTO/KOSHINETSU collected blood by blood type in an amount that corresponds to 90% more of the number of blood units on average supplied by that day of the week in the Tohoku Block, and provided constant units of blood to the Block to secure blood for platelet products needed in the Tohoku Block.Red blood cell products were also supplied to the Tohoku Block from March 20. The number of units needed for red blood cell products per day (764 units) was determined for each blood type in IWATE, MIYAGI, FUKUSHIMA and YAMAGATA.

(c) Wide-Area Transportation SystemAs for the supply blood products secured for transfusion, red blood cell products were delivered via the Tokyo BC to the medical institutions in IWATE, YAMAGATA, MIYAGI and FUKUSHIMA after adjustment of the nationwide supply-demand

[Support from BCs nationwide (Miyagi BC)]

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Figure 2-51 Number of blood donors before / after the disaster

40,000

35,000

30,000

25,000

20,000

15,000

10,000

5,000

0

2,500

2,000

1,500

1,000

500

0

Nationwide

TOHOKU


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by shuttle vehicles or directly from the disaster sites via airports available by the most convenient route on a case-by-case basis.The Hokkaido Block also dispatched 2 staff who were in charge of the restoration of the integrated system of blood services and maintenance control at the Miyagi BC.As delivery staff and supply support vehicles for the Yamagata BC, 14 staff and 1 vehicle were dispatched by the Aichi Block, engaged in the delivery of source blood and samples for testing collected at Yamagata BC to Niigata BC.Okayama Block deployed 4 preparation staff in total to the Niigata BC to process source blood for the Yamagata BC. Fukuoka Block deployed 8 testing staff in total to the Tokyo BC to test samples for Aomori and Akita BCs. Combined with the number of BSH staff for about a month, 100 support staff and 8 support vehicles were dispatched.

Figure 2-52 Figure Omitted

b. Support System for the blood centers in the Disaster-Stricken Areas

(a) Personnel Support (Staff in Charge of Supply, Preparation, and Testing)

As for personnel to support the facilities, etc., in disaster-stricken areas, it was required to ensure coordination between the Blocks and the deployment of support staff and vehicles based on the information collected by the Miyagi BC, a hub center. BSH at the Headquarter Office deployed 2 staff (1 team), 12 staff in total to the Miyagi BC HDC for liaison and coordination duties.Tokyo, Aichi, Osaka and Fukuoka Blocks deployed 60 delivery staff and 7 vehicles in total for delivery support services to the Miyagi BC.These staff carried out coordination in advance with staff in charge of liaison and coordination dispatched from BSH at the Miyagi BC HDC. They were deployed

(b) Support for RestorationAfter the disaster, the Miyagi BC had difficulties in providing preparing and testing services, and the Fukushima BC in providing preparing services. Thus, information in relation to the following was collected as that required for resuming the services.

Figure 2-53 Status of personnel support for the facilities, etc., of the disaster-stricken areasDestination facilities for support

Section Support items No. of dispatched staff (no. of vehicles) Dispatching Block Deployment term

MIY

AGI

Integrated control

Liaison between BSH at the Headquarters Office and facilitiesControl of support staff

12 staff BSH 3/17-4/16

Supply

Delivery staff・Coordination of supply / demand adjusted products throughout the TOHOKU region (TOKYO, TOCHIGI, FUKUSHIMA, MIYAGI)

・Distributions to medical institutions in prefectures

22 staff TOKYO 3/17-4/168 staff AICHI 3/17-4/420 staff OSAKA 3/17-4/1510 staff FUKUOKA 3/17-4/6

Emergency vehicles for supporting supplies delivery (7 vehicles) TOKYO, AICHI,

OSAKA, FUKUOKA 3/17-4/16Administration Maintenance of unified system for blood service 2 staff HOKKAIDO 3/22-3/26YAMAGATA

SupplyDelivery staff

・Delivering duties of source blood and samples to Niigata BC 14 staff AICHI 3/18-4/11

Supply support emergency vehicles （1 vehicle） AICHI 3/18-4/11

NIIGATA Preparation

Preparation staff・Processing duties using source blood from blood collected at the Yamagata BC Testing staff

4 staff OKAYAMA 3/18-4/14

TOKYO TestingTesting staff

・Testing duties for blood collected at Aomori and Akita BC

8 staff FUKUOKA 3/11-4/14

　 Total 100 staff

（8 vehicles）　 Approx. one month

・Restoring daily life for the staff and ensuring stable commuting

・Restoring capabilities for providing the necessary lifelines and wastewater treatment

・Ensuring stable routes to deliver source blood and/or testing samples

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transferred to and stored at the Fukushima BC and the Center took care of the orders which had been received by the Hara Supply Branch.As one of the measures to deal with radioactive substance leaks, BSH at the Headquarters procured direct reading dosimeter devices in order to control the staff dose exposure to radiation, and delivered them to Fukushima BC on March 13. Based on the Guidelines on Risk Management by BSH, they instructed, when delivering blood components within a 30-km radius zone around the Daiichi Nuclear Plant, that the staff must carry a dosimeter for personal exposure control so that the cumulative dose will not exceed 20 mSv.Furthermore, assuming the possible expansion of the evacuation zone, coordination was made between the receiving and delivery agents for some 6,500 units of fresh frozen plasma stored at Iwaki BC, FUKUSHIMA, within the 45-km radius zone from the Fukushima Daiichi Nuclear Plant. On March 16, the Fukushima BC was instructed to transfer them to the Kyushu BC.　e. Damage and Destruction of the Koriyama Supply BranchThe Koriyama Supply Branch of the Fukushima BC suffered severe damage to its building due to the earthquakes, and was suggested to withdraw from the resident building manager because of the risk of collapse. However, because the Branch deals with 35% of the supplies within the prefecture, the Fukushima BC expected the Branch to continue supplying blood components (only administrative staff and a night watchman’s functions to be transferred). For the time being, on March 24, 292 units of fresh frozen plasma (FFP) stored at the Branch were transferred to the Fukushima BC, and the building of the Branch remained in use together with the vehicle lot secured on the opposite side for parking blood transport vehicles as a hiding place.To respond this, BSH advised the Fukushima BC on April 4 that the possible separation of the administrative office and the blood storage facility would not be desirable in terms of management, requesting the Center to temporarily close the Branch and to discuss the possibility of providing services based in the Fukushima BC as a hub of these services.However, concerned about claims for any delay in delivery from the medical institutions within the Koriyama Branch territory, the Fukushima BC hoped

To ensure appropriate preparation and quality controls at preparation plants, BSH deployed four technical staff in total to support checking the instruments and the operating status at each site.

Figure 2-54 Personnel support for the restoration 　　　of testing / production duties at

　　　　 facilities in the disaster-hit areasDestination

facilitiesServices for

supportDeployment

term

Miyagi BC preparation/testing services 4/12-15

Fukushima BC preparation services 4/18

c. Supplies Procurement for Supporting the Disaster-Stricken Areas

Liaison and coordination staff deployed to Miyagi hub BC HDC were engaged in coordinating support requests for food and supplies at the other BCs. Based on this information, the staff requested the procurement of food and supplies from hub BCs (other than those in the disaster-stricken areas), loading them into vehicles used for the deployment of the support staff on site.The supplies procured and delivered include: food (packed rice, cup noodles, cup-o-soup, canned food, etc.), sanitary goods, fuel, portable fuel cans, tableware, etc.

d. Response to the Nuclear AccidentOn March 12, BSH, in expecting already an expansion of the evacuation zone following the Fukushima Daiichi Nuclear Power Plant accident, withdrew the Hara Supply Branch which stands within 25-km from the plant, so that to ensure the safety of its staff and blood components. The stock of the blood were then

[BC staff loading kerosene onto a blood donation vehicle]


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(3) Other Special Remarksa. Document Preparation (a) Reporting on the Current Status of the Blood and Blood Products Division, Pharmaceutical and Food Safety Bureau, MHLW.In response to a referral on the damage status on an hourly basis, etc., made by the Blood and Blood Products Division, Pharmaceutical and Food Safety Bureau, MHLW for the announcement of a government report, press release, etc., we reported via phone and e-mail in regards to updates on damage to blood centers, stocks of remaining blood components, blood donation, supplies to medical institutions, etc.As the inventory of red blood cell products had been stably secured since March 18, one daily periodical reporting was provided regarding the “Supply status of blood components, etc. ” and “List of blood components stocks (for each BC)”.

(b) Press ReleaseRequests for news coverage and inquiries immediately after the disaster (3/13-24) included 12 newspaper publishers in total, 9 TV stations in total, 4 other news related entities in total, and 2 overseas entities in total (BBC from Britain and Russia) . Most of these inquiries related to “whether or not blood stocks are sufficient and successfully supplied”. Thus, we made efforts to publicize and explain the situation on our website that there was no difficulty in obtaining a constant supply of the stocks, and that we hoped for long term cooperation in blood donations to avoid any temporary concentration of blood donors.The following information was placed on our website as shown in Figure 2-55.

to continue providing the service, even temporarily, through the Branch. And it did not make any changes in the supply system where the Fukushima BC served as a hub.With severe aftershocks continuing on April 11 and 12 BSH at the Headquarters instructed the Fukushima BC to supply necessities on April 13, and to identify and present problems they found in the supply system from Fukushima BC to the medical institutions in the Branch territory on April 15. It also instructed that the Branch building should again be provided with some expert assessment and report on the current status.Based on the building research report that the Fukushima BC sent on April 18, the following suggestions were made to the Fukushima BC: 1) to find a new place for relocation, and move to the site as soon as possible, 2) until the relocation, to maintain the current system and supplies from the Branch.A suitable site was later found in KORIYAMA for the relocation and the Branch resumed services at the new location on and after March 5, 2012.

f. Organization of BSH at the Headquarters (Staff Replacement)

Immediately after the disaster, the Emergency Blood Management Committee was established in BSH in accordance with the Procedures for Crisis Management on BSH at the Headquarters to cope with around-the-clock operations. On March 13, 3 teams (general response, supply and demand, and technical teams) were organized to introduce a 2-shift working system starting on 9:00 and 17:00. It also deployed staff to HDC at the Headquarters to share the related information.Since April 1, night-shift operations were discontinued.

Figure 2-55 Other Information provided from BSH at the Headquarters entered in the disaster-related web pages　　　　　　　　　　　　　　　　　　

Date Title DescriptionMarch 14 Constant Supply of Plasma

DerivativesPlasma derivatives are processed at a plant in CHITOSE, HOKKAIDO, which was free from damage and any problems regarding the manufacturing system due to the earthquakes. In addition, we explained that there were plenty of the product stocks and we were able to provide a constant supply and meet any emergency delivery requirements.

March 20 Responding to Misinformation on Insufficient Blood

Informing that, although rumors regarding a shortage of blood components for transfusion and plasma derivatives have been circulated, the stock has been constantly secured, thus successfully responding to orders from medical institutions.

April 19 Consultation Service for Earthquake Exposed Hemophilic Patients

Informing that the Japanese Society on Thrombosis and Hemostasis began consultation services for patients and their families in the disaster-stricken areas.

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be eased from 25% to 15%, and required submission of the documents again based upon the revision. In particular, with regards to three facilities whose contracted power was over 500 kW, (SAITAMA, TOKYO, KANAGAWA), the Ministry subsequently requested us to submit information on the background to the centers established to date, the number of the staff (by section and by composition) , annual quantity/number of the production/tests/supplies, number of voluntary blood donors (annually and daily), as well as power saving measures that the three centers had normally taken, the number of in-house power generation units, power generation capacity, connection status, and operating hours during full gas tanks, and we responded to these inquiries.On May 26, the Ministry of Economy, Trade and Industry publ ished the “Power Consumption Re s t r i c t i o n s Sub j e c t t o Ar t i c l e 2 7 o f t h e Electrimunicipal Business Act. “According to the Ordinance, large consumers of electricity with over 500 kW that directly contract with Tokyo and Tohoku Electric Power Companies will have to put restrictions on power; while, “demand facilities essential for human life and health” do not need to mitigate restrictions. As a result of a subsequent inquiry to the MHLW, it turned out that a large consumers of electricity with over 500 kW of contracted power supply (Tokyo, Saitama and Kanagawa BCs) had the measures to put restrictions (reduction rate: 0%) applied to them. (Headquarters Building was not eligible.)On June 16, we submitted an application form pertaining to the mitigation of power restrictions with the necessary documents to the Ministry of Economy, Trade and Industry (documents to explain that the facility is applicable, and documents with proof of the power ratio shared by pharmaceutical manufacturers

b. Response to Planned Power Outages (a) OutlineFrom March 15 planned power outages were carried out throughout the TEPCO supply area in the wake of the Fukushima Daiichi Nuclear Power Plant accident. BSH at the Headquarters obtained information regarding the effect on blood centers services by the planned outage from the web sites of TEPCO, and Tohoku Electric Power, MHLW, and provided information to the related blood centers for services. It was reported to the MHLW that the effect on blood services would be severe and requested the related government agencies to exclude blood centers from the planned power outage coverage. The blood collection centers changed and shortened their open hours, testing/preparation facilities extended their working hours to provide nighttime services, with supply facilities for power generated in-house to refrigeration facilities to keep the products in cold storage. These efforts helped avoid any major trouble. As Tokyo’s 23 wards were excluded from the coverage, there was no significant impact on the services provided by the Tokyo BC.

(b) Procedure for Exemption from the Application of the Ordinance to Restrict Power Consumption

To be exempted from application of the Ordinance to Restrict Power Consumption, as requested by MHLW, we prepared and submitted a list of facilities we expected to be excluded from application of the law, the reasons for this, for power consumption from July to September last year, the feasible power saving plans, electricity distribution images at the facilities, etc. from April 6 - 13. On April 21, we were informed that the restrictions on power consumption under the Ordinance to Restrict Power Consumption would

Date Title DescriptionJune 7 Responding to false news that, at

a blood donation station in Tokyo, some people were refused blood donation on the grounds that they came from the evacuation zone in FUKUSHIMA.

Responding to misleading news placed in newspapers and magazine articles as if people living in the disaster areas had been refused to give blood donations.Informing that we accept blood, as usual, donated by people living in the evacuation zone after the Fukushima Daiichi Nuclear Power Plant accident.

June 7 Acceptance of Blood Donated by Evacuees from the Nuclear Accident

By informing the public that as usual we accept blood donated by those from the Evacuation Zone, Planned Evacuation Zone and Emergency Evacuation Preparation Zone.However, among the “workers/operators” in the Fukushima Daiichi Plant those whose accumulated exposure dose exceeded 100 mSv since the disaster took place should refrain from blood donations considering any possible impact on the health of the donor for the time being, at least for 6 months from the last day of radiation exposure.


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5. Various Activities Responding to Needs(1) Medical Activities Engaged in by Teachers

and Students of the JRCS Ishinomaki School of Nursing

Situated at a little less than 2 km from the coastal zone, the JRCS Ishinomaki School of Nursing had their graduation ceremony on the previous day of the disaster. On the day the disaster occurred, there were 94 people in total; including 39 first and second graders each, 6 third graders, 8 teachers and 2 school staff. After the disaster took place, some neighboring people gathered at the school.However, they found that the tidal wave was almost hitting the school, so they decided to take shelter at the Minato Elementary School with the residents, leaving some teachers and staff behind. The students were also among the victims; however, people at the shelter welcomed them, saying, “We’ve got nurses!”. And what with the request from a responsible person (School Minister), the teachers and students started providing medical services at the isolated elementary school.Evacuees from around the shelter continued to gather around Minato Elementary School. Some patients were carried to the school building by ambulances because they were unable to be transferred to a hospital. The number of evacuees swelled to approximately 1,200 at the peak time. In this situation, the teachers and students provided medical care for those who suffered bone fractures, had mud all over their bodies, were elderly or bed-ridden, etc. Furthermore, they provided services including assistance with restroom use for Parkinson’s disease patients, exchange of diapers and changes in the posture for bedridden elderly people, guiding children to the restroom, caring for those with dementia loitering around. They even scooped up feces from the toilet when people complained that the restroom was dirty, arranged that water, if any, was distributed first to children and elderly people, and provided assistance if the air-ambulance was available. Without sufficient water or food, shivering with cold, not knowing when a rescue team would come, the students continued providing services beyond the scope of rescue/nursing or care.On March 14, doctors and pharmacists finally began traveling from shelter to shelter to provide medical care, and ambulance helicopters for the sick and injured brought food and water one by one. In a short

at each facility).Subsequently, the Ministry of Economy, Trade and Industry released a notice as of June 22, 2011 on measures to mitigate restrictions on power consumption to three blood centers. On July 1, the three blood centers submitted their energy-saving action plans in relation to the measures to mitigate restrictions on power consumption to the MHLW.

c. Cooperation in Identifying Unidentified PersonsThe National Police Agency asked JRCS for technical advice and guidance regarding the identification of many unidentified persons in the GEJET.JRCS stores some blood samples from donors in the refrigerator for 11 years with the aim of conducting cause studies, such as for transfusion-transmitted infectious diseases, and for retrospective studies on prevention of the expansion of infections. We decided to submit the stored blood samples in cooperation with the National Police Agency and provide a DNA-type examination to identify unidentified persons.In principle, stored blood samples should not be used for purposes other than the original purpose; however, because proof of the identification of victims had been lost due to the tsunami and earthquake, the samples were needed for the identification of unidentified persons. Considering the fact that the request was coming from the families and relatives of the victims, we decided to cooperate with them as an exceptional measure. The conditions of cooperation were as the following.

The blood to be supplied is only a portion of the stored blood (a very small amount), which will not affect, if any, retrospective studies (3) in the future.Through this cooperation agreement, as of October 10, 2012, the National Police Agency asked the JRCS for cooperation concerning 1,785 missing persons, and 35 victims were identified out of the 144 blood samples JRCS presented to the Agency.

・To be a missing person in GEJET・To be requested by the victim’s family members or

relatives・To be used in DNA analysis only for the purpose of

identifying the person ・To dispose of the blood after use・To avoid affecting the purpose of specimen storage

(the supplied blood must be of a small amount)

(3) If a donor is suspected of being infected, his/her blood previously donated should also be studied to confirm the safety of the blood component.

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while, it turned out that JRCS medical teams would visit from shelter to shelter to provide medical care. The teachers and students of the Nursing School concluded their services after 4 days.

(2) Nursing TeamsIn the disaster areas, support for the elderly people who required nursing care was an urgent problem, and there was also a need to support welfare evacuation centers, special nursing homes for the aged, long-term care health facilities, etc., in the disaster-hit areas. They newly organized a “care team” consisting of care workers to cope with services in response to nursing needs, and a notice dated April 8, entitled “Dispatch of Caring Teams to the GEJET Disaster-Affected Areas (Request)” was released from the HDC at the Headquarters.

The services included the following two programs.In principle, one team served for 9 days (including 2 days of movement and transfer). One team consisted of 6-7 staff (including 4-5 caregivers, 1 volunteer instructor for the Healthy Life Support Class, 1 staff in charge of liaison and coordination).In fact, the care-giver teams provided services for two terms (1st term and 2nd term of deployment).

・To dispatch nursing care workers for “institutional support” to replace those who work at special nursing homes, geriatric health services facilities, welfare evacuation centers in the disaster areas.

・Assuming the support mentioned above in principle, support measures for elderly people in the shelters, including organizing classes mainly for volunteer instructors for the Healthy Life Support Class, assisting with bathroom use for the elderly and handicapped people using the bathing support equipment of the SDF, etc. (Support for disaster shelters, etc.)

Figure 2-56　Activities of caring team1st deployment 2nd deployment

Duration

From April 14, 2011 to May 13

From May 31 to July 1, 2011

Service area

RIKUZEN-TAKATA, IWATE

OTSUCHI, KAMIHEIGUN, IWATE

Deployed staff

32 staff・Care giving staff 22 staff・Healthy life support volunteers 4 staff

・Coordination / liaison staff 6 staff

35 staff・Care giving staff 26 staff・Liaison / coordinating staff 9 staff

No. of deployed teams4 teams 11 teams

Service descriptions

・Institutional support (1 special care nursing home and 1 geriatric health services facilities)

・Support for the disaster shelters, etc.

・Institutional support (1 special care nursing home and 1 geriatric health services facility)

Destinations

・Kojuen, Special Care Nursing Home

・Matsubaraen, Geriatric Health Services Facility

・Laughter Hills, Special Care Nursing Home

・Care Plaza Otsuchi, Geriatric Health Services Facility


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In addition, the staff in charge of l iaison and coordination provided services in cooperation with RC volunteers and Tono Magokoro Net organized by Tono Social Welfare Council that JRCS also participates in, supported disaster victims at the shelters in OTSUCHI, providing supplies (hot towels, etc.) at the Magokoro Plaza.

Figure 2-58 Support for disaster victims in shelters, etc.

Service areas No. of service staff No. of participants

Cooperation with “Tono Magokoro Net” 98 451

Healthy Life Support Class at shelters, etc. 93 289

Figure 2-57 List of destination facilities for the JRCS care team staff

1

IWATEOumeisou, Nisseki

2nd deploymentOTSUCHI, KAMIHEIGUN, IWATE

1st deploymentRIKUZEN-TAKATA, IWATE

SAITAMASaikiken

TOKYOMusashino RCHP

SHIZUOKAShizuoka Chapter (volunteer for a class)Izu RC Geriatric Health Service Facilities

OKAYAMAOakayama RC Geriatric Health Service Facilities

Prefectures providing both 1st and 2nd deployment

Prefectures providing 2nd deployment

TOKUSHIMAHinomine Rehabilitation Center

YAMAGUCHIOnoda RCHPOnoda RC Geriatic Health Services Faciity

OSAKAOtemae Rehabilitation Center for Children with Physical Disabilities, Osaka RCHP

FUKUOKAFukuoka Chapter (Volunteer for a class)Taizyuen　Houzyuen　Yasuraginosato

YAMANASHIYamanashi RCHP

KAGOSHIMAKinkoen

OKINAWAAja Welfare Complex Facility, NAHA

MIEYamada Geriatric Health Services Facility

NAGANOAzumino RCHP

JRCS care teamList of destination facilities for the JRCS care giving team staff

The Office for the Establishment of Nursing Care Insurance Facilities in Hiroo (Project Office for the Establishment of Japanese Red Cross Welfare Complex Center), Disaster Management and Social Welfare Department at the Headquarters, carried out care-needs surveys of the elderly who required nursing care in RIKUZEN- TAKATA (April 8-10) and OTSUCHI (May 20-21). The survey topics included the actual situation of the support needs, a review of what was needed for the support, and a study of the services the care staff who did not to be trained could provide.JRCS runs special nursing homes for the aged at 8 places throughout the country. Deployment of the care giving team should be considered a new approach by taking advantage of JRCS human resources.

(3) Nursing CareFor several months after the disaster day, people gradually moved the basis of their daily life from the disaster shelters to temporary housing. Since June 1, 2011, nursing care teams were deployed mainly in disaster shelters at the Rikuzen-Takata Daiichi Junior High School, IWATE, engaged in services including health guidance such as prevention of the worsening of chronic disorders of the victims, health counseling, and elderly people’s care.Changes in both mental and physical health conditions were expected in this whole new environment for senior citizens. It was important to support the health and

［Feeding in an elderly care facility [RIKUZEN-TAKATA] (April 16, tweet page of the Mainichi shimbun (Newspapers))］

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On the other hand, from October 2011 to March 2012, 6 branches of the JRCS Colleges of Nursing provided a nursing care project to support nursing practice over the medium and long term. Before the project, at the end of June, the college members were dispatched to RIKUZEN-TAKATA to discuss the role and activities to be provided by the above-mentioned nursing care teams, the significance of the nursing care project by these six colleges, and the future. In August, the members deployed by the colleges discussed with the public health team of RIKUZEN-TAKATA about their services and methods for the nursing care project.The pro ject act iv i t ies were carr ied out ten times intermittently in October. With the goal of contributing to support for the healthy life of disaster victims both mentally and physically, they provided various services including diet nutrition guidance, exercise instruction, health counseling, blood pressure measurement, gross movement, massage and stretching. Each team served for 2-5 days.

Figure 2-60　Dispatch performance of the 　　　 Nursing Care Project

Dispatch term

June, 2011 and August (for discussion)October 3, 2011 - March 22, 2012

Service site

RIKUZEN-TAKATA, IWATE

Hub for services

Temporary housing, employment promotion housing in RIKUZEN-TAKATA

Deployed staff

10 teams (29 staff)

Dispatching college

JRCS Hiroshima College of Nursing (7 staff), JRCS Toyota College of Nursing (6 staff), JRCS College of Nursing (6 staff), JRCS Akita College of Nursing (3 staff), JRCS Hokkaido College of Nursing (4 staff), JRCS Kyushu International College of Nursing (3 staff)

(4) Team for Setting up Small-Scale Water SystemsThe hygiene environment seriously deteriorated in disaster shelters and the repair of water and sewage systems was not successfully completed in ISHINOMAKI, MIYAGI. In particular, many disaster shelters did not have hand-washing stations around the temporary toilets, and the provision of antiseptic

life of those living alone or in two-person households. Nursing care teams continued their services until the end of August through cooperation with medical teams, psychosocial support teams, and health support teams.A nursing care team consisted of two experienced nurses, including certified nurses, certified instructors for the Healthy Life Courses, etc., and each team served for 5 days in principle.Their main services were as follows.

Figure 2-59　Results of nursing care team deployment

Deployment term

Fr. May 20, 2011 to the end of May (including the survey)Fr. June 1, 2011 to the end of August

Service sites RIKUZEN-TAKATA, IWATE

Hub points

Disaster shelter at Rikuzen-Takata Daiichi Junior High School and other shelters, temporary housing facilities and evacuee houses in the neighborhood

Deployed staff 17 teams (35 staff in total)

Dispatching hospital

Asahikawa RCHP (4 staff), Date RCHP (4 staff), Kitami RCHP (4 staff), Kushiro RCHP (4 staff), Hachinohe RCHP (6 staff), Akita RCHP (6 staff), Morioka RCHP (7 staff)

No. of staff providing services in total

818 (including 695 or 85% of those 60 years or older)(No. of those serviced / surveyed by health nurses: 547)

＜Everyday Life Support＞・Assistance with clean-up, excretion, and foot care

for those staying in a room for senior citizens in a disaster shelter

＜Health Guidance / Education＞・Visit the at-home or temporary housing facilities.

Conducting surveys on health and living conditions, identifying those who need support (requests from the health nurse team)

・Guidance on medication for the at-home or temporary housing facilities of evacuees, diet advice, living guidance, psychosocial care, health consultations

・Assessment of ADL (Activities of daily life) for senior citizens moving to temporary housing facilities and cooperation with the rehabilitation teams


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(5) Services for Disaster Shelters in Non-disaster Stricken Areas

a. Services for Evacuees to “former Grand Prince Hotel Akasaka”

Many disaster victims evacuated from FUKUSHIMA to TOKYO due to their fear of the Fukushima Daiichi Nuclear Power Plant accident. The Tokyo Metropolitan Government designated the “former Grand Prince Hotel Akasaka”, which had closed its hotel business on March 31, 2011, as the second disaster shelter in order to accommodate the evacuees to TOKYO. As a result, the peak time saw 800 people staying at this hotel from April 19 to June 30.JRCS Medical Center, a hospital near the hotel, provided medical services for the evacuees, including a 24-hour hot-line service for 20 people, “psychosocial care” for 40 people, visiting senior citizens for medical care for 26 households, general outpatient consultation services for 121 people, and aromatherapy for 200 people.

b. Deployment of Medical Teams to Kose Sports Park Budokan in YAMANASHI

A disaster shelter at the Kose Sports Park Budokan in YAMANASHI was constructed by the prefecture. Dr. Toshio Inoue from the Inoue Internal-Pediatric Clinic, a leader of Medical Team-6 of the Yamanashi Chapter, offered medical services including health counseling. Reporting to the Manager in charge of the service (responsible person at the temporary disaster shelter) of the Prefectural Social Welfare Council, it was decided to provide the health counseling service.The health counseling service was provided four times to some 50 evacuees in total on March 27, April 3, 10, and 17, including a blood-pressure check, urinary test, etc.

liquid was insufficient. This needed to be immediately taken care of. To improve the hygiene environment of the disaster shelters, we decided to install stations for hand-washing, etc., around the toilets in the shelters of ISHINOMAKI.The Headquarters Office procured 12 water system units (water tanks and faucets for small water-supply systems), 9 units of which were installed at disaster shelters that had been identified as having need for support. (The remaining 3 units were stored by Ishinomaki RCHP). Installation of the water systems was coordinated in advance with the Ishinomaki Water Department. The Municipal Waterworks Bureau was in charge of filling water in the tanks. After installing the units, it was agreed to supply water after requests that the Municipal Waterworks Bureau received from the disaster shelters, or periodically when water trucks traveled from shelter to shelter. Water system facilities (including water tanks, and the faucets of small-scale water system) were assigned to ISHINOMAKI, and the management was in the charge of the representative of the disaster shelters.This water system was one usual ly used by Emergency Response Units (ERUs) in their overseas services and was used for the first time in Japan.

　　　　　　　　　©nobuyuki kobayashi [Children hand-washing at a water system installed in a disaster-shelter]

Development of Disaster Relief Activities with Ishinomaki Red Cross Hospital (RCHP) as a Hub Hospital

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This chapter describes medical relief services provided at the venue of Ishinomaki RCHP, MIYAGI. Medical relief activities in ISHINOMAKI are characterized by the extensive number of its medical teams deployed for long periods and, more remarkably, through cooperation with medical institutions other than JRCS within/outside the region. In this context, this whole chapter introduces the medical relief services for Great East Japan Earthquake and Tsunami (GEJET) as they clearly show the characteristics of the services.

1. Damage due to the GEJET (1) Damage Status in ISHINOMAKIThe earthquake was significant in scale with a tremor of an intensity of 4 upper lasting about 160 seconds, as well as 2 jolts of intensity 6 lower.

1

The quake subsequently caused a massive tsunami that devastated the coastal regions. In the 40 minutes after the earthquake occurred, a very high tide of about 8.6 meters was observed at AYUKAWA, ISHINOMAKI.

2

In ONAGAWA, adjacent to ISHINOMAKI, Onagawa Municipality Hospital situated some 16 meters above sea level was inundated with about 2 meters of water.The tsunami swept the buildings across coastal lands, leaving behind debris. In the central part area of ISHINOMAKI, 73 ㎢ of the site (or 13.2% of the town or approx. 30% of the plain) was flooded. Ishinomaki municipal government office, Firefighting Head office, Fire House, Police Station, etc., were within the flooded areas. Water did not recede around Ishinomaki municipal government office for 3 days, which was temporarily isolated.Furthermore, 20 fires occurred in the territory of the Ishinomaki Firefighting Headquarters'. In KADOWAKI and MINAMIHAMA, situated to the west of Kitakami River, a large-scale fire occurred immediately after the tsunami and kept burning for 2 days.The number of fatalities in ISHINOMAKI, HIGASHI MATSUSHIMA and ONAGAWA reached 5,224, and the number of missing persons was 744 (as of February 28, 2013). It is also estimated that some 42, 000 people took refuge at more than 300 evacuation center in ISHINOMAKI in the initial phase of the disaster.

Figure 3-2 Human suffering in ISHINOMAKI（Unit: Number of casualties）

No. of fatalities Number of missing personsDirect cause

of deathIndirect cause

of death Total

ISHINOMAKI 3,256 242 3,498 448HIGASHI MATSUSHIMA 1,061 63 1,124 28

ONAGAWA 580 22 602 268Total 4,897 327 5,224 744

Source: Prepared by “Damage Situation of the GEJET, MIYAGI

Chapter 3　Development of Disaster Relief Activities with Ishinomaki Red Cross Hospital (RCHP) as a Hub Hospital

・Situated in the northeastern part of the coastal area of MIYAGI (Relocated from the coastal site and newly constructed in May 2006)

・26 clinical departments, 402 beds (10 beds for Critical Care Center)

・No. of staff: 901 (as of March 1, 2011)・Main fanction certificated as below, etc.➢Disaster Relief Core Hospital (designated in 1997)➢Regional Emergency and Critical Care Center

(established in 2009)➢Regional Medical Association Hospital➢Designated Regional Cancer Centers and Hospitals➢Miyagi Maternal and Perinatal Care Center➢Designated Hospital for Postgraduate Clinical Training➢Designated Hospital for Category 2 Infectious Diseases➢Facility for organ donations following brain death ・Ishinomaki medical service area (ISHINOMAKI,

HIGASHI MATSUSHIMA, ONAGAWA): Approx. 220,000 residents, surrounding area: approx. 100,000 residents, Total: approx. 300,000 residents

[Damage status in ISHINOMAKI (taken from the side of Hiyoriyama Park) ]

(1) “Earthquake and Tsunami Warning for a Disaster Zone” (2011) prepared by the Meteorological Agency(2) “2011 off the Pacific Coast of Tohoku Earthquake (it was renamed GEJET later)”, prepared by the Extreme Disaster Management Headquarters, Cabinet office (17:00, December 27, 2011).

Figure 3-1 Profile of Ishinomaki RCHP

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seismic structure to “prepare for protecting the local community from a disaster” at a site 4.5 km inland from the coastal zone in 2006.

(b) ElevatorsThe hospital has 11 elevators, including 5 units designed to include a generator backup system. These units allowed additional setting up with a monitoring device. However, all of the hospital's 11 elevators stopped working due to the power outage. And from a legal point of view, once an elevator stops, it is not allowed to be restarted until a nationally certified technician (elevator test technician) checks it to ensure safety. As the elevator company employees in charge of ISHINOMAKI were also victims of the disaster they were unable to conduct repair work for the elevators. On the evening of March 13, a testing staff member from the elevator company came to the hospital from Tokyo, although he came to the conclusion that they would “stop the elevators as they are considering possible aftershocks”.As a result, required to take the stairs to carry both patients and meals. It required a certain number of peoples to carry the patients up the stairs (each wheelchair took 4 people to carry it up, and a stretcher required 6 ). Food and medicines were carried in “bucket brigade” fashion, including some that were relatively heavy. The work was extremely difficult because the stairs were also too narrow to carry patients and supplies.From March 14, 8 elevators came into operation, the responsibility for which was shouldered by the hospital (3 elevators remained stopped until March 21 when the failure of their seismoscopes was repaired).

(c) Hospital Information System, etc.With an in-house power generator, the hospital information system (HIS) for electronic charts or medical affairs accounting worked normally.However, the only available systems were those connected to emergency power outlets by way of the in-house power generator; and the following devices were available for service.

Amid this turmoil, every single medical institution in the Ishinomaki area, except for Ishinomaki RCHP, suffered severe damage. Only 5 institutions in the area were available to provide medical services immediately after the earthquake. Ishinomaki Municipal Emergency Medical Clinic and Ishinomaki Municipal Hospital (206 beds for general patients) which had played a central role in primary and secondary emergency care were also unavailable to provide medical services. Ishinomaki RCHP was left as the only available hospital to respond to primary to third level emergency care services, resulting in a situation in which patients in the area were concentrated on the hospital.

Figure 3-3 Comparison between the flooded areas of GEJET 　　　　and the Tsunami Hazard Map in ISHINOMAKI

Source:“Report of the Committee for Technical Investigation on Countermeasures for Earthquakes and Tsunamis Based on the Lessons Learned from the 2011 off the Pacific coast of Tohoku Earthquake” by the Cabinet Office

(2) Damage to Ishinomaki RCHPa. Damage to the Building/Equipment, etc. (a) BuildingFollowing the unprecedented damage in the entire the Ishinomaki area, Ishinomaki RCHP suffered minor damage to its building and machinery, including

“cracks on the road in front of the entrance”, “precision instruments for testing broken in exam rooms on the first floor”, “documents scattered from the open shelves of the fifth floor ward staff station” without any major damage to the building and machinery.As background to this and as mentioned later, the hospital was relocated and newly constructed as a

・One room (out of 3) for general radiography・Three portable (out of 3) radiography units ・One CT unit (out of 2)・One MRI unit (out of 1)・One X-ray fluoroscopy unit (out of 2)・Two angiography units (out of 2)

A Map by“Geospatial Information Authority of Japan”Ish inomaki Tsunami Hazard Map

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disaster. The amount of clean water stored was only 190 t, a half-day’s worth of stock (as instructed by the Health Center). People were alearted to save water throughout the hospital and asked the Waterworks Department of the City to supply water via the community wireless system. A water truck (10 t) arrived from ISHINOMAKI in the afternoon of March 12, and a private water wagon of 20 t capacity came to supply water. On a preferential basis, the city government supply was restored at 17:00, March 16.The amount of water for general use (mainly for restrooms) was 470 t, 3-days worth of stock. Artificial dialysis, requiring 10 t a day, was carried out using the water for miscellaneous use. As the stock of general service water was running out, 400 t of water was transferred for firefighting into the water tank from March 13.There were 3 water tanks for Firefighting with 600 t of water in total usually stored; therefore, it was possible to leave 200 t in the event of a fire even when 400 t of water was used for general service purposes.Sewage functions remained because there was an inland sewage disposal plant in the western district of the city (cf. the sewage disposal plant of the eastern district was damaged by the tsunami). Inside the hospital, the sewage functions were maintained although subsidence of the land had caused part of the sewage pipe around the entrance to incline in reverse.

(c) Utility gasTo prepare for an earthquake, the city gas was supplied using supposedly quake-resistant, low- and medium-pressure gas pipeline networks. However, Ishinomaki Gas Co., the supplier, located close to the port, was affected by the tsunami and immediately discontinued supplying utility gas in the wake of the disaster.On March 23, Ishinomaki Gas borrowed a mobile gas generator from Shizuoka Chubu Gas, installing it in the premises of the hospital. We brought in technicians from a boiler company in OSAKA to have it remodeled by midnight on March 23 so that it could supply low-pressure gas using a boiler for a mid-pressure gas network. Liquid gas was vaporized using several tankers and employing 2 men for 24 hours, and was then directly delivered to the hospital. With the low-pressure gas supplied, it was temporarily restored from March 24 and fully restored on April 10.

PACS (an image database system where medical video diagnostic devices such as CT and MRI are connected to computers via a network, and test images are electronically stored, searched and analyzed) was available for use. However, the images that were taken could not be stored or delivered for several days after the disaster; there was no choice but to handle film input.

b. Damage to Lifelines (a) ElectricityAlthough the power outage lasted 2 days, the power switched to an in-house power generator, then there was no major disruption until it was restored on March 13.In order to reduce the risk of power outages, we received power from 2 transformer substations of the electric power company so that we could use a standby power system even when the main line was off. On March 13 at 12:00 the main line was restored and the standby line was restored on March 19.Two in-house power generators were installed on the roof, while an uninterruptible power supply (UPS) was available for important units such as the operation room, switching to in-house power generator settings without a power outage. The heavy oil to operate the generator for 3 days was stored (20,000 liters; 1,500 kw/h - 1,000 kw/h/day). However, because insufficient fuel remained to continue, we requested Ishinomaki municipal and Miyagi prefectural governments and JRCS Headquarters to supply heavy oil. On March 14, a private tanker from NIIGATA supplied 8,000 liters of heavy oil. Electricity was prioritized for medical purposes and some lighting equipment. Blood tests were only provided for emergency cases, while radiographic examinations were available , including X-ray photography, CT and MR images. PCs were also available, the staff could send test results and instructions for drug prescriptions to the related Departments via the ordering system and provide medical, testing and accounting services as usual.

(b) Water and SewageThe water system is divided into 2 types; drinking water and general services water. In addition, 2 water receiving tanks had been installed for each line to spread the risk.Water outages lasted 5 days due to this earthquake

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(d) Medical GasA stock of medical gas (oxygen) for 2 weeks was available, although it was used 30 to 40% higher than usual. While we were unable to get in touch with the supplier, a gas tanker carrier came from AOMORI and AKITA on March 15 to provide us with a supply.Until returning to normal operation on April 11, we filled liquid oxygen tanks with liquid oxygen six times (more times were needed due to the unstable supply; a single time filling did not make the tank full). Liquid nitrogen was filled one time.Nevertheless running short of the small medical gas cylinders, local companies were also suffered in affected area so that the headquarter supported to collect them.

(e) CommunicationAs shown in the following table, fixed-line phones and cell-phones were not usable, and community wireless systems and satellite-based mobile phones were only available for service. PHS phones were available within the hospital.

Type SituationFixed-line phones

Both of the two NTT base stations were affected and their landline had been disconnected for 10 days. It was restored in the evening of March 20.

Cell phones Not connectable some 2 hours after the earthquake. Staff from DoCoMo Shop Ishinomaki Branch, under contract to Disaster Recovery and Support Services, brought us 10 cell phones on the day of disaster. However, they had connection problems even though they had priority telephone links in a disaster. Therefore, we requested them “to establish a base station” on March 16. After negotiations with the Sendai Branch, a station was set up, standing on high ground, close to the hospital and the connection was restored.

Satellite-based mobile phones

Connectable. However, it interrupted the voice communication due to inaudibility. We had borrowed one set of satellite-based mobile phone from DoCoMo Shop Ishinomaki Branch before the disaster, and one more set was delivered on the disaster day. (Later, we borrowed additional sets).

Multi-Channel Access (MCA) Radio System 3

We had agreed to use this system at the time of disaster with our neighboring hospitals but it was not available in this time to connect with the hospitals that had been affected by the disaster.

Community Wireless System

The Community Wireless System directly connected to the municipal government was available for service. A Self Defense Force (SDF) Advance Unit, unable to arrive at City Hall, also used it when they came to the hospital.

PHS The general switchboard, connectable to the PHS handy nurse call system, was available within the hospital.

Internet Not available for 10 days.

c. Human SufferingThere were no injuries to about 1,000 staff who were working inside the hospital on the day of the disaster. There were also no injuries or fatalities to some 380 inpatients in the wards or about 100 outpatients in the outpatient departments.On the other hand, 32 staff lost their relatives within the second degree (9 were missing), 383 staff had their homes completely or partially destroyed, partially damaged, or flooded above the ground floor level.

2. Activities inside the Hospital(1) Response in the Acute Phase by Timeline Ordera. Situation Immediately after the Disaster OccurredAt 14:50, immediately after the disaster occurred, the Ishinomaki RCHP Headquarters for Disaster Control (HDC) was established. Then a lifeline check was completed in some 20 minutes.At 15:03, Dr. Kaneta, HDC Assistant Director, assessed the situation as Level 3 considering the size of the disaster, which was informed via in-hospital broadcasting. The “Disaster Response Manual” of the hospital assumes 3 levels depending on the degree of the disaster. Level 3, the highest level, refers to a situation in which medical services in normal times become unavailable, and all of the staff have to be engaged in disaster response for the long term. At 15:12, all surgical operations were stopped in the operating room.To classify patients by priority for treatment, a

“Green” area (patients with mild conditions or F/U) was established around the front entrance of the waiting hall in the lobby, and a “Yellow” area (patients with moderate conditions or those on stand-by treatment) in the waiting room for outpatients in the lobby. A “Red” area (patients with serious conditions/first priority for treatment) was established in the Regional Emergency and Critical Care Center so that the patients might be easily transported by land or air ambulance crews from a heliport site. A “Black” area (for the deceased) was established in the Rehabilitation Department at the end of the 1st floor hall. Because it was as cold as a midwinter day, the location of the triage post (to classify patients according to their condition) was changed to around the entrance of the hospital. The triage area had been set up by 3:25p.m. and staff were assigned at 3:43p.m. The parking lot

(3) MCA Radio System refers to a communication system for professional use that allows many users to share a multiple frequency band (phone line channel) of the 800 MHz range for the efficient use of radio waves. It has resistance to interference and need no certificate for use.

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municipal governors to provide relief activities.At 2:26a.m. on March 12, the first rescue team arrived from Hachinohe RCHP, followed by a medical team from Nagaoka RCHP at 3:30a.m.

c. The Next Day and ThereafterOn the day following the earthquake, 17 medical teams (13 JRCS medical team and 4 DMAT teams) came together from across the nation. However, the roads were covered with debris and land subsidence was found in the roads, which did not allow the medical teams to travel for long distances. On the other hand, in order to cope with the increasing number of patients, some teams provided in-hospital support services for the patients, rather than traveling from shelter to shelter to provide medical care in the neighborhood.On the second day after the disaster, an Emergency Fire Response Team joined forces with other rescue teams, and the number of ambulance for transporting patients to the hospital surged to 109. In the 48 hours after the disaster, the number of serious cases that were transferred to the Red area totaled 115. Some people suffered from “tsunami pneumonia”, which resulted from swallowing saltwater mixed with oil and dirt. Many elderly people had aggravation of their chronic condition. To cope with the increasing number of inpatients, we increased the number of beds by up to 50.On the day following the disaster, 779 patients, and on the 3rd day, 1,251 patients were transferred to the hospital, which at normal times has 60 emergency patients a day on average. Helicopters from the SDF, the Coast Guard and the Police were waiting in the air, which numbered 63 on the 3rd day alone. There was a deluge of patients inside the hospital. Running out of food in storage, we managed to eat the food and

for use as a temporary heliport was also immediately closed to all vehicles and was made ready to serve as a heliport.

b. Timeline of the Day of the DisasterAt 3:23p.m. the first patient with a mild injury was carried to the hospital. An ambulance vehicle from Ishinomaki District Wide Area Firefighting Headquarters Guard Division carried the first patient classified into the “Red” area at 4:20p.m. As one of the ambulance crews said, “ISHINOMAKI is severely damaged by the tsunami”. The staff members voluntarily came in one by one, reporting the same. However, the rescue operations did not go smoothly with 2 out of 3 ambulance service groups for Firefighting being affected by the disaster, and 12 out of 17 ambulance vehicles in ISHINOMAKI swept away. The number of ambulance transported patients to the hospital ended up being 9 vehicles on the day of the disaster.At 4:25p.m. the in-house broadcasting system provided the instruction that “those on the day shift should not go home, but just stand by”. At 6:37p.m. the leaders of each Department at HDC were convened and shared information with the instruction to divide the teams into 3 shifts so they could take a rest because an avalanche of patients was expected from the next day. At 8:00 p.m. assuming the situation was to become prolonged, it was instructed that “two thirds of the staff may go home because our emergency state will be lifted by 8:00a.m. the next morning”. However, the staff found on their way home that roads and bridges were covered with debris and water, and many of them returned to the hospital. Furthermore, bus and taxi services were unavailable for people supporting inpatients, as well as for outpatients; thus they remained in the hospital as

“returner refugees”. While the whole city was engulfed in darkness due to the power outage, an increasing number of people came on foot or by car to the hospital, which was the only building lit up due to the lighting provided by the in-house power generator.At 9:43p.m. the Ground SDF arrived. based on a request for disaster relief operations, an SDF Advance Unit was leaving for Ishinomaki City Hall from Tagajo Army Post, TAGAJO. However, they were unable to reach the City Hall due to the flooding and dropped by at Ishinomaki RCHP where the community wireless network was installed. And then for 4 days they stayed at the hospital, communicating with the

[Staff gathering at Ishinomaki RCHP HDC from each Department]

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disaster; however, the number surged on the next day and thereafter, peaking at 150 vehicles on March 14 with 689 vehicles in total over the 7 days after the disaster. These transportation services also included those provided by the SDF, or by helicopters, and the staff were busy responding to them. Over the one week after the disaster (as of 14:46, March 18) we had accepted 4,181 patients.In these circumstances, the Ishinomaki Wide-Area Fire Department accepted/handed over ambulance vehicles, handed over duties, recorded, and liaised with DMAT. It deployed two emergency medical technicians until April 20, two coordinators resided at the heliport in order to support safety management around the clock.

b. The Red areaPatients triaged to the Red area numbered only 17 on the first day, but the number peaked at 74 on the next day, adding up to 283 patients in total for a week after the disaster.Exogenous diseases accounted for a majority of the 48-hour (from the disaster) patients and, remarkably, many cases showed “hypothermia” in which rectal temperatures (anal temperature measurement) range below 35 degrees Celsius. This was because many people had been soaked in snowy seawater for many hours, or were wet through and waiting for help in places without any heating. Many people suffered from so-called “tsunami pneumonia”, chemical pneumonia, that resulted from swallowing saltwater mixed with foreign objects and oil after the tsunami carried away ships and machinery, while there were few external injury cases.It was about 48 hours after the disaster that some changes were noticed in the condition of the patients who had been brought in the hospital; the number of exogenous disease cases (i.e., external injuries,

supplies sent from the Headquarters and brought in by the medical teams.What had worsened the situation was an increase in number of people who, other than patients, visited the hospital for non-medical services, to ask for drugs, to find their families, or for the purpose of using the toilet, shelter, etc. And once they were in, many of them “wanted to stay in the hospital” to take refuge.If this situation had continued, it would have become more difficult for the hospital to accept severely affected patients. Thus, the hospital set up a guidance desk to ask the purpose of their visit prior to triage, this was a “Triage before the Triage Service”. The

“Green” area was moved to dERU established by the JRCS medical Center at the front entrance outside.

(2) Triage Area Establisheda. Triage PostThe triage post, where patients are to be diagnosed and firstly classified into the Red, Yellow, Green, or Black areas after examining their physiological condition, was set up at around the entrance of the hospital and later moved to the front entrance outside the building. Doctors, interns, nurse managers, nurses, clinical engineers and administration staff were engaged in the triage practice in rotation every 3 to 4 hours.On the first day, there were not many patients, approximately 100. However, on the day following March 12, we dealt with close to 800 cases for triage.At the triage post, patients were classified by color according to their priority for treatment, tags with the appropriate color coding were attached to their wrists, and they were guided to each area. At the reception desk the staff always served to provide dedicated IDs by recording the reference ID for an outpatient on the surface of his/her triage tag and issuing a disaster-related clinical records. (There were so many patients in the Green area that specific reference numbers were unaccountable.) By using the electronic medical record system, the number of patients were managed subsequently in order to maintain and store medical records, including tags and charts, and to enable the Medical Affairs Department to easily handle the documentation work. Approximately 12,000 disaster-related clinical records were generated up to the end of March.As mentioned before, only 9 ambulance services would be provided on the day of the earthquake

[Hospital staff providing medical services in the hospital lobby flooded with patients]

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arrangement of bus services to the disaster shelters.The patients transferred on the second day also included elderly people requiring nursing care who were at their homes or nursing facilities when caught in the tsunami, and patients receiving HOT (home oxygen therapy) at their homes. They were brought into us due power outages and medical device breakdown. The so-called “disaster challenged” needed more space for medical care and medical transportation. In view of the situation, we established an “Outpatient Treatment Room” in the “Outpatient Chemotherapy Center”, a “special department available for the addition of beds” as designated in the Disaster Response Manual.For 12 days from March 12 to March 24 when the medical transportation service was completed, the Outpatient Chemotherapy Center with 15 beds for medical services accepted a peak number of 47 patients daily, which was 2 to 3 times the number of beds. With regards to the breakdown of patients, the proportion of HOT patients accounted for approx. 50%, and those requiring nursing care for some 30%. After March 19, electricity was restored; and the number decreased with people getting home or using medical transportation.After April 4, the services were handed over to JRCS medical teams gathering across the nation for support. The Yellow and Green areas were integrated to form a “Yellow-Green area”.

d. The Green areaThe Green area was for patients with mild illnesses/injuries who were able to walk. Init ial ly the temperature was cold and the area was set up in the Waiting Hall, immediately close to the front entrance of the hospital.The disaster day saw only 47 patients arriving. On the second day they numbered 552, and on the third day 1,037, many of whom stayed inside the hospital. In order to prioritize severe patients triaged to Red and Yellow areas, There was no choice but to set up dERU at the front entrance, moving the Green area from the Waiting Hall inside the hospital to outside the building.On March 23 the dERU was withdrawn. On April 4 medical teams took over the services of the Yellow area, which was integrated with the Green to “Yellow-Green” area.

hypothermia, etc.) decreased and the number of endogenous disease cases increased. This is presumed to be because elderly people, as well as patients suffering from diabetes and heart disease, lost their medicines and their health condition deteriorated.The number of emergency patients, even for those in a chronic phase, did not decrease. There were some 100 patients in the hospital as compared to 64 a day on average before the disaster. In total, 2,290 patients had been brought in for 3 months. Many of them were transferred from disaster shelters. As for the breakdown by symptom, there were many cases of pneumonia, digestive organ disorders, and cardiovascular diseases. Those suffering from infections or dehydration also came to us over a period of one to two months.Potentially lethal patients had been brought in to the Red area one by one. The staff members focused on making empty beds available for incoming patients, moving mildly affected patients to the Yellow area, or to the hospital wards once the treatment methods for them were identified. In the 48 hours after the disaster, 118 patients triaged to the Red area included 64 (54.2%) hospitalized patients and 40 (33.9%) patients transferred to Yellow and Green areas.Later on, the staff members identified patients (supposedly) transferrable by the Regional Medical Liaison Office and collected information on their potential destinations, prepared a “list of patients”, and had emergency physicians in charge of the Red area arrange transfer methods for the patients.

c. The Yellow AreaThe Yellow area was for moderately ill patients who are conscious, verbally responsive when asked their name, or otherwise those who are “waiting for hospitalization”. This area was established in the outpatients room on the first floor. Due to the large number of patients, the medical teams joined forces for in-hospital support.For one week after the disaster the patients numbered 1,050, many of whom did not need to be hospitalized and were able to go home as soon as the treatment was over. However, many people had lost their homes they could return to or their vehicles. There was a concern that, if the present situation were to continue, many patients would stay inside the hospital, disrupting our care for severely ill patients. Therefore we talked with the City Hall officials for the

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(3) Responses by Each Departmenta. Dialysis Treatment CenterIn Ishinomaki Medical Service Area, all dialysis treatment centers except the Ishinomaki RCHP were affected by the disaster. Therefore, the hospital accepted all of the 540 patients on dialysis therapy in the area. In 2008, the

“Disaster Networking System for the Ishinomaki Medical Service Area” with the related facilities in the Ishinomaki Area, sharing information on the number of beds, etc., had already established to cooperate with each other in the event of a disaster. On the day following the earthquake, clinical engineers from 2 institutions came over to the hospital, attending to the patients.On the second day, the peak number, 124 patients were accepted. Dialysis patients were provided with therapy for “3 hours, 2 times a week” instead of “for 4 hours, 3 times a week” in normal times; and with 5 courses instead of 3 courses daily.To secure materials and drugs necessary for the dialysis was the key to controlling the flood of patients. Dialysis materials for 240 occasions, assuming 2 courses for 4 days had been prepared and ones on a regular service a periodic basis just delivered for the day. However, it was difficult to obtain more because all effective means of communication were cut off and the wholesalers were affected by the disaster. In order to procure the materials and drugs, the hospital made contact with the manufacturers and wholesalers by using satellite-based mobile phones, and requested the JRCS medical teams to bring the materials and drugs needed for dialysis as relief supplies. In addition, a facility in SENDAI accepted about 40 patients, and other facilities in HOKKAIDO, YAMAGATA, etc., accepted those who were able to stay for a long duration.RCHPs across the nation provided support to the Dialysis Treatment Center. They included, as hemocatharsis therapy, assembling/priming the blood circuit, assistance for needle puncturing/blood returning, preparations for devices and drugs in use, etc. This assistance allowed the Center staff to take a temporary break from providing the services.

b. Outpatients Receiving HOT Therapy and the HOT Center

Patients on home oxygen therapy (HOT) cannot survive without using such medical devices as a respirator, oxygen/transfusion pump for the home, etc. Once these become unavailable due to a power outage or other causes, the situation is lethal and those patients will die

e. The Black areaThe “Black” tagged corpses lay in repose for a short duration in the Black area. A team consisting of 10 professional staff, including doctors, nurses, clinical psychologists, laboratory technicians, rehabilitation staff and administrative staff was organized to provide services on a round-the-clock basis. They had to face the sorrow of the bereaved, which was a grueling duty in both mental and physical terms.Most of those transferred to Black area were chronic pulmonary aspergillosis (CPA) cases (dead-on-arrival). The day of the disaster saw 2 patients, the second day 11, and the third day saw the largest number of transferred patients, 23 patients. On around the fourth day we began to see patients who had died of pneumonia. Until April 5, the day of the withdrawal, 131 corpses had been brought in, including 70 bodies accepted by their families and funeral service agencies, and 61 bodies transferred to a designated morgue facility.The Rehabilitation Room at the end of the first floor was used as the morgue room. They were supposed to be placed for a short duration until being accepted by the funeral service agencies; however, the duration was prolonged because the agencies themselves were affected. The designated morgue room was sunny with higher temperatures, which generated an offensive odor. With an increase in the number of corpses, the morgue room on the basement floor of the hospital was also used.The road was also so flooded that ambulance service teams were unable to carry the corpses to the gymnasium, designated as a morgue, brought the dead bodies to the hospital. The number of corpses went on increasing as those who died in the hospital wards were added. On March 14 we managed to carry the 17 corpses that had been placed in the hospital into the morgue of the City Hall. On March 15, the crematory services were restored.

Figure 3-4 Triage results for the week after the 　　　　　disaster (until 14:46 of March 18)

The Green area2,769 patients

66%

The Black area79 patients

2%

The Red area283 patients7%

The Yellow area1,050 patients25%

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c. Midwives CenterIn regards to obstetrics and gynecology department or midwives facilities, all of the four institutions in Ishinomaki area, except Ishinomaki RCHP, were affected by the disaster. Thus, expectant mothers were concentrated in the hospital. Sixty-one pregnant women in the first 2 weeks, and 110 over one month were delivered. At normal times there are some 50 deliveries a month; thus, it was more than double.On the night of the disaster day, a Midwives Center was established and integrating outpatient services and the ward were under the control of a Maternity Ward Manager. At normal times they may be discharged from the hospital in 5 days after a spontaneous delivery, but the number of days was changed to 3 days. Devices used for delivery were also in short supply, which were borrowed from hospitals in the Sendai Medical Service Area. At the impact phase milk and diapers were running out as well, but they were supplied by the related manufacturers. To arrange and control those relief supplies was also one of the major services.On March 16, ten nurses and eight midwives were dispatched through the JRCS Headquarters. The service was provided on a rotation basis until May 14. In total 105 nurses were deployed for the ward's support and care services, and 100 midwives for delivery support. The hospital also arranged for obstetricians to be available on a weekly rotation for some 2 months until September.

d. Responding to an Increase in the Number of Pneumonia Cases

After the disaster, the number of patients suffering from endogenous diseases, mainly pneumonia, increased enormously. For 2 months from March 11 to May 9, those emergency patients hospitalized in Respiratory Medicine numbered 316, 3 times the total for the whole of the previous year (105 patients). They included 190 pneumonia cases, accounting for 60% of the total.There were three possible causes of pneumonia as follows.

within a few hours. While Ishinomaki RCHP normally deals with 88 patients, it is estimated that there were approximately 200 patients in the entire Ishinomaki area. (Many people were expected to die due to the shortage of oxygen, or because they were unable to move and escape.)On the earthquake disaster day nine patients came to the RCHP for oxygen. Those who visited the hospital to ask for oxygen were triaged to the Yellow area, guided to the Waiting Hall in the hospital. Designated as a treatment area in the event of a disaster, this area has a medical gas system to supply oxygen installed in the wall with medical power supplies. We gathered the patients at a spot with the central plumbing system for the oxygen service.It was expected to have a flood of patients coming in who were unable to use their oxygen concentration devices at home due to the tsunami and prolonged power outage. So on the next day, March 12, a “HOT Service for Outpatients” was established temporarily to provide oxygen at the Chemotherapy Center and other hospital rooms. There were 26 patients on March 12, and 29 patients (the peak number) on March 13.On March 16, a “HOT Center” was established at the Rehabilitation Center with 50 oxygen condensers borrowed. Because only up to 30 amperes were available, 30 oxygen condensers were only set up. This was not enough, therefore the patients ware asked to directly lay blankets on the floor between the beds in a four-bed room of the ward or Chemotherapy Center. Owing to malnutrition and the poor environment, 20% of the patients had exacerbation.On March 25 electricity was restored. The patients who were able to get home was asked to move to other hospitals, thus transferring 29 patients. On this day, there was no patients on home oxygen therapy.

・Aspiration pneumonia: Insufficient oral care due to the water outage may increase bacteria in the saliva, which flows into the trachea and triggers aspiration pneumonia.

・Tsunami pneumonia: Caused by swallowing sludge in the seawater, oil generated from vehicles and machinery, and chemical substances from factories.

・Dust pneumonia: Bacterial pneumonia caused by inhaling dust containing chemical substances generated decades ago in sludge brought by the tsunami. [A view of the HOT Center]

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three PCs for ordering prescriptions online at the front entrance. However, as the temperature dropped significantly, the Counter was moved inside the hospital from the second day, with two more PCs to alleviate congestion.The day after the disaster, the duration of a prescription for medication was limited to 3 days.On the disaster day and the following day, medicine stocks for about 3 days, and borrowed some from 4 general pharmacies around the hospital if insufficient inventory was in stock. Due to the power outage, medications that should be stored in a cool place were also stocked in the Pharmacy Department, such as insulin from the 4 general pharmacies around the hospital, for delivery to the patients. Drug stocks were running out for the first three days because the wholesalers were affected and due to the lack of gasoline; however, the necessary medicines were provided by sending out requests nationwide. Specifically, these supplies were from the Headquarters, Tohoku University Academic Society, Miyagi Local Government, private doctors, business entities, etc. Medical teams across the nation, including JRCS.The staff members were on three-shift work schedules from March 13 to 16, and on two shifts from March 17 to April 3. Because the Ishinomaki RCHP staff alone was not sufficient to meet the shortage of personnel, pharmacists were delegated from Tohoku University, Japan Pharmaceutical Association, Japanese Society of Hospital Pharmacists, Sendai RCHP, and JRCS Headquarters. Pharmacists from JRCS medical teams joined forces as well. As of August 15, 1,203 support staff in total had been assigned.

(b) Mobile Pharmacy, “Team Melon-Pan”The next problem was how to deal with patients in the disaster shelters. The identified problems were shared with the Ishinomaki Pharmacist Association;

“We want to deliver medicines to patients with chronic diseases who are not able to visit us”, “the drugs brought in by the medical teams are not sufficient to cover the range of chronic diseases”, etc. In this context, the concept of pharmacist teams traveling from shelter to shelter to provide medicines started. The Disaster Relief Act was to be applied to normal medical services, as well as disaster medical relief, covering free medications until the end of June. A “Team Melon-Pan” consisting of doctors from Ishinomaki RCHP, pharmacists and the Pharmacist

Asbestos was also a concern as well. Under co-sponsorship with the Fit Test Workshop, the Ishinomaki RCHP organized a “Special Local Seminar on the Use of Respiratory Protective Equipment (Protective Gear) for Professionals Engaged in Disaster Restoration/Rehabilitation Work” two times in May and June, when demolition and the removal of damaged houses started on a full scale for disaster rehabilitation. Participants in the seminar included volunteer doctors and nurses belonging to local NPOs, nurses from Ishinomaki Municipal Hospital affected by the disaster, health center staff, local government site managers, company managers in charge of debris removal, Firefighters, nursing teachers of high schools adjacent to debris-collection points, RCHP related staff, etc.

e. Response by the Hospital Pharmacy (a) Response to the Acute PhasePharmacies in ISHINOMAKI suffered from major damage; out of 97 pharmacies in total, 38 were totally destroyed, and 31 were half destroyed. The Ishinomaki Pharmacist Association did not function at all.In these circumstances people who lost their medicines due to the tsunami flooded into the Ishinomaki RCHP from the early morning of the day after the disaster. Thus, the Pharmacy Department began providing medical services at about 7:30 a.m. Immediately after the earthquake, 3 staff were assigned to the triage area, and 1 staff at a temporary pharmacy established inside the hospital. The appropriate prescription for drugs was issued regardless of whether the patient had a primary care doctor (PMD). In order not to disrupt other medical services in the hospital, we established a “Temporary Prescription Counter” with a LAN cable with a length of 50 meters connecting

Figure 3-5 Acceptance of Patients Requiring Nursing Care

No. of patients Patients requiringnursing case

Hemodialysis(HD) patientsHOT patients Other

No. of days after the disaster

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they also provided guidance on medication, collected information on the hygiene conditions in the disaster shelters, produced “Okusuri-Techo (Drug Passbooks)” that are indispensable when handing over information on a patient's drugs to other medical institutions. They produced “Okusuri-Techo” that covers the history of a patient's prescription drugs for all of the patients at the disaster shelters so that the passbooks might be used for those without prescription records or who were running out of medication.

Figure 3-6 Outline of the services provided by Team Melon-Pan

f. Psychosocial Support Services(a) Responses to Patients in the Acute Phase and

affected peopleThe earthquake dealt a heavy blow to people not only physically but also mentally. As Ishinomaki RCHP does not have a Psychiatry Department, psychiatrists from outside the hospital provided medical services. In cooperation with local government officials, JRCS Psychosocial Care staff also pitched in until the patient care could be provided by psychiatrists.Ishinomaki RCHP has Psychology Department with one clinical psychologist and two clinical development psychologists in service. On the disaster day, immediately after the HDC was established, they went on duty in the whole hospital on rotation, caring for those in a panic state, with hyperventilation syndrome, strong anxiety, etc., including among inpatients and outpatients staying inside, and their attending family members.On and after the second day, patients triaged to the Yellow and Green areas included those who lost their house or family due to the tsunami, or those who were at a loss searching for their family members in vain, those who kept crying or had difficulty in maintaining verbal communication, etc. In the same way as other patients, mental disorder patients were transferred to Ishinomaki RCHP, the only functioning hospital for psychiatric patients; we asked their doctors

Association staff was organized to provide mobile pharmacy services, traveling from shelter to shelter to provide medicines.The “Team Melon-Pan” delivered prescribed drugs provided by Ishinomaki RCHP to chronic disease patients at the disaster shelters. The team was named due to their hope to “deliver joy to people like a mobile bakery that sells melon-pan (a melon-shaped and melon-flavored bread roll)”. At the most difficult time after the earthquake disaster, day after day those melon-shaped bread rolls just before their best-before date had been delivered as meals for the staff, which also contributed to the name.

The Team Melon-Pan traveled from shelter to shelter, obtaining information on the patients in order to write their prescriptions. They prepared the drugs according to the prescriptions at the Ishinomaki RCHP, delivering them to the disaster shelters including those prescribed by the medical teams. In some cases the medical teams dropped by the hospital to pick up the medicines and then brought them to the disaster shelters.The medical teams, including JRCS Medical Team, brought medical prescription sheets from their hospitals whose formats were not common. Then the medical teams and the Team Melon-Pan integrated the formats of the prescription to prevent omissions in the necessary records, and to alleviate stress when preparing the drugs.From April, three to four pharmacists and one driver (hospital staff) started traveling from shelter to shelter in the city every morning and evening. Because there were too many kinds of medicines for chronic diseases including diabetes, they produced and took the prescription to the hospital and delivered the prescribed drugs. Not only delivering the drugs,

[Team Melon-Pan]

・Participants: 143 staff　➢　Ishinomaki RCHP pharmacy staff (20), and

doctors (3), JRCS Support Team (99), General pharmacies around the RCHP (5) , Japan Pharmaceutical Association supporters (16)

・Total mileage: 15,880 km・No. of disaster shelters visited: 161 sites (683 sites in

total)・No. of drug prescription sheets: 4,273

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Subsequently, from April 7, each psychiatrist from RCHPs across the nation pitched in for in-hospital support on a weekly shift rotation. Until October 14 they dispatched 30 staff in total, providing medical services to about 140 patients. Mental health care for the hospital staff was also provided in cooperation with industrial doctors. After the in-hospital needs decreased, two staff of the Clinical Psychology Department shared information with public health nurses and travelled from shelter to shelter to provide medical care with the Psychosocial Support Team. In cooperation with the JRCS Psychosocial Support Team and the Joint Medical Team they visited patients in the community (at disaster shelters or their houses) if necessary.

(d) Cooperation with Local CommunitiesWe maintained close communication and cooperation with local government officials, public health nurses who were familiar with the local situation, and Clinical Psychology Department. Psychiatric Medical Teams of Tohoku University Hospital, JRCS “Psychosocial Care Team”, and the public health nurses of ISHINOMAKI and HIGASHI-MATSUSHIMA at Ishinomaki RCHP as a hub hospital gathered to hold a “psychosocial care support joint meeting” where they reported on what they had done and what the disaster victims needed, discussing mental consultations for the disaster victims, and taking up active listening requests and challenges, etc. The meeting was held once daily in the acute phase of the disaster, once every two days from late March, once a week from April, and once every other week from August. After September, psychiatrists in the Ishinomaki Medical Area, Miyagi Welfare Office joined forces for a monthly meeting,

“Joint Meeting on Psychosocial Care Support for the Ishinomaki Medical area”.

g. Food Procurement/ProvisionFollowing the earthquake, a Level 3 was declared and the use of the kitchen was restricted. Gas was not available either, and water had to be saved for medical use on a priority basis. The emergency food that had been stocked for disasters was served. The elevators were not working and it was hard to deliver the emergency food, water pet bottles that had been stored in the second basement floor to each ward of the hospital.Although there was no food stored for the staff, the

to generate documents on their information and handed them over to public health nurses and local government officials. Before long psychiatrists from Tohoku University Hospital came to provide support, responding to the bereaved and assisting to carry corpses in the Black Area.

(b) Responding to the StaffThe HDC focused on psychosocial care, establishing a “Refreshing Room” for staff personnel at the reception room and deployed psychiatric doctors.On March 16, a Refreshing Room was established next to the Hospital Director’s Room. For four months until July 18, footbaths and hand massage services, active listening, etc., were provided by support teams, mainly JRCS Psychosocial Support Teams. These services were used by 134 people in total from March 16 to 31, 252 in total in April, 104 in total in May, 20 in total in June, 45 in total in July; adding up to 555 in total.Also, those who hoped to receive psychiatric care from the beginning, or claimed chronic sleep loss and strong anxiety were referred to psychiatric doctors providing assistance.

(c) Responding to Patients and Disaster affected populations in chronic stage

As for psychosocial care support many organizations cooperated in providing services.On March 14, the JRCS “Psychosocial Care Support Teams” joined forces for the program, and 38 teams with 365 staff in total provided services until September 1st. The services provided mainly included support for the evacuees. The teams periodically visited three to five shelters that seemed to have many patients with psychosocial problems. They also sometimes dropped by the shelters that did not have enough support from the local government. They also responded to individual cases that had been requested by the Joint Medical Teams, referring them to psychiatric doctors as needed, and were engaged in social welfare management services including life support. They also helped supporters (local government officials who managed the disaster shelters and the supporting volunteers) and hospital staff.The psychiatrists received support from Tohoku University Hospital, providing medical services and drug prescriptions at the Emergency Medical Department in the hospital and the disaster shelters.

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hospital for an interview, repeatedly broadcasting that they were “reporting from Ishinomaki RCHP, the only functioning hospital in ISHINOMAKI”.In using media, many people got info about the hospital. The shortage of medicines, fuel and food supplies that was talked about was written in articles, resulting in more support over time. On March 18, after a dietitian claimed, “the remaining food will last only one day” in a live televised interview, many supplies were sent from the neighborhood and across the nation.These PR activities may have sometimes helped patients and affected people. The hospital staff asked a local FM radio station, “Radio Ishinomaki”, to make an announcement that oxygen was provided to patients receiving HOT therapy. The whole of the radio station of Radio Ishinomaki was affected by the disaster and yet they managed to continue broadcasting services using a microphone on an apple crate at the top of Mt. Hiyori, where a transmission station was located. Before the disaster it was talked about cooperation at the time of an emergency, and so their 10:30 radio program was available to provide information for local people on medical services at Ishinomaki RCHP, disease prevention and other precautions.

(4) Transportation and Transfer Support for Patients and Evacuees

Immediately after the disaster, the Ishinomaki RCHP accepted all patients who flooded to the hospital, including those who had “completed receiving medical care”, “no place to go after being released from the hospital”, “returner refugees”. On March 13, It was begun to sort the people lying on the floor into

“patients” and “evacuees”. Acute patients who needed treatment at the hospital were transferred to

supplier of the hospital store was supposed to provide merchandise to them in times of an emergency, so they received sweet buns and sweets sold at the store. (In fact, the staff were in service at their workplaces and had no time to eat; only a small portion of them managed to have time to eat them).150 kg of rice in stock was boiled over 2 days using cookers from midnight on the day of the disaster, preparing rice balls throughout the night. On the following day, boiled rice was available. However, it was impossible to use plates; the amount available for each staff was one rice ball at breakfast, lunch and dinner.From March 12, relief and food supplies were delivered from RCHPs across the nation and the Headquarters, etc. Because those food items would expire in another 2 days at the most, food items were delivered within the expiration dates to the patients, and those just before or with ambiguous expiration dates to the staff. Subsequently, a disconnection in the communication lines prevented us from ordering more food (in two weeks food delivery was available). JRCS medical teams were asked to bring the necessary supplies.On March 16 water services were restored, which allowed them to cook food materials. However, on March 17, the relief supplies that had been periodically provided stopped, leaving food stocks (except rice) only for another 2 days. On March 18, the hospital asked for the public to help them cope with food shortages in an interview televised live. Following this, relief supplies began to be delivered from across the nation, which enabled them to solve the inventory problem of the shortages on March 22 - 23.On April 12 about 80% of the meal services were restored and by May 11 they were fully resumed.

h. Public RelationsFor this earthquake disaster, the Ishinomaki RCHP was willing to receive media exposure.However, immediately after the disaster no mass media asked for an interview. This was because the hangar for helicopters used for media coverage at Sendai Airport was swept away by the tsunami.The first reporter that visited us was from Kyodo News Enterprise. After the interview, an article was produced, titled, “As If in A Field Hospital”, which was delivered through local papers. On March 14, a popular anchorman and TV station crew came to the

[Providing information at a press conference with a flood of news reporters]

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b. Support for the Transfer of EvacueesSome patients needed hospitalization, some outpatients had already completed their treatment, or those accompanying the patients, evacuees, etc. stayed inside the hospital, claiming they had “no place to go home to”,

“no means of moving (by vehicle or by bus)”. They numbered 600 at the peak time, lying on the floor for accommodation.In order to keep the hospital working, these people had to be moved from the hospital. The Ishinomaki RCHP asked local HDC for a shuttle bus service to the disaster shelters, which became available for two weeks from March 14. People on the list to be moved included those who had supposedly “completed treatment” and

“returner refugees” staying inside the hospital. The staff tried persuading them, one by one, to “move from the hospital because we are unable to even serve meals”. However, few people accepted the request at first, and many of them vented their frustration because few bus services were available with limited destinations.Thus the hospital tried to locate “Welfare Shelters” that would accept those who needed nursing support (such as helpers) for assisted living and, after discussions with the City Hall, “Yugakukan”, a communication facility serving multiple purposes, accepted people from March 16.

c. Whereabouts information roomOn March 11 an “Whereabout infomation room” was established in the Medical Center next to the Emergency and Critical Care Center. However, telephones and the internet were unavailable, and people flooded the Office asking whether or not their family members were receiving medical care there. In these circumstances, the room was moved the office to a tent outside the hospital on March 14, and

medical and nursing facilities, and people who visited the hospital for evacuation purposes were transferred using a shuttle bus connecting the hospital and the disaster shelters. On the other hand, people seeking information on the safety of their family members still came to the hospital.

a. Transportation of the PatientsAmong nearby medical institutions affected by the disaster, Ishinomaki RCHP, a critical emergency center, was the only hospital in the area that had accepted many patients. However, the number of beds of the hospital was limited to 402 beds plus an additional 50 temporary beds. The problem was how the hospital could maintain its functions as an acute-phase hospital. Thus, transportation service was started for the patients.An interview survey was carried out to identify patients who were able to transfer to another hospital. However, it was hard to deal with many patients who were unable to say their names, those who had no family left to care for them, or whose triage tags were removed in the hospital. Because communication tools were unavailable, the staff visited medical institutions and nursing facilities within the range of a 30-minute walk, and tried contacting the hospitals in remote areas using satellite-based mobile phones for the purpose of asking whether or not they could accept our patients. However, their reactions were not very favorable. From March 13 to 15 we managed to transfer only 16 patients.From March 16, emergency physicians was invited in the Red area integrate and control the list of transferable patients for the arrangement of transportation methods, which allowed the staff to efficiently identify the potential patients transferable to other hospitals. That Tohoku University Hospital mainly accepted those transportation cases accelerated finding recipient hospitals for these patients. The transportation process for the patients went smoothly because, at Tohoku University Hospital, the procedures had been integrated by their HDC, not by each department as usual. Also, thanks to the efforts by Yamagata Prefectural Central Hospital, Geriatric Health Services Facilities, etc., in YAMAGATA accepted many seniors requiring nursing care. More than 500 patients for March and April in total were transported those facilities.

Figure 3-7 Breakdown of transportation cases

Destination of transportation(March/April=534 patients)

Transportationto outsidethe prefecture68 cases12.7%

Hospital486 cases91%

Within MIYAGI103 cases 19%

Tohoku University Hospital195 cases 36%

Surrounding Medical Area73 cases 14%

Ishinomaki Medical Area63 cases 12 %

Adjacent prefectures42 cases 8%

Remote areas10 cases 2%

Facilities48 cases 90%

Within MIYAGI20 cases 4%

Adjacent prefectures15 cases 3%

Remote areas1 case 02%

Ishinomaki Medical Area9 cases 2%

Welfare evacuationshelters21 cases 4%

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for these patients continued for a long period of time.Arrangements or adjustments to be made for staff deployment were based upon a request from Ishinomaki RCHP and the Headquarters informed the Block Representative Chapters of the requested number of dispatched staff per job title and their service duration. Under the scheme, the Block Representative Chapters requested the deployment of staff to each medical institution, mainly RCHPs, via the each chapter of each prefecture. Most of the dispatched workers were RCHP staff. The Chapters, Blood Centers, and the Headquarters also provided for cooperation in deploying administrative staff.While responding to the needs for manpower, the dispatching side gradually found it difficult to secure human resources. In addition, it was sometimes unable to provide the requested number of staff and extend their service duration.Therefore, in order to appropriately identify the local needs and smoothly coordinate staff deployment, two Headquarters staff, in principle, resided at the hospital on a rotation basis until the end of July. The staff dispatched from each medical facility across the nation gathered at the Headquarters to have a briefing, and then they entered the disaster area by using a large chartered bus. Because the Tohoku Shinkansen service was restored from the middle of May, it was possible to enter the area directly from the facilities they belonged to using the public transportation system.It was necessary to keep in mind when the staff was dispatched that they provide information to the next staff about “psychosocial care for the staff”, “useful tips for the staff’s activities”, etc. The support staff took a land route to ISHINOMAKI. They arrived at the city in the evening where the sky was dusky due to the power outage and were unable to directly witness the miserable situation of the damaged coastal area. Ishinomaki RCHP did not suffer from major damage. Other than the large number of injured and sick, the situation looked as if there had been no disaster at all. And one of the major characteristics of this disaster was that even support staff member assigned to the hospital found it difficult to have a sense of reality that they were in a disaster area. Therefore, there was a huge gap between the image of medical services, their sense of exaltation and mission before their deployment, and the sense of accomplishment and fulfilment they actually obtained

added a second tent on March 16. On March 18, it was moved to a large-sized tent (air tent). Subsequently, as telephone lines and the internet were resumed, the room was closed on April 4. Initially it aimed to “collect and post information on our patients”. However, responding to an increase in the needs of the visitors, the service expanded and gradually shifted its focus to “setting up and maintenance of the message board” and “collecting and providing shelter lists outside the hospital”.

(5) Deployment of Support Staff from the HeadquartersAs discussed in above, Ishinomaki RCHP had to deal with the patients and affected people flooding to the hospital from the entire Ishinomaki Medical Area under a very difficult situation in the wake of the disaster. Therefore, in addition to the medical teams, the Headquarters dispatched the support staff mainly from RCHPs across the nation based on a request from Ishinomaki RCHP. Doctors belonging to the medical teams provided in-hospital support as necessary until the end of March before a full-scale adjustment/arrangement began with a formal notice from the Headquarters. Addressed official dispatch letters to the chapters and facilities across the nation, as of March 25 were sent to the relevant pharmacists, nurses, midwives, nursing teachers, as of March 28 to internists, as of April 4 to psychiatrists, and as of April 8 to clinical engineers and administration staff. The physicians mainly provided medical services at the Regional Emergency and Critical Care Center. Due to an increase in the number of patients in the General Medicine and Respiratory Department during the Japanese long holiday season on May or summer season, human resources were arranged for each department to cope with the situation apart from the support for the Regional Emergency and Critical Care Center. The nurses and midwives supported the ward, triage, and nursing school teaching. The pharmacists mainly assisted in the preparation of medicines in the hospital. The clinical engineers provided hemocatharsis therapy and cardiovascular related services, and the administration staff were engaged in assessment duties in Ishinomaki Joint Medical Team. The support services at each department were completed, one by one, by around the end of August. However, the psychiatrists continued their services until March 31, 2012, because the need for mental care

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to identify the number of injured and sick was needed in order to determine which disaster shelters should be prioritized. The assessment was expected it would take a lot of manpower and so that fewer personnel would be left for traveling from shelter to shelter to provide medical care. After a discussion on whether or not the assessment is needed , finally we came to a conclusion and decided to go ahead with it because “we should clearly identify the status, identifying shelters with emergency needs, and go to these first”.For three days from March 17 to 19, while the medical teams traveled from shelter to shelter to provide medical care, the staff members evaluated the level of medical needs, etc. As a result of the calculation using the assessment sheets during the night of March 19, although more than one week had passed since the disaster took place, people at 35 shelters were living with a shortage of supplies of food. About 100 shelters had sanitation problems with their toilets not flushing properly.Subsequently, data of these disaster shelters was to be updated every day, posted and stored in chronological order. The data helped to determine the deployment strategies for the medical teams and to take the following measures for the deteriorating hygiene conditions within the shelters.

b. Assessment MethodThe assessment covered the following items: the number of people accommodated in the entire shelter, the number of patients in total receiving medical services and the number according to the disease (fever: 38°C or more, coughing, vomiting, diarrhea, influenza, respiratory illness, breathing difficulty), evaluation of lifelines and the hygiene environment (water, food, electricity, blankets, heating, hygiene status/toilets), and the needs from each department (pediatric needs, psychiatry needs, obstetrics and gynecological needs, and dentistry needs).Among the above items, the lifelines/hygiene status related items and the needs per department were evaluated at four levels, “◎, ○, △, × (Very Good, Good, Fair and Poor)”. There is a rough indication in the explanatory notes: “◎ (Very Good) refers to all, ○ (Good) to 50% or more, △ (Fair) refers to less than 50%, and × (Poor) to zero” . However, the staff did not necessarily have to evaluate the items based on strict standards. What was more important to locate the shelters evaluated as “×(poor)”, and it was considered

from the support services; the deployed staff tended to wonder and question whether or not they “really contributed to the support”. Therefore, it was a point of providing a careful explanation on how the hospital and the staff was functioning.Initially they used meeting rooms in the Ishinomaki RCHP for lodging, but increasingly used accommodations in the city from around May or June.For approximately one year, more than 1,000 staff from across the nation provided support services to Ishinomaki RCHP, which was a large-scale, sustainable and unprecedented project combining the deployment of medical team staff and support to the disaster facilities.Through the coordination work by the Headquarters, 4,874 staff in total (1,477 physicians, 2,426 nurses, 839 pharmacists and 132 clinical engineers) had been dispatched for hospital support from March 12 to July 31 (or March 31, 2012 for psychiatrists) from RCHPs across the nation.

3. Joint Medical Team Activities in the Ishinomaki Area

At the Ishinomaki RCHP many medical teams including JRCS medical teams gathered, where the medical functions including traveling from shelter to shelter to provide medical care were integrated as the

“Ishinomaki Area Joint Medical Team”. As the City Hall was damaged by the disaster, the Joint Medical Team was engaged in not only medical services, but also public health and welfare activities that were otherwise provided by the local government.It is considered this is a rare example of where many medical institutions, including JRCS, cooperated with each other, serving a large-scale project over a long period of time in various areas such as medical and other services. The services provided by Ishinomaki Area Joint Medical Team are described as follows;

(1) Assessment and Improvement in the State of the Disaster Shelters

a. Background to the Assessment ServicesThe HDC staff of the hospital waited until the water receded from the road, and visited Ishinomaki City Hall to assess the damage and obtained a list of 328 disaster shelters. It was estimated that approximately 42,000 people had evacuated. However, the list only covered the names of the shelters and number of people accommodated; no details were available about the needs of each shelter. Therefore, the assessment

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from spreading within the hospital and maintained a normal hospital environment. Initially, one doctor and one nurse specialized in infectious diseases (and later, two nurses) traveled from shelter to shelter to prevent infectious diseases.First of all, ICT carried out risk assessment of the disaster shelters. They asked the medical teams traveling from shelter to shelter to roughly investigate whether or not water was available, sewage in the toilets was properly disposed of, the number of portable toilets was sufficient, etc. And based on the results, they identified which disaster shelter was facing a serious condition, and provided the necessary supplies (masks and hand disinfectants) to prevent infectious diseases with instruction on how to use them. The supplies distributed to the shelters also included masks, disinfectants, hand disinfectants, etc. As followed identifying the infectious diseases on site, lifeline availability and the number of evacuees, it was decided what should be allocated where. The team gathered these supplies by supporting from the Headquarters and personal connections. From morning to the evening, asking it was investigated how the toilets were used and cleaned as part of instruction on hygiene management with visiting up to 4 to 5 disaster shelter a day. As there was no sewage, four lots of wrap-type toilets

4

were found from the warehouse of the Ishinomaki Government Office and distributed 90 units to the disaster shelters. it was informed that alcohol disinfectant could not kill norovirus; the effective way would be hand-washing with water. In order to prepare tap water for hand-washing, tanks for small-scale water systems that are used in developing countries were provided at 11 disaster shelters through cooperation with the International Red Cross and Red Crescent. From the examination of the assessment data on the shelters that was updated every day, a follow-up the survey was conducted about coughing, fever, digestive cases, and intervened with the patients as necessary. For example, when one of the shelters had 20 diarrhea cases, ICT immediately went over there to deliver soap and focused on hand-washing instructions.

that there would be no significant difference among those judged as “×(Poor)” . It was also necessary to avoid causing additional stress on the evaluators with excessively detailed standards.The results of the assessment sheets were input as electronic data every day. The input work was initially provided by a Kokushikan University team and, later, it was handed over to JRCS Headquarters and Ishinomaki RCHP HDC support staff. The data was also published on the Internet with the support of Google Japan.

Figure 3-8 Assessment sheet formatFormat omitted

The data results helped to examine chronological changes in each disaster shelter. It was examined the number of people accommodated by the shelter, the number of patients receiving medical services, the changes in the ratio of patients receiving medical services (the number of patients receiving the services out of the number of people accommodated by the shelter) or the number of patients by symptom, such as coughing, etc. Discussions were held to determine the factors, if any, that caused a surge of patients at the shelter in order to increase the visits.

c. Response after the AssessmentDr. Tadashi Ishii, the Coordinator controlling the Ishinomaki Area Joint Medical Team (discussed below) went to Ishinomaki City Hall for the purpose of coping with the shortage of food supplies at the disaster shelters. He also participated in a Medical Coordination Council held at the Miyagi Prefectural Office to ask for food supplies for the disaster shelters. The medical teams also arranged the delivery of food supplies to the shelter.In regards to improvements in the hygiene environment, it was difficult for the traveling medical teams from shelter to shelter to even prevent infectious diseases. Public sanitation services should essentially be the responsibility of local government officials, including public health nurses. However, both the City Hall and Health Center were affected and not functioning properly. Therefore, an Infection Control Team (ICT) from the Ishinomaki RCHP was deployed. This team carried out staff education to prevent infectious diseases

(4) A portable, deodorized legless chair type toilet. One can urinate or defecate on a vinyl mat prepared in advance, then push the button to have it disposed in the sewage and have the next vinyl mat charged automatically.

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and aspiration pneumonia patients due to their prolonged stay at the shelters. In particular, it was the big issue that elderly people who had been able to walk before the disaster lost their capability to walk, and those who had been independent in going to the toilet became all-day diaper users. Therefore a project was established with the city officials to focus on a “welfare-shelter” in order to maintain the degree of independence that the elderly people had because it was more efficient to concentrate the public health nurses and care managers who traveled from shelter to shelter at a single site. The assesment was conveyed about patients requiring nursing care at 132 disaster shelters in the former Ishinomaki area (except HIGASHI MATSUSHIMA and ONAGAWA) in a week, identifying 76 relevant patients. Out of these patients, almost half needed nursing care, and one quarter of them could move to welfare-shelters, etc. Through cooperation with the city government officials,

“Yugakukan” was also used as a welfare shelter. This facility accommodated 358 people in total, including elderly people, infants/pregnant women, and their family members. In addition, ICT recommended that the City Hall specify the Monou Farmers’ Training Center as a welfare evacuation center, which was so designated on April 29. In ISHINOMAKI ICT established welfare evacuation centers at 12 sites in total one by one from the disaster day. The above centers included 10 facilities for elderly people, none of which had been designated as such before the disaster.However, the number of users of the welfare evacuation centers and welfare shelters was limited because many gave the reasons “I would like to stay as close as possible to my home”, “I don’t want to live where public transportation is limited”, “I do not want to be apart from my family”, etc.

d. Installation of a Short-Stay BasePatients with infectious diseases become more prevalent in the chronic phase. When it became warmer, there were more cases of chicken pox, mumps, streptococcus hemolyticus infection and hand-foot-and-mouth diseases. In normal times, most of the patients would have recovered by taking a rest at home. However, there is a risk of them spreading the infection in the setting of a disaster shelter.To provide a facility for patients to stay until their recovery and in order to prevent contagious diseases (such as influenza) from spreading, a short-stay base was installed with about 20 beds on the fourth floor of Ishinomaki Royal Hospital. This was established as a high quality disaster shelter, not as a hospital, based on the following concepts.

(2) Assessment for Patients Requiring Nursing CareThe environment of disaster shelters gradually improved, and no serious events (such as outbreaks of infectious diseases) occurred. However, the number of emergency patients did not decrease even in the chronic stage, and patients visiting the hospital numbered some 100 a day, almost double the 60 patients on average at normal times.

At this stage, the increasing visitors included vulnerable groups (children and elderly people) claiming ill health, pneumonia patients supposedly caused by dust, [Welfare Shelter Established for People Requiring Nursing Support (Yugakukan)]

Figure 3-9 Trends in the Number of Emergency Patients

The number of emergency patientsremained the same.

Duration:　2011.3.11 -6.8 (80 days)Total: 17,344 peopleThe Red area: 2,290 peopl

Total number

The Red area

No. of daysafter the disaster

Patients

・Preparing for accepting patients whose condition may worsen in the setting of a disaster shelter although they would otherwise be allowed to go home in normal times

・Isolating people from the shelters where infectious diseases could spread

・When things settled down, patients awaiting to be transported to other hospitals may be accepted

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because people were unable to brush their teeth due to water shortages in the areas where water services had not been restored), and the number of people that had to be transported to the hospital increased. Coughing, sputum, breathlessness and dyspnea cases increased as well.

b. Improvement of the Deep Vein Thrombosis (DVT) Positive Rate

Immediately after the disaster, the shelters became densely crowded. This increased the positive rate of DVT; however, it decreased gradually. On April 21 the schools resumed activities and those sheltered in schools had to move to gymnasiums and local community centers. The evacuees cleaned their houses in the day time and returned to their accommodation at night. Thus, some of the shelters were again densely crowded. The shelter space per person was about a single bed or smaller in which they were unable to move or sleep well. This may have affected the increasing positive rate of DVT, along with a higher risk of cerebral infarction.

c. Information on Economy-Class Syndrome (ECS) to Raise Awareness

Ishinomaki RCHP asked the medical teams visiting the disaster shelters on March 13-14 to remind people about the ECS. The instructions included taking enough water, eating and exercising, etc. However, due to the poor conditions in the shelters, such health tips were far from accepted.From March 23 “compression stockings” (500 pieces each of S, M, L and LL sizes) were distributed to prevent ECS at the shelters.Also, as for the prevention of ECS, test apparatuses were collected and using lower limb venous ultrasonography was started from March 27 at the shelters. This examination revealed that there were many patients suffering from ECS. The Ishinomaki RCHP staff visited disaster shelters with physical therapists to recommend that the evacuees be physically active and conducted exercises with them.

d. Influence on Chronic DiseasesThe stress of life in a shelter can change the conditions of patients with chronic diseases, causing

“high blood pressure”, “myocardial infarction”, etc. Some of them who were taking “Warfarin” were transported due to cerebral hemorrhaging although

(3) Providing Medical Services for Diseases Caused by Conditions in the Disaster Shelter

The newly established welfare evacuation centers, etc., allowed for a decrease in the number patients requiring nursing care to some extent. However, if the same conditions remain, it is considered that it will have some impact on their health, including muscle weakness. Those staying in the shelters for a prolonged period had a higher risk of developing or worsening diseases due to the aggravation of the living environment, climatic and psychological factors.

a. Locomotive Syndrome, Aspiration Pneumonia, etc., in Elderly People

People in a disaster shelter have decreased mobility, sitting or lying down even in the day. In particular, elderly people are unwilling to move because of the difficulty of getting up from the floor, which results in a loss in muscle strength. An investigation of independence ability targeting about 1,000 elderly people staying at the shelters over the one month after the disaster was conveyed with the cooperation of Miyagi Physical Therapy Association/Association of Occupational Therapists. According to the results, people who were bedridden or close to bedridden status almost doubled in number compared to before the disaster. Those who needed assistance reached 2.3% of the total.Aspiration pneumonia cases due to being bedridden increased (one of the causes was insufficient oral care

【Welfare Evacuation Centers】These are institutions designated under the Disaster Relief Act. According to the “Guidelines on the Establishment/Administration of Welfare Evacuation Centers” prepared by JRCS, people eligible to attend such a center include those who have special needs regarding their living shelter (such as elderly people, challenged people, pregnant women, infants and sick people), and those who do not need to be hospitalized at care insurance facilities or medical institutions but require home nursing care. The prefectures, cities, towns and villages shall establish these centers at designated disaster shelters (elementary and junior high schools, public halls, etc.), welfare facilities for the aged (day service centers, etc.) , welfare facilities for the disabled (both public and private), health centers, schools for disabled children, lodging accommodations (both public and private) and provide the following services.

・ One life consultant staff for every 10 evacuees was assigned

・ Consumption items including paper diapers, stomas were secured in addition to portable toilets, handrails, temporary slopes, information transmission systems, and partitions

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and surveillance on medical needs in the Ishinomaki Area, and medical support to Ishinomaki RCHP, a hub hospital for disaster response. The participating medical teams are listed below.

Doctors familiar with disaster medicine joined forces on a rotation basis immediately after the disaster in order to support Dr. Ishii, a commander of the Joint Medical Team, coordinating the orientation for the medical teams, assigning service areas and providing advice and guidance on the decisions on service strategies.More personnel were needed to handle a great deal of administration work and maintain the functions of the headquarters, thus nine staff, in addition to two assistants of Dr. Ishii, were in charge of administration services for the newly established department.

However, due to the heavy workload, nine staff on a 24-hour basis was not enough to deal with the data, including data management.

they had taken the same dose of this anticoagulant drug (that can help prevent blood coagulation) before the disaster, and even lethal cases were observed. As the result of the test of the anticoagulant effects of Warfarin in the patients taking the medication, it was found that some of them indicated obviously higher values. It is considered that the unbalanced diet at the shelter had affected their health. Thus, the medical teams decided to provide the above test once a month when adding the prescription of Warfarin at the shelters.Some of the patients taking Warfarin even self-adjusted the dose when the drug was scarce. In this case, too, their test results were considered and re-established the doses. Some people were unable to report that they were taking Warfarin. Therefore, the RCHP staff asked the patients in the inquiry, “did your doctor tell you not to eat natto (fermented soy beans)?”

5 in order to acquire

information on their medication history management.An unbalanced diet may also affect the blood sugar control of diabetes mellitus patients, and the medical teams had to provide a service for blood sugar control.

(4) Services by the Ishinomaki Area Joint Medical Team

On March 20, MIYAGI and ISHINOMAKI local government officials gave Dr. Ishii a free hand in establishing the “Ishinomaki Area Joint Medical Team”, a team organized by staff across the nation with an integrated chain of command.

a. Administration of the TeamsBased on the philosophy of offering hygiene, health care and mental stability through medical services to all people living in the Ishinomaki Area, the Ishinomaki Area Joint Medical Team provided medical services

[Staff meeting of the Joint Medical Team]

・Japan Medical Association and Japan Dental Association Medical Care Teams

・Tohoku University Medical Team, Ishinomaki Municipal Hospital (local)

・University Medical Teams dispatched under contract with Tohoku University

・Hospital Medical Teams dispatched under contract between the prefectures

・JRCS medical teams・Psychiatrist Groups・SDF Medical Teams

(5) Because natto containing high Vitamin K counteracts the effects of Warfarin.

・Registration/erase of the medical teams (maintenance, management, listing of them)

・Management/maintenance of assessment data updated daily

・Data control, including daily reports on the condition of each patient and the number of visiting patients

・Control and delivery of supplied materials・Maintenance and store of the Daily Records of the

medical teams・Preparation and control of a Line Table・Acquisition, organization and delivery of various

documented information (traffic conditions, gas station locations, etc.)

・Daily update of documented meeting references and minutes

・A great deal of coordination with the organizations deploying the medical teams

・Preparation of a chronology (recording of a timeline or sequence of events)

・Maintenance of supplies lent to the teams

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Under the Area / Line System, considering the number of disaster shelters, etc., the areas around ISHINOMAKI were devided into 14 zones, and appointed medical teams available for long-term service as “Area Leaders”, leaving the management of the areas in their hands.The medical teams were divided into a “Line”, medical teams that provided support for one month or longer, and a “Spot”, support teams active for a short duration of time.

Figure 3-10 Organization of the Area / Line SystemFigure omitted

The necessary number of Line teams under an Area Leader was allocated, adjusting it for each area depending on whether or not a clinic was resumed or disaster shelters were consolidated/abolished. This aimed at providing long-term, stable medical support by subdividing, consolidating and abolishing the areas themselves. The number of medical teams to be deployed was decided based on the results of the assessments made at the shelters.

c. Toward Reviving Community Heath CareThe services provided by the medical teams gradually improved the environment of disaster shelters, avoiding serious consequences such as the spread of contagious diseases. As the number of shelters was decreasing and the local medical institutions resumed their functions, the services provided by the medical teams gradually declined. However, the number of emergency patients transferred to Ishinomaki RCHP did not return to the level of before the disaster due to the significant impact of the Ishinomaki Nighttime Emergency Center and Ishinomaki Municipal Hospital, which had been heavily damaged and had no prospect of resuming services. Support was also sought for OGATSUMACHI and KITAKAMICHO, which were severely damaged by the tsunami. The medical teams had been dispatched to the Ishinomaki Medical Area until September 30.One problem in particular was that KITAKAMI and OGATSU/OSU became areas without a doctor. Another problem was the collapse of the Kitakami Bridge, which caused ambulance vehicles to take time to get access.To cope with this problem, first-aid stations were established in the areas without a doctor (including Hashiura First Aid Station in a flooded area where

In these circumstances, JRCS continuously deployed 1,501 support staff in total to the headquarters from March 12 to July 31 (including 206 doctors and 1,295 nurses / administration staff / volunteers). They were in charge of collecting information on the support teams, carrying out assessments and registering the Daily Records of the medical teams. Four nurse managers from the Sendai RCHP were also engaged in recording a range of negotiations and the preparation of team lists on a rotation basis. Furthermore, staff from the Headquarters and Chapters resided for liaison and coordination.This support enabled the administrative staff in the hospital to focus on secretarial duties (accompanying meetings, preparation of minute summaries, preparation/management of documents for media interviews, preparation of the chronology, scheduling, etc.) This enabled the staff to handle a great deal of information on time, providing such information to doctor leaders immediately. The leaders assessed the current situation to decide on their service strategy.

b. Introducing Area / Line SystemAlmost two weeks had passed since the disaster. However, staff at the Ishinomaki RCHP were extremely exhausted, what with inquiries about the medical teams and supplies night and day, the staff registry ceremony from arrival to leaving. Because of the high turnout of medical teams, the assignment work became more complex, and until midnight every day the staff had to decide on the service site assigned to each team for the following day. Also, a problem that was very time wasting was that many medical institutions managed their services at their own discretion. In this context, it was decided to introduce a system that was to be called “Area / Line System” later, in which a team serving for a long period of time should be responsible for its own management to some extent.

[Staff supporting the Joint Medical Team]

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Note) Teams serving for more than one day were counted as one per day. Therefore, the number of medical teams is not the same as those in Chapter 2.

4. Approach from Before the DisasterAs discussed in the above, Ishinomaki RCHP was able to maintain its functions at the time of the disaster, providing medical services on an extensive scale. This is because the hospital had been engaged in a range of activities toward creating a disaster-proof hospital even in normal times.

(1) Preparation of the hardware parts of Supporting Hospital Functions

a. LocationThe Ishinomaki RCHP, which was relocated from Minato District (to the east of Kitakami River) in the coastal area to Abuta District (about 4.5 km directly from the sea) in an inland area in 2006, avoided any impact from the tsunami this time. Situated at the site where the former Ishinomaki RCHP used to be five years ago, the flood water reached the ceiling of the first floor of the Ishinomaki Red Cross Nursing School building.

b. Quake-Absorbing StructureAs the hospital adopted a quake-proof structure absorbing the level of energy released by an earthquake due to its base-isolated layer, there was no significant damage to the building and medical equipment.The quake-absorbing structure protected the

“information system” as well, allowing electric charts and ordering systems to be used just by inputting patient data on the PC. For diagnosis and testing services, it was important to be able to obtain patient information just by viewing the monitor. If the system had been down, the hospital would have had to use paper slips that we had not used on a daily basis amid the turmoil with the

one team was dispatched per day, while practicing evacuation drills). The Ishinomaki RCHP negotiated an increase in the shuttle bus services and appealed to the related agencies to secure transportation means for the elderly people who had lost their vehicles or their family members who could drive them by car. The First-Aid Stations continued to be run until September 30.In this chronic phase, the focus was on “how to connect to and revitalize local medical services, and how to make a soft-landing to restore them to their previous state”. To this end, the goal of our services was to achieve

“independence support” whereby people could find and visit their own primary care physician and not be too dependent on the medical teams. And the following strategies for our services were established until the withdrawal.

As mentioned above, the Joint Medical Team was designed only to play the role of revitalizing the collapsed local medical services.

Figure 3-11 Changes in the number of Ishinomaki 　 Area Joint Medical Teams

Until September 30, teams in service numbered 3,633 in total (including 1,101 JRCS medical teams)

Changes in the numbers of Ishinomaki Area Joint Medical Teams

Teams

(mm/dd)

・To inform people that the teams would be active for a limited time (so that people did not take it for granted that the medical teams will be always available)

・To provide information on practitioners that had resumed their services and recommend people to visit them

・To reduce the frequency of visits to the shelters; i.e., from every day to once a week.

・To have people secure their transportation means (such as a shuttle bus service) in rural medically underserved areas and to get medical services for themselves. Four fixed-point medical stations were established with free shuttle bus services for a limited time that traveled between the City Hall, private clinics, JRCS, shopping centers and the shelters.

・To take continuing measures to provide for patients in need of nursing care since the shelter accommodating these patients will not be closed.

・To provide health and safety management for disaster victims

・To keep providing services at fixed medical stations in rural medically underserved areas, the goal of which was to establish clinics.

　Finally, to ensure that the clinics provide medical services under the health insurance.

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could be liquefiable in the wake of a major earthquake. As a result, the tsunami water flooded the rice fields around the site through agricultural waterways and other routes. In the morning of March 12 the water fulfilled the rice fields; however, the site was saved from flooding.

d. Turnaround Drive and Large Eaves　The space before the front entrance prepared as a turnaround drive was not used other than for events. However, it was effectively used for parking the vehicles of the JRCS medical teams, setting up tents for living and for information on the whereabouts of the affected people. The “large eaves” (roof set before the front entrance for the turnaround drive) were about an area of 25 m × 15 m and 5m in height without an uneven surface between the road and the building. In the event of a disaster this allowed for flexible use of services, such as triage, the setting up of a tent for medical practice, etc.

e. Heliport Located at Ground LevelConsidering the convenience for the SDF and Fire Fighters, one unit of a heliport located at the ground level was established, the cost of which was lower compared to that of a heliport located on the roof top. The ground was also improved so that an air ambulance could move horizontally along the route connecting the heliport and the emergency entrance, allowing for the more efficient transportation of patients. This was very effective at the time of the disaster when many injured people had to be transported. Since the elevators had stopped, it was hard work to move the patients manually from the rooftop heliport to the Red area on the 1st Floor.

flood of patients after the disaster. Not only would this have caused chaos, it was expected that it would have increased the burden of manually inputting the medical data.

Figure 3-12 Outline of the Ishinomaki RCHP building

Structure 7th floor1st basement1st floor of the towerRabar Structure (Specialized Structure), Quake-Absorbing Structure

Completion year May 15, 2006

Site area 69,815.86 m2

Building area 101,173.41 m2 (including the main hospital ward/accessory ward)32,370.78 m2 (including the main hospital ward/accessory ward)

Total floor space 32,486.82 m2

Quake-proof equipment

Laminated rubber: 6 units, steel L-type damper devices: 16 unitsSeismic isolation rubber integrated U-type damper devices: 30 unitsElastic sliding bearings: 74 units

c. Banking for the Foundations and Sand-PilesAs the hospital is situated in the watershed areas of the former Kitakami River basin, we designed the landscape expecting flooding, raising the ground level higher than the flood level in the past.There is a diluvial formation 60 meters underground, thus friction piles were used for the foundation structure. This includes a mixture of clay layers in the middle which may sink or subside under strong pressure, and sand layers through which strong acid groundwater flows. A “Piled Raft” method was adopted to help relieve the burden on the piles. Also,

“sand-piles” were used because the sand in the superficial layer (up to 10 meters under the surface)

[126 units of quake-proof equipment supporting 35,000t building]

Emergencyentrance Heliport

[Bird’s eye view (aerial photograph) of the hospital building and heliport]

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a. Preparation of the Disaster Response ManualDue to changes in the building and facilities of the hospital, which was relocated and newly constructed in May 2006, the Ishinomaki RCHP decided to work on a full-scale revision of the Disaster Response Manual prepared in 2002. In February 2007, a “Subcommittee on the Disaster Response Manual” was organized as a sub-organization of the “the Disaster Preparedness Committee” (chaired by the Hospital Director). With reference to the disaster manual by the Disaster Medical Centers of TACHIKAWA, TOKYO, a team consisting of three doctors, six nurses, and two paramedics (pharmacists, radiography and laboratory technicians, etc.) gathered every other week for one year, sharing their responsibilities according to their job titles to produce the manual. In preparing the manual, the names of the managers of each department (updated upon every transfer) were included, because not only “what to do” but also “who to do it” was considered important. The hospital also interviewed the staff to find out their views and reduced the amount of text so that it was more readable.

b. Seminars and TrainingParticipants in the seminars were mainly members of the six medical teams with a high level of awareness of disaster medical services, but it had to be expanded to involve more staff. To this end, a seminar on disaster management for all of the staff was started in 2006.A “Program for Basic Seminar” was developed to allow the participants to study from the basics, and those who took the seminar once may then become an instructor of the Basic Course, to pass on the knowledge to the staff within the hospital.As a result, the number of participants in the seminar increased to 723 in FY2007 from only 73 in FY2001. The RCHP developed an annual plan for the Medical Seminar Program, which was about an hour session that started at 17:30 every Wednesday.

Figure 3-13 Attendance at the seminar on disaster ManagementFY2001 FY2006 FY2007 FY2008 FY2009 FY2010

73 participants

472 participants

723 participants

630 participants

611 participants

523 participants

In order to identify the achievements of the seminar, in January 2008 a tabletop exercise was provided that assumes how the hospital should respond to a large-

f. Underground Service YardCots, mattresses, etc., were stored in a storage warehouse in the parking lot . However , the stockpile was not enough to meet the demand. The underground service yard (which had been always used for the transportation of supplies from chapters and facilities around nation) had a wide space for transportation and storage, allowing smooth and efficient transportation using trucks. g. Outdoor Electrical Outlets and Medical Gases in

the Waiting HallIt was useful to have installed "outdoor electrical outlets for external generators” at the pillar of the front entrance. The number of patients increased on the third day after the disaster, on March 13. The patients who could walk in the Green area were moved to the dERU of the JRCS Medical Center set up outside for medical services. At this time, the electrical outlets installed outdoors were very useful. On the wall of the east side of the Waiting Hall, which had been used for treating patients triaged to the Yellow area, we installed and effectively used corridor wall-mounted medical gases (four oxygen outlets) which had not been used at normal times, as well as medical outlets for patients using oxygen inhalers.

(2) Inprovement of the Disaster Regime and Human Development

Having not experienced a massive earthquake since 1978, Miyagi prefecture estimated that major earthquakes would occur at a likelihood of “70% in 10 years, 90% in 20 years, and 99% in 30 years” After the relocation, Ishinomaki RCHP focused on disaster countermeasures, including working on a full-scale revision of the Disaster Response Manual) in 2007.

[Medical gases and electric outlets installed in the corridor of the Waiting Room]

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to respond to an earthquake disaster and cooperate with each other. The 6th Meeting was scheduled for March 22, 2011. The relationship developed through this Council effectively led to a more efficient disaster response.

Figure 3-14 Organizations participating in the Ishinomaki Disaster 　Medicine Representative Network Council

(b) Concluding Support Agreements for Disasters with Private Enterprises and Entities

In September 2010, a support agreement in relation to disasters was concluded with three entities consisting of the DoCoMo Shop Ishinomaki Store, Sekisui House Sendai Branch, Shisuikai (volunteers from restaurants in ISHINOMAKI). It provides for these entities to rush to the hospital to provide support services in the event of a large-scale disaster. Aiming at the improvement of the support technology for disaster response and smooth cooperation, the agreement also provides that the staff shall participate in disaster drills and events held by the hospital more than once a year. At the time of the earthquake, DoCoMo Shop Ishinomaki Branch rented satellite-based mobile phones and cell-phones. At the request of Dr. Ishii via a text message, a transmission station for cell phones was established near the hospital, which improved the communication environment. The Sekisui House Sendai Branch set up a tent in front of the front entrance. Shisuikai prepared a soup kitchen service inside the hospital, providing meals to the staff.

(c) Cooperation with Ishinomaki city The Ishinomaki Regional Disaster Prevention Plan

scale disaster, and in July we held a disaster drill. On June 6, 2010, we developed and carried out the

“Disaster Drill to Respond to Large-Scale Earthquake Disasters”, together with the “Miyagi Prefectural Disaster Drill with an Air Ambulance Med-Helicopter” and “Ishinomaki city Emergency Drill” to strengthen cooperation with the related organizations.

(3) Liaison with External OrganizationsAt the disaster time, it is essential to cooperate with external organizations, thus the Ishinomaki RCHP has the following relationship

a. Establishing Relationships with Disaster Medical Experts

The Ishinomaki RCHP deployed one medical team in the event of the Iwate-Miyagi Nairiku Earthquake in June 2008; however, it had no experience in dispatching Japan DMAT which had been organized to serve in the disaster impact phase (approximately within 48 hours). So several members of the staff participated in a Japan DMAT Seminar held at the Disaster Medical Center in TACHIKAWA, TOKYO in November of the same year. From 2009, they participated in the “JRCS DMAT Seminar” hosted by the Headquarters once every three months with the aim of acquiring technical skills and have a deeper understanding so that the JRCS Medical Team can cooperate with Japan DMAT in the impact phase. This allowed them to develop personal relationships with disaster experts. These people rushed to ISHINOMAKI at the time of the disaster time, staying at the HDC on a rotation basis, and supported us with their know-how over a long period of time.

b. Establishing Relationships in the Community(a) Establishing the “Ishinomaki Disaster Medicine

Representative Network Council”On January 22, 2010, Dr. Ishii called on Fire Department, Health Center, the police, the SDF, Medical Associations, neighborhood hospitals as it was

“essential to cooperate not only with the government but also with the related organizations in the event of a major disaster. In particular, it is important for disaster medicine representatives to be meeting face-to-face from before a disaster”. And he established a Council consisting of these representatives. They had met once every three months to discuss how

・ Eastern Region Public Health and Welfare Office, MIYAGI

・ Disaster Prevent ion Off ice , General Affa irs Department of Ishinomaki

・ Ishinomaki Medical Association・ Higashi-Matsushima Department of Health and

Welfare・ Matsushima Air Base・ Tohoku Area Hygiene Squad, Ground Self-Defense

Force・ Ishinomaki Coast Guard・ Ishinomaki Police Station・ Ishinomaki Wide Area Fire Department・ Japanese DMAT (Director of the Tohoku District)・ Neighborhood hospitals (Ishinomaki Municipal

Hospital, Onagawa Municipal Hospital, Senseki Hospital, Makabe Hospital, etc.)

・ Ishinomaki Dialysis Network

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provided that the Ishinomaki Municipal Hospital shall play a pivotal role. However, just when the earthquake occurred, the Ishinomaki RCHP aimed at preparing a more practical plan in which the Ishinomaki RCHP, a hub hospital in the event of a disaster, should have a pivotal role, and almost completed the discussion with the City staff in charge of disaster prevention for its enforcement from April 2011. Based upon the plan, the City officials provided a shuttle-transportation service for water for artificial dialysis to the Ishinomaki RCHP which was expected to be in need of the water supplied by water truck (10t vehicle). Because problems of communication environment were identified when the City participated in the tabletop simulation that Ishinomaki RCHP first carried out in 2003, three months later a disaster community wireless system was set up for the first time other than in municipal facilities. Since then, cooperation through municipal training was developed, which had a positive effect at the time of this disaster.

(d) Commissioning of a “Miyagi Disaster Medical Care Coordinator”In February 2011, the Miyagi Governor appointed Dr. Ishii as the “Miyagi Disaster Medical Care Coordinator”, the sixth in the prefecture. Dr. Ishii was in charge of disaster response since he took office as Director of the Medical Social Services Department of the Ishinomaki RCHP in April 2007. His work was highly evaluated, such as for establishing and practicing a mechanism for disaster response at the hospital, gaining experience of disaster relief services, setting up the “Ishinomaki Area Disaster Medicine Representative Network Council”, and concluding disaster agreements with business entities. He was recommended by the local Medical Association, etc. Responsible for the coastal block, the coordinator shall be engaged in disaster control when a disaster occurs in the area. If a disaster takes place in other areas, the coordinator shall join the prefectural office.The Ishinomaki Joint Medical Teams made good use of the title “Disaster Medical Care Coordinator” when establishing disaster relief coordination. The public title enhanced negotiations with the authorities, allowing for smooth coordination between the organizations.

Response to the Fukushima Daiichi Nuclear Power Plant Accident

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One of the characteristics of the Great East Japan Earthquake and Tsunami (GEJET) was not only its significant damage in the wake of the earthquake, but also that it caused a nuclear plant accident that generated a tremendous and long-term impact on the country. In these circumstances, the Japanese Red Cross Society (JRCS) had to provide medical services at a level that it had never experienced in a disaster response situation domestically. At normal times there were no assumptions or preparedness, or insufficient information, for this level of natural disaster, and it was with the utmost difficulty that medical activities were able to be provided.Radioactive contamination caused by the accident reached a significant level not only in the short term, but it has remained for a long period of time and is yet to be solved. The JRCS will still need to keep responding to the nuclear plant accident. It should be noted that the record on the response to the Fukushima Daiichi Nuclear Power Plant Accident described below only serves as an intermediate record, and our services still have a long way to go.

1. Outline of the Accident (1) Situation Immediately after the GEJET

1

Nuclear reactors No.1-3 of the Fukushima Daiichi Nuclear Power Plant and all reactors of the Onagawa Nuclear Power Plant automatically stopped operating in the wake of the earthquake. With the automatic halt to power generator, the Emergency Diesel Generators (EDG) started to maintain the functions of reactor cooling and cooling of the pools used to store used nuclear reactor fuel. However, the EDG were stopped due to the tsunami that followed the earthquake, and all of the reactors from No.1 to No.5 of the Fukushima Daiichi Nuclear Power Plant lost all AC power. Through cooperation with the government, Tokyo Electric Power Company (TEPCO) took some measures to restore power. However, the work was very challenging.The isolation condenser (IC) of Reactor No. 1 was crippled, and Reactors No. 2 and 3 lost DC power (battery) and their cooling water supply; which caused

their core cooling function to stop working. Lowering of the water level in the reactor and the exposed reactor core triggered damage to the core, leading to a meltdown over time. This was followed by an explosion in the upper part of the reactor building, possibly due to combustion of hydrogen that leaked out from a storage container of the nuclear reactor No.1 and 3. This destroyed the operational floors of the reactor buildings, releasing a great deal of radioactive materials into the air.Following the explosion at Reactor No. 3, there was also an explosion possibly due to accumulated hydrogen in the building of Reactor No. 4, destroying the upper part of the reactor building. In this reactor all the core fuel had been transferred to the used fuel pool for the periodic inspection. At this time, a hydrogen explosion also took place somewhere supposedly adjacent to the suppression chamber in Reactor No.2, possibly damaging it.On the day of the disaster, the Government issued a

“Declaration of a Nuclear Emergency Situation (on the Events Involved in the Fukushima Daiichi Nuclear Power Plant)”, which provided a Prime Minister’s

Chapter 4　Response to the Fukushima Daiichi Nuclear Power Plant Accident

Figure 4-1　Situation of the nuclear power plants　　 immediately after the disaster

(Number of reactors that were automatically shut down: 10 reactors (as of 18:45, March 11)

Nuclear plant PWR (kW) Situation

TEPCO

Fukushima Daiichi Nuclear Power Plant

Reactor No.1 460,000Automatic shut downReactor No.2 784,000

Reactor No.3 784,000Reactor No.4 784,000

Suspended for periodic maintenanceReactor No.5 784,000

Reactor No.6 1,100,000Fukushima Daini Nuclear Power Plant Reactor No.1 1,100,000

Automatic shut down

Reactor No.2 1,100,000Reactor No.3 1,100,000Reactor No.4 1,100,000

Tohoku Electric Power

Onagawa Nuclear Power Plant

Reactor No.1 524,000Reactor No.2 825,000Reactor No.3 825,000

Source;"Report on Earthquake Damage (5th)" by the Ministry of Economy, Trade and Industry, the Nuclear and Industrial Safety Agency (As of 20:00, March 11)

(1) Report of Japanese Government to the IAEA Ministerial Conference on Nuclear Safety - The Accident at TEPCO's Fukushima Nuclear Power Stations – June, 2011 issued by Nuclear Emergency Response Headquarters

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a. Evacuation ZoneSome people were identified who still stayed in or entered the designated zone for withdrawal and evacuation. Because it was difficult to ensure the safety of these people, and some impact outside the zone was also feared. The zone was newly designated as an “Evacuation Zone” to prevent a risk to the lives and health of the residents.Based upon the provision of Article 20.3 of the Act on Special Measures Concerning Nuclear Emergency Preparedness, the Head of the Nuclear Emergency Response Headquarters shall notify local government authorities of the zone that the residents must evacuate (including the area and waters within a 20-km radius of the Fukushima Daiichi Nuclear Power Plant).

b. Planned Evacuation ZoneIn consideration of radiological protection reference values (20-100 mSv a year) defined in the International Commission on Radiological Protection (ICRP) and the International Atomic Energy Agency (IAEA), the area where the cumulative quantity of radioactive materials might reach 20 mSv within a period of one year from the disaster was designated as the Planned Evacuation Zone.In principle, the residents within the Zone must be evacuated to outside the Zone within approximately one month for the Planned Evacuation. The designated areas included KATSURAO, NAMIE, IIDATE, and part of KAWAMATA and part of MINAMI-SOMA, other than those designated for the evacuation and withdrawal as of March 12 (within a 20-km radius of the Fukushima Daiichi Nuclear Power Plant).

c. Emergency Evacuation Preparation ZoneBecause the accident had yet to settle down, most of the area in the 20-30 km range was designated as an

“Indoor Evacuation Zone”. The possibility could not be ruled out that indoor evacuation and shelter services would be still in high demand in the future. Therefore, in principle, the former “Indoor Evacuation Zone” other than the above mentioned “Planned Evacuation Zone” was designated as an “Emergency Evacuation Preparation Zone”. The residents in the Zone were required to follow the following points.

Decree ordering the residents within a 3-km radius of Fukushima Daiichi Nuclear Power Plant to evacuate and residents within a 3-10 km radius to stay indoors.On the second day, the Government issued a further

“Declaration of a Nuclear Emergency Situation (on the Events Involved in Fukushima Daini Nuclear Power Plant)”, which provided a Prime Minister’s Decree ordering residents within 3-km radius of Fukushima Daini Nuclear Power Plant to evacuate and residents within a 3-10 km radius to stay indoors, and residents within a 20-km radius of Fukushima Daiichi Nuclear Power Plant to evacuate”.On March 15, the Government issued a Prime Minister’s Decree to the residents within a 20-30 km radius of Fukushima Daiichi Nuclear Power Plant ordering them to stay indoors.

(2) Designation of the Evacuation Zone, Planned Evacuation Zone, and Emergency Evacuation Preparation Zone

In the evacuation zone beyond the 20-km radius of the Fukushima Daiichi Nuclear Power Plant, if radioactive materials locally accumulate and the residents continue to live within the zone, the cumulative dose could increase to a higher level. In addition, there was deep concern that the accident status of the Plant was still unstable.On April 21, according to Article 20.3 of the Act on Special Measures Concerning Nuclear Emergency Preparedness (Act No. 156 of December 17, 1999), the Head of the Nuclear Emergency Response Headquarters (Prime Minister) issued an order addressed to the related prefectural and city governments to “designate the area within a 20-km radius of the plant as an Evacuation Zone” and to

“prohibit residents other than those who are engaged in Emergency Response Measures to enter and/or exit the Nuclear Evacuation Zone”.On the following day, April 22, the indoor evacuation order within the range of a radius of 20-30 km from Fukushima Daiichi Nuclear Power Plant was lifted, and the Planned Evacuation Zone and Emergency Evacuation Preparation Zone were established. The Government also issued an order to “the residents of the Planned Evacuation Zone and Emergency Evacuation Preparation Zone to make a planned withdrawal for evacuation, or always be prepared for a withdrawal or for indoor evacuation at the time of an emergency”.

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OKUMA, FUTABA and NAMIE as of July 31; OKUMA as of November 30; and KATSURAO, TOMIOKA, and NAMIE as of March 7, 2013. The rearranged zones were designated as "zones in preparation for the lifting of the evacuation order," "restricted residence areas," and "difficult-to-return zones”.

Figure 4-2 Outline of the "zones in preparation for the lifting　　　　　 of the evacuation order," "restricted residence

　　　 areas," and "difficult-to-return zones”　　

Zones in preparation for the lifting of the evacuation order

Areas where the annual cumulative quantity of radioactive materials was confirmed to be 20 mSv or less

Restricted residence areas

Referring to areas where the cumulative quantity of radioactive materials could exceed 20 mSv annually, and people residing in these areas had to continue to be evacuated from the viewpoint of reducing their exposure to radioactive materials.

Difficult-to-return zones

These are areas where the annual cumulative quantity of radioactive materials could not be less than 20 mSv even when five years have passed, and the current annual cumulative quantity of radioactive materials is more than 50 mSv.

Figure 4-3 Conceptual diagram of the Exclusion and　　　　　 Evacuation Zones (as of March 7, 2013)

Figure omitted

2. JRCS Medical Services (Response to Radiation)

(1) Policy for Response to RadiationOn March 15, a policy that “at present, all activities in an area within a radius of 30 km from the nuclear plant in question (where the disaster occurred) in accordance with the government’s response status” was determined by a notice given from the Headquarters of Disaster Control (HDC) at the Headquarters to the Secretary General of the Block Representative Chapters.Subsequently, on March 19, a notice on safety measures for medical services in FUKUSHIMA was given by the HDC at the Headquarters to the Secretary General of the Representative Chapter and the other chapters in the 1st Brock. This notice stipulated that a sufficient care should be taken to provide guidance given by the Medical Coordination Headquarters for Emergency Exposure in FUKUSHIMA.And on March 22, a notice was given by the HDC

The population of the “Evacuation Zone” was approximately 78,000, the “Planned Evacuation Zone" approximately 10,000, and the “Emergency Evacuation Preparation Zone" approximately 58,500.On the other hand, within some areas outside the Planned Evacuation Zone and the Evacuation Zone, which was not wide enough to be designated as the Planned Evacuation Zone, there were some spots where the cumulative quantity ratio of radioactive materials one year after the disaster was estimated to be more than 20 mSv in the air. These areas were designated as the “Specific Spots Recommended for Evacuation” to warn people residing there of the risk, and to provide and promote support for evacuation. On June 16 a policy based on these measures was released. These Specific Spots Recommended for Evacuation included part of DATE, MINAMI-SOMA, and KAWAUCHI

(3) Lifting the Designated Zone Status, etc.On September 30, the Government held a meeting at the Nuclear Emergency Response Headquarters in the Prime Minister's office, and decided on and officially announced the lifting of part of the designated

“Emergency Evacuation Preparation Zone”. The Government took all measures to support people in order for them to return home, including restoration of the schools that had been closed. In accordance with the restoration plan stipulating how municipal governments should provide decontamination and other services, the evacuating residents were to be encouraged to return home if they were ready.It was also decided to rearrange the Exclusion and Evacuation Zones included in the following cities and villages: KAWAUCHI, TAMURA and MINAMI-SOMA according to the decision as of March 30, 2012; IIDATE as of June 15, NARAHA, TOMIOKA,

・To be always prepared for an emergency evacuation or indoor evacuation at the time of an emergency

・To continue self-evacuation; in particular, children, pregnant women, people requiring nursing care, and inpatients, etc., should not access the Zone

・To close nursery schools, kindergartens, elementary and junior high schools, and high schools

・It was inevitable that some residents needed to access the Zone for unavoidable reasons due to their job. However, in these cases, they also had to be sure to be always prepared for self-evacuation and indoor evacuation by themselves.

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(2) Medical Team Services in FUKUSHIMAInitially, after the disaster, medical teams started medical services in various areas in FUKUSHIMA, including the cities and villages along the coast, including MINAMI-SOMA.However, after the news release about the nuclear plant accident, the medical teams that were not prepared for protection from radioactive materials were not assured of their safety. Until March 15, no JRCS policy had been established. Due to these circumstances, Fukushima Chapter, the medical teams belonging to the Fukushima Chapter, coordinators belonging to the Niigata Chapter, doctors, nurse managers and administration staff of the medical teams gathered at the Fukushima Chapter in the evening of March 13 to hold a Medical Team Action Meeting on the radioactive environment. In this meeting, the Fukushima Chapter HDC canceled their medical services under the control of the Head of the Fukushima Chapter due to the fact that the current conditions did not allow them to secure the safety of the medical teams. In the wake of this decision, the medical teams contacted the chapters and hospitals from which they were deployed for instruction. As a result, the teams dispatched outside the FUKUSHIMA were withdrawn from there on the following day.

Firstly, news about the nuclear plant accident was provided to the cities and villages surrounding the plant, and whether or not the medical teams should continue their services was discussed. However, the local medical teams were not equipped with protective gear for providing services in a radioactive environment, and they did not have a policy on how to provide safety measures for the medical services, either. Thus, the deployment of support teams from other Chapters to Fukushima Chapter was forced to be temporarily suspended.

at the Headquarters to the Secretary General of the Representative Chapter and the other chapters in the 1st Brock to inform them of the following:

On April 22, including the above measures, the following service strategies for medical teams in FUKUSHIMA were issued with a notice from the HDC at the Headquarters.

Figure 4-4 Safety measures for medical teams in FUKUSHIMA

(April 22, 2011)

Safety measures

Medical services shall not be provided within the range of 30 km from the Nuclear Plant (changed to within the range of 20 km from June 6). Each medical team shall ensure safety in accordance with the JRCS Radiation Safety Manual (developed through cooperation of both Hiroshima and Nagasaki Genbaku RCHPs) and be provided with a briefing at the time of handover. Emergency and other advice, etc., shall be provided by the Fukushima Chapter / Department of Radiology, Fukushima RCHP.

Free rental of dosimeters, etc.

Personal dosimeters (100 sets in total) will be lent to medical teams on active service.The alarm shall be set so that it will set off if the cumulative radiation dose reaches 1 mSv, and people shall be evacuated if it exceeds this value.

Maintenance of protective

materials, etc.

For any emergency, protective clothing sets (protective clothing, goggles, N95 masks, gloves) shall always be prepared at the Fukushima Chapter, Aizu Wakamatsu Red Cross Blood Center (RCBC).Geiger counter devices shall be prepared at the Fukushima Chapter.Iodine agents shall always be prepared at the Fukushima RCHP.

Recording of the exposure

dose

To record the exposure dose at the time of service, assess human safety based on the recorded data at the end of the service, and manage the record at the Headquarters.

[The Fukushima Chapter HDC and medical teams discussing the services under the radioactive environment (in the evening of March 13 at the Fukushima Chapter)]

① For medical teams dispatched to FUKUSHIMA to be accompanied by radiological technicians, if at all possible.

② To dispatch experts from Hiroshima and Nagasaki Genbaku Red Cross Hospitals (RCHP) and establish a system for providing information and advice on safety measures for medical services.

③ To maintain supplies of protective materials, including dosimeters, protective clothing and medical supplies, etc.

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they were to receive lectures on basic knowledge regarding radiation and take advice and guidance on how to use the protective gear from Medical Advisors at Fukushima Chapter.The medical teams serving AIZU WAKAMATSU, traveling far from Fukushima City, only received a briefing at the time of the handover among the teams.

Figure 4-6　Outline of medical team guidance by the 　　　 Medical Coordination Headquarters

　　　　　 for Emergency Exposure in FUKUSHIMA

Services and Responsibilities

・Responding to exposed/contaminated patients: Emergency exposure medicine teams

・Responding to residents: Screening/medical teams

・Responding to inpatients for transportation: DMAT

Safety control

・Zoning: No service within a range of 30 km from the Fukushima Nuclear Power Plant

・Protection from radiation damage・Space dosimeter: More than 20 μSV/h (Evacuation if reaching 100 μSV/h: to inform

the headquarters for instruction) ・Use of a personal dosimeter: To evacuate if

it reached 1 mSv/h*・Measures against internal contamination ・To wear Tyvek suits・To keep iodine tablets in reserve for those

under 40 years of age・To keep a supply of N95 breathing

protection apparatus in reserve

Reporting of registration

・Registration using a reporting form・Meeting time: 8:00, 20:00・In principle, to withdraw in time for the

20:00 meeting ・Reporting the contact address to the

headquarters; to send a blank email to the emergency address to resist to get information.

Services

・Screening・Filling in the Service Report Form

These measures allowed the medical teams from outside the prefecture to serve FUKUSHIMA again. Azuma General Gymnasium (in FUKUSHIMA) and Kawahigashi Public Gymnasium (in AIZU WAKAMATSU) functioned as hub facilities for JRCS medical teams services, including those from the Fukushima Chapter.

(3) Radiation AdvisorMedical Advisors on Emergency Exposure from both the Nagasaki and Hiroshima Genbaku RCHPs permanently stationed at the Fukushima Chapter HDC for a program developed to provide information and advice on safety measures.

From March 19, Medical Coordination Headquarters for Emergency Exposure in FUKUSHIMA started providing information so that information on safety measures for the medical services within the prefecture was available, along with advice and guidance directly given from experts at the Medical Coordination Headquarters, which was notified from the HDC at the Headquarters as of the same date.The Fukushima Chapter HDC started stationing Medical Advisors for Emergency Exposure from March 22, with protective materials (including dosimeters, protective clothes and medical supplies) prepared from March 25. In other words, when the medical teams provided the services in FUKUSHIMA,

Figure 4-5 By service day/region/chapter of affiliation　　　　　　　　　　　　Medical team services in FUKUSHIMA (March, 2011)

0

2

4

6

8

10

12

TeamsMedical teams of the Fukushima ChapterSoso Area, othersMedical teams of the Fukushima ChapterKenpoku AreaSupporting medical teams from outside FUKUSHIMASoso Area, othersSupporting medical teams from outside FUKUSHIMAKenpoku AreaSupporting medical teams from outside FUKUSHIMAAizu Area

March 11

March 13

March 15

March 17

March 19

March 21

March 23

March 25

March 27

March 29

March 31

(Note)The “Soso Area, others” include those other than north part of FUKUSHIMA and those other than the AIZU Area (SOMA, MINAMI-SOMA, IWAKI, Fukushima Airport, etc.), and those covering some areas within the prefecture, and those covering areas within and outside the prefectures. If a medical team had provided services covering within and outside the prefectures, but is not sure when and where (within or outside the prefecture) they provided those services, it shall be deemed that they had served within the prefecture for all service days.Source: Report of the JRCS medical services for the GEJET (As of September 2012)

* The value was mentioned in a notification issued by the HDC at the Headquarters during the disaster. Afterwards, the JRCS’s “Manual for Relief Activities under Nuclear Disasters” was created, in which the description of the value was revised to: “To evacuate if cumulative doses reach 1 mSv during an activity”.

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Medical Advisors on Emergency Exposure also instructed seminars four times for evacuees from the earthquake and nuclear accident, volunteers and the press in order to provide correct basic knowledge on radiation.

(4) International Committee of the Red Cross (ICRC) SupportExperts from ICRC on radiation disasters visited Japan on March 19, providing advice on how the JRCS should respond to the Fukushima Daiichi Nuclear Power Plant accident.The following is the specific advice: the advice included those that had not received radiation hazard training who shall be deemed as amateurs in accordance with the ICRC standards; In this case, they should be told that the maximum permitted value of radiation is 1 mSv per service; the medical team staff shall carry a personal dosimeter when providing services; the medical team staff shall take a rest in TOCHIGI or other prefectures at night in order to shorten the period of stay in the radiation affected areas; a system shall be established where advice and guidance from experts is always available; the records shall include how long each staff stayed where, as well as their radiation exposure dose, etc.ICRC also provided 80 units of portable dosimeters for detecting radiation.

Figure 4-8 ICRC experts visiting JRCS

3. Medical Services for TemporaryAccess to a Restricted Area

(1) Background until Services Starteda. Summary of the Support Project for Temporary

Access by ResidentsThe Nuclear Disaster Response (NDR) Local Headquarters established at the Fukushima local government in May 2011 started a support project for local people to gain temporary access to their homes in the Evacuation Zone (restricted area within a radius of 20 km from the Fukushima Daiichi Nuclear Power Plant). For this project, the NDR Local Headquarters established a transfer station within the area and

Figure 4-7　Services provided by Medical Advisors on Emergency Exposure　　

Duration of Services Affiliation of Medical Advisor

3/22-3/24 Nagasaki Genbaku RCHP

3/25-3/28 Nagasaki Genbaku RCHPHiroshima Genbaku RCHP

3/28-4/3 Nagasaki Genbaku RCHP3/28-4/1 Hiroshima Genbaku RCHP4/3-4/5 Nagasaki University4/1-4/5

Hiroshima Genbaku RCHP

4/5-4/9

4/10-4/13

4/14-4/17

4/17-4/21

4/21-4/25

4/26-4/29 Hiroshima Red Cross Blood Centre (RCBC)Hiroshima Genbaku RCHP

*Duration of services refers to the service days in FUKUSHIMA.

Medical Advisor on Emergency Exposure provides the following services:

Mr. Gregor Malich (Head of Nuclear Radiation Biochemistry Operatinal Response Project , ICRC)Mr. Steve Donelly (Technical Advisor of Nuclear Rediation Biochemistry Operational Response Project, ICRC)

【Radiation Safety Specialists】〇Briefing before the services on safety measures

related matters for medical teams 　・Basic knowledge on radiation　・How to wear/take off protective suits　・How to use a dosimeter 〇Briefing after the services to medical teams on

safety measures　・Health management based upon the dosimeter data　・Points to remember for life in the future〇General advice on radiation to the medical teams〇Instructions at the time of an emergency　・Instructions on wearing protective clothing 　・Evacuation orders〇General advice on radiation to the Fukushima Chapter

【Support staff for Radiation Safety Specialists】〇Management of protective clothing, dosimeters, etc.　・The appropriate size for each medical team

individual must be available.　・The protective clothing, dosimeters, etc., shall be

on loan, not given. Once a medical team ends its services, these devices should be available for the next medical team

　・Recording of pickup/return　・Identifying the damage status, etc.〇Specific explanation on how to adjust and use dosimeters〇Recording of various data from dosimeters　・To record various data from dosimeters by the

medical team staff〇Other supporting duties

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to assign the Fukushima Chapter deal with it after discussions between them. The Fukushima Chapter then deployed medical teams on May 25, 26 and 27 as well. And on June 1, the Fukushima Chapter again requested the HDC at the Headquarters to adjust and coordinate the deployed teams in all blocks since medical services support in a sustainable way was necessary for those accessing the Evacuation Zone in which it was expected there would be challenges to face in the future. From the above circumstances, the HDC at the Headquarter was to deploy medical teams serving to support temporary access to the restricted areas. On June 6, the restriction area for medical services was revised to the 20 km-zone, which made it possible to expand services at the transfer stations established within the 20-30 km zone.

c. Outline of the Medical ServicesIn principle, a JRCS medical team deployed to Bajikoen in MINAMI-SOMA, consisted of four staff (one doctor, two nurses, and one administrative staff). (However, we asked for the dispatch of two administrative staff if the team uses a vehicle owned by the Chapter deploying the medical team). A medical team also organized after February 2012, was to consist of three staff (two nurses and one administrative staff) in principle, excluding cases where a doctor was to be deployed, because the medical transportation system was already redeployed to local sites.According to the itinerary, the staff should enter the Fukushima Chapter by 16:00 on the day prior to the service, receive a briefing at the Chapter, then move to their accommodations (within Fukushima city). After providing the services for a couple of days, the staff returned to Fukushima Chapter, going to the Fukushima Station then home after being picked up/

within a range of 20 – 30 km (the Planned Evacuation Zone, and the Emergency Evacuation Preparation Zone). The residents accessed the Evacuation Zone through the transfer station by bus, and returned to the transfer station again. There were 4 hub stations in total (Bajikoen in MINAMI-SOMA, Kodo-Gymnasium in TAMURA, Kawauchi Municipal Athletic Center, Chuo Gymnasium in HIRONO).The medical teams of the NDR Local Headquarters provided health checks, briefings on health concerns, testing of radiation values after their return from outside the Evacuation Zone, and the checking of the exposure dosage of the residents. They also provided medical services for the injured, if any, at the transfer stations.

b. Why JRCS was InvolvedThe medical teams of the NDR Local Headquarters were requested to provide medical services at the transfer stations so that the residents might temporar i ly access the Evacuat ion Zone ( to temporarily return to their homes). On May 22, one medical team from the Fukushima Chapter was dispatched for this service, which was reported from the Fukushima Chapter to the HDC at the Headquarters on March 17. This also included a request to the Headquarters to provide support because temporary entry into the Evacuation Zone was planned to continue, and other prefectures could be asked to deploy their medical teams if the Fukushima Chapter could not handle the situation.Based on these circumstances, on May 22 one medical team was dispatched to provide medical services for temporary access from the Fukushima Chapter to the public-Gymnasium in TAMURA.On the other hand, on May 24, the Ministry of Health, Labor and Welfare made a phone call to the HDC at the Headquarters to report that: Japan DMAT and National Disaster Medical Center were providing medical services for temporary access, and Fukushima RCHP had also deployed medical teams. However, there were increasing opportunities for those in the three local governments to work together and this permitted the residents to access their homes temporarily. Including for the care of elderly people, they requested an increase in the number of the JRCS teams to be assigned.Respond ing t o the above , t he HDC a t the Headquarters and the Medical Department decided

[Medical services for temporary access to restricted areas (Bajikoen, MINAMI-SOMA)]

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4. Other Services(1) Humanitarian Response ProjectIn 2011, the International Federation of the Red Cross and Red Crescent Societies secretariat to prepare a "Humanitarian Response Project" (tentative name)” to examine specific concepts towards implementing the “Human Impact of a Nuclear Accident (Draft)" at the IFRC General Assembly (2011) was set up on September 1, 2011. The secretariat had provided study sessions three times concerning the radiation impacts, etc.On November 2, 2011, we invited Dr. Ivan Ushichenko, President of the Ukrainian Red Cross Society and two other members of their staff to Japan. He gave a presentation entitled, “Chernobyl Humanitarian Support and Rehabilitation Projects”, to the JRCS staff, to explain how the Ukrainian Red Cross Society had responded to the Chernobyl Nuclear Accident.

returned by the Chapter. As conditions for the service, the following points were presented in a notice issued by the HDC at the Headquarters.

(2) Service PerformanceMedical services had been repeatedly provided for temporary access to the restricted areas. JRCS medical teams were dispatched for the 1st round (May - August, 2011), 2nd round (September – December, 2011) and 3rd round (February – March 2012). In total, 87 JRCS medical teams were engaged in these services totaling 132 days. A support project for temporary access to the restricted areas had been decided on and implemented considering the opinions of the local residents. Accordingly, the requested days for deployment by the residents gradually increased. However, because the medical teams of the NDR Local Headquarters did not present any requests for a planned deployment, it was difficult to adjust and coordinate the deployment services.Initially, Fukushima Chapter deployed medical teams. This coordination was carried out within the 1st Block Chapter to cope with the increasing number of requests for their services. However, as it became difficult to keep responding to these requests after July in the 1st round, HDC at the Headquarters requested the 2nd Block to deal with the deployment of services. A 2nd round was provided by the 1st Block, mainly from the Fukushima Chapter. A 3rd round was again carried out by 2nd Block. And those that had urgently determined and requested the deployment of services on and after March 10 were dealt with by the medical teams deployed by the Miyagi and Fukushima Chapters.

Figure 4-9 Medical services for temporary 　　　　access to a restricted area

May 10 - December 31, 2011 (1st -2nd rounds)

February 11 - March 31, 2012 (3rd round)

　 Chapter name No. of medical teams dispatched Days of service No. of medical

teams dispatched Days of service

The 1st Block

HOKKAIDO 2 3 　　AOMORI 5 10 　　IWATE 1 2 　　MIYAGI 3 6 3 5AKITA 3 5 　　YAMAGATA 3 6 　　FUKUSHIMA 38 38 4 4

Subtotal 55 70 7 9

The 2nd Block

IBARAKI 2 4 1 2TOCHIGI 3 4 1 3GUNMA 1 2 1 2SAITAMA 2 4 1 2CHIBA 2 5 1 2TOKYO 2 5 1 3KANAGAWA 2 4 1 2NIIGATA 1 2 1 3YAMANASHI 2 4 　　

Subtotal 17 34 8 19Total 72 104 15 28

Medical equipment that the medical teams bring ・Medical equipment and materials owned by the

Fukushima Chapter shall be used; only personal equipment shall be brought (helmets, lace-up shoes are not necessary)

・Relief uniform and plain clothes・Radiation materials/equipment (dosimeters, etc.) had

already been prepared at the Fukushima ChapterVehicles used by medical teams・Vehicles in service will be those used by medical

teams of the Fukushima Chapter・Medical care sets used for medical services shall be

loaded onto the vehicles

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In addition, financial support from overseas shall be allocated to the budget required to administer the secretariat.

(2) Contribution to Nuclear Disaster Control Measures of the International Red Cross and Red Crescent Movement (RCRC)

In order to contribute to following up the “Resolution on the Humanitarian Impact of a Nuclear Accident" at the IFRC General Assembly in 2011, we held a "National Society Consultation Meeting on Nuclear Disaster Preparedness" at the JRCS Headquarters for three days from May 14, 2012, to identify the importance of developing international guidelines for supporting nuclear disaster victims.

(3) Response to Nuclear Hazards through the Project for Support for Post-Disaster Recovery from the GEJET

JRCS is now engaged in improving the environment based upon a good knowledge of radioactive exposure impacts, as well as contributing to a project in order to alleviating the situation of people with unease concerning the nuclear accident /radiation doses through a Project on Support for Post-Disaster Recovery from the GEJET and other services provided by the related Departments.

a. Contributing to Health Management for the Fukushima People

As a means of support for medical equipment (whole body counters (WBC), etc.) used for Surveys on the Prefectural Residents’ Health Management Program by Fukushima Medical College, we donated a set of testing equipment/apparatus to the College, as well as installing a WBC at the Fukushima RCHP. From April, 2012, we conducted surveys on health management as a delegated task from Fukushima city.

b. Responding to a Survey on Health Management for Evacuees living outside FUKUSHIMA

As a survey on health management for evacuees living outside FUKUSHIMA, 17 RCHPs across the nation provided health care support in 2012, continuing the service from 2011.

c. Donation of Devices to Measure Radiation in Materials Used for Meal Services and Domestic Cooking

To measure the radiation dosage from food, we donated 77 devices to FUKUSHIMA, 29 devices to NIHONMATSU and KAWAUCHI, and 3 to MIYAGI.

On January 6, 2012, we invited Mr. Akira Sugaya, Mayor of MATSUMOTO, NAGANO, to give a presentation on "Nuclear Hazards and Radiation Exposure – Lessons Learnt from Medical Support after the Chernobyl Accident", as a mayor struggling with disaster prevention and local medical care to protect the life and property of the citizens’, and as a doctor who had been involved in providing medical services in Chernobyl and still had a good knowledge of local information.Furthermore, on February 16, 2012, we invited Ms. Tomoko Kusama, Dean of the Oita University of Nursing and Health Sciences to give a presentation on "Lessons Learnt from an INES Level 7 Nuclear Accident”, as a promoter of disaster prevention, including nuclear disaster control measures, and nursing education.On April 1, 2012, the “Secretariat for Nuclear Hazard Measures” was established at the Disaster Management and Social Welfare Department of the Headquarters in order to prepare for the same project. The duties of the secretariat were to discuss the implementation of the humanitarian response after a nuclear accident, “Humanitarian Response Project after a Nuclear Accident (tentative title)” as follows.

(1) Development of universal guidelines on humanitarian support after a nuclear hazard

(2) Following up monitoring, etc., on the health of victims, etc.

(3) Studying the environmental impacts after a nuclear accident

(4) Establishing a Data Center for a nuclear accident (5) Other training functions, maintenance of Memorial

Hall functions, etc.

[Mr. Ushichenko, President of the Ukrainian Red Cross Society (JRCS Headquarters)]

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services and behavioral standards for medical teams, as well as a Code of Conduct for medical teams, focusing on conformity with the behavioral standards provided by Japan DMAT and the ICRC in order to contribute to improving the disaster preparedness capacity of the medical team staff. In addition, we will strengthen the equipment and materials required, provide an environment for training or seminars, promptly deploy Emergency Radiation Exposure Advisors to the Chapters HDC in the three disaster-affected areas, and provide appropriate advice and guidance to the medical team staff.

k. Training for ExpertsWe concluded an agreement with Hiroshima University to promote cooperation on the education and study areas regarding emergency radiation exposure, and promoted these achievements. This agreement also aims at improving the expertise of JRCS professionals in radiation and disaster medical care. We are now working on promoting the attendance of medical staff in a leading program in doctoral education at the graduate school at the same university.

l. Introduction of Nursing Education to Cope with Nuclear Accidents

We are now reviewing the current disaster nursing education, and discussing the addition of a seminar program on nuclear plant accidents in order to develop basic knowledge on radiation among medical team staff through RCHP nurses seminars at the Japanese Red Cross Institute for Nurse Manager and related facilities.

m. Response to Healthcare Needs in IWAKINurses, public health nurses and other related professionals deployed by the RCHP and the Japanese Red Cross College of Nursing visited about 2,000 NAMIE residents currently evacuated to IWAKI to research their healthcare needs, making proposals on healthcare and welfare measures based on the results.

d. Summer Camp ProgramInviting children from the three disaster-affected prefectures (IWATE and MIYAGI, FUKUSHIMA), we organized a summer camp program for 4 days and 3 nights, 11 times from July 21 to August 23, 2012, to promote children’s mental stability and healthy growth.

e. Construction of a Temporary GymnasiumTo help promote education for children in the evacuation areas, we constructed a temporary gymnasium in IIDATE to support the construction of temporary gymnasiums around schools in the disaster affected areas that had been completed by April 2012.

f. Play Areas inside BuildingsTo provide a space to play for children who feel uneasy and cannot play outside, we established a

“Smile Park” in FUKUSHIMA in February 2012, followed by 6 sites in 4 cities (including those planned) within the prefecture in FY2012.

g. Health and Safety Seminars and Exchange Meeting for Evacuees from the Nuclear Accident

To promote mental and physical health for evacuees living in temporary housing, we organized workshop of health and safety and exchange parties such as a “Red Cross Health Class” in temporary accommodations, etc.

h. Lectures on Health Related MattersFor the 160,000 Fukushima people who had been evacuated within and outside the prefecture, we invited instructors from the Louis Pasteur Center for Medical Research to give lectures that helped improve their knowledge of radiation and health care.

i. Child Safety Course (Short Course) including Basic Knowledge on Radiation and Prevention Measures

In order to provide correct knowledge on radiation and prevention measures for families with small children as part of the short-term workshops for infant safety, we organized Child-Raising Support Network Programs in cooperation with the Co-op at 14 Chapters totaling 27 times (including those scheduled).

j. Developing a Code of Conduct for Medical Services in the Event of a Nuclear Hazard

In preparation for the occurrence of a nuclear hazard, we are currently developing guidelines for medical

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b. Timing of its EstablishmentPlanned for the second half of FY2013.

c. OrganizationThis center shall be established in the JRCS Headquarters. In the Fukushima Chapter, a local office to collect and file information sent from FUKUSHIMA shall be established. In addition, "Radiation Protection Advisors” shall be appointed to provide advice and guidance on information and achievements pertaining to the nuclear disaster. These Advisors shall be appropriately selected from among those with a good knowledge of radiation risks other than the JRCS, medical professionals from Hiroshima and Nagasaki Genbaku RCHPs and Fukushima RCHP.

(4) Establishment of the Red Cross Nuclear Disaster Resources Center

As part of the main program of the “Human Response Project in the event of a Nuclear Accident”, we are now planning/preparing a Red Cross Nuclear Disaster Resources Center.

a. Purpose of the center EstablishmentJRCS shall establish a Nuclear Disaster Resources Center to disseminate information on nuclear disaster control measures including, in particular, disaster relief services, radiation prevention measures and healthcare management, and to provide recommendations to governments, as well as to disseminate information that can contribute to guidelines for National Red Cross and Red Crescent Societies (NS) in other countries. This center has the following four roles.

・To record and file JRCS services pertaining to nuclear disaster management in FUKUSHIMA (disaster relief and health care for children)

・To disseminate local information based on interview surveys conducted by JRCS staff and volunteers; cooperate with local governments and promote rehabilitation support programs and seminars, etc.

・Based on this information and data, to collect and file information obtained by organizing symposiums, participating in related meetings, and communicating with other institutions. In particular, to disseminate information pertaining to nuclear disaster control measures; specifically disaster relief or on how to protect people from radiation, promote healthcare management and conduct archiving.

・To assess the aspects of the response to a nuclear disaster that JRCS should deal with in future for all of its services, make recommendations to governments, and disseminate information that needs to be provided to NS in other countries .

[Nurses conducting an interview survey on the health condition of the residents]

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1. Development of the Psychosocial Care Program

(1) Psychosocial Care of the Japanese Red Cross Society (JRCS)

a. Concept and Scope of the Psychosocial Care Program of the JRCS

The psychosocial care program of the JRCS is based on the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings of the Inter-Agency Standing Committee (IASC), which is composed of United Nations agencies and various other humanitarian support organizations. These guidelines provide direction on both mental health (psychiatric care) and psychosocial support (psychosocial support and other forms of support). The psychosocial care provided by the JRCS adopts the latter concept of psychosocial support from the International Federation of Red Cross and Red Crescent Societies (IFRC).The classification between psychiatric care and psychosocial care of the JRCS is listed below:

The psychosocial care program of the JRCS does not aim at treatment by providing such psychiatric care, but at a) listening to the sufferings of the affected people and establishing a sense of safety by talking about the stress they feel and how to cope with it, b) taking responsible for referring the affected people to psychiatrists if it is considered that they need the help of specialists, and c) supporting the work of the health nurses in the affected communities through these

activities.Besides the psychosocial care team of the JRCS, teams dispatched from national and prefectural government staff and form hospital staff within and outside the regions engage in the psychosocial care work in the affected areas. While centering on their role as psychiatrists, these teams implement care similar to psychiatric care; the psychosocial care of the JRCS also needs to take responsibility for referring the affected people to psychiatrists if they are considered to need the help of specialists.

b. The rule for the psychosocial care staffPsychosocial care staff members are dispatched on the basis of the decisions made by the Head of the Chapter in the affected area in principle, and the dispatched staff operates under the leadership of the Head of the Chapter in the affected area. The Headquarters for Disaster Control (HDC) of the Chapter in the affected area quickly identifies the situation and needs of the affected people, develops an action plan for psychosocial care work, conducts the management and coordination of this work, and technically supports the psychosocial care staff

1.

Figure 5-2　JRCS Guidelines on Psychosocial 　　　　　support at the time of disaster.

Chapter 5　Psychosocial Care

Mental health Psychosocial support

Psychiatric care Psychological therapy Social support Psychological support

Psychiatrist PsychotherapistHealth nurse

Psychological care staff of the JRCS

Other Psychosocial care Psychosocial care of the JRCS

Psychological care in a broad sense

(Decisions regarding psychosocial care implementation)4. In principle, whether the psychosocial care work is conducted or not at the time of a disaster is determined by the Head of the Chapter quickly and voluntarily.(Management of the staff)6. The staff operating in an affected area shall be under the leadership of the Head of the Chapter in the affected area.(Implementation requests from the Headquarters)8. When a chapter in the affected area is required to conduct psychosocial care over the long term and requires the dispatch of psychosocial care staff from chapters outside the affected area, the Headquarters coordinates the dispatch from chapters throughout the country while maintaining close contact with the receiving chapter. Moreover, the staff of the

Figure 5-1 Classification of Psychological Care

(1) Chapter 2, 2 (Psychosocial Care Implementation Manual)


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Note that any chapter can request the dispatch of psychosocial care staff members from other chapters throughout the country if there are not enough staff members in the affected chapter due to the large scale of the disaster. The Headquarters coordinates the dispatch in this case.The Head of the Chapter in the affected area can establish a Psychosocial Care Center in order to integrate overall psychosocial care work as required.

(2) Decision on the action policy for the Great East Japan Earthquake and Tsunami (GEJET)

The JRCS conducted the ful l - f ledge practice of psychosocia l care in the Ni igata Chuetsu Earthquake of October 2004. Since the scale of the disaster in the case of the GEJET was far larger than this one, large-scale activities were developed, such as the long-term, wide-ranging nationwide coordination of the dispatch of personnel. As for the dispatch of psychosocial care staff involved in the GEJET, the psychosocial care was mainly conducted to accompany medical teams immediately after the disaster in response to the “Policy for the Future Dispatch of Medical Teams (Draft)” released on March 13, 2011, which notes that “the medical teams to be dispatched shall be accompanied by psychosocial care staff as far as possible and carry out meticulous relief activities according to the needs.” The psychosocial care staff members, most of whom were nurses, were often dispatched as part of the staff members of medical teams, especially immediately after a disaster.On the other hand, on March 13, two psychosocial care instructors immediate ly headed to the Ishinomaki Red Cross Hospital (RCHP), and started psychosocial support for the disaster victims around ISHINOMAKI, MIYAGI, separately from the activities involved in accompanying the medical

teams. They were supposed to be dispatched to a site in New Zealand from March 11 to 22 in order to support the people affected by the New Zealand Earthquake. In addition, independent psychosocial care teams were dispatched to ISHINOMAKI from the 2nd block at almost the same time.Along with these actions, on March 15, in the Ishinomaki RCHP expart of phychosocial and health care team gatherd from the Hospital in and outside of MIYAGI and started operations in the Ishinomaki Medical Region.In addition, in IWATE, although the psychosocial care had initially been conducted by accompanying the medical teams, a Psychosocial Care Center was established at the HDC in the Iwate Chapter on April 9, and independent psychosocial support activities were launched. In IWATE, the Center t r i ed to coord inate wi th each organ iza t i on concerned, as well as conduct needs assessments, including the propriety of continuation in the areas where psychosocial support activities had been deployed. Besides this, it dispatched Dr. Makishima of the JRCS Medical Center as a psychosocial care coordinator

2 from April 8 to August 12, aiming

at providing advice and guidance on psychosocial support.Furthermore , based on the “Po l i cy for the Future Dispatch of Psychosocial Care Staff to the GEJET Disaster-Stricken Areas”, the HDC at the Headquarters provided notification to each chapter that in principle the medical teams to be dispatched should be accompanied by two or more psychosocial care staff members (if it is impossible to be accompanied by psychosocial care staff in an individual medical facility, the staff shall be coordinated and dispatched within a chapter and a block, and it shall arrange cars to travel to the site in case the psychosocial care staff members need to operate independently away from the medical teams.Along with the activit ies of the independent psychosocial care teams, the psychosocial care staff continued to operate to accompany medical teams in IWATE and MIYAGI as well.The dispatch was conducted based on coordination by a block according to the policy for dispatch.

Headquarters can also be dispatched as required.(Psychosocial Care Center)12. The Head of the Chapter in the affected area shall establish a Psychosocial Care Center as part of the Chapter HDC, and is required to integrate it with the overall care work.

(2) A psychosocial care coordinator was appointed in order to avoid confusion over information caused by the input of psychosocial care staff from different regions for short periods, and to coordinate local psychosocial care by staying in the region for a long period.Until the end of November, Dr. Makishima was requested to work as a psychosocial care coordinator and took part in the activities in the Chapter, the project, “Kokoro no Kizuna” and the like, after the withdrawal of the psychosocial care teams.

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However, it faced difficulties to ensure sufficient staff to form a balance with the medical team staff, since most of the care staff were nurses, and to provide liaison/coordination staff for the dispatch of independent teams. In this earthquake disaster, the activities of the psychiatrist teams and various bodies dispatched at the national level were deployed based on requests from the affected prefectures, etc., besides the JRCS, which left many issues such as confusion caused by differences in the perception of the role of operations and activity areas.

(3) Overview of the psychosocial care activitiesa. Number of staff operating in Psychosocial CareIn to ta l , 1 , 016 peop le were engaged in the psychosocial care activities of the JRCS from March 11 to September, 2011 (Figure 5-3). Of these, there were 288 staff accompanying medical teams and 728 staff in independent psychosocial care teams. In addition, besides those reporting from the Headquarters, all medical teams of the Fukushima Chapter were engaged in psychosoc ia l care activities.

Figure 5-3　Number of Staff Operating in 　 Psychosocial Care

Accompanying type

Team type

(Number of teams)

Total

IWATE 161 399（39teams） 560

MIYAGI 110 329（87teams） 439

FUKUSHIMA 16 16

TOCHIGI 1 1

TOTAL 288 728 （126teams） 1,016

Souce: Prepared by the Relief Activities Reports of the JRCS in GEJET (As of September 2012)

b. Number of staff operating in Psychosocial CareThe cumulative number of psychosocial care staff was 4,058 (Figure 5-4). From March to April many staff operated to accompany medical teams, but subsequently, the psychosocial care was gradually activated as independent psychosocial care teams partly because a Psychosocial Care Center was established in IWATE. The most active month was June, with the cumulative number of working staff at over 1,000 for the month. In August, the number gradually declined. On September 1, the dispatch of psychosocial care teams ended from the non-affected prefectures. During this period, the teams provided 14,039 disaster victims with psychosocial care in the three affected prefectures, MIYAGI, IWATE and FUKUSHIMA as a whole.

0

100

200

300

400

500

600

700

IWA

TE

MIY

AG

I

FUKU

SHIM

A

IWA

TE

MIY

AG

I

FUKU

SHIM

A

IWA

TE

MIY

AG

I

FUKU

SHIM

A

IWA

TE

MIY

AG

I

FUKU

SHIM

A

IWA

TE

MIY

AG

I

FUKU

SHIM

A

IWA

TE

MIY

AG

I

FUKU

SHIM

A

IWA

TE

MIY

AG

I

FUKU

SHIM

A

TO

CH

IGI

March April May June July August September

(Unit: Cumulative number of staff) Team type Accompanying type

187127

22

398

236

26

480

347

1

656

431

0

437 431

047

228

0 0 031

Source: Prepared by the Relief Activities Reports of the JRCS in GEJET (As of September 2012)

Figure 5-4　Number of Staff Operating in Psychosocial Care


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Furthermore, the activity performance in each prefecture was as follows: cumulative total of 2,205 staff in IWATE, 1,803 staff in MIYAGI, 49 staff in FUKUSHIMA and 1 staff person in TOCHIGI.In addition, as for each block unit of dispatched resources, many staff members were dispatched from the 2nd block close to the three affected prefectures, which involved a cumulative total of 1,090 psychosocial care staff. Moreover, under the coordination of the JRCS Headquarters, the 1st, 2nd and 4th blocks conducted their activities around IWATE, and the 3rd, 5th and 6th blocks operated around MIYAGI. Furthermore, as for the block units, each block dispatched almost equal numbers of staff to the disaster areas and provided psychosocial support (Figure 5-5).

(4) Psychosocial care for the staff dispatched to the site and the Headquarters staff

a. Preparation of a mental health support flow chart for the dispatched staff of the JRCS

Before the disaster occurred, there were no JRCS guidelines concerning psychosocial support for the staff in advance of and after their dispatch to the affected areas, and organizational efforts lagged behind.Therefore, the JRCS prepared a mental health support flow chart for the dispatched staff with advice from Mr. Sota Shimozono of the Japanese Ground Self Defense Forces (SDF) Medical School immediately after the GEJET (Figure 5-6). The completed flow chart was distributed to JRCS facilities nationwide through the Headquarters and block representative chapters in

March 17, after being put to a HDC meeting at the Headquarters and gaining its approval.There were no guidelines on days off after completing the tasks, etc., up to then. Thus the completed flow chart helped to integrate the JRCS as a whole, including psychosocial support for the dispatched staff after the completion of their tasks.

b. Preparation of messages for the staffIshinomaki RCHP established a room for refreshing and relaxation for the hospital staff and sent messages to them. This was introduced by the Headquarters as well, allowing for the fact that even staff members who were not dispatched to the affected areas may feel much stressed. In March 25 the message made in the hospital was modified for the Headquarters, and displayed in the lavatories in order to draw attention of every staff member (Figure 5-7).

Figure 5-5　Number of Staff Operating in Psychosocial Care by Block

0 200 400 600 800 1,000 1,200

1B

2B

3B

4B

5B

6B

(Unit: Cumulative number of staff)

IWATE MIYAGI FUKUSHIMA TOCHIGI

548

1,090

539

702

622

557


[A psychosocial care staff member listens to the voices of children]

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Figure 5-6　The JRCS Mental Health Support Flow Chart for the Dispatched Staff

Figure 5-7　Messages for the Staff members

Mental Health Support Structure for the Dispatched Staff such as Medical Teams

Before dispatch

During dispatching

5-7 days 2 days 2 weeks

Daily workDay off

Things to doThings to pay attention to

-Attend a briefing on the destination and the contents of the tasks, and possible problems and risks.

-Be mentally prepared for the things that could occur.

-Accept the fact that your emotions and body responses are a natural phenomenon as a human being.

-Get sufficient sleep on the days off.

-Refrain from making any refreshing changes like too much socializing.

-Refrain from the consumption of alcohol.

-Identify your own role, know what people expect from you, and do not expect too much from yourself.

-Talk about the experiences of the day by making time to gather at end of the day whenever possible.

Shortly after the dispatch

-Consult with specialists such as an industrial doctor.

When the next staff members are about to go to the site

During the two weeks after the dispatch or after completing the tasks

-Tell your experiences to the staff members who are to be dispatched next.

-Provide advice: 1) what kind of stress you felt, 2) how you responded to the stress and 3) what other staff members should prepare for.

-Take sufficient days off and avoid placing too much burden on yourself in the course of the work.

-Conduct debriefing meetings in small groups. (Discuss what happened and what you felt about it.)

-Discuss how to change your attitude as well as the events during the dispatch where possible.

(Note) This flow chart was prepared with reference to the mental health support program of the Japan Ground SDF at the time of an earthquake disaster.

Dear staff members,Thank you for your hard work every day.Even though you are not dispatched to the affected areas, you are a disaster supporter as long as you are undertaking tasks at the Headquarters.Under a state of high stress from dealing with situations where things are always changing and the future is uncertain, have you experienced a situation like the following, for example?

□ Cannot sleep　□ Have no appetite　□ Feel uneasy/scary　□ Always feel tense□ Feel frustrated　□ Become startled by slight noises□ Become deeply preoccupied with the earthquake or tsunami　□ Feel in a daze　□ Cannot trust anyone□ Suddenly flash back to the earthquake or tsunami　□ Cannot go out

Knowing about these stress symptoms will help you to cope with stress. These symptoms can be seen in many people who are facing an emergency situation like this, but they will mostly subside as time goes by.The important things to enable you to quickly restore your mental state and healthy body are:

　　-Take sufficient rest and do not force yourself;　　-Be aware of your life rhythms such as eating and sleeping;　　-Talk with reliable persons; and　　-Actively practice your own way of relaxing.

For the recovery of the mind and body of people that have undergone severe stress, it is important for others around to support them. Please encourage them to take a rest and treat them with patience. Let's overcome the difficulties and support each other!If you are worried about something or have something on your mind, contact the psychosocial care staff first.


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c. Mental health of the initial medical teamsA questionnaire survey was conducted to understand the mental health of staff members who were engaged in relief activities of the initial medical teams in the areas affected by the GEJET (Figure 5-8).

Figure 5-8　Outline of the Survey on Mental Health

　　　　　　　Respondents evaluated the stress in the operations (pain) using an 11-point scale, rating from “not painful at all” (0) to “very painful” (10). The whole average score was 4.96 and one third of the respondents indicated each of the ranges of 0-3, 4-6 and 7-10 (Figure 5-9).

Figure 5-9　Stress during the Operations (pain)　

In addition, as a result of asking what they did to relieve stress after being dispatched, nearly half of the respondents stated “took time off” and “talked to friends, colleagues or family members about my own experience” (Figure 5-10).

Figure 5-10　Things the members did in order to　　　　　　 Relieve Stress after the Dispatch

The results showed the current situation that some staff members felt stress during the relief activities, In adittion, it revealed to cope with the stress after these activities.

(5) Psychosocial care activities by the trainees of the JRCS Institute for Nurse Managers

In GEJET, since prolongation of the disaster response activities was expected due to its scale and range, the dispatch of trainees had been considered early in the JRCS Headquarters. However, the dispatch of trainees was rejected once, because the trainees are required to attend four-fifths or more in the class for each subject in the Nurse Administrator Training I (April 12-July 22, 2011), a course to gain a qualification for the first level of Certified Nurse Administrator.On the other hand, the psychosocial care coordinator engaging in care support in IWATE reported that it was difficult to obtain the number of psychosocial care staff required despite the rising need for psychosocial care at that time. Thus, in order to find a way to dispatch trainees to the disaster areas while assuring their training, only applicants was dispatched during the early May holiday season. Nineteen trainees applied for this, and the psychosocial care center in the Iwate Chapter was asked to coordinate the activities as well as prepare the good required for the activities such as uniforms, the necessities for the work, the means of transportation, accommodation and the like. As a result of this coordination, it was decided to send the trainees to RIKUZENTAKATA with three psychosocial care instructors, including full-

Name: Questionnaire Survey on Mental Health(1) Purpose of the surveyUnderstand the stress levels of the JRCS staff who are engaged in relief activities for in GEJET and consider psychosocial support for the dispatched staff during relief activities.(2) Period of the surveyAugust 5-September 22, 2011(3) Subjects of the survey-Staff members of the initial medical teams (medical teams including dERU and DMAT)*In this survey, the initial actions are intended for those in attendance on March 11, 2011.-Staff members of the independent psychosocial care teams dispatched to MIYAGI in March.-Psychosocial care staff accompany the medical team dispatched to IWATE in March(4) Number of questionnaire respondentsNumber of questionnaire respondents (percent of respondents): 363 respondents (including psychosocial care staff: 98 persons)(5) Attributions■ Gender:Male (197 persons), Female (163 persons), Not given (3 persons)■ Age:20s (52 persons), 30s (131 persons), 40s (121 persons), 50s (59 persons), Unknown (0 person)■ Occupation:Doctor (45 persons), Nurse (164 persons), Clerical position (113 persons), Pharmacist (18 persons), Others (20 persons), Not given (3 persons)

17

16

29

59

25

52

39

57

44

10

8

0 10 20 30 40 50 60 70

0

1

2

3

4

5

6

7

8

9

10

(Person)（n=356） (Average: 4.96)

193

134

32

164

25

88

31

0 50 100 150 200 250

Took time off

Talked with the members dispatched together

Talked with one's superior or manager of the facility

Talked with friends, colleagues or a familymember about my own experience

Received counseling

Did nothing much

Others

(Person)

355 respondents (including multiple answers)

140


time teachers of the Institute for Nurse Managers.The trainees, divided into three groups, flexibly operated to suit the requirements of the affected people, etc., at various places such as evacuation centers and the geriatric health services facility in RIKUZENTAKATA. The contents of the operation were: to provide health counseling and a mobile clinic, to provide massages to the support staff, to set up a place to relax, to active listening to the affected people while helping them with their moving to temporary housing; and to support the cleaning of the body for people in nursing homes and the like. Approximately 300 staff members were involved over three days from May 1 to 3. This was also a valuable experience for the trainees.

2. Activities in the three Chapters in the affected areas

(1) Activity status in the Iwate Chaptera. Activity status of the psychosocial care staff in IWATEIn IWATE, the psychosocial care staff started operations in March 13 by accompanying medical teams. From April 4 to August 12, Dr. Makishima of the JRCS Medical Center was dispatched as the psychosocial care coordinator. On April 9, a Psychosocial Care Center was established and an independent psychosocial care teams also started operations.Until the end of March, the psychosocial care staff had operated by accompanying medical teams and a cumulative total of 187 staff were engaged for that month. From April, the activities of the independent psychosocial care teams had increased (the activities of accompanying medical teams decreased because of this). From April to July, the cumulative number of staff was about 400 per month.

Figure 5-11　Number of Staff Operating　　　　　　　　Psychosocial Care in IWATE


I n IWATE , t h e JRCS was r e spons i b l e f o r RIKUZENTAKATA, YAMADA and KAMAISHI. The psychosocial care coordinator and the Iwate Chapter dispatched clinical psychotherapists, who are psychosocial care instructors of the JRCS, as coordinators for each district in operation and put them in charge of the overall coordination. The staff dispatched as coordinators were clinical psychotherapists who belong to the Psychosocial Support Center for GEJET. This organization was established by the Japanese Society of Certified Clinical Psychologists and the Association of Japanese Clinical Psychology. In an agreement between the JRCS and the Japanese Psychological Support Center for The GEJET, they were dispatched as psychosocial care volunteers of the JRCS to each district within IWATE. (The agreement of the JRCS and the Japanese Psychological Support Center for GEJET is described later.)

b. Distinctive activity status of the Iwate ChapterAfter the withdrawal of the psychosocial care teams, the Iwate Chapter started psychosocial care in cooperation with the Society of Certified Clinical Psychologists in IWATE. While the movement of persons from the evacuation centers to temporary housing was proceeding, concern about the collapse of traditional communities and the lack of communication among the residents was raised. Thus, this activity was conducted aiming at strengthening the local communities and promoting recovery through “the formulation of communities”, “the establishment of mutual support among the affected people”, and

“support for independence.”Every Saturday the support team visits the temporary housing and tried to make the evacuees feel relaxed by listening to them while having tea with them or measuring their blood pressure.The psychosocial support activities of the Iwate Chapter started on September 10, 2011, and were held a total of 50 times and engaged a cumulative total of 1,276 people up to September 22, 2012. The location of the activities held was at the Nakasato temporary housing in Miyako, but moved to the Takahama temporary housing in the same city in July, 2012. (From July to August the care activities were conducted at the Nakasato and the Takahama temporary housings every other week, and in September moved completely to the Takahama temporary housing.)

0

137

313

590

432

47

187261

167

665 0

0

100

200

300

400

500

600

700


Team type Accompanying type (Unit: Cumulative number of staff)


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In addition, the clinical psychotherapists belonging to the Society of Certified Clinical Psychologists in IWATE, as well as the staff of the Iwate Chapter and the JRCS volunteers, participated in these activities. The cumulative total number of participants reached 283.

(2) Activity status in the Miyagi Chaptera. Activity status of the psychosocial care staff in MIYAGIIIn MIYAGI, on March 13, two psychosocial care instructors arrived at the Ishinomaki RCHP. At the almost same time, the psychosocial care teams from the 2nd block started operations, and on March 15, the independent psychosocial care teams took over its work.From April to August, a cumulative total of over 200 staff per month were engaged in psychosocial care activities.

The JRCS psychosocial care teams jointly operated as members of the psychosocial care team with the support teams of the prefectural organizations, doctors, universities and other organizations with the

“Psychosocial Care Center” of the Miyagi Chapter as the base, which was established in the Ishinomaki RCHP. Dr. Makishima, who had operated as the psychosocial care coordinator in IWATE from April, joined those in MIYAGI and provided guidance from May. The Psychosocial Care Center of the Ishinomaki RCHP coordinated not only the JRCS teams, but also other teams and appointed a clinical psychotherapist of the hospital as a coordinator. The coordination had the difficult task of smoothly coordinating all the psychosocial care teams, partly because it was necessary to coordinate with psychiatrists who had medical knowledge.

Figure 5-12　Number of Operating Staff in 　　　　　　 Psychosocial Care in MIYAGI

b. Distinctive activity status of the Miyagi ChapterOn June 18, 2011, the Miyagi Chapter started operations by organizing a unique psychosocial care team that put volunteers (including the Society of Certified Clinical Psychologists in MIYAGI) at the center of the activities, in parallel with the operation of the psychosocial care teams dispatched from each chapter. Every Saturday and Sunday they operated at evacuation centers in ISHINOMAKI and ONAGAWA, and listened attentively, and provided consultations while performing relaxation. For the children recreational spaces were provided, which they enjoyed.The Specific Red Cross Volunteer Corps such as the Nursing Volunteers (health counseling, etc.) and the Beauty Care Volunteers (hot compress treatment, etc.) entered the evacuation centers and listened attentively to the disaster victims in order to help them to relieve stress, whereas the Community Red Cross Volunteers

[Psychosocial support activity at the former Kamaishi Daiichi Junior High School]

[A psychosocial care staff member listening to a disaster victim at the evacuation center within ISHINOMAKI]

79

206

68

408 426

228

348 30

279

23 5 0 00

100

200

300

400

500


Team type Accompanying type(Unit: Cumulative number of staff)

Source: Prepared by the Relief Activities Report of the JRCS in GEJET (As of September 2012)

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Corps provided something cold such as shave ice, and the Youth Volunteers were enjoying recreational activities with the children outside the centers. These activities were conducted through cooperation among the Specific, Community and Youth Red Cross Volunteers Corps.At the evacuation centers, these activities were conducted 33 times in total and provided psychosocial care for 1,776 people up to October 15, 2011. The Nursing and Youth Volunteers, and clinical psychotherapists belonging to the Society of Certified Clinical Psychologists in MIYAGI were involved in these activities. The cumulative number of participants reached 336.

Moreover, even after the activities ended at the evacuation centers, the psychosocial care started at temporary housing from October 22, 2011. They initially prepared hot meals, and provided relaxation and recreation opportunities, etc., but gradually increased consultation activities by visiting people from house to house. When the staff distributed pamphlets to inform people of the weekend activities, staff members listened attentively to the people they spoke to as well.At the temporary housing, a total 23 periods of activities were carried out, providing psychosocial care for 931 people until the end of September 2012. A cumulative total of 243 participants, including Red Cross Volunteers and clinical psychotherapists, were involved in the same way as in the activities at the evacuation centers.

(3) Activity status in the Fukushima Chaptera. Activity status of the psychosocial care staff in

FUKUSHIMAIn FUKUSHIMA, the psychosocial care staff started operations from March 20 by accompanying medical teams. Since the disaster situation in the Fukushima Chapter was different from that in IWATE and MIYAGI, a cumulative total of only 49 staff were involved in psychosocial care in the Fukushima Chapter. A Psychosocial Care Center was not established in the Fukushima Chapter.

Figure 5-13　Number of Operating Staff in 　　　　　　　　　　Psychosocial Care in FUKUSHIMA

FUKUSHIMA has the characteristics of the disaster such as the large number of evacuees and small number of injured people due to the impact of the Fukushima Daiichi Nuclear Power Plant Accident, and the long distance between the disaster areas and the evacuation centers. Thus many of consultations received by psychosocial support operations concerned health issues associated with the nuclear accident. Furthermore, in the Fukushima Chapter, all staff members of the medical teams provided psychosocial support as well as relief activities.Besides, based on the status of local evacuation centers that the Chapter knew about, the Chapter also requested the HDC at the Headquarters to dispatch psychosocial care staff in a document of March 27, 2011.

b. Distinctive activity status of the Fukushima ChapterThe Fukushima Chapter also has carried out various distinctive activities, after the end of the psychosocial support activities by the teams dispatched from various areas. One of these activities was the Red Cross Health Class at the evacuation centers in

Nursing Red Cross Volunteers Corps (the Ishinomaki evacuation center)

Youth Red Cross Volunteers Corps (the Ishinomaki evacuation center)

Clinical psychotherapists of the Society of Certified Clinical Psychologists in MIYAGI (left side of the bottom left, middle of the bottom right)

[Scenes of psychosocial support activities by the Miyagi Chapter]

0 0 0 0 0 0 0

22

26

1 0 0 0 00

5

10

15

20

25

30


Team type Accompanying type (Unit: Cumulative number of staff)

Souce: Prepared by the Relief Activities Reports of the JRCS in GEJET (As of September 2012)


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FUKUSHIMA, which started from September 9, 2011. These are intended to prevent disuse syndrome and provide care prevention for people with concerns about the health of their mind and body due to the difficult living conditions, as well as to reduce the feeling of isolation and loneliness caused by the collapse of communities. Mainly the Red Cross Volunteers organize activities such as health checks, healthy life courses and fun parties.The Red cross Health Class was held total 21 times, 8 times in FY 2011 and 13 times before September 11 in FY 2012, involving a cumulative total of 1,017 paticipants.In addition, the Red Cross Health Lectures were held for Fukushima residents who were concerned about their health due especially to the Fukushima nuclear power plant accident, which included lectures by doctors and specialists on radiation, and relaxation activities provided by the Red Cross Volunteers. A cumulative total of 470 people participated in these lectures, which were conducted one time in FY2011 and four times as of September FY2012.

Other activities were carried out mainly by the Fukushima Chapter as follows.

Figure 5-14　Activities by the Fukushima Chapter

Name Summary

The JRCS Nordic Style Walking

The practice of Nordic Style Walking, walking using two poles, which helps increase whole body endurance and strengthens the muscles of both the upper and lower body, as well as reducing stress and overcoming a lack of physical exercise by walking outside while chatting with others.

Movie screenings

Screening of movies suitable for recovery support

The JRCS Workshops for protecting life and health

Holding workshops on first aid (e.g. methods of cardiopulmonary resuscitation and defibrillation through the use of an AED [automated external defibrillator]), a healthy life course, and a life course for the elderly at the time of a disaster

Smile Parks in FUKUSHIMA

Provision of places to have good fun and get exercise for preschool children who lack exercise and bear a psychological burden because of the limited opportunities for outside activities due to concerns about radiation exposure from the nuclear power plant accident; Provision of permanent playground equipment (e.g. a ball pool, cyber wheel and air track) and various programs (e.g. a kids exercise club, storytelling using picture books, information panel exhibitions of the JRCS projects, and hometown art).

Social events for residents in the evacuation area

Organize events (single-day) to provide opportunities for the residents evacuated from NAMIE (aged 65 years or more) who are living in the temporary housing to communicate with the residents still in this area before GEJET.

[Relaxation activities by nurses of the Red Cross Blood Center - Azuma Gymnasium]

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3. Cooperation with local government bodies and other parties concerned

(1) Cooperation with local government bodies and health care centers

a. Activities of the psychosocial care teams dispatched by the Ministry of Health, Labour and Welfare (MHLW)

Under Article 30 of the Basic Law on Natural Disasters, the affected local municipalities shall request the Government of Japan (GoJ) to arrange the dispatch of psychosocial care teams (in relation to the GEJET, IWATE, MIYAGI, FUKUSHIMA and SENDAI requested the dispatch of psychosocial care teams) and accept psychosocial care teams from other prefectures through the MHLW.A cumulative total of 57 teams and 3,498 staff were dispatched to the affected areas through the MHLW (as of 14:00, March 23, 2012, according to the 2011 Disaster Situation and Response to the GEJET by the MHLW <116th Report> ).The psychosocial care teams that were dispatched based on requests to the GoJ fully coordinated with the prefectures (a mental health and welfare center in each prefecture handled this) before deciding which local municipalities that they will take charge of.The “GEJET: Psychosocial Care Team Activity Manual in the Affected Areas Ver. 2” published by

the National Institute of Mental Health, the National Center of Neurology and Psychiatry (NCNP) describes the psychosocial care teams dispatched to the affected municipalities. In the section on the Structure of Psychosocial Care Teams, it defines them as “a team composed of multiple staff who are from various professional backgrounds as follows (the appropriate number in the team should be considered in light of its ability to travel by car)”.

Besides, including those from the JRCS not all teams that operated in the disaster area as psychosocial care teams were dispatched through the MHLW. In some cases the prefectural government directly requested medical institutions to dispatch psychosocial care teams. For example, IWATE accepted teams dispatched through personal communications with doctors within the prefecture. These teams were registered as psychosocial care teams at the Iwate

Figure 5-15　Flow of the Dispatch of the Psychosocial Care Team

各都道府県の心のケアチーム派遣機関

厚生労働省

被災地の行政機関（各都道府県の精神保健福祉センター

など）

被災地の避難所、精神科医療機関など

Matching between the affected government bodies and the dispatching institutions by the MHLW based on a request for the dispatch

Dispatch the teams after coordinating with the local government bodies in the affected area.

Local government bodies in the affected area request the MHLW to dispatch teams

Allocate the teams to each area after coordinating with a health care center and local municipalities, etc. in each area.

Dispatching Institutions of the Psychosocial Care Teams in each prefecture

The MHLW

Local Government Bodies in the affected areas (e.g. mental health and welfare centers in each prefecture)

Evacuation Centers or Psychiatric Care Organizations, etc., in the affected areas

(2)

(3)

(1)

(4)

Source: Prepared by partly adding to and modifying the “GEJET: Psychosocial Care Team Activity Manual in the Affected Areas Ver. 2”, the NCNP

-Psychiatrist,-Nurse, Public health nurse,-Psychiatric social workers,-Child Mental health specialist (e.g. pediatric psychiatrist, clinical psychotherapist), and-Due to the assurance of communications with the staff and logistics, it is useful if a driver and clerical staff accompany them.


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Mental Health Welfare Center and operated in the allocated areas on an equal basis with teams dispatched through the GoJ.

b. Cooperation between the JRCS and local government bodies/health care centers

The psychosocial care teams dispatched to the affected areas through coordination by each prefectural government are to operate by sharing roles and information under rules set by the health care centers or local municipalities in the appropriate area by region. It is important to establish this cooperation not only among the dispatched psychosocial care teams, but also with local public health nurses who travel to evacuation centers and housing within the affected areas, as well as others. Thus the activities proceeded through sharing information on evacuees who have a possible problem.For example, in the Ishinomaki region, a clinical psychotherapist from the JRCS coordinated the psychosocial care teams as a liaison. In the early period after the disaster they had a meeting every day and shared the information with the public health nurses of the city and the psychosocial care teams. Through these opportunities, the leaders of the evacuation centers or health care nurses traveling to the evacuation centers and housing within the disaster areas continually provide information to the psychosocial care teams when they recognized evacuees with a problem.In addition, in IWATE, the psychosocial care liaison provided coordination for the Iwate prefectural government or local municipalities regarding the dispatch destination at the start of the psychosocial support activities of the JRCS. The Iwate prefectural government or local municipalities also adjusted their activities in order to gain further understanding of the JRCS psychosocial support activities, as well as to support them in the most suitable way in each municipality. As a result of these consultations in advance, in MIYAKO, IWATE the psychosocial care teams of the JRCS were able to operate as health support teams. Since they could operate in a way that was suitable for the municipal governments (framework), as the accepting site, the Miyako Health Care Center also could respond smoothly, resulting in very high reputation for the activities of the JRCS.

(2) Cooperation with the Japanese Society of Certified Clinical Psychologists, etc.

In case of the GEJET disaster, the JRCS concluded an agreement with the Japanese Psychosocial Support Center for GEJET (“the Psychosocial Support Center”), which was established by the Japanese Society of Certified Clinical Psychologists and the Association of Japanese Clinical Psychology, and operated the psychosocial care in collaboration with them. In March 15, 2012, the JRCS offered the Psychosocial Support Center cooperation in the psychosocial care activities, and then the care activities were able to start collaboratively on March 20. Moreover, from March 23 to 27, the JRCS psychosocial care teams and the Psychosocial Support Center jointly dispatched an advance team and visited the affected areas in MIYAGI and IWATE (ISHINOMAKI, MORIOKA, MIYAKO, YAMADA, KAMAISHI and RIKUZENTAKATA) and evacuation centers in the affected areas.As a major activity through cooperation between the JRCS and the Psychosocial Support Center, joint psychosocial care teams were deployed five times in the Ishinomaki area in MIYAGI and RIKUZENTAKATA in IWATE from April 7 to June 30.The joint psychosocial care teams included one or two staff so that a clinical psychotherapist joined in the JRCS psychosocial care team as a care volunteer of the JRCS psychosocial care. While measuring blood pressure, etc., the JRCS nurse provided the care, whereas the accompanying clinical psychotherapist l istened attentively especial ly to people who seemed to have a problem. In addition, the clinical psychotherapist not only listened, but also provided professional care where needed. The joint team operated 21 days in total and a cumulative total of 60 clinical psychotherapists of the psychosocial support center engaged in these activities.Furthermore, at the start of the dispatch of clinical psychotherapists to the disaster areas, the JRCS and the Psychosocial Support Center jointly held training workshops on psychosocial care at the time of a disaster. A total of three workshops, two in IWATE and one in AKITA, were held with approximately 160 participants. Through these activities, the Psychosocial Support Center appreciated the opportunity to gain know-how on JRCS activities at the time of a disaster.There are other on-going forms of collaboration among each prefecture. In IWATE in cooperation between

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the Iwate Chapter and the Society of Certified Clinical Psychologists in IWATE, psychosocial care was conducted at evacuation centers in MIYAKO from April to August. It operated 58 days in total and a cumulative total of 130 clinical psychotherapists were dispatched from the Society of Certified Clinical Psychologists in IWATE and other areas.After the withdrawal of the JRCS psychosocial care teams, the Society of Certified Clinical Psychologists in IWATE conducted the psychosocial support in cooperation with the Iwate Chapter. Also in MIYAGI, the Society of Certified Clinical Psychologists in MIYAGI provided psychosocial support in collaboration with the Miyagi Chapter. From June to August, 2011, a cumulative total of 38 clinical psychotherapists were involved.In addition, after the withdrawal of the JRCS psychosocial care teams, the Society of Certified Clinical Psychologists in MIYAGI also conducted psychosocial care at evacuation centers and temporary housing in collaboration with the Miyagi Chapter and this collaboration continues.

(3) Participation in the Kokoro no Kizuna ProjectThe JRCS participated in the project, “Human-care: Kokoro no Kizuna Project”. This project was developed mainly by GlaxoSmithKline plc, a major global pharmaceutical company, through industry-government-academia collaboration for the purpose of providing psychosocial support for people in disaster areas. From July 23 to September 4, 2011, the project traveled to a total of 56 places for temporary housing, community centers and meeting places in IWATE, MIYAGI, and FUKUSHIMA, involving 1,633 participants.This project conducted health seminars and held tea parties. In the health seminars, clinical psychotherapists provided lectures on stress prevention and opportunities for participants to get exercise. In addition, in the tea parties, clinical psychotherapists or nurses who had been trained in psychosocial care listened to the participants and provided the care in a professional way where needed.Other than the health seminars or the tea parties, they conducted sport seminars, harp performances, concerts by professional singers, storytelling or drawing parties for children and oil massages for staff of the municipalities.

[A scene of the civic medical symposium for citizens - Iwate Prefectural Hall]

Distribution of Relief Supplies

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1. The Situation in the Headquarters(1) Outline of the Distribution of Relief Supplies

by the Japanese Red Cross Society (JRCS)The JRCS stocks relief supplies and distributes them at the time of a disaster, based on the JRCS Disaster Relief Rules and Operations Planning.Relief supplies for the affected people are categorized as “blankets”, “emergency kits”, “sleeping kits” and

“other items”. An "emergency kit" is a set of goods that are deemed necessary for daily life immediately after a disaster, such as a portable radio, an electric torch, bandages, paper plates, eating utensils, a booklet entitled "Health Symptoms You Should Pay Attention to at the Time of a Disaster". A "sleeping kit" is a set including a camping mat, a pillow, an eye mask, a set of earplugs, and a pair of slippers and socks. The "blankets", "emergency kits" and "sleeping kits" are stocked at the Headquarters and at all chapters. The "other items" include additional supplies that are stocked in individual chapters, such as mats in the Fukushima Chapter and bath towels in the Iwate Chapter. Although it does not provide water, food, clothing, etc., as relief supplies, the JRCS also procured and distributed these goods based on requests from local municipalities, including ISHINOMAKI, in this earthquake disaster.As for distributing relief supplies such as necessities for

daily life, the Regional Disaster Prevention Plans of the three affected prefectures, such as IWATE, MIYAGI and FUKUSHIMA, state that; (i) local municipalities shall identify the requirements of the affected people, and then procure, and distribute the supplies; (ii) if it is not possible for local municipalities to procure these supplies, they shall request the prefectural government to procure them or nominate agencies to supply them. The prefectural government shall secure supplies after coordinating with the national government, the traders concerned and other entities. The JRCS also operates its relief activities based on the Regional Disaster Prevention Plan adopted by each municipality.Each chapter continually maintains a stock of a given amount of relief supplies for every branch within the prefecture. If the scale of the disaster is small enough to be dealt with using the existing stocks of its own, the chapter distributes supplies to the branches close to the affected areas, based on requests from the departments of municipalities or the Social Welfare Council. If, however, the scale of the disaster is too large to be handled using its own stocks the chapter in the affected area also mobilizes supplies from the stocks of chapters within the block, in coordination with the representative chapter of the block. Furthermore, the chapters in the affected areas can request the Headquarters to coordinate the supplies if the scale of the disaster is much greater. Meanwhile, whenever such requests were made, the Headquarters coordinates supplies that are stocked in the Headquarters and chapters throughout the nation through the representative chapters of the blocks. Then the relief supplies are delivered from the Headquarters and directly from chapters throughout the country to the chapters, local municipalities and distribution points for in the affected areas. In this mega disaster, the Headquarters, coordinated the supplies of the Headquarters and chapters through the representative chapters of the blocks, and then delivered them to the requesting chapters in the affected areas. The delivery was conducted by private companies that had stand-by agreements with the Headquarters to provide transportation for relief supplies at the time of a disaster.As a general rule, any chapter in a block that includes

Chapter 6　Distribution of Relief Supplies

[Blankets]

[Emergency kits] [Sleeping kits]

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elief Supplies


the chapters of affected prefectures supports the work of the transportation of supplies through the representative chapter of its own block. In this disaster, however, the Miyagi Chapter, which is the representative chapter for the first block covering the HOKKAIDO and TOHOKU regions, was itself affected by the disaster, so that chapters in the unaffected prefectures within the block and neighboring chapters outside the block made direct contact with affected chapters without going through the Miyagi Chapter and delivered the supplies to the affected chapters that had made the requests.

(2) Distribution of relief suppliesa. Distribution track record of relief suppliesIn the JRCS relief activities related to this disaster, a total of 148,493 blankets, 38,437 emergency kits and 15,406 sleeping kits were distributed, of which 105,510 blankets, 28,818 emergency kits and 12,500 sleeping kits were distributed to the three prefectures of IWATE, MIYAGI and FUKUSHIMA.

1

A large contribution of relief supplies supported by the JRCS involved the distribution of blankets for the initial response. The JRCS distributed approximately 88,000 blankets over five days from March 11 to 15. This accounts for approximately 60% of the total number of blankets distributed by the JRCS. In comparison with this, the Government of Japan (GoJ) distributed approximately 97,000 blankets over the initial five days. This accounts for only 24% of the total (409,672 blankets) distributed by the GoJ.Furthermore, the largest number of blankets distributed by the JRCS was on March 12, the day

b. Evaluation of relief supply distribution by affected people

A questionnaire survey was conducted six months after the disaster as follows to obtain feedback on JRCS activities from affected people.

Figure 6-3　Summary of the Questionnaire　　　　　　　　Survey of the affected people 　

Figure 6-1　Number of Distributed Relief Supplies 　　　　　　　　 (Coordinated by the Headquarters)

Figure 6-2　Trend in the cumulative Total 　　　　　　　　Number of Distributed Blankets

1,000

10,9205,000

88,490

16,3986,000

16,02016,020

1,5001,500 1,500

42,983

9,619

2,9060

20,000

40,000

60,000

80,000

100,000

Blankets (pieces) Emergency kits (kits) Sleeping kits (kits)

IWATE

MIYAGI

FUKUSHIMA

Other prefectures

0

50,000

100,000

150,000

200,000

250,000

300,000

350,000

400,000

3/11 3/12 3/13 3/14 3/15 3/16 3/17 3/18 3/19 3/20 3/21

Number of pieces

GoJ JRCS

(1) These figures do not include the distributed relief goods to the affected areas that had been stocked in the affected prefectures for a disaster, whereas they include the goods in stock at each chapter.

(Note) The data for March 15 of the GoJ is the total number of blankets distributed from March 11-15. There was no daily data before March 14.Source: Prepared from the data of the General Affairs Department at the Headquarters and data of the healthy life support team for the affected people

Name: Survey on the Great East Japan Earthquake and Tsunami (GEJET) of 2011(1) Purpose of the surveyObtain feedback from the affected people on JRCS activities(2) Period of the surveySeptember 10-25, 2011(3) Subjects of the surveyThe affected people of evacuation centers or temporary housing in KAMAISHI and RIKUZEN-TAKATA, IWATE, KESENNUMA and ISHINOMAKI, MIYAGI, and FUKUSHIMA, FUKUSHIMA(4) Numbers of questionnaires distributed/respondentsQuestionnaires distributed: 874Questionnaire respondents (percent of respondents): 474 (54%)(5) Attribution■ Sex:Male (193 persons), Female (251 persons), Not given (30 persons)■ Age:20s (9 persons), 30s (30 persons), 40s (65 persons), 50s (78

following the disaster (GoJ distributed the largest number of blankets on March 16). This shows that the JRCS distributed blankets very quickly.

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The survey shows that over 90% of the respondents indicated that all the relief goods such as blankets, emergency kits, and sleeping kits were “very useful” or “relatively useful”, suggesting that the relief goods were helpful for the affected people. Over 80% also reported that those goods were “distributed at the time they were required” or “distributed at the time required to some extent”, suggesting that they were mostly distributed at the time they were needed.

(3) Status of support for facilitiesIn the event of a natural disaster, it is also necessary to supply daily necessities for the activities of chapters, Red Cross Hospitals (RCHPs) and Red Cross Blood Centers (RCBCs). Especially for RCHPs in the affected areas, in addition to the necessities including medical supplies, food, water and fuel for the RCHP staff and inpatients at ordinary times, there is a growing need for goods in order to accept injured people from the disaster. When it is difficult to procure these goods in the affected areas, the Headquarters and neighboring chapters support the facilities.

Usefulness of the blanket

Figure 6-4　Results of the Questionnaire Survey of Affected People

Timing of the distribution of the sleeping kits

Very useful as a relief supply:75%

Relatively useful as a relief supply:21%

A little useful as a relief supply:2%

Not useful as a relief supply:1%

No idea:1%

(n=263)

Timing of the distribution of the emergency kits

emergency kits were distributed in a sufficient number and at the time they were needed, 25%

emergency kits were distributed at the required time to some extent, 58%

Emergency kits were distributed at no particular time, 12%

Few emergency kits were distributed at the time they were needed, 3%

No idea:2%(n=157)

Timing of the distribution of the blanket

Blankets were distributed in a sufficient number and at the time they were needed, 28%

Blankets were distributed at the required time to some extent, 52%

Blankets were distributed at no particular time, 11%

Few blankets were distributed at the time they were needed, 8%

No idea:1%(n=262)

Usefulness of the sleeping kits

Very useful as a relief supply:64%

Relatively usefulas a relief supply:28%


Not useful as a relief supply:0%

No idea:2%(n=105)

Usefulness of the emergency kits

Very useful as a relief supply63%

Relatively useful as a relief supply31%


Not useful as a relief supply, 2%

No idea1%(n=170)

Sleep kits were distributed in a sufficient number and at the time they were needed30%

Sleep kits were distributed at the required time to some extent, 53%

Sleep kits were distributed at no particular time,13%

Few sleep kits were distributed at the time they were needed, 3%

No idea:1%(n=110)

persons), 60s (106 persons), over 70s (165 persons), Not given (21 persons)

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Distribution destinations

Arrival date Items Procurement

method

Miyagi RCBC

Mar. 21 Gasoline, Kerosene, (1,170 L in total) Donation

Mar. 27 Gasoline (400 L) Donation

Source: Prepared from the data of the General Affairs Department at the Headquarters

(4) Procurement of goodsa. Procurement from stocksThe JRCS mainly stores principal items around the country. Before the disaster, at the end of December 2010, the total inventory of stocks was approximately 210,000 blankets, approximately 80,000 emergency kits, and approximately 30,000 sleeping kits. The 84.4% of total blankets (105,510 pieces) that were distributed to the three affected prefectures through the Headquarters were procured from the stocks of the Headquarters and chapters in non-affected areas. Emergency kits and sleeping kits were procured from the stocks.Comparing the inventory number by block before the disaster to the number of released goods related to the disaster, the percent of blankets released in the 1st and 2nd blocks was higher because these blocks are largely covered the affected areas. In the 2nd block, part of CHIBA and IBARAKI were damaged; blankets were supplied within the prefecture, as well as were preferentially distributed based on their proximity to the affected areas (IWATE, MIYAGI, FUKUSHIMA).In view of the percent of contributions by item, blankets were procured mostly from nearby blocks. On the other hand, as for sleeping kits and emergency kits there is no association between the distance and the percentage of the release.Approximately 70% of the blankets and approximately 50% of sleeping kits and emergency kits in stock were distributed during this relief activity.

b. Procurement by purchasingIn order to meet the needs immediately after the disaster, blankets, which were requested in large numbers at the initial stages of the disaster event, were partly procured by purchasing from distributors instead of waiting for delivery from the chapters. Other items were also purchased including various foods, fuel and commodities for facilities support, and clothes, portable gas cooking stoves, commodities, partitions and the like for the evacuation centers depending on the needs at the site. Major procurement

In the three affected prefectures by this disaster, there are four RCHPs, such as the Morioka, Ishinomaki, Sendai and Fukushima and three RCBCs, of which three facilities including the Ishinomaki RCHP, Sendai RCHP and Miyagi RCBC accepted supports from the Headquarters for their facilities. Among these facilities the Ishinomaki RCHP could barely escape from the disaster because it is located on the coast and could maintain its function, so that a large number of patients and affected people were taken in at the time of the disaster, and afterwards the hospital continued to accept emergency patients totaling several times the number in ordinary times. At peak times, 70 teams of medical and nursing staff were staying there, thus the need for large quantities of various goods arose.Furthermore, even though the Ishinomaki RCHP managed to obtain relief goods, including medical goods from MIYAGI, and received generous donations from all over the country, they were not always sufficient. Thus the Headquarters provided relief goods, such as blankets and food, based on the requests from the RCHP.

Figure 6-5　Track record of support for facilities Distribution destinations

Arrival date Items Procurement

method

Ishinomaki RCHP

Mar. 12

Packages of instant noodles (27,000 meals) Donation

Food (e.g. Retort-pouch rice 1,000 meals) DonationInstant cup noodles (1,500 pieces) Donation

Mar. 13Blankets (2,000 pieces) StocksFormula (144 cases) Diapers (244 cases), etc. Donation

Mar. 15 Blankets (3,000 pieces) StocksMineral water (4,300 bottles) Donation

Mar. 17 Emergency kits (2,100 kits) StockT-shirts (900 pieces), underpants (1,300 pieces), sanitary goods, etc. Purchased

Mar. 18Cooked and dried packed rice (20,000 meals), crackers (10 boxes), water (120 boxes), etc.

Donation

Mar. 19 Instant noodle (30,000 pieces) DonationMar. 22 Blankets (380 pieces) StocksMar. 23 Food DonationMar 30 Retort-pouch curry (1,000 meals) DonationMar. 31 Rice (1,200 kg) DonationMar. 31 Various foods (e.g. canned food) PurchasedApr. 2 Emergency toilets (200 units) Stocks

Apr. 2 Nursing bottle antiseptic solution (200 bottles) Purchased

Apr. 12 Water tanks (12 pieces) Purchased

Sendai RCHP

Mar. 13 Heavy oil (14 kL) PurchasedMar. 19 Mineral water (2 10t-trucks) DonationMar. 26 Frozen food (2,000 meals) Purchased

152


the JRCS, and coordinated their delivery to the affected areas. It had no choice but to reject many offers because it was impossible to develop a system for the timely distribution of a large variety of relief goods except for blankets, emergency kits and sleeping kits in accordance with the needs in the disaster areas.

Figure 6-8　Distributed Goods Procured by Donation

Arrival date Item Amount Distribution

destinations

Mar. 19Mineral water 1 10t-truck Fukushima Medical

University

Mineral water 4 10t-trucks Kikuta Terminal (FUKUSHIMA)

Mar. 20 Mineral water 2 10t-trucks Sasaya Warehouse (FUKUSHIMA)

Mar. 22 Mineral water 6 10t-trucks Sendai Unyu Soko K.K..

Mar. 25Masks 10,000 pieces Ishinomaki Sports Park

Toothbrushes 10,000 pieces Ishinomaki Sports Park

Mar. 26

Clothes (underwear) 22,000 pieces Rikuzen-takata Yokota Elementary School

Clothes (underwear) 15,000 pieces Ofunato Takkon Elementary School

Sanitary goods, 1 10t-truck

Ishinomaki Sports Park

Dry-cell batteries 50,000 pieces

Alcohol disinfectant gel Approx. 10,000 pieces

Thermal, sweat-absorbent underwear 2,500 pieces

Mar. 29 Clothes 120,000 pieces

Mar. 30 Rice 10t

Mar. 31 Light oil, Kerosene 300 L

Apr. 11 Dry-cell batteries Approx. 130,000 pieces(Note) Excludes relief goods for facilities support.Source: Prepared from the data of the General Affairs Department at the Headquarters

d. Procurement from each chapter Besides blankets, emergency kits and sleeping kits, the goods that were procured by each chapter itself in the prefectures were delivered to the affected areas. Mainly the chapters that were close to the disaster areas, such as those in the HOKKAIDO, TOHOKU and KANTO regions sent various goods including food, drinking water and commodities to the affected areas. Above all, YAMAGATA sent many goods to affected areas mainly MIYAGI locating next to YAMAGATA.

goods and distribution destinations by purchasing are described as Figure 6-7. The JRCS could not ensure that the requested commercial products could be made available in this disaster, despite agreements on commodity procurement (with charge) with Ito-Yokado Co., Lawson, Inc. and Familymart Co.

Figure 6-6　Numbers of Relief Goods in Stock 　　　　　　　　 before the GEJET and Release Goods

　　　　　　　related to the Disaster in each chapter

　

Stock before the disaster2 (at the end of Dec. 2010)

(pieces, kits, sets)

Number of Release related to the disaster

(pieces, kits, sets)

Blankets Emergency kits

Sleeping kits Blankets Emergency

kitsSleeping

kits

Headquarters 25,660 7,078 687 23,521 7,052 505

1st block 15,437 12,958 3,392 15,851 6,946 109

2nd block 49,874 13,430 6,942 57,804 5,340 2,682

3rd block 33,629 13,647 6,992 17,640 4,113 6,140

4th block 33,230 9,913 4,045 19,241 6,253 2,000

5th block 25,729 12,959 3,360 8,950 6,849 2,010

6th block 27,449 10,424 5,333 5,486 1,884 1,960

Total 211,008 80,409 30,751 148,493 38,437 15,406(Note) Includes release supported by other blocks.Source: Prepared from the data of the General Affairs Department at the Headquarters

Figure 6-7　Distributed Goods Procured by PurchasingArrival date Items Amount Delivery placesMar. 21 Clothes Approx. 14,000 pieces Ishinomaki Sports Park

Mar. 25 Partitions 350 sets Evacuation centers in IWATE (6 places)

Mar. 26 Portable gas cooking stoves 1,400 sets Ishinomaki Sports Park

Mar. 31 Handbarrows 800 units Ishinomaki Sports Park(Note) Excludes relief goods for facilities support.Source: Prepared from the data of the General Affairs Department at the Headquarters

c. Procurement by donationAs the JRCS does not in principle accept the donation of goods, it did not encourage people to provide support through the donation of goods at the time of this disaster. This is because it is difficult to distribute donated goods to meet the needs of the affected people as the timing is critical. In the case of this disaster, however, the JRCS accepted the donation of goods that matched the needs and that were available in certain quantities among those goods that were requested to be directly donated to

(2) Since the chapter’s own procurement goods were not included in this inventory list, the actual stocks were more than is shown.

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Items Release date

Release amount

Release places

Yamagata Chapter

Bottled tea (345 ml) Mar. 18 1,080 bottles Tsurumaki Child’s House (SENDAI)

Snacks, candies (3-5 pieces) Mar. 18 2,714 sets

Miyagi Chapter

White rice Mar. 18 1,000 meals

Rice Mar. 18 90 kg

Packed meal Mar. 19 50 packs

Snacks, candies (3-4 pieces) Mar. 19 510 sets

Bread (2 pieces/pack) Mar. 19 50 packs

Packed meal Mar. 19 31 packs

Miyagi RCBCSnacks, Candies (3-4 pieces) Mar. 19 31 sets

Bread (2 pieces/pack) Mar 19 31 packs

Packed meals Mar. 20 50 packs Miyagi Chapter

Packed meals Mar. 20 31 packs Miyagi RCBC





Bottled tea (345 ml) Mar. 22 1,008 bottles Miyagi Chapter

Bread (2 pieces/pack) Mar. 22 360 packs Miyagi Chapter

Cooked rice Mar. 23 1,020 meals Kesennuma Social Welfare Council

Bottled tea (345 ml) Mar. 23 1,080 bottles Kesennuma Social Welfare Council

Snacks, Candies Mar. 23 13,200 packs Kesennuma Social Welfare Council







Rice snacks, Candies (3 kinds, 500 cases) Mar. 25 10,000 packs

Kesennuma Social Welfare Council

Cooked rice (60 pieces × 17 cases) Mar. 25 1,020 pieces


Figure 6-9　Distributed Goods Procured by each chapter

Items Release date

Release amount

Release places

Hokkaido Chapter

Disposable diapers, masks, gowns, etc. Mar. 15 28,416 pieces Ishinomaki RCHP

Disposable diapers Mar. 15 26,440 pieces Ishinomaki RCHPDisposable diapers Mar. 18 9,802 pieces Nodamura village Council

Bio air refresher Mar. 24, 27 324 pieces

Kamaishi Daiichi Junior High School

Masks Mar. 27 12,900 pieces

Cassette cooking gas cylinders, dry-cell batteries, etc.

Mar. 27, 29 452 pieces

Nurse shoes Apr. 12 30 pairs

Cassette cooking gas cylinders, dry-cell batteries, etc.

Apr. 15 4,001 pieces

Solar charging systems for mobile phones

May 12 25 unitsKamaishi Daiichi Junior High School and other 3 places

LED desk lumps May 12 200 piecesKamaishi Daiichi Junior High School and other 3 places

Masks Jun. 17 4,577 pieces Ofunato Support Network Center

Iwate Chapter

Bottled water (500 ml) Mar. 14 2,310 bottles

Iwate

Iwate Headquarter of Disaster Control(HDC)

Energy-supplement food “Calorie Mate”

Mar. 14, 5,520 pieces Iwate local HDC

Beach towels Mar. 12 880 pieces HANAMAKI, YAMADA, etc.

Dust masks Apr. 9 10,000 pieces Iwate local HDC

Sleeping bags Apr. 15 1,698 pieces

Storage of goods whose destination was not yet determined

Masks Apr. 25 96,000 pieces Morioka RCHPA

kita Chapter

Paper fans 13:00, Jun. 16 500 pieces Rikuzen-takata Daiichi Junior High School

T-shirts 13:00, Jun. 16 1,627 pieces Rikuzen-takata Daiichi Junior High School

Clothes Aug. 6-7 100 pieces “Moving Star Festival” hall, RIKUZEN-TAKATA

Yamagata Chapter

Festive red rice Mar. 13 2,000 pieces Miyagi ChapterRice balls Mar. 13 200 pieces Miyagi ChapterRice balls Mar. 14 800 pieces

Ishinomaki RCHPDrinking water (1L) Mar. 14 4,350 bottlesPocket warmer “Hokkairo” Mar. 14 2,400 pieces

Cooked rice by a soup kitchen Mar. 18 110 kg

Tsurumaki Child’s House (SENDAI)

Chinese dumplings Mar. 18 500 meals

Bread rolls Mar. 18 800 pieces

Snacks, candies (3 pieces) Mar. 18 500 packs

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Items Release date

Release amount

Release places

Yamagata Chapter

Socks Apr. 16 5,295 pairs Kesennuma Social Welfare Council

Chinese rice porridge (360 g × 12 pieces)

Apr. 16 1,135 cases Kesennuma Social Welfare Council

Canned rice porridge Apr. 23 31,920 cans Kamaishi HDC

Canned rice porridge Apr. 24 31,920 cans Kesennuma HDC

Canned rice porridge Apr. 30 27,360 cans

Relief Goods Coordinating Group at Miyagi HDC

Wheel chairs May 14 28 units Fukushima Chapter

Rice (30 kg × 35 sacks, 10 kg × 33 sack, 5 kg × 7 sacks, 2 kg × 4 sacks)

May 17 1,423 kg Watari HDC, MIYAGI

“Milk Cake” (50 packs) May 17 20 boxes Watari HDC,

MIYAGINabisco RITZ Crackers (6 pieces) May 17 50 boxes Watari HDC,

MIYAGI

Canned rice porridge Jun. 2 624 cans Fukushima Chapter

Canned rice porridge Jul. 8 1,248 cans Fukushima Chapter

Fukushima Chapter

Aluminium mats Mar. 11- 1,000 pieces FUKUSHIMA

and 7 other placesDisposable masks Mar. 15- 864,800 pieces KORIYAMA,

IWAKI, etc.Living ware (towels, work gloves, disposable chopsticks)

Mar. 19- Little by littleEvacuation centers in FUKUSHIMA, SOMA, etc.

Disposable masksOn a continuing basis

235,200 pieces FUKUSHIMA, etc.

Ibaraki Chapter

Commodities sets Mar. 14 30 sets CHIKUSEI

Commodities sets Mar. 17 650 sets KITAIBARAKI

Commodities sets Mar. 17 20 sets NAKA

Commodities sets Mar. 18 330 sets TONE

Commodities sets Mar. 28 30 sets TSUKUBA

Items Release date

Release amount

Release places

Yamagata Chapter

Margarine (20 pieces × 18 boxes) Mar. 25 360 pieces Kesennuma Social

Welfare Council

Packed meals Mar. 26 30 pieces Miyagi Chapter

Packed meals Mar. 26 31 pieces Miyagi RCBC

Packed white rice Mar. 27 720 meals Ishinomaki RCHP

Snacks, Candies (8 kinds, 585 cases) Mar. 27 15,020 packs Ishinomaki RCHP


Miyagi ChapterJam (20 piece × 8 boxes) Mar. 27 160 pieces

Packed meals Mar. 27 30 pieces


Packed meals March 28 20 pieces Miyagi Chapter






Azulene mouthwash solution “Azuleone Gargle liquid 1%”

Mar. 30 320 bottles Ishinomaki RCHP

Fluticasone Nasal Solution 25μg for Pediatric “Isei” 56 sprays

Mar. 30 300 bottles Ishinomaki RCHP

Surgical masks Mar. 30 2,000 pieces Fukushima Chapter

Azulene mouthwash solution “Azuleone Gargle liquid 1%”

Mar. 30 9,680 bottles Fukushima RCHP



Cheese sausages Apr. 16 61 cases

Kesennuma Social Welfare Council

Cooked rice (200 g × 20 pieces) Apr. 16 46 cases

Sea bream rice (375 g × 20 pieces) Apr. 16 55 cases

Chicken fried rice (375 g × 20 pieces) Apr. 16 6 cases

Rice boiled with edible wild plants (180 g × 20 pieces)

Apr. 16 75 cases

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Items Release date

Release amount

Release places

Toyama Chapter

Xylocaine spray Mar. 15 6 pieces

Ishinomaki RCHP

Xylocaine jelly Mar. 15 30 pieces

Volmagen Suppositories 25 mg Mar. 15 150 pieces

Novolin R Mar. 15 15 pieces

Anhiba 100 mg Mar. 15 200 pieces

Insulin Syringes Mar. 15 8 packs

Warfarin Mar. 15 100 tablets

Bayaspirin Mar. 15 500 tablets

Solita-T 500 ml Mar. 15 3 boxes

Oxygen cylinders Mar. 15 10 tanks

Diapers (for Adults) Mar. 15 59 packs

Diapers (for Children) Mar. 15 30 packs

Plastic gloves L Mar. 15 2 boxes

Plastic gloves M Mar. 15 1 boxes

Ethanol for disinfection Mar. 15 2 boxes

Surgical mask III Mar. 15 5 cases

Urine absorbent pads Mar. 15 30 packs

Sanitary napkins Mar. 15 10 packs

Oolong tea Mar. 15 10 boxes

Retort rice porridge “Okayukko” Mar. 15 1,200 packs

Corn soup Mar. 15 1,200 packs

Water 2L Mar. 15 360 bottles

Aichi Chapter

Magic rice (rice) Mar. 12 500 meals

Sendai RCHP

Magic rice (rice porridge) Mar. 12 500 meals

Emergency Canned food Mar. 12 328 pieces

Canned bread Mar. 12 264 pieces

Canned crackers Mar. 12 133 pieces

Items Release date

Release amount

Release places

Tochigi Chapter

Portable beds Mar. 11 189 units Otawara RCHP

Futon bedding sets Mar. 11 62 sets Evacuation centers within TOCHIGI

Futon bedding sets Mar. 11 5 sets Otawara RCHP

Dry shampoo Mar. 13 150 pieces Haga RCHP

Hardtack Mar. 13 250 pieces Fukushima Chapter

Drinking water Mar. 13 120 L Fukushima Chapter

Rice Mar. 16 130 kg

Ishinomaki RCHPRice Mar. 18 450 kg

Retort curry Mar. 18 1,500 meals

Cup miso soup Mar. 18 1,500 meals

Dried Udon noodles Mar. 31 1,200 meals Fukushima Chapter

Dried Somen noodles Mar. 31 600 meals Fukushima Chapter

Chiba Chapter

Commodities sets Mar. 12 200 sets TOGANE

Commodities sets Mar. 25 1,500 sets YAMAMOTO

Commodities sets Mar. 12 420 sets Places within CHIBA

Gauzes Mar. 12 200 pieces TOGANE

Gauzes Mar. 12 730 pieces Places within CHIBA

Bath towels Mar. 12 200 pieces TOGANE

Bath towels Mar. 12 810 pieces Places within CHIBA

Linen sheets Mar. 12 700 pieces Places within CHIBA

Tokyo Chapter

Compressed towels Mar. 14, etc. 1,552 pieces ISHINOMAKI, KAMAISHI

Kanagaw

a Chapter

Hand sanitizers (from Diversey Co.) As needed 6,000 pieces Evacuees in

municipal housingWater purifier (from Grand Dukes Corporation)

As needed 8,000 units Evacuees in municipal housing

Candies (from Eitaro Sohonpo Co.) As needed 70,000 pieces

Distributed mainly during mobile clinics in KAMAISHI

Specified low-power transceivers (from the Tokyo Chapter)

Nothing in particular 30 units Nothing in

particular

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Items Release date

Release amount

Release places

Aichi Chapter

CalorieMate Mar. 12 540 pieces

Sendai RCHP

Drinking water for storage Mar. 12 11 cases

Canned bread Mar. 12 2,592 pieces

Juice Mar. 12 870 bottles

Soup Mar. 12 1,740 meals

Mie Chapter

Sweet bean jelly Apr. 13 5,000 pieces Ishinomaki RCHP

Okayam

a Chapter

Helmets Mar. 21 1,000 pieces (50 cases)

Iwate Chapter: 100 pieces OKAYAMA → Affected areas: 900 pieces

Medical masks Mar. 22 100 cases (50,000 pieces)

Iwate Chapter

Gas cylinders Mar. 27 100 tanks

Headquarters

Generators Mar. 27 15 units

Disposable underpants/Disposable pads

Mar. 27 6 packs

Cup noodle Mar. 27 300 pieces

Medical goods Mar. 19

Neo Umor 500 g Cerocral tablet

100 tablets Amaryl 100

tablets Cabagin KOWA

1,000 tabletsRikuzen-takata Daiichi Junior High SchoolMasks (adult/

children) Mar. 19 13 boxes

Toothbrushes Mar. 19 5 boxes

Towels Mar. 19 3 boxes

Tokushima Chapter

LED pen lights Mar. 17 400 pieces

Yamada local HDC (Yamada-minami Elementary School)

(Note) Excludes blankets, emergency kits, and sleeping kitsSource: Prepared from the “Report on JRCS Medical Activities at the Great East Japan Earthquake and Tsunami” (As of September 2012)

(5) Delivery of goodsThe delivery from the Headquarters or the chapters to the affected areas was conducted by requesting the transport operators who had concluded an agreement on the delivery of goods in the event of a natural disaster (Sagawa Express Co. and Nippon Express). The volunteers, including mainly nursing students, helped to get the relief goods out from the Headquarters warehouse at the JRCS College of Nursing for dispatch. The relief goods were smoothly delivered to municipalities, storage areas and large evacuation centers in three affected area.

2. Activities in the three chapters in the affected areas

(1) Activity status at the Iwate Chaptera. Information collection and transmissionIn past natural disasters, the Councils of Social Welfare of the cities or towns and the welfare divisions of municipalities, which serve as the contact point for the Branches, directly informed the prefectural need for relief goods through the HDCs. In this case, however, the power and communications blackout in MORIOKA and the affected areas prevented them from contacting the chapters. At 15:00, March 11, two Iwate chapter staff joined the Iwate HDC in order to gather information. They, however, could not initially identify the disaster situation of the severely affected coastal areas, such as RIKUZEN-TAKATA OFUNATO, KAMAISHI, OTSUCHI and YAMADA, due to the enormous damage caused by the tsunami in the coastal areas of IWATE.On the day of the tsunami, the Iwate Chapter accepted distribution requests for relief goods only from the domestic Emergency Response Unit (dERU) of Morioka RCHP operating at the JR and fire academy in the city. The next day, March 12, there were requests for relief goods from city offices, such as HANAMAKI and KUJI.

[Loading relief goods from the warehouse to a truck (the JRCS College of Nursing)]

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and volunteers delivered the goods and the municipalities picked them up. As buildings that had served as landmarks were washed away by the tsunami, only the RCBC staff with knowledge of the local landscape were the right persons to conduct the delivery. When the medical team on the way to the affected areas requested the delivery of gasoline, the volunteers, who were also familiar with the region, played an important role. The goods distributed based on the needs survey by support staff dispatched from the Headquarters were directly delivered from the Headquarters and Chapters to the evacuation centers, municipalities and other sites.The trend in the relief goods distribution by the Iwate Chapter is shown in the figure on the following page. Within five days after the disaster the distribution had only been conducted in HANAMAKI, KUJI and MORIOKA, etc. From March 19, the direct delivery of the emergency kits and the sleeping kits from the Headquarters to the municipalities on the coastal area obviously increased. A total of approximately 5,000 sleeping kits and approximately 12,000 emergency kits were distributed by May 24. On the other hand, the blankets were not distributed until March 28, since they had been distributed to MORIOKA, KUJI and HANAMAKI up to March 14. This was because the Iwate prefectural HDC that received the donations of blankets, and the Chapter did not receive any requests. Only approximately 900 blankets in total were distributed by the Chapter from March 12 to May 24. The distribution after March 28 was used for people in secondary evacuation centers including the residents of employment promotion housing, which was used as an evacuation center. The number of blankets distributed each time was few; 10 to 43 pieces. The Iwate Chapter exceptionally has a stock of bath towels, which other Chapters did not have. 215 bath towels in total were distributed from March 28.

Within a week after the disaster, the many requests that the Chapter received were for food, gasoline, medical goods, materials and other supplies from the medical teams operating within its jurisdiction.The 10 staff of the Iwate Chapter were not sufficient to conduct the needs survey. On March 17, eight staff in two teams from the Headquarters joined to support the Iwate Chapter, of which one team conducted the survey on the need for relief goods and on the establishment of an operating base. The needs survey team traveled to six cities and towns including MIYAKO, YAMADA, OTSUCHI, KAMAISHI, OFUNATO and RIKUZEN-TAKATA over nine days and interviewed people in charge of relief supplies at the municipalities. Through these interviews, they identified what was most essential among the three relief goods that the JRCS stocks and other goods required by these people. As for relief goods, they obtained the needs information, which was informed to the Chapter and the Headquarters. As for other needs for goods, the Chapter contacted Iwate prefectural HDC. If the prefecture replied that it wanted to request the JRCS to supply the goods, the Chapter reported this to the Headquarters. After determining the supply, then the Headquarters contacted the local government. In YAMADA, RIKUZEN-TAKATA and MIYAKO, the support staff from the Headquarters were present when the relief goods arrived on site. While helping to unload the goods, the staff members were talking with people in the evacuation centers, and identified further needs, such as for partitions, water and underwear other than the immediate relief goods.

b. Procurement and deliveryBefore the disaster, the Iwate Chapter decided to store relief goods in several places in the prefecture in order to diversify the risk and accelerate the provision of supplies, and sited the warehouses for stocks in the coastal area, such as MIYAKO, KAMAISHI and OFUNATO, separate from the Chapter that was located in inland. Unfortunately, those stocks were washed away by the huge tsunami. At 0:00, March 13, the stock of blankets almost completely vanished except for those that had been scheduled to be distributed the next day. In addition, the electrically-driven shutters of warehouses did not operate due to the power outage immediately after the disaster, which also created an unanticipated situation in that it had to request the fire brigade to supply blankets on the day of the disaster.The delivery from the Chapter was conducted in a way that the transport operator (Akabou), the staff of RCBC [Distribution of sleeping sets within IWATE]

158


Figure 6-10　Trend in Relief Goods Distribution by the Iwate Chapter

　 Distribution destinations Blankets (pieces)

Emergency kits (kits)

Sleeping kits (sets)

Bath towels (pieces) Others Procurement resources

Mar. 12Morioka RCHP 70 　　　　 Fire academyKUJI 200 　　　　 Chapter stocks

14HANAMAKI 300 78 　　　　Iwate Prefectural HDC 　　　　 Water, CalorieMate Tokyo Chapter

18

IWAIZUMI 　 90 　　　 Relief centerOtsuchi High School 　 216 　　　 Chapter stocksOtsuchi Community Center 　 138 　　　 Emergency centerOtsuchi Laughter Hills 　 72 　　　　

19

Tanohata Village Office 　 150 　　　　SHIWA 　 42 　　　 Chapter stocksKAMAISHI 　 2,004 　　　 Tokyo ChapterMIYAKO 　 1,380 　　　 Headquarters (direct delivery)

20HANAMAKI 　　　　 Beach towels 　YAMADA 　　　　 Beach towels 　

22

YAMADA 　 930 　　　

Headquarters (direct delivery)

RIKUZEN-TAKATA 　 2,298 　　　NODA 　 162 　　　MIYAKO 　　 1,450 　　

23

Rikuzen-takata Kezoji 　　 300 　　Rikuzen-takata Marunaka warehouse 　　 100 　　Rikuzen-takata Chouenji 　　 125 　　Rikuzen-takata Hirota Elementary School 　　 525 　　Ofunato Takkon Elementary School 　 2,220 　　　

24

Ofunato Takkon Elementary School 　　 1,500 　　Otsuchi Sports Park 　　 1,000 　　Otsuchi evacuation center 　 1,140 　　　Yamada Town Office 　 492 　　　　

25

RIKUZEN-TAKATA 　　　　 Partitions

Headquarters (direct delivery)

OFUNATO 　　　　 PartitionsKAMAISHI 　　　　 PartitionsOTSUCHI 　　　　 PartitionsYAMADA 　　　　 PartitionsMIYAKO 　　　　 Partitions

28 MORIOKA 10 　　 10 　

Chapter stocks30ICHINOSEKI 10 　　 10 　HIRONO 43 17 　 70 　

Apr. 8 MORIOKA 10 　　 10 　12 Fudai Village Office 　 72 　　　

Headquarters (direct delivery)Fudai Elementary School 　 432 　　　

16

ESASHI, OSHU 20 6 　 10 　Chapter stocksMAESAWA, OSHU 30 12 　 30 　

ISAWA, OSHU 30 12 　 10 　HIRONO 30 　　　　　

20 Kamaisi Sea Plaza Yu 　　　　 Chinese rice porridge Yamagata Chapter (direct delivery)24 TONO 20 12 　　　　

May 17 TAKIZAWA 30 12 　 25 　Chapter stocks24 ICHINOSEKI 40 12 　 20 　

HANAMAKI 30 　　 20 　Total 873 11,999 5,000 215 　

Source: Prepared by the Iwate Chapter’s inventory

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(2) Activity status at the Miyagi Chaptera. Information collection and transmissionAs for the relief goods, the Miyagi Chapter transmitted the information to the Headquarters on the needs that had been identified through coordination with the prefectural HDC and the affected municipalities, and the Headquarters procured and arranged the delivery except to the extent that the Chapter managed to respond to.At midnight on March 11 when the Miyagi Chapter staff including the Headquarters support staff joined in the prefectural HDC, it had already prepared a list of needs for water, food, blankets and other supplies (hereafter referred as the “needs list”) as well as the number of evacuees by each city, town and village, but not covering all cities, towns and villages. As the local HDC was in turmoil, the Chapter had arranged to receive offers of possible goods and the amount made by providers rather than that the prefecture would request the related facilities to distribute them. The support staff who were gathering information made an offer of blankets to people in charge of the prefecture after reading the needs list. When they obtained the prefecture’s agreement, the staff informed the Headquarters and then it coordinated and arranged the delivery for distribution. In the early period this method was conducted smoothly, but over the following days, the growing number of offers to provide supplies from the GoJ and other organizations and the absence of the personnel in charge made it difficult to understand the updated descriptions of the needs list. Thus the information sent to the Headquarters decreased and the task ended on March 14. The Miyagi Chapter was distributed the greatest number of blankets among the three affected prefectures. This is largely because they started to gather the needs information the night of the disaster and started acting faster than other providers and the JRCS staff could conduct the procurement and coordination of the delivery by staying at the local HDC.

b. Procurement and deliveryIn response to requests, the Headquarters conducted procurement and coordination of the delivery of stocks from chapters around the country. Then the goods were directly delivered from the Headquarters and chapters to the evacuation centers and municipalities within MIYAGI. Approximately 88,000 blankets and approximately 16,000 emergency kits and 6,000 sleeping kits were distributed from March 12 to April 14.

Figure 6-11　Distribution of Relief Goods by the Miyagi Chapter (Chapter stocks) 　

Blankets (pieces)

Emergency kits (kits)

Sleeping kits (kits)

Within MIYAGI 6,502 386 　Miyagi government office 2,130 　　

Tohoku University Hospital/Tohoku Pharmaceutical University Hospital

500 　　

ISHINOMAKI 170 420 　SHIOGAMA 　 1,000 40KAKUDA 　 504 15KURIHARA 　　 19SENDAI 　　 30RIFU 　 20 　MINAMISANRIKU 　 588 　Discharge (Stock of JRCS Ishinomaki School of Nursing)

　 2,076 　

Total 9,302 4,994 104Source: Prepared according to the Miyagi Chapter’s withdrawal slip of relief goods

Furthermore, there were the goods that were distributed based on direct requests to the prefectural government office and other places to which many affected people rushed, as well as the Miyagi Chapter. In the Miyagi Chapter, approximately 9,000 blankets, approximately 5,000 emergency kits and approximately 100 sleeping kits were distributed by the end of May.Based on the agreement with the Trucking Association, the Miyagi government entrusted the transport operators belonging to the association with the delivery from the Chapter to the affected areas. Without access to a means of delivery in the initial stage of the response, the Chapter staff also delivered the goods themselves. The support of volunteers was part of this effort, however, they were also affected and it was difficult to contact them to request the initial activity.

[Delivering relief goods into the evacuation center in MINAMISANRIKU]

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arrived from neighboring cities, towns and villages, and at 18:00, the Chapter stuff left their Chapter to deliver them. From around 21:00 of the same day, request for blanket distribution arrived continuously received.

b. Procurement and deliveryOn March 12, the blankets were delivered from the Niigata Chapter (1,000 pieces) and the Headquarters (approximately 5,000 pieces). All the blankets from the Niigata Chapter were sent to TOMIOKA. The Fukushima Chapter had a limited number of blankets, only approximately 2,000 pieces, even with the addition of the stock at the Branches. Expecting that the disaster damage would be spread over a large area, distribution of blankets was conducted as arranged with the prefecture for fear of the shortage.

Figure 6-12　Trend in Relief Goods Distribution to the Miyagi Chapter (Coordinated by the Headquarters) Arrival date Distribution destinations Blankets

(pieces)Emergency kits (kits)

Sleeping kits (kits) Name of supplying Chapters, etc.

Mar. 11 Miyagi East Regional Promotion Office 700 　　 YAMANASHI

12

Miyagi Regional Promotion Office 13,450 　　 The HeadquartersShiroishi City Office 1,020 　　 SAITAMATomiya Town Office 1,470 　　 KANAGAWA, NIIGATANatori City Office, Iwanuma City Office 9,810 　　 MIE, SHIGA, KYOTO, OSAKA

13

Iwanuma City Office 2,400 　　 The HeadquartersIshinomaki RCHP 2,000 　　 The HeadquartersRifu Town Office 1,190 　　 SAITAMATomiya Town Office 980 　　 TOKYONatori City Office 9,090 　　 TOKYOTagajo City Office 3,000 　　 KANAGAWANatori City Office, Iwanuma City Office 4,690 　　 AICHI, HYOGO, NARA, WAKAYAMA

14

Iwanuma City Office, Watari Town Office 5,000 　　 CHIBAYamamoto Town Office, JGSDF Kasuminome Army Camp 4,500 　　 TOTTORI, OKAYAMA,

HIROSHIMA, YAMAGUCHIMatsushima Town Office, Kurihara City Office 4,000 　　 TOKUSHIMA, KAGAWA, EHIME, KOCHI

15Ishinomaki RCHP 3,000 　　 Tokyo Chapter

Kesennuma City Office 11,690 2,490 　 SHIGA, KYOTO, OSAKA, NARA, WAKAYAMA/Headquarters

16 Higashimatsushima City Office 3,680 　　 Purchased

17 Ishinomaki Sports Park 2,300 　　 DonationIshinomaki RCHP 　 2,100 　 The Headquarters

18 Ishinomaki Sports Park 1,500 　　 Purchased

19

Miyagi Prefectural HDC 2,000 　　 PurchasedNatori City Office 　 1,074 　 TOKYOTagajo City Office 　 966 　 TOKYOYamamoto Town Office 　 1,302 　 The Headquarters

22 Ishinomaki RCHP 380 　　 YAMAGATAOomagari Elementary School, HIGASHIMATSUSHIMA 370 　　 GUNMA

23 Kesennuma Gymnasium 　 2,700 　 HIROSHIMA, OKAYAMAIshinomai Sports Park 　　 2,000 Nagano Chapter

29 Minamisanriku Bayside Arena 　 2,040 　 HIROSHIMA, OKAYAMA, YAMAGUCHI30 Minamisanriku Bayside Arena 　 2,000 　 OSAKA

31 Watari Sato Memorial Gymnasium 　 2,004 1,400 TOTTORI, SHIMANE, TOKUSHIMA, EHIME, KAGAWA, KOCHI, OKAYAMA, HIROSHIMA, YAMAGUCHI

Total 88,220 16,676 3,400(Note) Excludes the distribution to the Miyagi ChapterSource: Prepared from the data of the General Affairs Department at the Headquarters

(3) Activity status at the Fukushima Chaptera. Information collection and transmissionImmediate after the disaster, information was gathered from the news on TV, etc., because there was no access to landline phones as well as difficulties of access to mobile phones for emergencies. Radio transmission was available, which allowed communication within the JRCS. Since the Miyagi Chapter of the 1st block representative chapter was unable to serve as the leader due to the damage from the disaster, Chapters in the 1st block had to operate independently.At 17:00 on March 11, the Fukushima Chapter staff were dispatched to the prefectural government office and started to gather information and then transmit the damage situation to the Chapter and the Headquarters. At 17:10 on March 11, the first request for blankets

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As for the blankets, the advance notice said that the donated goods were to be delivered to the prefectural government office. Thus, as the requests from cities, towns and villages were concentrated at the prefectural HDC, the prefecture and the JRCS were to take charge of part of the provision. In that context, the information on the needs and flow of goods in FUKUSHIMA was the closest to the basic flow that had been simulated in the Regional Disaster Prevention Plan.From March 11 to 14, up to 1,500 blankets were distributed to 18 cities, towns and villages in FUKUSHIMA. And the mattresses were also distributed from the stock at the Fukushima Chapter, although the number was limited.Preservation of extra JRCS blankets was required by the prefecture in order to set up the secondary evacuation centers. Owing to the reactor explosion at the Fukushima Daiichi Nuclear Power Plant, a secondary evacuation was implemented, using Ryokans (Japanese-style hotels), hotels and facilities outside the prefecture as secondary evacuation centers, so that the demand for blankets reached a limit. After the donated blankets arrived at the prefectural government on March 15, blanket provision by the JRCS was limited. The activities of relief supply distribution by the Fukushima Chapter

reached a peak from March 12 to 14 and approximately 80% of the blankets from the Fukushima Chapter were distributed in this period. Activities were still conducted at a low level after April, but the distribution of relief goods was almost completed by the end of March.The shipping from the Fukushima Chapter to cities, towns and villages was conducted through three means: delivery by transport operators belonging to the Trucking Association with whom the prefecture had concluded an agreement, delivery by the Chapter staff, and pickup by other parties including municipalities.

[A volunteer carrying blankets]

Figure 6-13　Trend in Relief Goods Distribution by the Fukushima Chapter

　Distribution Procurement


Blankets (pieces)

Mattresses (pieces) Other items Suppliers Blankets

(pieces)Other items

Mar. 11

Shinryou Branch 70 20 　 Niigata Chapter 1,000 　SHIRAKAWA 200 　　　　SUGAKAWA 350 40 　　　Fukushima prefectural HDC 1,500 　　　　

12

TOMIOKA 1,000 　　 Headquarters 4,816 　NAMIE 800 　　　　MINAMISOMA 1,000 　 Water, towels Costco Wholesale Japan, LTD* 　 WaterONO 150 　　　　　TAMURA 1,500 　　　　　NARAHA 700 　　　　　

14

NAKAJIMA 　 60 　　　　Motomiya High School 40 120 　　　　Ishikawa Town Office 400 　　　　　AZUMA (within FUKUSHIMA) 200 　　　　　Tamakawa Village Office 50 　　　　　Asakawa Town Office 100 　　　　　Furudono Town Office 20 　　　　　Hirata Village Office 30 　　　　　FUKUSHIMA 　 30 　　　　

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This center, which was a rented private warehouse, had 826 square meters of floor area with a storage capacity for a substantial amount of goods was located approximately five kilometers from the nearest highway interchange within a 10-minute drive.As a large amount of relief goods were sent to this center, the athletic club students (baseball and soccer clubs) of the high schools belonging to the junior Red Cross helped to load and unload them.Based on the needs survey by the liaison/coordination staff dispatched to the site from the Headquarters, Yamagata Chapter staff shipped the stored goods to the evacuation centers, temporary housing, meeting places and other sites in the affected areas of IWATE, MIYAGI and FUKUSHIMA. The relief goods had been delivered until April of 2012 to 128 places in total, including 33 places in IWATE, 46 places in MIYAGI, 20 places in FUKUSHIMA and 29 evacuation centers set up in YAMAGATA.The number of relief goods from the Yamagata Chapter to various places reached 26,840 blankets, 41,790 bottles of drinking water, and 198,212 meals, even primary ones.

Figure 6-14　Delivery Status of Relief Goods　　　　　 from Yamagata Chapter　　

Delivery places Blankets Drinking wate FoodIWATE 33 places 12,308 pieces 11,088 bottles 34,200 mealsMIYAGI 46 places 7,270 pieces 26,010 bottles 159,920 mealsFUKUSHIMA 20 places 4,117 pieces 4,692 bottles 4,092 mealsYAMAGATA 29 places 3,145 pieces

Total 128 places 26,840 pieces 41,790 bottles 198,212 mealsSource: Prepared from the data of the Yamagata Chapter

(4) Activity status at the Yamagata ChapterThe Yamagata Chapter, which is adjacent to the disaster areas, played an important role as a hub for relief goods support.From March 13, two days after the disaster, the Yamagata Chapter started to transport food and drinking water to the Miyagi Chapter, Miyagi RCBC and Ishinomaki RCHP, which had a shortage of food due to the cutting off of lifelines. In addition, it transported packed meals for staff that were rushed to MIYAGI from across the nation, as well as a total of 833 meals for the staff of the local HDC and RCBC.Furthermore, a relief supply delivery center was established in Yamagata as a hub warehouse from March 30, 2011, to the end of March, 2012. This was intended for the storage of relief supplies from abroad, entrusted by GoJ, and then shipped to the three disaster areas in response to requests from the Headquarters.

[The relief supply delivery center (YAMAGATA)]

　Distribution Procurement


Blankets (pieces)

Mattresses (pieces) Other items Suppliers Blankets

(pieces)Other items

15 　　　 Kumamoto Chapter 1,300 　　　　 Fukuoka Chapter 2,300 　

16 Medical Schools, Chapters, etc. 　　 Water Miyazaki Chapter 1,460 　19 Azuma Gymnasium 　 The Headquarters 6,000 　20 DATE 230 　　　

22 Aizu Center 300 　 Masks 　　Azuma Gymnasium 　　 Disposable diapers International Rotary* 　 Disposable diapers

24 　　 SAGA* 　 Masks　　 Rotary* 　 Cup noodles

25 KORIYAMA/TAMURA/IWAKI 　　 Masks System TALKS Inc.* 　 Dosimeters26 SOMA 220 　 Masks 　　　30 SOMA, SHINCHI 　　 Masks 　　　

Subtotal 　 8,860 270 　　 16,876 　Total 　 10,155 975 　　 16,876 　

　　　　(Note) *Represents donors. The total includes delivery with an uncertain delivery date.　　　　Source: Prepared according to the Fukushima Chapter diary

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(5) Activity status at the Osaka ChapterThe Osaka Chapter had improved its disaster relief warehouse in Takatsuki RCHP, aiming at strengthening the disaster relief structure in March 2010.On March 13, 2011, two days after the disaster, the disaster relief warehouse in Takatsuki RCHP was requested by the HDC at the Headquarters to be a collection base for relief goods from the 4th block, and to conduct carry-in and carry-out of supplies with the support of Red Cross disaster-response volunteers.8,690 blankets, 2,490 emergency kits and 750 sleeping kits were sent to the affected areas from the disaster relief warehouse in Takatsuki RCHP.

3. Other support status(1) Priority supply of gasoline from JX Nippon

Oil and Energy CorporationImmediately after the disaster, the disaster areas faced a severe gasoline shortage, which posed an obstacle to relief activities carried out by the JRCS. Thus, the JRCS asked JX Nippon Oil and Energy to accommodate the JRCS with a gasoline supply through Mr. Fumiaki Watari, a member of Board of Governors the JRCS and Adviser of JX Holdings, Inc. This enabled the JRCS to receive refueling services preferentially at gas stations (Ishinomaki Akebono SS) in ISHINOMAKI from March 18.

(2) Securing the means of transportation for the disaster areas by Sakura Kotsu

In its efforts to support Ishinomaki RCHP, the shutdown of the Tohoku Shinkansen line immediately after the disaster had created a challenge for the JRCS to secure the means of transportation for support

staff. Thus, through the Fukushima Chapter, the JRCS requested Mr. Akira Kozakura, a Board of Governors of the JRCS and the Chief Executive Officer (CEO) of Sakura Kotsu, Co., to arrange buses to secure a means of transportation between the Headquarters and the affected areas. From March 30, 2011, the bus service started between the Headquarters and Ishinomaki RCHP to dispatch the staff (mainly medical staff) to provide support for the hospital. In addition, the JRCS asked Sakura Kotsu to run volunteer bus trips to remove debris and rubble within MIYAGI. A total of 27 bus trips were offered for the dispatch of staff and volunteers, which provided smooth transportation to Ishinomaki RCHP and the affected areas in MIYAGI.

(3) Donation of medical equipment, etc.Mainly hospitals in the affected areas accepted donations of medical equipment and for purchasing equipment related to medical operations from various companies through the Headquarters. These are listed in Figure 6-15.

4. Status of support from overseas(1) Background to receiving relief goods

support from overseasThere were numerous offers from Red Cross and Red Crescent Societies worldwide to support the affected people in GEJET. Since it would take a lot of time for shipping to Japan and could not fit to the needs in affected area, the JRCS had to decline the receipt of relief supplies from abroad in principle. On the other hand, more than 60 countries and international organizations offered to provide relief goods to GoJ immediately after the disaster. In consideration of the standards, packing units, transport period to Japan and the like, the Ministry of Foreign Affairs of Japan (MOFA) selected items to meet the needs, and approached these governments for support with four relief items; blankets, mattresses, bottled mineral water and plastic containers.In March 15, the Humanitarian Assistance and Emergency Relief Division, International Cooperation Bureau of MOFA approached the JRCS regarding the acceptance of these relief supplies. At the same time, MOFA referred to fire stations, Self Defense Force (SDF) and police stations and others regarding their needs, besides the JRCS. It later asked non-governmental organizations (NGOs) in the country about the acceptance of relief supplies.

[Red Cross disaster prevention volunteers sorting out the relief goods]

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49,000 blankets were received from India, Canada, Thailand and the Ukraine. The United Nations World Food Programme (WFP) Japan Relations Office was in charge of conducting domestic customs procedures and shipping to the designated areas and the JRCS was in charge of the unloading and distribution in the affected areas.The Tochigi Chapter rented an adjacent gymnasium and received 10,000 relief blankets from Thailand for the evacuees from FUKUSHIMA on March 19.Although the shipment of 10,000 blankets for the Iwate Chapter, 21,000 for the Miyagi Chapter and 10,000 for the Fukushima Chapter were initially arranged, this was suddenly canceled in response to a notice that blankets were no longer required since the needs of the affected areas were met as of March 19. Therefore, the destination of 5,000 blankets, part

(2) Acceptance of blanketsa. Action in acute phaseAs of March 15, the Headquarters received requests for 65,000 blankets (55,000 in MIYAGI and 10,000 in FUKUSHIMA) from the HDCs in the affected prefectures. In addition, through the Chapters it obtained the information on the requirement for 50,000 blankets in IWATE and 20,000-30,000 blankets in order to wrap the bodies of deceased victims in MIYAGI. Thus, it replied to the MOFA that it would accept blankets from GoJ to dispatch to the affected areas.As a storage area for the goods, MOFA secured a 330 square-meter warehouse with a capacity of 100 tons from the JICA (Japan International Cooperation Agency). The first cargo of the arranged blankets arrived at 8:00, March 16, and finally approximately

Figure 6-15　List of Donations of Medical Equipment, etc.

Donors Description AmountEquivalent or amount of the donation (yen)

Deployment locations Notes

Mochida Siemens Medical Systems Co.

Ultrasonic diagnostic equipment 5 units 6,500,000 Ishinomaki RCHP

Goods donations

Shimadzu Corporation

X-ray systems for mobile clinics 10 sets 183,200,000

Sendai RCHPIshinomaki RCHPAkita RCHPHachinohe RCHPMorioka RCHPFukushima RCHP

Nihon Kohden Corporation

Tents, outside heaters for tents 1 set 7,085,000 Ishinomaki RCHP

Toshiba Medical Systems Corporation

Ultrasonic diagnostic equipment 10 sets 32,000,000

Sendai RCHPIshinomaki RCHPHachinohe RCHPMorioka RCHPFukushima RCHP

Canon Inc. Movable X-ray equipment 5 sets 60,000,000

Ishinomaki RCHPIwate Medical Association Takata Clinic

Goods donationsLeasing

Hachinohe RCHPGoods donationsMorioka RCHP

Akita RCHPThe Rotary Club of Tokyo Setagaya South Japan

Purchase of high-standard ambulances 1 unit 10,000,000 Ishinomaki RCHP

Money donationsSawai Pharmaceutical Co.

Destruction restoration work for buildings, etc., purchase of medical equipment

50,000,000 Sendai RCHP

Renewal of air conditioning and the purchase of medical equipment

25,000,000 Morioka RCHP

Rescue vehicles, medical equipment and equipment maintenance

25,000,000 Fukushima RCHP

Source: Prepared from the data of the Organizational Development Department at the Headquarters

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(3) Other supportChinese companies announced that they would provide a concrete pumping vehicle to be used as an aerial platform vehicle in order to respond to the Fukushima Daiichi Nuclear Power Plant Accident. In response to the announcement by the Tokyo Electric Power Company (TEPCO) that they would accept this offer, the vehicle was delivered from the Red Cross Society of China to the JRCS through the Red Cross route. This vehicle was presented to TEPCO on March 23, 2011, and used on site. The relief goods from overseas are listed as follows.

Figure 6-16　List of Relief Goods from Overseas

Items Supporting countries Amount

Blankets

India 21,238 pieces

Canada 5,460 pieces

Thailand 19,900 pieces

Ukraine 2,000 pieces

Vehicle to respond to the nuclear accident (concrete pumping vehicle)

Red Cross Society of China 1 unit

Medical rubber gloves China 3,250,000 pairs

Temporary toilets China 60 units

Happo porridge China NGO 77,568 cans

T-shirts Philippine Red Cross 5,000 pieces

Tea (tea bags) Bangladesh Red Crescent Society 600 kg

(Note) Blankets, Medical rubber gloves and Temporary toilets were provided through MOFA.

of the shipment of blankets that was supposed to be destined for the Iwate Chapter, was changed to the Yamagata Chapter for the affected people who had to be evacuated from FUKUSHIMA and these arrived on March 21.Whereas the blanket supply was concentrated on the prefectural HDCs in the affected areas from municipalities or private companies around the country, the need for these rapidly came to an end.

b. Distribution of blankets in the recovery periodThe JRCS sought other needs for 28,598 relief blankets from overseas that had not been delivered to the affected people, and after gaining agreement through discussions with MOFA decided to use the blankets for disaster relief activities in Japan without limiting their use for recovery support in the affected areas or GEJET.It referred the blanket needs to IWATE, MIYAGI, FUKUSHIMA and SDF, etc. as stock for the recovery period or in preparation for a possible disaster in the future, but no facilities receive the blankets.The re f o r e , t h e GEJET Recove ry P rog ram Headquarters and the three affected Chapter staff conducted door-to-door checks to ask residents whether they needed blankets while showing a sample blanket in the three prefectures of IWATE, MIYAGI and FUKUSHIMA. Many residents needed them, and 13,892 blankets were distributed from September 2011 to February 24, 2012. As for the distribution to the residents, the finely tuned responses were appreciated by them, such as checking individual intentions and delivering directly.The blankets that remained were stocked at the branches, etc., in preparation for a possible disaster in the future by repacking them individually for easy management.

[Blankets being delivered to the Tochigi Chapter]

Red Cross Volunteer Activities

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Red Cross disaster-response volunteers (DRV) register themselves with the chapters of the Japanese Red Cross Society (JRCS) in accordance with the Regional Disaster-Prevention Plans and the JRCS Disaster-Prevention Operation Plans, and if a disaster occurs, they engage themselves in activities such as first aid for victims as well as recovery through coordination by the JRCS. If a disaster occurs, DRV centers are also established in the affected areas and at the chapters of the JRCS, and act as bases to gather information on and assess the needs of the victims, ensure information-sharing between Headquarter for Disaster Control (HDC) and Red Cross DRV, coordinate activities among the volunteers, including Red Cross Volunteer Corps, and take other necessary measures. However, the volunteer centers could not be set up in the coastal areas hit by the disaster because of the devastating impact inflicted in these areas, a situation that also made it difficult to carry out the activities of the centers of the chapters in the three affected prefectures (IWATE, MIYAGI, and FUKUSHIMA).For this reason, the JRCS established a volunteer center at the Headquarters for the first time in its history and provided support such as coordination to dispatch volunteers registered with its chapters nationwide to the volunteer centers of the chapters in the three affected prefectures.All practical operations related to the establishment and operation of the volunteer center at the Headquarters were undertaken by personnel such as Red Cross volunteer leaders registered with chapters, and the JRCS Headquarters personnel were engaged in activities such as coordination with the receiving chapters and the provision of logistic support so that these volunteers could effectively carry out their job.

1. Activities of the DRV center at the Headquarters

(1) Establishment and operation of the DRV center at the Headquarters

a. Starting up the DRV center at the HeadquartersImmediately after the disaster occurred, chapters of the JRCS in the three affected prefectures were

unable to promptly establish a DRV center due to the immense amount of damage caused by the disaster. Therefore, HDC at the Headquarters staff who belong to volunteer section which coordinate volunteers considered supporting the three affected prefectures on a block-by-block basis, that is assigned 2nd Block to take responsibility for IWATE, 3rd Block for MIYAGI, and 4th Block for FUKUSHIMA, and sounded out the chapters on the possibility of helping set up a volunteer centers in the affected prefectures by dispatching Red Cross volunteer leaders and other personnel from each of these blocks. But this plan could not be implemented mainly because, in addition to the fact that there was no such precedent, the chapters in these blocks did not assume that they would have to send their Red Cross volunteers to other prefectures and were concerned about ensuring their safety in the affected areas as they did not know what the situation was immediately after the occurrence of the disaster.The next step taken was to establish a volunteer center at the Headquarters, and this center considered helping set up a volunteer center in each of the three affected prefectures. This plan was approved at a meeting at the Headquarters on March 14. At that time, since only MIYAGI needed support, the volunteer center at the Headquarters was organized on March 15 under the leadership of DRV leaders from chapters in Greater Tokyo area for the main purpose of helping to operate a volunteer center in MIYAGI.The major duties of the center were to:

The priority tasks expected for the immediate future were to:

Chapter 7　Red Cross Volunteer Activities

・ Provide support for the operations of the Headquarters ・ Support the operations of medical teams in the

affected areas・ Perform duties as Red Cross DRV at the volunteer

centers of the chapters in the three affected prefectures

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operation. Member volunteers took responsibility for various kinds of coordination under the leadership of its head, who supervised them. Duties such as decisions on policies and other principles of action as well as notifications to Chapters were performed by the personnel of the Volunteer Team. The Head of the Center was responsible for coordination with JRCS personnel and other members for liaison with affected areas and coordination and communication related to various kinds of dispatch.

DRVs. At first, the Center provided support mainly to Miyagi Chapter and built a support system for Iwate while assessing the local situation. But with respect to Fukushima, it was difficult to do so partly because of the effects of the nuclear accident.In addit ion , based on the information that a communications environment was not available in the affected areas, the Center prepared PCs and mobile

On March 16, the Headquarters issued a document to the chapters to:

b. Organizational structure of the DRV Center at the Headquarters

The Red Cross DRV Center at the Headquarters was organized so that Red Cross DRV leaders and district leaders from nationwide played a central role in its

c. Cooperation among Red Cross DRVsThe contact addresses and phone numbers for Red Cross DRVs registered with Chapters were unknown, but the Volunteer Center established means of communications by gathering information mainly through the list of participants in DRV leader training, which was resumed in FY2010, mailing lists, and networks of personal connections among Red Cross

［DRV Center set up at the Headquarters］

Figure 7-1 Organization of the Headquarters DRV Center for the Great East Japan Earthquake and Tsunami (GEJET)

Operations Team (Volunteer Team)Head of the Volunteer TeamMembers

Headquarters DRV Center

Center head

General Affairs

● Liaison and coordination with the Headquarters Volunteer Team

● Response to inquiries from the general public

● Management of vehicles and equipment

● Organization of expense statements from DRVs who returned and handing over duties to the Headquarters’ Volunteer Team

● Taking out insurance policies for DRVs dispatched (including the reception of insurance benefits) and handing over duties to the Headquar-ters’ Volunteer Team

Communications

● Sending volunteer rotation lists to the Headquarters’ Volunteer Team, Chapters in the affected areas, and local volunteer centers daily

● Receiving and putting together journals of local volunteer centers and identifying local needs via email

● Gathering information on local traffic conditions

● Updating the website of the Headquarters’ Volunteer Center (local information, recruitment of new volunteers, rotation lists, and the posting of information on points to note)

Training

● Registration of DRVs● Pre-dispatch orientation

for DRVs to be dispatched● Reception of reports and

expense statements from DRVs who returned

● Meetings to hear the reports of DRVs who returned and confirmation of whether they were mentally and physically sound

Dispatch of DRVs

● Processing requests made by Chapters for dispatch and their registration with PC

● Confirmation of whether volunteers could be received by local volunteer centers as requested by the Chapters

● Preparation of dispatch rotation lists

● Creation of notices to Chapters of decisions on dispatch

・ Announce the establishment of the DRV center at the Headquarters

・ Preliminary request the dispatch of DRV to the volunteer center at the Headquarters and in the affected areas

・ Choose Red Cross DRV leaders and district’s ones and dispatch them to the volunteer center of the chapter in MIYAGI through the HDC at the Headquarters and the chapters

・ Define the duties of the volunteers・ Organize the rotation of personnel at the volunteer

center at the headquarters

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Center considered expanding the scale of shuttle bus services to transport Red Cross DRVs (such as Red Cross volunteers) other than Red Cross DRV leaders. These shuttle buses started to be operated in the name of “recovery support buses” on April 7, and their operation ended on May 7 as the Shinkansen and other public means of transport returned to normal.

e. Method of recruiting Red Cross DRVsThe Headquarters requested all Chapters to collect Red Cross DRVs wishing to work for TOHOKU from among their registered ones, and each chapter replied to the DRV Center at the Headquarters by facsimile. Based on these replies, the DRV Center at the Headquarters confirmed with the applicants and dispatched them while coordinating with the volunteer centers of the Iwate and Miyagi Chapters.Bu t s i n ce t he approva l p rocedure s a t t he Headquarters and Chapters required some time, it actually took time before relevant information reached Red Cross DRVs. In addition, due to changes in the method of recruitment and the extension of deadlines for the acceptance of applications, several notifications were simultaneously issued, giving rise to some confusion among applicants. Therefore, the Center communicated the latest information as much as possible by posting it at the dedicated website.

terminals dedicated to Chapter DRV centers in the three affected prefectures and delivered them there using shuttle bus services, thus maintaining lines of communication.Furthermore, in order to provide information on matters such as the recruitment of volunteers, some DRV leaders launched a website dedicated to the Center. JRCS’s ordinary reporting line requires going through Chapters and the Headquarters, but the dedicated website enabled volunteers to respond swiftly to the situation, which was changing every moment, by interacting directly with each other through the website. On March 21, the dedicated website started operation after consultations with the Headquarters.

d. Operation of shuttle bus servicesIn terms of access to the affected areas, there was no hope of railways such as Shinkansen and air services returning to normal, and the only way to send personnel and goods to those areas was to enable JRCS vehicles to pass through expressways as persons engaged in disaster dispatch, etc. Therefore, the Volunteer Center started to operate shuttle buses. It rented a minivan for eight passengers, secured a driver from among Red Cross DRVs, and dispatched the first shuttle bus on March 18.Since the affected areas lacked gasoline supplies, the shuttle bus took with them gasoline in portable cans in addition to food and other supplies. Later, until the lack of gasoline in the affected areas settled down, the HDC at the Headquarters instructed not only shuttle buses, but also all other vehicles leaving the Headquarters for the affected areas to carry gasoline in portable cans.Shuttle buses were scheduled to make a round-trip in two days, spending the first day heading for TOHOKU and the second returning from there, and various clever ideas were used to make the scheduling of the dispatch of Red Cross DRVs easy. In addition to Red Cross DRVs, shuttle buses carried personnel and goods if there were empty seats. At first, the Volunteer Center considered extending the shuttle bus services to IWATE, but except for some departures, shuttle buses did not go as far as IWATE because a trip to IWATE placed a heavy burden on the driver in terms of distance and time and because other routes such as air transport became available.Furthermore, as time passed, there were growing activity needs not only among Red Cross DRV leaders, but also at the disaster volunteer centers established by Social Welfare Councils. For this reason, the Volunteer

［Recovery support bus schedule］

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for survivors, the Headquarters dispatched Red Cross DRV leaders in the hope that they would be coordinators to support for the Chapter DRV center as the same as it was expected in the beginning , but the dispatch gave rise to confusion as the part of the Red Cross DRVs who were believed to give services directly in affected areas. Since the areas hit by the earthquake were far away from TOKYO, and public means of transport were disrupted, it was extremely difficult to reach the affected areas. Therefore, the Volunteer Center provided shuttle services by minivan and a large bus between the Headquarters and the affected areas, maintaining a means of transport for Red Cross DRVs from the Headquarters and the Chapters. This idea was proposed by the Head of the DRV Center at the Headquarters, and all arrangements, including the procurement of vehicles and drivers, were made by volunteers with briefings for Red Cross DRVs to be sent by shuttle bus given by the volunteers.

This shuttle service represented the first “recovery support volunteers” dispatched by the JRCS to the affected areas. On April 4, the Headquarters requested section managers responsible for Red Cross volunteers at 2nd Block chapters (Tochigi, Saitama, Chiba, Tokyo, and Kanagawa) to recruit and dispatch recovery support volunteers as below.

f. Operation of the DRV Center at the Headquarters and the rotation of volunteers

The DRV Center at the Headquarters was operated mainly by Red Cross DRV leaders from chapters throughout nationwide, and these leaders took turns to serve as the Head of the Center, which coordinated all volunteer operations and performed duties such as entering data in various PCs and answering telephone calls and facsimile messages.At first, many volunteer leaders gathered from across the country, but mainly because replacing the head of the Center with a new one once every five to six days caused problems with the operation of the Center, a volunteer leader from Tokyo, Saitama, Chiba, or Kanagawa Chapters was in principle appointed as head of the Center and replaced by a new one once every seven days. In addition, since it was difficult to secure volunteers for the operation of the Center outside the Japanese long holiday season (April 29 to May 5), the Chapters of these four prefectures continued to supply volunteers by rotation while figuring out how to secure a minimum number of volunteers.Volunteer activities included the collection of data on volunteer needs to identify them and coordination with the HDC of the three affected prefectures and the HDC at the Headquarters concerning volunteer activities. Moreover, another major requirement for activities was the ability to use a PC such as coordinating, confirming, and communicating with volunteers dispatched, as well as creating documents and keeping records using a PC.

g. Evaluation of the DRV Center at the HeadquartersTwo meetings, one in November 2011 and the other in March 2012, were held for Red Cross DRV leaders and staff of the Headquarters, both of whom were engaged in the Center’s activities, to evaluate the DRV Center at the Headquarters.

(2) Dispatching Volunteers to the affected areasThe first step for dispatching volunteers to the affected areas was to collect Red Cross DRVs leaders who served as coordinators to support the Chapter DRV center in the three affected prefectures. Meanwhile, as time went by, Red Cross DRVs were also needed in the direct services to the affected people. Partly because there were times when it failed to make appropriate decisions on, or did not have sufficient information on, the needs had been changing

1. Operation of shuttle services by minivan (March 18 to May 7)

　There were a total of 25 departures with a minivan leaving once every two days.

　The total number of users was 224 (including drivers).2. Operation of shuttle services by bus (April 7 to June 26)　There were a total of 11 departures with a large bus

leaving every Thursday and returning on Sunday.　The total number of users was 419.

〔Purpose〕Three weeks have passed since the occurrence of the disaster, but the areas hit by the tsunami need the help of many volunteers. Therefore, we want to recruit “recovery support volunteers” from among Red Cross volunteers and so forth. They will work only during the weekend.

〔Details of activities〕(1)Removal of mud from houses and stores in areas hit 　by the tsunami(2)Removal of debris, etc.

〔Activity area〕MIYAGI’s TAGAJO, HIGASHIMATSUSHIMA, IWANUMA and WATARI

〔Means of transport〕A chartered bus will be used for both ways.

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to the Miyagi Chapter and KESENNUMA because the Volunteer Center’s policy was to send them mainly to MIYAGI, but that the dispatch of volunteers to MIYAGI stopped at the end of June with the destination of dispatch shifting to TONO, IWATE after July.As of August 31, the total number of volunteers who, at the Headquarters’ request, gathered from various chapters to support victims was 3,636, including the chapters’ DRVs; “recovery support volunteers,” the first to be dispatched to the affected areas; personnel of the Headquarters; and shuttle bus drivers.

2. Activities of volunteers in the affected areas

(1) IWATEMORIOKA, where the Iwate Chapter is located, suffered only relatively little damage. Around 5:00 p.m. on March 11, Red Cross DRV leaders gathered and established a DRV center at the Chapter. Eight Red Cross DRV leaders had been registered with the Chapter, but only two of them could actually work as such because the other six were aged or victims of the earthquake. Nearly 80% of First Aid Volunteers Corps consisted of nurses, police officers, fire fighters, nursing care givers, etc., and could not join Red Cross DRVs in their activities because they were busy with their own duties.Meanwhile, in the four coastal areas of RIKUZEN-TAKATA, OFUNATO, KAMAISHI, and OTSUCHI, which had been struck a disastrous blow, Red Cross DRV leaders could not establish a DRV center, nor could they assess the situation there and identify the needs of the victims.After a DRV center was set up in TONO, located almost halfway between MORIOKA and the coastal areas, on April 8 it became possible to provide support effectively using the center as a relay point.On March 28, about two weeks after the earthquake, the Tono Magokoro Network was organized under the leadership of the Social Welfare Council of TONO in accordance with the city’s disaster-prevention plan. The Tono Magokoro Network cooperated with many volunteers and organizations such as NPOs, NGOs, Nippon Foundation, the JRCS Headquarters, the JRCS Iwate Chapter, and JICA to provide support to RIKUZEN-TAKATA, OFUNATO, KAMAISHI, and OTSUCHI. Immediately after the network was formed, Red Cross DRVs hardly participated in the organization except for some of the local Red Cross Community Volunteer Corps who provided hot meals

The figure below indicates the number of Red Cross DRVs sent by chapters at the Headquarters’ request. In Figure 7-2, the “Headquarters” show the number of Red Cross DRVs who joined the DRV Center at the Headquarters, where they coordinated and supported the dispatch of Red Cross DRVs. “Miyagi” shows that of Red Cross DRVs who were sent to the DRV center established at the Miyagi Chapter, “KESENNUMA” that of Red Cross DRVs who were sent to the DRV center established in KESENNUMA, and “TONO” that of Red Cross DRVs who were sent to the DRVs center that worked with the Tono Magokoro Network. “Drivers” refers to the number of volunteer drivers for shuttle services between the Headquarters and the three areas mentioned above.A look at the number of volunteers by month shows that from March to June, many volunteers were sent

Figure 7-2　Trends in the Total Number of DRVs, etc., 　 Dispatched at the Request of the

　　　　　Headquarters (March to August 2011)

14

67

26

338

122

126

231

114

42

76

407

249

8

202

446

468

184

56

98

222

140

0 100 200 300 400 500

Headquarters

Miyagi Chapter

KESENNUMA

TONO

Drivers

March

April

May

June

July

August

［Shuttle bus heading for the affected areas with volunteers on board］

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a. RIKUZEN-TAKATAThe contact address for JRCS in RIKUZEN-TAKATA was the city government office, but the government office did not work because its building had been washed away. The building of RIKUZEN-TAKATA’s Social Welfare Council had also been washed away with six of its 15 personnel, including the chairman, missing, but on March 15, four days later, the Council built a temporary office at the Rikuzen-takata Driving School, where a DRV center was set up on March 17. In late April, two Red Cross DRVs, one from the Kanagawa Chapter and the other from the Chiba Chapter, joined the volunteer center in its activities. The Red Cross DRVs that had joined the Tono Magokoro Network moved to urge other Red

to the victims. The Network soon faced difficulties in coordinating volunteers by matching their abilities with local needs. On April 7, a DRV leader from the Kanagawa Chapter who visited TONO learned about the difficult situation that the Network was faced with and requested Headquarters to dispatch DRV leaders skilled in coordinating volunteers.On April 8, Red Cross DRV leaders sent by the Headquarters took leadership in establishing a Tono DRV center, which served as a subordinate center to support the coastal areas. A succession of Red Cross DRV leaders entered TONO and matched the abilities of the volunteers with local needs, thus gradually building a system that fully worked only if DRVs were dispatched rather than their leaders. The Tono Magokoro Network served as a rear base for volunteers in the four coastal areas, and the dispatch of volunteer leaders through the Headquarters continued until the end of August. In summer, during which the dispatch of volunteer leaders was concentrated, they joined satellite bases (local activity centers) as their operations staff members, engaging in support activities such as reminding victims that they should be careful not to develop heatstroke, get hurt, or step on nails.

［Establishment of a volunteer center on the day of the earthquake］

Figure 7-3 Organizational Chart for the JRCS Iwate Chapter DRV Center (Shared by the Tono Social Welfare Council)

・・・・・・

Tono Magokoro Network

Representative and deputy representative

Secretary-general JRCS Iwate Chapter

Head of the DRV center(DRV leader)

Volunteer coordinators(DRV leaders sent by the Headquarters)

Affected areas

RIKUZEN-TAKATA OFUNATO KAMAISHI OTSUCHI

[Division of roles]

lodging Relief supplies (procurement, management, and delivery)Vehicle team (transfer (bus) and transport)Work team (cleaning up and materials and equipment)Care team (dipping legs in hot water, giving a bath, and the distribution of food)Information team (identification of needs and public relations)

Deputy head of the CenterOne official from the Tono city government

Deputy head of the Center(In charge of supporting the Chapter and medical teams)Two officials from the Morioka city government, One official from the Oshu city government

Assistance in the operation

Assistance in the operations

Tono Red Cross Volunteer CorpsHanamaki Red Cross Volunteer CorpsFormer firefighters Ordinary volunteers

First Aid Red Cross Volunteer CorpsMorioka Red Cross Volunteer CorpsFormer firefighters Ordinary volunteers

Volunteers from municipalities in the prefectureVolunteers from locations nationwide

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and the Red Cross DRV leaders jointly operated the volunteer center. This caused confusion for some time, but on March 26, with the establishment of the Otsuchi DRV center, the Red Cross DRV center was closed, and all Red Cross volunteers withdrew from the town.

(2) MIYAGIThe Miyagi Chapter established a DRV center on March 14, three days after the occurrence of the earthquake. Immediately after the earthquake occurred, Red Cross DRV leaders in the prefecture gathered at the Chapter, but had difficulties in setting up a DRV center because it was their first time to do so when a large disaster occurred. Therefore, experienced Red Cross DRV leaders from other prefectures rushed to the Chapter via the Headquarters for support and undertook almost everything needed to set up such a center. Several days later, they handed the volunteer center over to the Miyagi Chapter without problems. These leaders from outside assisted in setting up a volunteer center in various parts of the prefecture while supporting the Chapter’s volunteer center.Immediately after the disaster, the needs of affected areas were unknown because the communications environment broke down, causing great confusion. The Chapter sent Red Cross DRV leaders from MIYAGI and those from other prefectures, who had been dispatched via the Headquarters, to affected areas to identify their needs and reflect the identified needs in the activities of its volunteers.Soon many Red Cross DRVs sent by shuttle minivan and bus joined the Chapter’s volunteer center, and volunteer activities unfolded without major confusion as their abilities were matched with the needs of victims.

Cross DRVs to come to RIKUZEN-TAKATA. Red Cross DRV leaders performed duties such as making the need to gargle and wash their hands known to the evacuees. Those stationed permanently at the Tono volunteer sub-center often visited RIKUZEN-TAKATA to perform duties such as reminding ordinary volunteers that they should be careful not to get hurt.After a while, at places other than the DRV center as well, Red Cross DRVs individually started their activities.In some areas of the city, the process of setting up a base, receiving volunteers, conducting needs surveys, and dispatching volunteers based on the identified needs was being established.

b. OTSUCHIThe building of the Otsuchi Social Welfare Council had been washed away, leaving several of its personnel missing. The Otsuchi town government set up the HDC at the central community center, which had escaped damage, and the town’s administrative functions such as the temporary Headquarters of the Social Welfare Council were gathered at the community center, which also served as an evacuation center. At first, only one person was responsible for the town’s DRV center, but later, around ten officials sent by the governments of Nagoya City as well as MIE, GIFU and other prefectures at the Japan Council of Social Welfare’s request joined the center, and on March 20, they started preparations to set up a volunteer center. On March 26, the center began to receive volunteers, and around 20 volunteers worked in the town each day.Two Red Cross DRVs entered OTSUCHI when the contact address for the Social Welfare Council still remained at the central community center. The Otsuchi town government had decided since early on that a volunteer center should be established solely by the Social Welfare Council when a disaster occurred, but Red Cross DRV leaders set up a Red Cross DRV center earlier than the Council, giving rise to confusion for some time. They put up a tent in front of the community center, and using it as their center, they started to receive and dispatch volunteers around the clock. Members of TONO’s civic groups, school teachers, and officials from municipalities, all of who had assembled to work as volunteers as soon as possible, gathered at this center, began to work as its operation staff members such as coordinators and liaison personnel, and received similar organizations that came later. Thus these people

［A scene from the meeting at the DRV center］

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aid and reminding victims that they should be careful not to develop heatstroke. In ISHINOMAKI, a major base specializing in medical relief was being built under the leadership of the Ishinomaki Red Cross Hospital (RCHP). A DRV leader went to the aera as thinking about the possibility of supporting it, but a considerable number of NPOs nationwide had dispatched their members to ISHINOMAKI by the thousands. Therefore, Red Cross DRVs worked at both the hospital and the Social Welfare Council’s DRV center.Meanwhile, Red Cross Community Volunteers Corps organized locally in each municipality effectively used the training and experience they had received and gained on a daily basis to carry out relief activities independently in their respective communities in a way that met the needs of the communities.

At first, however, the Headquarters could not identify the needs of the DRV center of the local Social Welfare Council in detail and dispatched many Red Cross DRV leaders to the volunteer center to assist its operations. But most of the work actually needed was to clean up houses hit and damaged by the tsunami and remove mud from them, and such a gap bewildered some of the DRV dispatched from the Headquarters. Among the municipalities of MIYAGI, only KESENNUMA established a Red Cross DRV center at the local level.In KESENNUMA, there were also first-aid stations set up by the city government, and nurses and other personnel treated injured people. Red Cross DRVs also provided support making effective use of the training and experience they had previously received and acquired. Red Cross DRV leaders qualified as first aid instructors performed duties such as administering first

Figure 7-4 Activities of Red Cross Volunteer Corps under the Miyagi Chapter (as of the End of March 2012)Total number of

CorpsNumber of Corps that

actually workedNumber of volunteers who actually worked Major activities

Community Volunteer Corps 134 78 8,723

Distribution of cooked rice and food and support for such distribution, the distribution of relief supplies, visits to evacuation centers for inspection, water supply, the provision of shaved ice at evacuation centers, etc.

Specific Volunteer Corps 15 7 591 Support for exercises, massaging the palms, the operation of volunteer centers, etc.

Youth Volunteer Corps 3 1 102 Transport of relief supplies, the operation of volunteer centers, psychosocial care, etc.

Total 152 86 9,416

Figure 7-5 Activity System for the JRCS Miyagi Chapter’s DRVs and the Social Welfare Council’s Volunteers

Red Cross disaster medical services

Miyagi Chapter HDC

Prefectural government’s HDC

Mediation

Needs

Dispatch

Request for support

Cooperation

CooperationDispatch

Request for DRVs

Mediation Registration

Application

Ordinary volunteers

JRCS Miyagi ChapterDRV Center

(Major roles)(i) Communication and coordination with Red Cross Volunteer Corps

(ii) Acceptance of applications for DRV (iii) Communication and coordination with local volunteer centers

(iv) Collection of information on the damage caused by the disaster

(v) Collection of information on needs related to relief operations in general

Activity system for the prefectural government’s DRV center Activity system for the JRCS DRV center

Cooperation

NPOsVolunteer groups

Dispatch of DRVs

Prefectural government’s HDC

Municipal governments’ DRV centers

(Major roles)Identification of the needs of the victimsRegistration of DRVsRecruitment, reception, and assignment of DRVsCommunication of information

Prefectural government’s DRV center

(Major roles)(i) Support for the establishment of systems for the municipal governments’ DRV centers

(ii) Overall coordination for the activities of DRVs

(iii) Requests to JRCS Chapters and other organizations for support

(iv) Requests to municipal Social Welfare Councils in the prefecture for cooperation

(v) Dispatch and coordination of DRV coordinators

Red Cross Volunteers Corps

DRVs registered with JRCS

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of the JRCS Miyagi Chapter and Headquarters visited the volunteer center to provide cooperation. Since it had difficulties in conducting its operations due to the lack of personnel, the volunteer center asked the Chapter and the Headquarters to dispatch Red Cross DRVs, and around three of them took turns in helping to operate the volunteer center. In particular, Red Cross DRVs made all-out efforts to remind victims of the need for hygiene maintenance and the danger of injury and infections. In addition, they assisted in activities such as cleaning houses in the affected areas. Until the end of June, they came to the volunteer center periodically in order to support the volunteer center. In WATARI, Red Cross Community Volunteer Corps were not engaged in activities such as the distribution of food. There was a Red Cross Entertainers Volunteer Corps (usually engaged in volunteer activities such as recreation), but they also helped remove mud from houses.In WATARI, the section for JRCS to contact in the town government was the Health and Welfare Division, but since immediately after the earthquake this division had been so busy with its diverse original duties that it was not in a situation that enabled it to request the Red Cross Community Volunteer Corps for support.

(3) FUKUSHIMAAt 2:50 p.m., immediately after the earthquake, the Fukushima Chapter established a HDC and installed one of its personnel as the person in charge of volunteers. For this disaster, the Chapter did not set up its own DRV center. Depending on the contents of the requests, its Operations Division took responsibility for coordination, and its personnel communicated with Red Cross DRVs as requested, and in addition, the above-mentioned person in charge responded to inquiries about volunteers from prefectural residents (some inquiries from outside). From 10:00 a.m. on March 14, three days after the earthquake, the Fukushima Prefecture Disaster Volunteer Liaison Council held a meeting and decided to establish a Fukushima Prefecture Disaster Volunteer Center in accordance with the guidelines for receiving disaster volunteers it had formulated. The Fukushima Chapter was a member of the center, and Red Cross DRVs worked closely with the Fukushima Prefecture Social Welfare Council’s Disaster Volunteer Center. The Volunteer Center could not communicate with the affected coastal areas for about one week. During that interval, it strove to assess the situation in such areas

a. HIGASHIMATSUSHIMAThe Higashimatsushima City Social Welfare Council (located in the city’s welfare center for the aged) was not a designated evacuation center, but immediately after the earthquake, due to the heavy damage caused by the tsunami, many residents evacuated to public facilities, including the Council’s building. These facilities received them because they had a certain amount of space and a certain number of blankets stored for emergencies. During the first week after the earthquake, priority was given to life-saving operations, but preparations for a DRV center were made in parallel with these activities. On March 19, such a center was established on the second floor of the health center.Red Cross DRVs joined the volunteer center after March 20, and until that time, they had participated in volunteer activities mainly through the prefectural Social Welfare Council. Since the city’s Council did not have a sufficient number of personnel, they joined the DRV center as its staff members and performed duties such as listening to the victims concerning their needs in the affected areas.T h e s e c t i o n f o r J R C S t o c o n t a c t a t t h e Higashimatsushima city government was its Health and Welfare Department’s Health and Welfare Division, but this division was responsible for relief work and psychosocial care and served as the section for Red Cross Community Volunteer Corps to contact for activities such as the distribution of food while volunteer activities were the responsibility of the Social Welfare Council.In fact, most of the need for volunteers was for the removal of mud from houses, an important job to maintain the spaces for people to live in, and in most cases Red Cross DRVs were engaged in this type of activity.

b. WATARIIn WATARI, the Miyagi prefectural and Watari town governments and the Watari Social Welfare Council had concluded a three-party agreement and even decided specifically where the DRV centers should be set up.On March 12, a temporary reception desk for a DRV center was installed at the community center’s parking lot, and volunteers worked there for about one week. On March 19, a DRV center was established at the community center’s Nisshukan building, but the volunteer center had difficulties in recruiting volunteers because it was hard to make its existence known to those who needed it. Around that time, the personnel

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such Corps were formed in 59 municipalities. Local governments and Red Cross Community Volunteer Corps work with each other to conduct drills for food distribution, disaster prevention, etc., on a daily basis. On March 11 and 12, some Red Cross Community Volunteer Corps joined local governments in distributing relief supplies such as blankets.

a. AIZUWAKAMATSUIn AIZUWAKAMATSU, there was no total ly destroyed house with the damage caused remaining relatively moderate. Examples included fallen house

based on information provided by municipal Social Welfare Councils to their prefectural counterparts as well as the information received from DRVs and members of Red Cross Safety Volunteer Corps (first aid instructors) who had reached the coastal areas. Information from the municipal HDC in the affected areas was sometimes provided to the Chapter through the prefecture’s HDC or directly.Those ordinary people who wished to work as a volunteer were introduced to evacuation centers in the city, the section of the prefecture’s HDC that was responsible for volunteers and other relevant organizations. The Fukushima Chapter neither recruited DRVs nor collected volunteers from the general public and dispatched them to affected areas on its own initiative. Most of the activities of Red Cross Community Volunteers Corps were carried out at the request of administrative agencies with which they were registered. Immediately after the earthquake, some groups distributed cooked rice and other food independently. Nine Red Cross Community Volunteer Corps were formed and registered with six of the city government’s 16 branches. In the prefecture, 106

Figure 7-6 Organizational Chart of the Fukushima Chapter HDC

Figure 7-7 Organizational Chart of the Fukushima Prefecture Disaster Volunteer Center and its Duties

Secretary General (Head of the HDC)

Vice Secretary General (Deputy Head of the HDC)

The Chapter’s personnel were assigned to the teams listed below.

Relief activities (three persons)

Relief supplies (two

persons)

Information gathering (three persons)

Volunteers (one person)

Fuel (two persons)

Food (four persons)

Control of ordinary duties

(two persons)

(three persons)

Gienkin

General affairs team　(i) Budgets required for the Center’s operation,

accounting, and general affairs(ii) Reception and management of activity support

funds, etc.(iii) Coordination with the community chest of the pre-

fecture(iv) Other matters that are not the responsibility of

other teams

Information gathering and public relations team　(i) Gathering of information on the affected areas from the prefectural

government (and its HDC) and confirmation of the safety of volun-teer activity areas

(ii) Gathering of information on the affected areas from social welfare councils and community centers in these areas, investigation of and gathering information on the need for volunteers, etc.

(iii) Public relations activities such as the posting of information on the recruitment of volunteers, their activities, etc., on the website, as well as the provision of such information to the mass media

(iv) Communication with and the provision of information to related organizations as well as requests to them for support

(v) Support for volunteer-related organizations required for the Center’s operation and requests to them for staff members

Volunteer activities and Volunteer Center support team　(i) Gathering of information on the number of volunteers

received and needed(ii) Request to volunteer and volunteer support organizations for

support, etc.(iii) Identification and procurement of materials and equipment

required for volunteer activities (iv) Reception and coordination of materials and equipment

required for fund-raising, etc.(v) Support for the establishment and operation of municipal

volunteer centers and the dispatch of support personnel(vi) Coordination of and requests for the dispatch of support

staff members such as volunteer coordinators from munici-pal social welfare councils in the prefecture

Head of the Center (Full-time Vice President of the prefectural Social Welfare Council)

Supervisor (Secretary-General of the prefectural Social Welfare Council)

[Members of a Red Cross Community Volunteer Corps who distributed hot noodle dishes at the Azuma Gymnasium]

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they sorted out relief supplies and helped distribute them. The Red Cross DRVs listened to evacuees telling their stories while giving them a palm massage.

b. YABUKIIn YABUKI, about 3,000 houses collapsed, some were totally destroyed and others half or partially destroyed, and the roads were made impassable at many places. The water supply was cut off at about 4,000 locations. Unlike AIZUWAKAMATSU, the town sustained serious damage. Evacuation centers were set up at safe places in the affected area, local residents evacuated to the centers, and local volunteers, who were also victims, supported the evacuees. Thus all relief activities in the community were carried out by its members. The Yabuki Town Social Welfare Council sought support from Red Cross Volunteer Corps in the Nakahata, Mikami, and Yabuki areas. Local Red Cross DRV leaders played a pivotal role in making preparations to establish a disaster volunteer center. On March 14, having taken over the disaster volunteer center set up at the Yabuki municipal government immediately after the earthquake, they set up a new disaster volunteer center within the town’s Social Welfare Council. The Red Cross DRV leaders, who were engaged in the establishment and operation of the center, had experience in participating in the activities of disaster volunteer centers after the torrential rainfall in SHIRAKAWA in 1998 and the Niigata Chuetsu Earthquake in 2004 and were qualified as disaster prevention specialists.

The volunteer center, which was viewed as the disaster volunteer center of the Yabuki Town Social Welfare Council, participated in volunteer activities in the town first. Those who wished to work as a volunteer were all required to register with the disaster volunteer center. Red Cross DRV leaders made the most of their knowledge and experience to hold pre-dispatch

walls, tilted warehouses, collapsed brick fences, and damaged roads. Those who lived at the evacuation centers in the city came from the HAMADORI area. They were hit by the tsunami or forced to flee due to the nuclear accident.In AIZUWAKAMATSU, an administrative member of the JRCS Aizuwakamatsu Branch at the city government served as the person to contact for Red Cross affairs. This administrative member, who is also a Red Cross DRV district leader, was responsible for planning volunteer activities after the disaster.Red Cross DRV activities mostly consisted of the distribution of cooked rice and other food by Red Cross Community Volunteer Corps at the evacuation centers.On March 16, an evacuation center called “Fureai Taiikukan (contact gymnasium)” was set up, and Red Cross Female Volunteer Corps in AIZUWAKAMATSU was responsible for the distribution of food. Several evacuation centers were built in the city, and the city government assigned volunteers to these evacuation centers. In dividing the roles at the gymnasium, taking into consideration factors such as sanitary requirements, the number of volunteers needed, and experience, it was decided that Red Cross Community Volunteers Corps should be fully responsible for the distribution of food, and its district subgroups took turns to perform this work. Formed based on the city’s 14 administrative sections, these subgroups distributed food to victims smoothly without any confusion.At the gymnasium, the volunteers paid close attention to sanitation since a kitchen was built in a tent put up outdoors. The reason why only this Volunteer Corps was responsible for food distribution was that it was assumed that such arrangements would enable it to pay full attention to sanitation. The city government was also confident that the Volunteer Corp’s experience in annual food distribution drills would allow it to demonstrate its abilities to the full. The members of the Corps always used disposable gloves and sterilized the dishes and other utensils in a boiling water bath.Those who worked as volunteers at the gymnasium consisted of various people such as Red Cross DRVs, Social Welfare Council volunteers, members of women’s associations, district welfare commissioners, and other individuals, and they worked together by dividing roles among them. For example, the Social Welfare Council volunteers matched volunteers with needs and dispatched them to the disaster volunteer center set up by the city’s Social Welfare Council. At the gymnasium,

[Members of a Red Cross Community Volunteer Corps from YABUKI who distributed food]

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were engaged in volunteer activities while living at an evacuation center. Since the town’s government and Social Welfare Council had no food stored for emergencies, members of the volunteer groups offered for distribution some of the rice, vegetables and other ingredients that they had.

3. Volunteer activities at various Chapters

(1) Number of Red Cross Volunteer Corps etc., that operated at each Chapter and their activities

JRCS divides the 47 prefectures into six blocks. Since the earthquake of March 11 caused enormous damage to a wide range of areas centered on the 1st Block, the functions of Chapters in the block declined, but many Red Cross Volunteer Corps and DRV groups operated in the three affected prefectures: 229 for IWATE, 127 for MIYAGI and 124 for FUKUSHIMA. In the 2nd Block, in order to help the 1st Block Chapters, the largest number of Volunteer Corps among the six blocks operated; in five of 2nd Block nine Chapters, the number of Red Cross Volunteer Corps and DRVs that worked exceeded 100 each.The largest number of such Corps operated under the Saitama Chapter (225), followed by the Kanagawa (223), Tokyo Metropolitan (188), Chiba (162) and Ibaraki (104) Chapters in the stated order (Numbers in parentheses indicate the number of Red Cross Volunteer Corps DRVs that worked).

orientation sessions for the registered volunteers, reminding them that they should be “self-sufficient” when participating in volunteer activities. Thus they provided guidance similar to that provided for Red Cross disaster relief work.Immediately after the establishment of the center, due to the limited workforce, personnel of the Yabuki Town Social Welfare Council and DRV leaders gave top priority to visiting aged persons who lived alone for inspection and investigated the damage caused and the needs of the victims. They also visited evacuation centers in the town to back up volunteer activities by, for example, determining the person responsible for the management of each of them and laying down rules for the centers. The water supply was cut off at many locations, and a temporary water supply was established by the town government, but they supported this service on a voluntary basis. Furthermore, in order to ensure that the establishment of the disaster volunteer center was widely known to local residents, they made announcements through the town’s disaster-response wireless system and the public address system of the fire brigade’s waterpump vehicles.After the earthquake, the town government left the distribution of food in the town to the three district Red Cross Volunteer Corps. Since it supervised the evacuation centers, the government was responsible for food distribution too. Many members of these groups were also victims of the disaster. At first, with their houses destroyed, the heads of the three groups

Figure 7-8 Number of Red Cross Volunteer Corps, etc. that Operated at Each Chapter and Their Activities (1)(Period covered by the reports: March 11, 2011 to March 31, 2012)

ChaptersTotal number of Red Cross Volunteer Cops, etc.

Number of volunteers

Activities

RemarksCommunity Volunteer

Corps

Youth Volunteer

Corps

Specific Volunteer

CorpsDRVs, etc.

Junior Red Cross

Food distribution

Relief supplies

Support for

medical teams

Duties at the

volunteer centers

Collection of Gienkin

Other duties

The 1st Block

HOKKAIDO 4 1 63 2 1 71 693 ○ ○ ○ Support for Chapters in the affected areas and investigation of the needs of such areas

AOMORI 28 0 1 0 2 31 517 ○ ○ ○ ○ Visits to aged persons to talk to them

IWATE 69 10 23 5 122 229 10,735 ○ ○ ○ ○ ○ ○ Investigation of the need for volunteers, “psychosocial care”, driving services, tidying up of goods, etc.

MIYAGI 98 6 22 1 0 127 8,934 ○ ○ ○ ○ ○ ○ Massage service for evacuees, investigation of the safety of people, etc.

AKITA 39 18 0 4 29 90 6,613 ○ ○ ○ ○ ○ Investigation of the needs of the affected areas and blood donations

YAMAGATA 52 4 5 9 25 95 1,891 ○ ○ ○ ○ ○ Investigation of the needs of the affected areas, reception of Gienkin and hair cutting

FUKUSHIMA 111 2 4 7 0 124 6,686 ○ ○ ○ ○ ○ ○ Information gathering and investigation of the needs of the affected areas

The 2nd Block

IBARAKI 49 10 29 16 0 104 1,252 ○ ○ ○ ○ ○Investigation of the needs of the affected areas, road cleaning, cleaning up of houses, and listening to aged persons at facilities for them

TOCHIGI 8 0 34 16 12 70 717 ○ ○ ○ ○ ○ ○Visits to the children of families living at evacuation centers to tell stories with picture cards and play with them

GUNMA 0 11 25 22 36 94 184 ○ ○ ○ ○ ○ Information gathering using amateur radio and preparations to dispatch medical teams

SAITAMA 155 4 34 2 30 225 3,299 ○ ○ ○ ○ ○Providing amazake, green tea, and other beverages to the evacuees, playing musical instruments, and putting up carp streamers (koinobori)

180


Figure 7-9 Number of Red Cross Volunteer Corps, etc. That Operated at Each Chapter and Their Activities (2)(Period covered by the reports: March 11, 2011 to March 31, 2012)

Chapters Total number of Red Cross Volunteer Corps, etc.


Activities


Corps

Youth Volunteer

Corps

Specific Volunteer

CorpsDRVs, etc.

Junior Red Cross

Food distribution

Relief supplies

Support for medical

teams

Duties at the

volunteer centers


Other duties

The 4th Block

SHIGA 1 1 6 0 9 17 1,145 ○ ○ ○ ○ Transport of relief supplies, collection of Gienkin and support for the Chapter’s operations

KYOTO 0 0 20 0 0 20 167 ○ ○ ○Support for medical teams, removal of materials from the affected areas, and procedures for certificates to confirm vehicles for use as emergency vehicles

OSAKA 72 41 207 88 172 580 729 ○ ○ ○ ○Information gathering, visits to evacuation centers, support for the Chapter’s reception desk, fund-raising, and messages of encouragement

HYOGO 38 1 3 26 10 78 6,926 ○ ○ ○ ○ Driving services and activities at volunteer centers in the affected areas

NARA 48 0 45 15 20 128 181 ○ ○ ○ Answering phone calls and mailing receipts for Gienkin

WAKAYAMA 4 0 4 3 2 13 4,162 ○ ○ ○ ○Mailing of receipts for Gienkin support for medical teams, and support for the Chapter as communications and liaison officers

The 5th Block

TOTTORI 39 9 9 0 12 69 2,464 ○ ○ Collection of Gienkin

SHIMANE 106 3 6 4 61 180 3,262 ○ ○ ○ ○Duties at the Miyagi volunteer center, investigation of needs, collection of Gienkin and messages of encouragement for the affected areas

OKAYAMA 79 29 16 14 69 207 6,216 ○ ○ ○ ○ ○Reception of Gienkin and activity funds and duties at the volunteer centers (communications by phone and reception of applications for registration)

HIROSHIMA 7 1 3 0 16 27 16,640 ○ ○ Transport of goods and the collection of Gienkin

YAMAGUCHI 0 2 7 27 18 54 167 ○ ○ ○ ○ ○ Psychosocial care for volunteers, medical care for the wounded, and the filing of newspaper articles

TOKUSHIMA 38 1 2 2 31 74 140 ○ ○ Dispatch of volunteer groups for food distribution in KESENNUMA

KAGAWA 6 0 34 17 50 107 16,536 ○ ○ ○ Reorganization of medical equipment and volunteer work in ISHINOMAKI

EHIME 6 2 0 0 18 26 4,517 ○ ○ Collection of Gienkin

KOCHI 3 1 0 0 5 9 146 ○ ○ Preparations for the transport of goods and the collection of Gienkin

in areas that were further away from the affected areas, but in OKINAWA in 6th Block, the southernmost of all the blocks, 98 Volunteer Corps worked.The 47 Chapters combined had a total of 4,624 Red Cross Volunteers Corps and DRVs in which a total 179,517 people worked as volunteers.

The second largest number of Volunteer Corps came from 4th Block, an area where the Great Hanshin Awaji Earthquake of 1995 led residents to develop an extremely high level of awareness about DRVs. A total of 580 Volunteer Corps worked under the Osaka Chapter.In general, a smaller number of Volunteer Corps operated

ChaptersTotal number of Red Cross Volunteer Cops, etc.


Activities


Corps

Youth Volunteer

Corps

Specific Volunteer

CorpsDRVs, etc.

Junior Red Cross

Food distribution

Relief supplies

Support for

medical teams

Duties at the

volunteer centers


Other duties

CHIBA 129 8 12 10 3 162 7,369 ○ ○ ○ ○ ○ Removal of debris, lectures to support the daily life of the victims, etc.

TOKYO 51 22 29 84 2 188 1,994 ○ ○ ○ ○ ○ Support for stranded people and the transport of materials and equipment for medical teams

KANAGAWA 40 9 119 52 3 223 3,337 ○ ○ ○ ○ ○ Support for the Chapter’s HDC, public relations for blood donation, and support for psychosocial care

NIIGATA 26 4 11 4 1 46 1,626 ○ ○ ○ ○ ○ Psychosocial care, reception of evacuees, etc.

YAMANASHI 30 8 5 10 1 54 542 ○ ○ ○ ○ Support for the Chapter’s HDC and medical care for evacuees

The 3rd Block

TOYAMA 24 0 2 0 0 26 104 ○ ○ ○ Mailing of receipts for GienkinISHIKAWA 63 9 19 1 3 95 942 ○ ○ ○ ○ ○ Charity bazaars and the removal of mud

FUKUI 23 6 0 12 56 97 1,383 ○ ○ ○ ○ ○ Driver services for the relief work sites and cookingNAGANO 119 2 16 0 5 142 5,415 ○ ○ ○ ○ ○ Lectures to support the affected people lives, etc.

GIFU 162 3 0 0 0 165 3,864 ○ ○ Sorting of goods and the collection of Gienkin

SHIZUOKA 31 2 9 15 61 118 10,277 ○ ○ ○ ○ ○ Visits to evacuation centers for inspection, support for psychosocial care, and accompaniment for medical teams

AICHI 44 1 23 13 57 138 2,974 ○ ○ ○ ○ Collection of Gienkin sorting of relief supplies, and dERU cleaning and maintenance

MIE 9 1 0 3 3 16 353 ○ ○ ○ ○ Mailing of receipts for Gienkin support for medical teams, and the transport of relief supplies

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The table below indicates the breakdown of Red Cross Volunteer Corps, etc., at each chapter and the number of volunteers in the groups.

Chart 7-10 Breakdown of Red Cross Volunteer Corps, etc. at Each Chapter and the Number of Volunteers in the Corps

ChaptersCommunity Youth Specific DRVs, etc Junior Red Cross Total

Number of Corps


Number of Corps


Number of Corps


Number of Corps


Number of Corps


Number of Corps


1 HOKKAIDO 4 343 1 28 63 318 2 3 1 1 71 693 2 AOMORI 28 461 0 0 1 25 0 0 2 31 31 517 3 IWATE 69 1,469 10 90 23 170 5 115 122 8,891 229 10,735 4 MIYAGI 98 8,326 6 94 22 514 1 0 0 0 127 8,934 5 AKITA 39 3,346 18 324 0 0 4 13 29 2,930 90 6,613 6 YAMAGATA 52 1,044 4 40 5 111 9 89 25 607 95 1,891 7 FUKUSHIMA 111 6,470 2 93 4 59 7 64 0 0 124 6,6868 IBARAKI 49 970 10 35 29 148 16 99 0 0 104 1,252 9 TOCHIGI 8 199 0 0 34 152 16 95 12 271 70 717 10 GUNMA 0 0 11 70 25 51 22 63 36 0 94 184 11 SAITAMA 155 2,684 4 35 34 253 2 6 30 321 225 3,299 12 CHIBA 129 5,857 8 119 12 47 10 1,270 3 76 162 7,369 13 TOKYO 51 1,203 22 135 29 94 84 327 2 235 188 1,994 14 KANAGAWA 40 1,057 9 130 119 1,413 52 669 3 68 223 3,337 15 NIIGATA 26 920 4 72 11 627 4 7 1 0 46 1,626 16 TOYAMA 24 98 0 0 2 6 0 0 0 0 26 104 17 ISHIKAWA 63 527 9 54 19 137 1 1 3 223 95 942 18 FUKUI 23 338 6 35 0 0 12 33 56 977 97 1,383 19 YAMANASHI 30 336 8 22 5 8 10 12 1 164 54 542 20 NAGANO 119 5,123 2 46 16 119 0 0 5 127 142 5,415 21 GIFU 162 3,833 3 31 0 0 0 0 0 0 165 3,864 22 SHIZUOKA 31 933 2 2 9 35 15 20 61 9,287 118 10,277 23 AICHI 44 1,644 1 245 23 121 13 92 57 872 138 2,974 24 MIE 9 98 1 6 0 0 3 9 3 240 16 353 25 SHIGA 1 560 1 3 6 20 0 0 9 562 17 1,145 26 KYOTO 0 0 0 0 20 167 0 0 0 0 20 167 27 OSAKA 72 0 41 86 207 437 88 206 172 0 580 729 28 HYOGO 38 6,119 1 125 3 229 26 31 10 422 78 6,926

Chapters Total number of Red Cross Volunteer Corps, etc.


Activities


Corps

Youth Volunteer

Corps

Specific Volunteer

CorpsDRVs, etc.

Junior Red Cross

Food distribution

Relief supplies

Support for medical

teams

Duties at the

volunteer centers


Other duties

The 6th Block

FUKUOKA 4 1 6 2 48 61 18,326 ○ ○ ○ Charity concerts and calls for blood donations

SAGA 0 8 6 6 3 23 155 ○ ○ Reception of Gienkin support for the Chapter’s operations, and cleaning campaigns

NAGASAKI 3 0 5 4 3 15 408 ○ ○ ○ ○ ○ Charity swimming meets and the mailing of receipts for Gienkin

KUMAMOTO 0 1 20 2 1 24 145 ○ ○ ○ ○Mailing of receipts for Gienkin presentation of toasted laver (support supplies), and the creation of messages of encouragement for the affected areas

OITA 0 5 19 7 6 37 362 ○ ○ ○ Loading of sets of emergency supplies and the operation of volunteer centers

MIYAZAKI 14 0 1 0 1 16 13,288 ○ ○ Collection of Gienkin and the transportation of goods

KAGOSHIMA 15 2 8 0 6 31 764 ○ ○ ○ ○Creation of messages of encouragement for the affected areas, support for the Chapter’s operations, and the collection of vehicles used for medical teams

OKINAWA 81 6 5 5 1 98 970 ○ ○ ○ ○ Collection of Gienkin coordination at volunteer centers, and support for the Chapter’s operations

Total(47 Chapters) 1,928 255 917 510 1,014 4,624 179,517 13 43 21 27 46 39

182


＜Second round＞

DateSeptember 17 to 20, 2011＊Food was distributed at the place mentioned below from September 18 to 19.

Place Evacuation center at a gymnasium in ONAGWA, MIYAGI

Volunteers

■13 from the Tokushima Chapter　8 members from Community Red

Cross Volunteer Corps　5 personnel of the Tokushima

Chapter■15 from the Yamagata Chapter　10 members from Community Red

Cross Volunteer Corps 5 personnel of the Yamagata Chapter

(2) Initiatives at each Chaptera. Support for food distribution by Red Cross Volunteer

Corps from TOKUSHIMA and YAMAGATA and personnel of the Tokushima and Yamagata Chapters

1

Red Cross Volunteer Corps from TOKUSHIMA and YAMAGATA and personnel of the Tokushima and Yamagata Chapters helped distribute cooked rice and other food in KESENNUMA and ONAGAWA, MIYAGI.

＜First round＞

DateMay 11 to 14, 2011＊ Food was distributed at the place mentioned below from May 12 to 13.

PlaceEvacuation center at Koharagi Junior High School in KESENNUMA, MIYAGI

Volunteers

■15 from the Tokushima Chapter 10 members from Community Red Cross Volunteer Corps

　5 personnel of the Tokushima Chapter

■12 from the Yamagata Chapter　8 members from Community Red

Cross Volunteer Corps　4 personnel of the Yamagata

Chapter

［Food distribution using a portable rice cooker during disasters］

(1) Tokushima Red Cross Volunteer Corps “GEJET: A report on the food distribution group’s activities”

ChaptersCommunity Youth Specific DRVs, etc Junior Red Cross Total

Number of Corps


Number of Corps


Number of Corps


Number of Corps


Number of Corps


Number of Corps


29 NARA 48 0 0 0 45 141 15 40 20 0 128 181 30 WAKAYAMA 4 2,048 0 0 4 111 3 3 2 2,000 13 4,162 31 TOTTORI 39 1,234 9 42 9 216 0 0 12 972 69 2,464 32 SHIMANE 106 310 3 38 6 154 4 161 61 2,599 180 3,262 33 OKAYAMA 79 1,844 29 191 16 1,785 14 292 69 2,104 207 6,21634 HIROSHIMA 7 10,802 1 115 3 159 0 0 16 5,564 27 16,640 35 YAMAGUCHI 0 0 2 20 7 14 27 52 18 81 54 167 36 TOKUSHIMA 38 13 1 12 2 4 2 4 31 107 74 140 37 KAGAWA 6 380 0 0 34 362 17 69 50 15,725 107 16,536 38 EHIME 6 305 2 118 0 0 0 0 18 4,094 26 4,517 39 KOCHI 3 124 1 3 0 0 0 0 5 19 9 146 40 FUKUOKA 4 202 1 0 6 160 2 6 48 17,958 61 18,326 41 SAGA 0 0 8 59 6 17 6 60 3 19 23 155 42 NAGASAKI 3 70 0 0 5 71 4 72 3 195 15 408 43 KUMAMOTO 0 0 1 4 20 35 2 12 1 94 24 145 44 OITA 0 0 5 23 19 23 7 13 6 303 37 362 45 MIYAZAKI 14 134 0 0 1 2 0 0 1 13,152 16 13,288 46 KAGOSHIMA 15 580 2 11 8 20 0 0 6 153 31 764 47 OKINAWA 81 876 6 10 5 5 5 6 1 73 98 970

Total 1,928 72,880 255 2,566 917 8,540 510 4,014 1,014 91,517 4,624 179,517

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Operations

・The city government was responsible for announcements, confirmation of those who wished to attend, and their reception.

・Ten subgroups of the Red Cross Volunteer Corps took turns to prepare the meals.

・All expenses were borne by the Volunteer Corps.

Points to note

・Since the target was the victims of the disaster, all group members paid close attention to the participants they entertained and the arrangements they made.

・The group members entertained the participants just like Red Cross volunteers by offering personally prepared meals.

ScheduleDate Hosted by Venue

April 20 Headquarters Yaehara community center

May 11 Obitsu Obitsu community center

May 27 Kimitsu Fureaikan, first floor

June 15 Sadamoto and Sunami Sadamoto community center

June 22 Koito Koito community center

July 7 Kururi, Matsuoka and Kameyama

Agricultural Environment Improvement Center

July 20 Akimoto and Mishima Seiwa community center

August 10 Obitsu Obitsu community center

August 24 Headquarters Hotel Sennari

September 9 voluntary members Koito community center

September 21 HeadquartersShinshoji Temple and near Narita Airport

d. Activities by Red Cross Youth Volunteer Corps from SAPPORO and KUSHIRO

3 to support the affected

areas in MIYAGIVoluntary members of Red Cross Youth Volunteer Corps from SAPPORO and KUSHIRO participated in emergency psychosocial care sessions held by Volunteer Corps under the Miyagi Chapter at evacuation centers in the affected areas. Prior to their participation, at the Miyagi Chapter they received advance training in detail through lectures on aged persons who had experienced a disaster.

b. Food distribution and recreation by a Red Cross Volunteer Corps from NOSHIRO, AKITA

2

A Red Cross Volunteer Corps and DRVs from NOSHIRO, AKITA and personnel from the city government and other public institutions distributed cooked food and offered recreation at SAKARI in OFUNATO, IWATE.

Date 10:00 a.m. to 3:00 p.m. on March 24, 2012

Place Emergency temporary houses at SAWAKAWA in OFUNATO, IWATE

Volunteers

19 members of the Noshiro Red Cross Volunteer Corps3 personnel of the city government, etc.5 Red Cross DRVs, etc.

c. Exchanges between a Red Cross Volunteer Corps from KIMITSU, CHIBA and victims through home-cooked meals

KIMITSU received evacuees from prefectures such as FUKUSHIMA, and a Red Cross Volunteer Corps invited them to lunch to entertain them with meals and promote deeper interaction.

Outline of "the invitation to lunch"

Purposes

・Have evacuees spend their time in leisure activities

・Promote deeper interaction by serving personally prepared meals

・Have evacuees feel that it was a good experience to come to KIMITSU

Description

・The first exchange was held on April 20, 2011.　A similar program was implemented twice a

month until September of the same year.・Seven community centers in the city took

turns to offer a place for interaction.・The program lasted from 11:00 a.m. to 3:00 p.m.・Volunteers entertained the evacuees with

home-cooked meals using local ingredients.・The participants spent the day happily.

(2) Noshiro Red Cross Volunteer Corps: “Support for victims through food distribution, etc.”(3) Daiki Ichinoseki, “Records of activities of the Sapporo and Kushiro Youth Volunteer Groups after the GEJET: Implementation by Red Cross Community Youth Volunteer Corps of activities in remote affected areas,” May 1, 2012

［Recreation exchanges ］

184


friendship city with FUKAYA.The carp streamers raised in the wind in this project were collected by the Volunteer Corps from the city’s residents to encourage people to overcome obstacles like the carp fighting its way upstream, and a total of 227 carp streamers were offered by 44 donors. The residents of KAWAGUCHI offered the carp streamers that were put up in NIIGATA after the Chuetsu Earthquake in the hope that the thoughts of those who had formerly experienced a similar disaster would be conveyed to TOHOKU through the 227 carp streamers. These carp streamers were temporarily collected from NIIGATA and erected in TANOHATA. The Japan Koinobori Association also offered to donate some carp streamers. Fukuya c i t i z ens wro te warm messages o f encouragement on these carp streamers to support the reconstruction efforts.

f. Junior Red Cross (JRC) member schools in WAKAYAMA presented albums to encourage elementary school students in the affected areas

5

Students at the Wakayama Municipal Higashisando and Nagusa Elementary Schools, both were with the JRC member schools, voluntarily discussed what they could do for children of the same age in the affected areas and produced albums to encourage them referring to those that they exchanged with overseas children through inter exchange and friendship programs. Each of the students wrote a message in which they put their thoughts as a JRC member and delivered them to children at the Yamada Municipal Osawa Elementary School, located in YAMADA,

Date and time and

place

Day 1・Date and time: August 20, 10:00 a.m. to 3:00 p.m.・Place: Evacuation center at the Ishinomaki

Municipal Minato Elementary School

Day 2・Date and time: August 21, 10:00 a.m. to 2:00 p.m.・Place: Onagawa Municipal Daiichi

Elementary SchoolOnagawa gymnasium

Participating Volunteer

Corps

Sapporo Youth Volunteer Corps (5 persons)Kushiro Youth Volunteer Corps (1 person)Miyagi Nurse volunteer Corps and the Reijinkai Volunteer CorpsMiyagi Youth Volunteer CorpsCommunity Volunteer Corps

Details of activities

Emergency psychosocial careParticipants used the manual relaxation techniques learned from the lectures to support aged persons who experienced the disaster (methods for supporting a healthy life) to provide psychosocial care to those who lived at the evacuation center. They also offered ice cream and shaved ice at the evacuation center.

e. Carp streamer project by a Red Cross Volunteer Corps from FUKAYA, SAITAMA

4

When the Niigata-ken Chuetsu Earthquake occurred, the Fukaya Red Cross Volunteer Corps, which currently has 466 members, implemented a project for putting up carp streamers prepared with the heartfelt contributions of Fukaya citizens at the Kawaguchi Elementary School in KAWAGUCHI, NIIGATA, which was the epicenter of the earthquake. At that time, the Corps received many comments from the students, who said, “The carp streamers cheered us up,” and “We were happy.” Therefore, after the March 11 earthquake, they flew similarly prepared carp streamers in TANOHATA, IWATE, which is a

(4) Red Cross Community Volunteer Corps of FUKAYA, SAITAMA, “Let’s put up carp streamers in TANOHATA: An empathetic carp streamer project”(5) “JRC member schools presented an elementary school in an area hit by the Great East Japan Earthquake and Tsunami with albums to encourage them”

［Activities to provide emergency psychosocial care］［Empathetic carp streamer project］

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and other people watched, a box of pharmaceuticals such as painkillers and 19 boxes of sanitary supplies such as syringes and masks were loaded onto the Okayama unit’s airplane.Furthermore, on March 24, 100 helmets and 15,000 masks were flown to Hanamaki Airport. On March 27, the Head of the Kokura unit handed the 4,700 tooth brushes (the remaining 1,300 were delivered to the affected areas later) collected by Angel Wings, an NPO led by one of the unit’s members, over to the Okayama unit by flying back and forth, and the Okayama unit’s airplane carrying the tooth brushes headed for Hanamaki Airport. In these operations, the Okayama unit received support and cooperation from other units: relief supplies from the Kokura unit, the airplane from the Kumamoto unit, and fuel from the Okinawa unit.

SHIMOHEI, IWATE, where the Wakayama Chapter’s medical team had installed a dERU for medical relief.In the Osawa area, where the elementary school is located, 60% of the houses were totally or partially destroyed due to the tsunami, and there was also a heavy toll on its residents, but the elementary school, which stands on a hill, served as an evacuation center, receiving hundreds of victims. Later, they lived there together for five months. Fortunately, all the children who were at the school when the earthquake occurred were safe, but some of them suffered from the loss of their family members due to the tsunami and supported each other while facing lots of trouble and grief. The Osawa Elementary School was the first to receive encouraging albums from WAKAYAMA, and they were long displayed in the teachers’ room, cheering up the children and teachers of the school. These albums led to continued exchanges between the Osawa Elementary School and WAKAYAMA’s two elementary schools.

g. Red Cross Squadron Okayama unit6

On the morning of March 19, 2011, the Red Cross Squadron Okayama unit le f t Konan Airport (URAYASUMINAMI, MINAMI, OKAYAMA) for Hanamaki Airport in IWATE. The objective was to urgently supply pharmaceuticals and other goods to the JRCS Okayama Chapter’s medical team working in RIKUZEN-TAKATA, IWATE, which had been hit by the massive tsunami, and among the 38 units of the Red Cross Squadron the Okayama unit was the first to be mobilized to areas stricken by the earthquake of March 11. At Konan Airport, as Chapter personnel

(6) “Aeronca,” No. 521, May 1, 2011

［Albums of encouragement delivered to the Osawa Elementary School］

［Activities of the Red Cross Squadron Okayama unit］

Recovery Assistance Program

Chapter 8

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Since the occurrence of the Great East Japan Earthquake and Tsunami (GEJET) on March 11, 2011, the Japanese Red Cross Society (JRCS) has received huge sums of donation from overseas Red Cross and Red Crescent Societies, etc. Financed by these overseas donation, JRCS began to promote recovery assistance programs for the affected areas of the GEJET following emergency relief as well as the collection and reception of Gienkin .The cases in which JRCS had previously implemented projects for recovery support were mainly for large-scale disasters occurred in emerging and developing countries. This recovery assistance program is part of assistance activities for the largest scale of natural disaster that has ever occurred in a developed country, and it is thus extremely important to share our experience of this event internationally.

1. Organizational regime of the recovery assistance program

(1) Background to establishing a dedicated team for overseas donation and the development of an overall proposal for the assistance program

On March 14, 2011, JRCS had the first teleconference with the International Federation of Red Cross and Red Crescent Societies (IFRC) after the disaster. JRCS reported on the situation of the affected areas, the activities of the Japanese Government and JRCS and discussed what kind of support IFRC could provide. In the course of the discussions, it was revealed that the donation from the overseas National Societies had reached 30 billion yen. As the amount of overseas donation collected in the Great Hanshin-Awaji Earthquake was approximately 1 billion yen, this amount is far larger than ever before.The donation sent from each National Society should be used for purchasing the equipment and materials necessary for the disaster relief activities implemented by JRCS as well as for the direct costs of the other relief activities, in accordance with the “Principles and Rules for RCRC Disaster Relief”. However, in order to make maximum use of the huge sum of donation from overseas collected this time, it was required to

appropriately understand the needs of the three affected prefectures (IWATE and MIYAGI, FUKUSHIMA) and develop an efficient large-scale assistance program in addition to the traditional individual projects.The scheme for understanding the needs of the affected areas and reflecting them in the projects was the very first attempt for JRCS. As a first step from March 21, the Vice-President, Director General of the Compliance Management Office (Then： Director General of the Great East Japan Earthquake and Tsunami Response Task Force) and the Director General of the International Department made visits to the Governors of IWATE, MIYAGI and FUKUSHIMA. (They visited the Deputy Governor of MIYAGI instead of the Governor who was out attending the prefectural assembly.) They explained that JRCS was ready to provide recovery assistance programs utilizing the donation collected from the overseas National Societies, and introduced, as examples of assistance programs, the provision of electrical household appliances for temporary housing as well as the vehicles needed for activities on site. The purpose of these visits was to coordinate views with the government, but as it was a period when the Prefectures were still in a state of confusion trying to assess the damage, there were no specific requests or other responses at that point.On March 28, a dedicated team for responding to the donation from overseas was established in the Headquarters of Disaster Control (HDC) at the Headquarters. The dedicated team consisted of 8 members, and the members were called to come together in the President’s office and explained about the aims of establishing the dedicated team for responding to the donation along with its roles.In the afternoon of the same day, the donation of electrical household appliances to people evacuated to temporary housing was decided on as a assistance program financed by the donation from overseas in the meeting of the Executive Director General of the Administration Sector, Director Generals of the Compliance Management Office, the Planning and Public Relations Office, the International Department and other executives. The electrical household appliances package was composed of 6 electrical household appliances; a

Chapter 8　Recovery Assistance Program

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the donation collected through overseas Red Cross and Red Crescent Societies, etc.From the time of its establishment, a total of 13 meetings were held up to the end of December 2012. In addition, a total of 11 preliminary meetings among the Chapters in the three affected prefectures were held from September 2011 through December 2012.

Based on Article 6 of the above guidelines, JRCS established the “GEJET Recovery Task Force” in the Disaster Management and Social Welfare Department of the Operations Sector on May 1, 2011, with the aim of addressing the GEJET recovery assistance program in an intensive and comprehensive manner.

(3) Organizational structure of the GEJET Recovery Task Force

The GEJET Recovery Task Force is a self-contained organization with a certain amount of authority to implement the project. Regarding the responsible persons inside the Task Force, the experience and original posts

refrigerator, a TV set, a washing machine, microwave ovens, a rice cooker and an electric hot water dispensers. JRCS offered the local governor in affected prefectures the donation of electrical household appliances package for temporary housing via the Chapter in each prefecture, and with their willing consent JRCS started the project.Early in April, the members of the dedicated team were dispatched in turns to the three affected prefectures with the aim of on-site coordination and needs surveys for the project for the donation of electrical household appliances packages.Based on the needs survey conducted by the dispatched members, an assistance program plan with a budget of 30 billion yen was finalized on April 22 as the “Draft proposal for an overall plan for the GEJET relief and recovery project (financed by donation from overseas)”. The contents were as follows.

(2) Establishment of a Promotion Committee for the GEJET Recovery Assistance program

JRCS established a “Promotion Committee for the GEJET Recovery Assistance program” in the Headquarters to discuss and determine the details of the GEJET recovery assistance program financed by

【(Draft) GEJET Relief and Recovery Plan (financed by donation from overseas)】

・Distributing of emergency relief supplies; Purchase and replenishment of relief supplies

・Emergency medical service; Dispatching medical teams・Improving the living condition of evacuation centres

and temporary housing (installation of portable toilets, kitchens and shower facilities, provision of psychosocial care services and medical care, establishment of volunteer centres, provision and installation of electric household appliances, establishment of community centres)

・Rehabilitation and strengthening of health infrastructure: Rehabilitation of health system and strengthening of medical response capacity in disasters of the Ishinomaki area in MIYAGI.

・Social welfare, care for the elderly: provision of nursing beds and vehicles to social welfare institutions/ dispatch caregiving staff

・Improving the living conditions of affected people: Nordic walking to compensate for a lack of exercise

・Children’s education support: special assistance to the children in affected areas.

・Capacity building of JRCS national disaster preparedness: strengthening of JRCS Headquarters, Chapters and facilities.

・JRCS/IFRC’s programme support cost (public relations, reporting, management): salaries, external audit, etc.

【Guidelines for the Establishment of the council for the GEJET Recovery Assistance Program】　

Article 1.　Establish the council for the GEJET Recovery Assistance Program (hereafter “the Council”) to make consultations and to deliver operational decisions upon the recovery programmes supported by the donations from overseas societies and other institutions.

Article 2　The council for the GEJET Recovery Assistance Program shall be comprised of the members stated below:

(1) President(2) Vice President (Full-time)(3) Executive Director General (Administration Sector)(4) Executive Director General (Operations Sector)(5) Director General (General Affairs Department)(6) Director General (Compliance Management Office)(7) Director General (Disaster Management and Social

Welfare Department)(8) Director General (International Department)(9) Director General (GEJET Recovery Task Force)

Article 3　The President shall preside over the work of the Council.

Article 4　The Council shall be called by the President.Article 5　The President, should it be deemed necessary,

can invite a person other than the members to the Council for consultations.

Article 6　The GEJET Recovery Task Force（under the Disaster Management and Social Welfare Department) shall handle the general affairs of the Council as the Secretariat.

Article 7　The matters other than articulated herewith in relation to the management of the Council shall be separately defined by the President.

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The implementation regime of the recovery assistance program was as follows.◦The Recovery Task Force was composed of 51

members. There were 17 Headquarters staff (10 full-time and 7 part-time position staff) and 34 consigned / outsourced staff (mainly for dealing electrical household appliances).

◦1 fixed-term staff member of the Headquarters was dispatched to each of the three Prefectures of IWATE, MIYAGI and FUKUSHIMA for conducting needs surveys.

◦Consigned / outsourced staff was deployed as the persons in charge of dealing with the electrical household appliances in the above three affected area, in addition to the Headquarter staff members who were intermittently dispatched.

◦A call center responding to inquiries related to Gienkin and the donation of electrical household appliances packages was established in CHIBA and 15 staff members were deployed at the center.

of each staff member were taken into consideration.In establishing the Task Force, the “Guidelines for Establishing the GEJET Recovery Task Force”, which described its aims and activities, was formulated. According to the guidelines, the Task Force should have the aim of addressing, in an intensive and comprehensive manner, the GEJET recovery assistance program financed by the donation from overseas collected through overseas Red Cross Societies and other organizations, etc.

(6) General affairs of the council for the GEJET Recovery Assistance Program

(7) Other relevant matters３　Staffing

Those who are dispatched from the Headquarters to the Chapters shall work in close coordination with their counterparts in Chapters and shall provide supervision to the staff from the staffing agencies.

４　Date of Establishment1 May 2011

Figure 8-1 Regime of the GEJET Recovery Assistance Program (as of June 30, 2011)

the council for the GEJETRecovery Assistance Program

Disaster Management and Social Welfare Department(Disaster response, social welfare)

Compliance Management Office(Audit)

Blood Services Headquarters(Blood related coordination)

Planning and Public Relations Office(Public relations)

Medical Services Department(Recovery / improvement of the medical infrastructure)

Nursing Department(Health and hygiene / psychosocial care support)

International Department(Letters of agreement, reports)

General Affairs Department(Finance / contracts)

Human Resources Department(Staff dispatches / fixed-term employment)

Organizational Development Department(Volunteers, JRC)

Recovery Task ForceHeadquarters

Responsible for planning and overall coordination

Responsible for finance and contracts

Responsible for audits and business reports

17 Headquarters staff (10 full-time and 7 part-time position staff)

34 consigned / outsourced staff (mainly for dealing with electrical household appliances)

51 staff

Iwate ChapterResponsible staff in the Chapter

Headquarters staffNeeds survey: 1 staff

Consigned / outsourcedStaff in charge of electrical household appliances: 13 staffAssistant to the Headquarters staff: 1 staff

Miyagi ChapterResponsible staff in the Chapter

Headquarters staffNeeds survey: 1 staff


Fukushima ChapterResponsible staff in the Chapter

Headquarters staffNeeds survey: 1 staffElectrical household appliances: 1 staff


Ernst & Young SHINNIHON LCC(Audits)

Japan Research Institute, Limited(Support)

Call center in CHIBA (NTT Solco)15 staff

【Guidelines for the Establishment of the GEJET Recovery Task Force (extracts) 】１　Purpose

To manage the GEJET operations funded by the overseas National Societies and other institutions in comprehensive and intensive manners, the GEJET Recovery Task Force shall be established under the Disaster Management and Social Welfare Department (hereafter “Task Force”). This is a temporary arrangement based on the Article 3 of the JRCS Regulations on the Headquaters’ Organization.

２　Terms of Reference(1) Planning and overall management of the

GEJET programmes(2) Coordination with relevant administrative organs

(national and local governments emergency management headquarters, etc.) and with relevant institutions

(3) Contracts and authorization of order and delivery of merchandise

(4) Budget management(5) Audit, progress reporting and financial

reporting

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Figure 8-2 Changes in the personnel structure for recovery support

20 23 24 26 24 25 24 24

34 26 208 8 8 7 7

4439

21

4

15

15

13

1010 10 10 10

0

20

40

60

80

100

120

May 1

コールセンター

家電スタッフ

委託・派遣スタッフ

職員

2011 2012

Staff responsible for electrical household appliancesConsigned/Outsourced staffJRCS staff

Call center ｝｝Exterior staff

Recovery Task Force

Aug. 1 Oct. 1 Jan. 1 Apr. 1 Jul. 1 Oct. 1 End of December

(4) Holding of the Partnership Meeting for GEJET In the middle of April 2011, the holding of the Partnership Meeting for GEJET on May 9 was decided. Following this decision, a dedicated team for responding to donation from overseas formulated the basic policy as an overall plan for recovery, the fields and actual projects to be supported, and the method of providing financial report.On May 9, 2011, the meeting was held at the Headquarters in TOKYO. The main purpose of the meeting was so that Red Cross and Red Crescent Societies throughout the world who had transferred “donation” to JRCS to support its activities for the disaster recovery could get together to discuss the use of the donation from overseas that were expected to reach a total amount of over 30 billion yen. A total of 43 representative members from the Participating National Society (PNS) (such as the United States, Australia, Austria, the United Kingdom, Canada and China, total 18 societies), IFRC, ICRC, Embassies and Ministries of Foreign Affairs (MOFA) participated in the meeting, in addition to the 19 executives from JRCS, including the President and Vice-President.

＜Purpose of the meeting＞・Consensus on the purpose, period and outline of the

recovery assistance program・Confirmation of the role that JRCS should play in

the disaster recovery activities・Report and confirmation of the emergency relief

that JRCS conducts

・Discussion on the JRCS action plan from the early to middle stages of the recovery support

・Conclusion of an agreement on support from PNS for the future

Prior to the meeting, a minute of silence was offered for the victims of this great disaster. The President stated in the opening speech that “the support from our PNS throughout the world has touched our hearts, and we have reaffirmed the spirit of “togetherness” at the core of Red Cross activities”.In the meeting, JRCS presented to the PNS the planning for the projects that JRCS would develop with the use of donation from overseas in the future, and obtained unanimous agreement. In addition, it was agreed that the use of the funds was not basically specified.The basic policy of recovery support and the main projects agreed were as follows. (The total budget was approximately 30 billion yen at this stage.)

［Meeting of the PNS supporting the GEJET relief and recovery］

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Regarding the finance, the basic policy, reporting format and schedule were reported on.In the next day, the relevant parties of the Red Cross and Red Crescent Societies from throughout the world made inspection visits to Ishinomaki RCHP and evacuation centers (in Ishinomaki City) on May 10, and to an evacuation center (Takata Daiichi Junior High School in RIKUZEN-TAKATA) and temporary housings on May 11.The“monitoring visit by the Red Cross and Red Crescent Societies supporting the GEJET relief and recovery”was held over the three days from October 31 to November 2, 2011. JRCS explained the overall plan for recovery support and its progress to the PNS, and the IFRC evaluation team reported on the evaluation of the International Red Cross and Red Crescent Societies activities. Following the meeting, the members made inspection visits to the affected areas.On May 18, 2012, the“Second Meeting of the Red Cross and Red Crescent Societies supporting the GEJET relief and recovery”was held, in which the progress of the recovery assistance programs and the evaluation of IFRC activities were explained, and

【Main projects agreed】①Emergency reconstruction support for the medical

infrastructure (approximately 5 billion yen)・Emergency reconstruction support until complete

rebuild of the medical infrastructure around the Ishinomaki City including Ishinomaki Red Cross Hospital (RCHP)

②Support for improving the livelihoods of affected people (approximately 19 billion yen)

・Project to improve the environment in the evacuation centers (installation of water supply facilities and air purification systems, etc.)

・Project to donate electrical household appliance packages to evacuees living in temporary housing (the temporary housings under construction were for 70,000 to 80,000 households)

③Social welfare and support for the elderly (approximately 3.5 billion yen)

・Project to donate social welfare vehicles (provision of the means of access to services for the physically challenged, for the elderly who require nursing care, etc.)

・Project to install nursing beds (for special care nursing homes, geriatric health services facilities, etc.)

④Others (2.5 billion yen)・Purchasing and replenishment of relief goods (blankets,

emergency relief kits and partitions, etc., installation of a storage warehouse, etc.)

・Enhancement of the activities of the medical relief teams (upgrading the equipment of temporary health clinics)

the response of JRCS to the results of evaluation was reported on.The participants acknowledged the prompt implementation of the assistance programs and the accountability of JRCS.

2. Implementation regime of the recovery assistance programs

(1) Framework and basic policy of the basic planThis is the first experience for JRCS to develop recovery assistance programs in Japan based on such large-scale support from overseas. Therefore, each project has not always started with a clearly existing policy and strategy for recovery assistance programs from the beginning. Based on a rough policy, the purpose and meaning of the projects have become clear and detailed while each project has been promoted.

a. “Outline of the recovery support planning”JRCS hosted the PNS Meeting on May 9, 2011, in order to report on the future approach to the disaster recovery to overseas Red Cross and Red Crescent Societies. In the meeting, the “Outline of the GEJET Relief and Recovery Plan” was presented and agreement was obtained from them. The “Outline of the recovery support plan” consists of the basic plan, purpose and the main projects.The constrained conditions (special considerations) of the recovery assistance programs were stated in the basic plan of the “Outline of the GEJET Relief and Recovery Plan”, and the fields to be addressed in the future recovery assistance programs were presented in its purpose. The planned and implemented projects of JRCS as of May 2011, 2 months after the disaster, were shown in major initiative of the outline.

b. “GEJET Relief and Recovery Plan funded by the donation from overseas”

While promoting each project based on this “Outline of the GEJET Relief and Recovery Plan”, JRCS developed an overall and field-specific vision, reviewed the basic plan, promoted planning and organization of the project implementation plan, and developed a “GEJET Relief and Recovery Plan funded by the donation from overseas (vision and basic plan)”. The plan was decided on at the

“7th the council for the GEJET Recovery Assistance Program in FY2011” held in March 2012, and was agreed to at the PNS Meeting held in May 2012. The basic plan for the GEJET recovery assistance program consists of an overall vision, Divided vision by field and basic policy.

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Figure 8-3　Outline of the GEJET Relief and Recovery PlanBasic Approach

1. Utilizing the funds efficiently in implementing rapid response 2. Seeking fairness in delivering assistance to the widespread areas 3. Providing special attention to the vulnerable people including the elderly those who require care, children, etc.4. Implementing assistance in conformity with national or prefectural, municipal support plan. 5. Ensuring accountability to the domestic donors, PNS, media etc.

Objectives1. Rebuilding lives of affected people

―Improving the living condition in evacuation centres which is expected to prolong.―Facilitate smooth shift into temporally house and restart living with a sense of normalcy.―Rehabilitating social welfare service in affected areas.―Providing educational support for children.

2. Strengthening JRCS disaster response capacity ―Procurement of special vehicles for communication system, water provision, food supply, and temporary

showersMajor Initiatives

1. Improvement living conditions of evacuation centres and transitional shelters, including installation of sanitation facilities and electric appliances.

2. Provision of electric household appliances3. Provision of vehicles for social welfare institutions4. Provision of nursing beds 5. Children’s education support6. Capacity building of JRCS national disaster response

Figure 8-4　GEJET Relief and Recovery Plan funded by the donation from overseasOverall vision

We are committed to bridge the international community and the affected areas and contribute to safe and secure recovery through support to build the platform for livelihood, education, social welfare and medical service.

Divided vision by field

Improving the living conditions of affected people

We contribute to building the basis for the lives of the survivors towards recovery through support needed to revive communities and regain people’s everyday lives.

Children’s education support We contribute to building the basis for the future of the children through delivering items, places and comfort lost in the front line of education.

Social Welfare Support We contribute to building the basis for the elderly and the physically challenged to live reassured through supporting the recovery of the welfare services.

Medical Services SupportWe contribute to building the basis to protect lives and health of the survivors through supporting the restoration of local medical coordination structure and the strengthening of capacity to respond to disasters.

Assistance for Nuclear Power Plant Accident Victims

We contribute to alleviating anxiety over nuclear plant accident and radiation by setting the environment to accurately understand the ramification of nuclear radiation and its status.

Basic Policy

1.Effective utilization of the network of International Red Cross and Red Crescent Movement2. Implementation fairness and promptness in delivering assistance to the widespread areas.3.Collaboration with central government, prefecture, municipalities and other organizations4.Ensure the accountability domestically and internationally5.Implementation of support in soft and hard, fully utilizing JRCS resources6.Succession of the activities to be rooted locally

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a. Conclusion of agreementsWhen overseas Red Cross and Red Crescent Societies expressed their support for the recovery assistance program of the GEJET, JRCS exchanged copies of

“an agreement on the relief activities and recovery plan for the GEJET” with these PNS, as necessary. In the agreement, JRCS’s emergency relief, early rehabilitation, recovery plan, funds transfer and its use, accounting and audits, reports and other matters are described.The JRCS International Department manages the

Figure 8-5 Outline chart of the basic plan for the GEJET Relief and Recovery Plan

JRCS’s mission statement

Basic plan for the

recovery assistance

program

Vision

Basic policy

Project implementation plan

Overall vision

Divided visionby field






(Note) Definition of terms- Vision: Situation expected to be realized through the recovery assistance program (Model to be realized)- Basic policy: Direction of the recovery assistance program and the constrained conditions to achieve the vision (special considerations)- Divided vision by field: Fields of projects to be mainly addressed in order to achieve the vision- Basic plan for the recovery assistance program: General term for the vision, basic policy and focused specific-fields of the recovery assistance 　program, Plan to form the basis of the project implementation plan- Project implementation plan: Plan prepared for the individual project

In the overall vision, the focused fields to be specifically addressed in the GEJET recovery assistance program were clearly stated and the situation expected to be realized through the overall projects was presented. The vision was developed in anticipation of the goals at the third year from the start of the recovery assistance program. The areas of

“improving the living conditions of affected people”, “children’s education support”, “social welfare services”, “medical service” and “assistance for Nuclear Power Plant Accident Victims” were set as the focused fields, and specific visions for each focused field were presented. The basic policy presented in the PNS Meeting (held in May 2011)” was revised and the topic of “succession of the activities rooted in the community” was added.

(2) Project implementation processAlthough the project on “donating electrical household appliances packages” had already started as of May 9, 2011, JRCS’s implementation process for the GEJET recovery assistance program after May 9 was determined in parallel with the project as follows.

Figure 8-6 Implementation process of the recovery assistance programs

Conclusion of agreements

Planning of projectsProcurement / Operation

Expenditures / Project reporting

Ⅲ-3

Conclusion of agreements

Received fund control

Planning of projects

Procurement / Contracts

Operation of projects

Expenditures

Project reporting

- Negotiation and conclusion of agreements with overseas Red Cross and Red Crescent Societies

- Received fund control

- Planning of recovery assistance programs based on requests from the affected areas and the needs surveys

- Prepare the specifications for procurement, determine the number of goods requested from the affected areas, and select the suppliers

- Promotion of projects based on the plan, countermeasures to resolve problems, and response to the termination of projects

- Payment processing after the determination of expenses for the recovery assistance programs- Preparation of financial report

- Preparation of project reports and their disclosure, holding of the PNS Meeting

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reception status of donation from overseas at the following three time points: at the expression of support, at the conclusion of an agreement, and at the reception of donated funds. The amount of donation from overseas received as of the end of March 2013 was approximately 59.6 billion yen.

b. Planning of projects ; Procurement ; OperationJRCS draws up a plan for recovery assistance program funded by the donation from overseas based on the requests of the affected areas and needs surveys, and implements the projects after selecting the suppliers.The planning stage of projects generally consists of planning for projects based on specific requests from the affected areas (request-driven planning) and the planning of program based on ideas proposed by JRCS (project idea-driven planning). However, there were many cases in which a program was constructed through repeated discussions with the affected Prefecture and other communities from the beginning to satisfy their needs.Examples of request-driven planning include “support for constructing temporary gymnasiums”, “support for a community bus” and “donation of food radiation detectors”. Examples of project idea-driven planning include “donation of electrical household appliances packages”, “organization of mobile indoor play areas” and“implementation of Nordic walking”. In addition, a

“subsidy for pneumonia vaccines for the elderly” is an example of the projects that JRCS has constructed based on repeated discussions with the affected prefectures and other communities.

The forms of support in these projects include the donation of materials, support with personnel, knowledge and experience, and subsidies, and each form has a specific means of procurement.In the process of the donation of materials and the support of personnel, knowledge and experience, JRCS

prepares specification forms for the procurement, confirms the numbers of requests from the affected areas (the number of items to be procured), and selects the suppliers.In the form of subsidies, support is provided mainly for construction related projects by means of the delivery of subsidies. As it was the first experience for JRCS to provide subsidies, “administrative procedures for the implementation of recovery support subside projects for the GEJET” were prepared that describe the administrative procedures for delivering the subsidies.At the stage of operating the projects, promotion of the projects based on each plan, countermeasures to deal with problems and procedures for terminating the projects are focused on. The basic plan for the promotion of the projects is included in the details of the planning described in the written approval for implementing the projects.

c. Accounting ; Project reportingWith regards to the accounting ; project reporting, JRCS determines the expenditures for the recovery assistance program and submits regular program reports to the PNS. Regarding the expenditures for the recovery assistance program, the Recovery Task Force determines the amount of the payments, and the General Affairs Department of the Headquarter executes payment processing. As the information on the expenditures for the recovery assistance program, financial sources (which funds collected from overseas Red Cross and Red Crescent were used), program (for which recovery support, the funds were used) and the item of the expenses (what was the expense item) are managed using an existing accounting system. The accounting report is submitted once a year and the project reports are submitted every quarter.As the place for presenting the FY2011 report of the recovery assistance program for the GEJET to PNS, the PNS Meeting supporting the GEJET” was held in May 2012.

3. Actual achievements of the recovery assistance programs

(1) Implementation summary of the recovery assistance programs and the list of major projects

a. Geographical areas to be supportedThe projects started in March 2011 for the main supporting areas of IWATE, MIYAGI and

Figure 8-7 Flow of a planning of recovery assistance program (brief overview)

Request-driven planning

Project idea-driven planning

Start

Start

Reception of and discussion on the requests from the affected areas

Discussion on the project idea

Needs survey

Verification of the means

Decision on im

plementing the project

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other electrical household appliances.

(iii) Target areas/populationThe target areas are the eight affected prefectures of IWATE, MIYAGI, FUKUSHIMA, AOMORI, CHIBA, IBARAKI, TOCHIGI and NAGANO (those area to which the Disaster Relief Act applied due to the GEJET, and from which JRCS received assistance requests for electrical household appliances packages). The target population consists of those households that are permitted to live in temporary housing based on the Disaster Relief Act in these target areas. Temporary housing means “prefabricated housing constructed on a temporary basis” or “public housing or private-sector housing that the affected prefectures lease for people (hereinafter referred to as “deemed temporary housing”)”. At the start of the project, the target population was only the residents in the prefab temporary housing. However, along with the policy of the National and Prefectural Governments, the provision of temporary housing under the Disaster Relief Act is applicable to deemed temporary housing, and the scope of the target population of this project was thus also extended. With this policy of the National and Prefectural Governments, more evacuees living outside the affected prefectures came to live in deemed temporary housing and the range of recipients of donations of electrical household appliances packages was expanded to the whole of Japan.

(iv) Implementation periodThe project started in April 2011 and terminated with the delivery of the packages in response to the applications received from each municipality by the end of December 2012.

(v) Implementation detailsThis project is a project to donate electrical household appliances packages to residents in temporary housing. Each package consists of six items of electrical household appliances: a washing machine, a refrigerator, a TV set, a rice cooker, a microwave oven and an electric hot water dispensers.The first package of electrical household appliances was brought into prefab temporary housing in Rikuzen-takata City on April 7, 2011. Initially, the number of donated electrical household appliances packages was calculated to be 70,000 based on the number of packages requested by the affected

FUKUSHIMA where extensive and devastating damage was caused by the GEJET. In some of the projects, in addition to these three affected prefectures, the affected areas of AOMORI, IBARAKI, TOCHIGI, CHIBA and NAGANO, and the people who were evacuated mainly from FUKUSHIMA to places throughout Japan due to the effects of the nuclear power plant accident will be covered.

b. Forms of supportThe forms of support for the recovery assistance programs can be classified into the following three categories:(1) Donation of materials: Support to provide materials

that were lost in the disaster(2) Support of personnel, knowledge and experience:

Support through which JRCS directly provides services to the disaster victims

(3) Subsidies: Support subsidizing the expenses for constructing facilities and purchasing equipment (JRCS makes a decision on the support after discussions with the Prefecture and Municipalities)

(2) Outline of the major projectsa. Improving the living conditions(a) Donation of electrical household appliances

packages(i) BackgroundProviding electrical household appliances to residents living in temporary housing was beyond the scope of application of the Disaster Relief Act, but there was a great need on the part of the residents for electrical household appliances as a precondition for improving their living conditions. In past disasters, there have been cases where the assistance grant funding through the Act on Support for Reconstructing the Livelihoods of affected people was spent on purchasing electrical household appliances. In addition, JRCS had experience in providing electric hot water dispensers to the residents in temporary housing in past disasters, and thus the initiative for a project to donate electrical household appliances financed by donation from overseas was launched.

(ii) PurposeTo provide support to ensure that affected people forced to live in temporary housing due to the earthquake and Tsunami can make their lives as comfortable as possible in with a refrigerator and

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autonomous operation by the residents of the prefab temporary housing, only the meeting room/lounge was constructed but was not furnished inside.

(ii) PurposeBy furnishing the meeting rooms ; lounges, the purpose was to promote their utilization in order to contribute the development of mutual assistance systems and the effective operation of community associations among the residents of prefab temporary housing. In addition, by installing an AED in the meeting room, create an environment where the residents in the prefab temporary housing could provide a life-saving measure with the use of the AED.

(iii) Target areas / populationThe target meeting rooms/lounges were those constructed in the prefab temporary housing in IWATE, MIYAGI and FUKUSHIKA, and those for which JRCS received a request for assistance.

(iv) Implementation periodThis project started in June 2011 and was terminated in FY2012.

(v) Implementation detailsIn this project, JRCS provided a refrigerator, a TV set, an electric hot water dispensers, a vacuum cleaner, a radio-cassette recorder, a low table, floor cushions, a long desk, chairs, a filing cabinet, a whiteboard, an AED, etc., to the meeting room/lounge of the prefab temporary housing.The items of equipment for the meeting room/lounge of the prefab temporary housing were selected based on requests from the prefectures in the target areas.

(c) Implementation of Nordic walking(i) BackgroundAfter the emergency response activities just after the disaster had calmed down and the life of residents had been established in temporary housing, there was concern that the residents were facing a decline in their physical functions due to a lack of exercise, or mental instability due to a feeling of loss or solitude caused by the loss of family members or their way of life.The Hokkaido Chapter volunteers organized then an event of Nordic walking in the coastal area of IWATE. Nordic walking is a sport involving walking through the countryside using two walking poles, one in each

prefectures, but the number of applications rapidly increased during June through September 2011 to reach to 100,000 packages, far exceeding the 70,000 packages originally estimated. The number of applications decreased significantly after October 2011, and the reception of applications for this project terminated at the end of December 2012 with an accumulated total number of applications from 135,000 households. By prefecture, the number of households that received the packages was approximately 19,000 households in IWATE, approximately 49,000 in MIYAGI, approximately 65,000 in FUKUSHIMA and approximately 2,000 in other prefectures.For the termination of this project, in response to requests from prefectures that it is necessary to have enough time to notify the affected people of the termination of this project, it was decided to set the deadline for the final reception of applications in the municipalities as the end of December 2012.

(b) Furnishing public meeting rooms(i) BackgroundThis project was implemented after the period during which the emergency response activities just after the disaster had calmed down and mental care for the affected people was being focused on as another challenge. When the place of living for people moved from the shelters to temporary housing, as there was a fear that traditional local communities would break down and the residents in temporary housing would be isolated, a meeting room/lounge was constructed in areas of prefab temporary housing as a means of dealing with this concern. From the viewpoint of the formation and maintenance of the community, the active utilization of a meeting room; lounge was expected, but due to the principle of its

　　　　　　　　　©nobuyuki kobayashi[A family receiving an electrical household appliances package]　

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The walking poles are loaned out free of charge to those who participated in the trial walking and wish to borrow them to create an environment where they can voluntarily enjoy Nordic walking when no events are organized.In FY2011, 25 Nordic walking events were conducted in Miyako city etc., and the number of participants reached 259 people. As of the end of December 2012, a total of 84 events were organized in 53 places, and 809 people participated. In FUKUSHIMA events which are similar to Nordic walking were held. During July to November 2012, a total of 7 events were held with 156 participants, and the event continues today.

b. Social welfare services(a) Donation of nursing beds(i) BackgroundIn the GEJET, many social welfare facilities around the Tohoku coastal areas became unavailable due to the damage from the earthquake and tsunami. In response to special measures, the facilities that were spared its direct damage accepted patients requiring nursing care beyond their capacity, but as there were few facilities that had spare beds, the environment was such that nursing care was provided for the patients lying on mattresses placed directly on the floor and patients requiring nursing care could not receive appropriate care.Therefore, JRCS considered it necessary to improve the nursing environment for patients requiring nursing care as a socially vulnerable group and decided to implement support for providing nursing care beds.

hand. In addition to the general confirmation of the maintenance and promotion of good health, another effect was the promotion of communication among the participants, and this led the Iwate Chapter to adopt this style of Nordic walking as its leading recovery assistance program and organize the Nordic walking events actively.

(ii) PurposeProvide an opportunity for the residents in temporary housing to get exercise as well as to contribute to overcoming the lack of exercise and maintaining and promoting good health. In addition, as a secondary purpose, contribute to community formation among the residents in temporary housing through their participation in these events.

(iii) Target areas / populationThe target population of this project was the residents in prefab temporary housing in IWATE

(iv) Implementation periodIt started in November as a recovery assistance program and has continued after FY2012.

(v) Implementation detailsFor the residents in prefab temporary housing in IWATE, “trial walking” and “network walking” are organized as events based on Nordic walking.In the “trial walking”, after some instruction on Nordic walking, participants take a walk around the prefab temporary housing. The JRCS staff members do the rounds of prefab temporary housing about once in two months and organize this “trial walking”. This is expected to have the effect of providing an opportunity for the participants “to acquire regular fitness habits to maintain and promote good health” as well as “to facilitate communication in the community of residents in prefab temporary housing”.In the “network walking”, Nordic walking is conducted in an appropriate place in each area so that the participants in the “trial walking” can expand their communication exchanges. These “network walking” events are organized around twice a year (in spring and autumn). It is expected that increased opportunities for exchanges through Nordic walking will lead to the activation of communication in the local community beyond the areas of prefab temporary housing.

[Nordic walking]

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or destroyed and had difficulty in providing appropriate welfare services. In these facilities, rental cars or used cars were temporarily used as substitutes for the lost or damaged vehicles, however, as there were many requests for brand-new welfare vehicles that can be used for a long time in the future and that are useful for improving the quality of welfare services, JRCS considered it necessary to give assistance and decided to provide support for welfare vehicles.

(ii) PurposeThe purpose of this project is to donate welfare vehicles needed for social welfare facilities in order to help recover lost welfare services in the devastated areas due to the GEJET. With these welfare vehicles, the facilities can provide appropriate welfare services to the physically challenged. In addition, another purpose of this project is, by donating welfare vehicles to each municipality in the affected areas other than the welfare facilities, to facilitate the enhancement of welfare-related activities by utilizing them in health and welfare projects.

(iii) Target areas / populationThe target areas are the affected three prefectures, and the target facilities/organizations are the social welfare facilities and municipalities that had their welfare vehicles swept away or broken down in the disaster.

(iv) Implementation periodIn response to a request from MIYAGI in April 2011, the planning of this project started. The delivery of welfare vehicles to each social welfare facility and each municipality started in December 2011 and was completed in April 2012.

(v) Implementation detailsIn this project, JRCS donated welfare vehicles to the social welfare facilities and local governments that had their welfare vehicles swept away or destroyed in the disaster. For each affected prefecture, a total of 338 welfare vehicles of 11 different types were selected in consideration of the situation of each facility and municipality. Of these, 40 vehicles were delivered to IWATE, 145 to MIYAGI and 153 to FUKUSHIMA.

(ii) PurposeThe purpose of this project is to provide nursing care beds required for social welfare facilities that have accepted affected patients requiring nursing care and ensure that the affected people can receive appropriate care in an improved nursing care environment.

(iii) Target areas / populationThe target areas are the three affected prefectures and the target facilities are the social welfare facilities that newly accepted patients requiring nursing care who were affected in the disaster.

(iv) Implementation periodBased on a request from MIYAGI in April 2011, the first donation started in June. Then donations started in IWATE and FUKUSHIMA, and a series of donations continued until November 2011 for the three affected prefectures.

(v) Implementation detailsIn this project, JRCS donates sets of nursing care beds (a nursing care bed, side rails, a mattress) to the social welfare facilities that newly accept affected patients requiring nursing care. A total of 959 nursing care beds were donated in the three affected prefectures. Of these, 205 nursing care beds were donated to IWATE, 658 to MIYAGI, and 96 to FUKUSHIMA.

(b) Donation of welfare vehicles for the physically challenged(i) BackgroundIn the areas that were devastated by the tsunami, many vehicles floated away or broke down. The social welfare facilities, where welfare services are provided to the physically challenged, people requiring nursing care and the elderly, had many welfare vehicles swept away

[Nursing care beds]

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be constructed in Kawamata town with government subsidies. However, as the construction of a school gymnasium was ineligible for the subsidies, there were no prospects of having a school gymnasium at that time.

(ii) PurposeThis program aims to restore the educational environment lost in this disaster, supporting the construction of temporary school gymnasiums with the use of subsidies, which enable the eligible schools to continue providing physical exercise (PE) lessons, and to provide pupils and students with a place where they can do appropriate exercise and promote good health.

(iii) Target areas ; populationThe target areas and population of this project are the following schools in the cities of Ofunato and Otsuchi in IWATE and IITATE in FUKUSHIMA.

(iv) Implementation periodIn response to a request from each municipality, the support was sequentially provided from September 2011 through July 2012.

c. Education(a) Subsidy for constructing temporary gymnasiums(i) BackgroundFour elementary schools of Otsuchi, Otsuchi-kita, Akahama and Ando located in the coastal area of IWATE and Otsuchi Junior High School could not continue the school lessons in their original school buildings because they had been flooded or washed away, and they resumed their lessons in rented facilities in their own towns or towns nearby.In June 2011, the construction of temporary school buildings with government subsidies was decided on, but as the construction of a school gymnasium was ineligible for the subsidies at that time, there were no prospects of having a school gymnasium.Regarding Iitate Village in FUKUSHIMA, an entire area of the village was designated as a Planned Evacuation Area due to the accident at the Fukushima Daiichi Nuclear Power Plant, and the residents were forced to evacuate their homes. The three elementary schools of Kusano, Iitoi and Usuishi in Iitate Village resumed their lessons in the rented classrooms in a junior high school in Kawamata town, and received the decision that the temporary school buildings would

[Temporary gymnasium in Iitate village in FUKUSHIMA]

・Ofunato city in IWATE　133 students in Akasaki Junior High School・Otsuchi town in IWATE　735 pupils and students of the elementary schools

of Otsuchi, Otsuchi-kita, Akahama and Ando, and of Otsuchi Junior High School

・Iitate village in FUKUSHIMA (Gymnasium constructed in Kawamata town where the victims evacuated)

　Approximately 220 pupils of the elementary schools of Kusano, Iitoi and Usuishi in Iitate village

＜List of the types of vehicles donated＞Minivan type (bus type)Minivan type (wheelchair-accessible with a lift)Light motor vehicle (wheelchair-accessible)Vehicles with electric elevating seat (front passenger seat)Vehicles with electric elevating seat (backseats)Compact car (hatchback)Light van (hatchback)Lightweight truckLight motor vehicle (jeep type)Minivan typeLight van (hatchback with specification as a Red Cross rescue vehicle)

[Vehicle with an electric elevating seat]

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the schools who asked for support. In the areas where early assistance was required (Yamada town and Otsuchi town in IWATE, Okuma town in FUKUSHIMA), the support started using rented bus or the contracted operation of buses as a means of transportation from and to school. However, with the on-the-spot requests asking for school buses to be available not only for transportation to and from school, but also for other purposes including travelling classes, club activities, field trips, etc., the form of support was changed to the donation of school buses.Regarding the donation of school buses, JRCS took a survey of assistance requests which each school made through each prefectural Board of Education and Department of Health and Welfare, and determined the schools to be supported.

(v) Implementation detailsIn this program, JRCS gave assistance for the construction of temporary gymnasiums for eligible schools with government subsidies. In FY2011, 5 schools in Otsuchi town in IWATE, 3 schools in Iitate village in FUKUSHIMA, and in FY2012, 1 school in Ofunato city in IWATE received the funds. Otsuchi town in IWATE had planned to rebuild the school gymnasium before the disaster, and the construction of a temporary gymnasium was proceeding. Therefore, as the construction materials for the temporary gymnasium were already procured, the construction was not affected by the lack of funds or rising costs of the construction materials due to the disaster. As such, the temporary gymnasium could be constructed at an early date as well as at a low price.

(b) Providing school buses(i) BackgroundIn the affected areas of the disaster, some pupils and students moved into prefab temporary housing, and it became difficult for them to go to school on foot. When school education resumed in the affected areas, it was necessary to secure the means of transportation to school such as school buses in consideration of the distance from the prefab temporary housing to the school as well as the importance of ensuring the safety of the route to and from school.

(ii) PurposeThis program aims to ensure the safety of pupils and students when commuting to and from school by allocating school buses and to create an environment where pupils and students can focus on their schoolwork. In addition, it also aims to reduce the anxiety of their parents as a secondary benefit.

(iii) Target areas ; populationThe target population of this project is the pupils and students as well as the preschoolers living in the target areas shown in Figure 8-8.

(iv) Implementation periodIn response to a request from each Prefectural Board of Education, the support was provided from August 2011 through March 2013.

(v) Implementation detailsIn this program, JRCS allocates school buses to [Pupils going to a swimming pool on a donated school bus]

Figure 8-8 Target support areas and the details of 　　　　support by providing school buses

Target areas Implementation period

Form of support

Types of buses deployed

IWA

TE

Yamada town

Aug. - Dec. 2011 Rental of vehicles

6 mini-coaches (29-passenger)

Jan. 2012 Donation of vehicles


Otsuchi town

Apr. - Jul. 2012 Rental of vehicles


Aug. 2012 Donation of vehicles


FUK

USH

IMA

Okuma town

Oct. 2011 - Jul. 2012

Contracted operations

2 motor-coaches (50-passenger)

Aug. 2012 Donation of vehicles

2 motor-coaches (50-passenger)

Iwaki city Apr. 2012 - Mar. 2013

Contracted operations 1 motor-coach

Iwaki city(Nursery) Aug. 2012 Donation of

vehicles1 mini-coach (29-passenger)

Katsurao village Aug. 2012 Donation of

vehicles

1 mini-coach (29-passenger)1 medium-sized coach (42-passenger)

Naraha town Dec. 2012 Donation of

vehicles2 motor-coaches (48-passenger)

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(iv) Implementation periodThe events in the Smile Parks that were organized from February 2012 are shown in Figure 8-9, and have continued to be organized in FY2013.

(v) Implementation detailsIn this program, JRCS organizes and runs events intended to provide a place for the preschoolers living in FUKUSHIMA to get physical exercise using a gymnasium or other facility. The events were organized during the hours from 10 a.m. through 4 p.m., and staged events were organized with a playland available at all times in the gymnasium. In the playland, a set of play equipment, including large inflatable play equipment, a ball pool and cyber wheels was installed, and special programs including an exercise class, reading picture books, singing songs with finger plays as well as an invitation to meet special guests on Saturdays and Sundays, were provided as staged events. An event called “Furusato Art”, in which children put a message sticker on the petals of origami cherry blossoms to complete an artwork for thinking go to their home, was also conducted.

(c) Organizing mobile indoor play areas called “Smile Parks”(i) BackgroundIn FUKUSHIMA, a nuclear disaster occurred with the spread of radioactive materials following to the accident at the Fukushima Daiichi Nuclear Power Plant in addition to the disaster caused by the tsunami. Amid concerns that the air and soil had been contaminated, outdoor activities at the schools were restricted. Since the accident, the national and local governments have been engaged in decontamination of the soil in school playgrounds for the schools where the atmospheric radiation level was high.However, as the plan for decontamination is a long-term challenge and the parents still have anxiety even in the advanced stages of decontamination, outdoor activities have continued to remain restricted. As a result, mental stress and a decline in the physical strength of the children due to their lack of exercise came to be considered a problem.In elementary and junior high schools, certain countermeasures were taken, but the response for preschoolers was not necessarily sufficient. Consequently this project was proposed by the Fukushima Chapter to provide preschoolers with opportunities to get physical exercise.

(ii) PurposeThe purpose of this program is to provide a place to enable preschoolers who cannot play outdoors to get physical exercise due to the anxiety over radiation exposure and suffer from a lack of exercise and mental stress, and to help them relieve their mental stress as well as maintain and promote their ability to exercise.

(iii) Target areas / populationIn FY2011, as the event was implemented in a gymnasium located in Fukushima city and the invited kindergartens and nursery schools were located in the City, the main target population was the preschoolers living in Fukushima city. However, from FY2012, the number of places for conducting these events was expanded to four areas in the Prefecture and the target population was also broadly expanded to preschoolers living in FUKUSHIMA.

[Children energetically playing in a ball pool]

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in order to protect children’s health and safety and promote their psychological stability and healthy growth.

(iii) Target areas / population (participants)Pupils in 5th and 6th Grade of elementary schools and Students in 1st to 3rd Grade of junior high schools living in the three affected prefectures.

(iv) Implementation periodFrom Saturday, July 21, 2012 to Thursday, August 23, 2012Total 11 camps (3 nights / 4 days per camp, 320 children × 11 camps)The project to organize summer camps continues to be implemented in FY2013.

(e) Summer Camp(i) BackgroundFollowing the GEJET, children, as a vulnerable group in a disaster, live a psychologically stressful life with environmental changes in their education and daily life caused by the destruction of the educational facilities as well as human suffering.

(ii) PurposeIn such a situation, this project aims to have children regain their zest for life and to foster human resources that can take a leadership role in the community in the future through interactive learning in various youth programs that JRCS provides in its Junior Red Cross activities as well as through experiences and exchanges,

Figure 8-9 Implementation of the organization of Smile Parks in FUKUSHIMA

Fiscal Year Implementation period Venue of the

events

Total number of visitors (preschoolers, parents/

guardians)Name of the facility Target area

FY2011 Feb. 8 - 17, 2012 (10 days) FUKUSHIMA 5,340 Fukushima Prefecture Youth Center Fukushima City

FY2012

Jul. 3 - 13, 2012 (11 days) FUKUSHIMA 6,487 Fukushima City Minami Gymnasium Fukushima City, Kawamata Town, Nihonmatsu City

Jul. 22 - Aug. 3, 2012 (13 days) SOMA 5,297 Soma City General Welfare Center, Hamanasu-kan Soma City, Shinchi Town, Minami-soma City

Sep. 30 - Oct. 10, 2012 (11 days) IWAKI 7,607 Iwaki City Nanbu Arena of Minami-no-mori Sports Park Iwaki City

Oct. 16 - 25, 2012 (10 days) SHIRAKAWA 4,775 Shirakawa City Commemorative Gymnasium of National Sports Festival Shirakawa City, Nishigo Village, Izumizaki Village

Nov. 14 - 26, 2012 (13 days) SOMA 5,618 Sports Arena Soma Soma City, Shinchi Town, Minami-soma CityDec. 18 - 27, 2012 (10 days) FUKUSHIMA 5,766 Paruse Iizaka Fukushima City, Date City

Number of participantsBoys Girls Total Composition

IWATE 167 219 386 11.2％MIYAGI 723 793 1,516 43.9％

FUKUSHIMA 761 788 1,549 44.9％Total 1,651 1,800 3,451 100.0％

Number of staffType of staff Number of staff Number of staff per camp

Chief of the camp village (Headquarter staff) 　11 1

Group support staff

Red Cross Youth 175 16Japanese Red Cross College of Nursing / School of Nursing 141 13

Headquarter staff (including 20 prospective employees) 88 8

Adult volunteers 86 8First aid instructors (volunteers) 121 11

Organizing secretariat staff

Headquarter staff 60 5Instructor staff (JRC Teacher Sponsor) 43 4

Clinical psychotherapist 11 1Nurse 33 3Staff of Kinki Nippon Tourist Co., Ltd. 182 16

Total (during the camps) 951 86

Figure 8-10 Summary of the implementation of summer camps

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the participants, this camp focused on the “recognition” of various things through experience of the fundamental rules of living based on the know-how of the Junior Red Cross, interaction among the participants, field work (orienteering), horse riding, harvesting crops and various other experiential programs (options), and aimed to promote the growth of children.

(vi) Sum UpParticipants learned a lot of things including the rules necessary for group living, consideration for others, the importance of mutual cooperation, the existence of volunteers who were taking care of them, and a cooperative society, etc. In particular, they achieved an experience of becoming strongly connected by living together with children and volunteers who were complete strangers to each other. It is expected that this experience will nurture children in their growth in the course of recovery when they go back to their own community.

(v) Implementation detailsIn this camp, groups were organized by dividing approximately 320 participants per camp into groups of 14 to 15 children. The basic unit of camp activities was a group consisting of children with a diversity of ages, gender and home prefecture, attended by 1 to 3 volunteers per group. The volunteers participated in the camp after receiving training in advance concerning operational rules and mental attitude.In addition to the corporate volunteers, teachers from Junior Red Cross member schools, clinical psychotherapists, nurses and office staff of JRCS, and staff of a contracted travel agency participated in the camp as staff members and operated the camp, giving first priority to the safety and security of the participants.The program was developed in committee consisting of teachers of elementary and junior high schools who were instructors for the Junior Red Cross in the three affected prefectures, clinical psychotherapists and JRCS staff. In addition to the refreshment of the bodies and spirits of

ScheduleTime Day 1 Day 2 Day 3 Day 48:00 Morning assembly

BreakfastMoving to the work site Closing ceremony

Study program: First aid, etc. Group work: Making sausages, jam, etc.

Departure

12:00 　 Lunch

Activity program 1: Orienteering

Activity program 2: Experience of harvesting crops, dairy operations, fishing in a mountain stream, etc.

16:00 Arrival

Farewell partyOpening ceremony

Group meetingGroup meeting

Dinner / Taking a bath21:00 Lights-out

Cooperating companiesName of the company Details of the cooperation Cooperation provided

Jaguar Land Rover Japan Limited Vehicles 1 vehicleNTT docomo Inc. Satellite phones 2 satellite phonesHokkaido Coca-Cola Bottling Co., Ltd. Drinking water 28,000 bottles

Earth Chemical Co., Ltd.Portable insect repellent 4,000 repellentsInsect spray 120 spraysInsect repellent for rooms 80 repellents

Sapporo Tourist Association Entrance fee for Sapporo Hitsujigaoka Observation Hill 3,451 ticketsCasio Computer Co., Ltd. Watches 50 watchesJCB Co., Ltd.

Dispatch of volunteer staffMizuho Financial Group, Inc.House Foods Corp.

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a core hospital for the community in Ishinomaki city in MIYAGI and that Ishinomaki city and its surrounding areas were devastated particularly by the tsunami with badly damaged medical institutions and a great number of casualties, JRCS decided to give assistance for the recovery and rehabilitation of the medical infrastructure in Ishinomaki, Kesennuma medical region in line with the planning developed by Miyagi prefecture goverment. Through repeated consultations with the goverment just after the disaster, JRCS decided to focus on support corresponding to “(2) Setting up temporary clinics” and

“(3) Securing hospital beds (temporary)” of the short-term challenges towards the recovery of community healthcare in order to take on the role of facilitating the early recovery of medical functions and the healthcare provision system.

(ii) PurposeThe purpose of this project is to develop the infrastructure that can provide secured healthcare services for the local residents in the affected areas by rapidly recovering and rebuilding the lost medical functions and healthcare provision system in the Ishinomaki and Kesennuma Medical Regions. To this end, as it was necessary to facilitate the recovery and rebuilding of each medical institution located in the community as well as to recover the medical cooperation system in the community, the support plan covers the entire area according to the planning by Miyagi Prefecture.

In addition, the personal growth of the volunteers who attended to the children for four days was a secondary benefit.

d. Medical care(a) Rebuilding the Ishinomaki and Kesennuma Medical

Regions(i) BackgroundIn the affected areas, medical institutions were badly damaged by the GEJET. In particular, the coastal areas of MIYAGI suffered extensive damage from the tsunami after the earthquake and a large proportion of their medical functions were destroyed. Particularly in the Ishinomaki Medical Region, Ishinomaki RCHP faced a situation in which it was required to take on the great majority of primary emergency care, and its original function as an advanced emergency medical care facility was reduced. Therefore in FY2011, it was considered to be important to preferentially give assistance to medical institutions that had assumed primary emergency care. In the Kesennuma Medical Region, Shizugawa Public Hospital, which was the only hospital in MINAMI-SANRIKU, was completely destroyed and it was especially required to secure alternatives to reestablish its functions. In MIYAGI, a

“Review meeting to discuss the recovery of community healthcare” consisting of healthcare organizations, universities and local governments in MIYAGI was set up in May 2011 in order to facilitate the early recovery of the lost medical functions and healthcare provision system as well as to promote the recovery of a far-sighted medical infrastructure. Thereafter, in September 2011, six “short-term challenges” and three “medium- to long-term challenges” were compiled and the direction for recovering community healthcare was presented (see Figure 8-11).Based on the fact that JRCS had Ishinomaki RCHP as

Figure 8-11 Direction for recovering community healthcare (prepared in September 2011)

Short-term challenges

(1) Securing medical relief teams(2) Setting up temporary clinics, etc.(3) Securing hospital beds (temporary)(4) Improvement of the systems for

psychosocial care, public health activities, nursing care support, etc.

(5) Employment measures for healthcare professionals and to prevent the outflow of them

(6) Countermeasures for the early resumption of the operation of medical institutions

Medium- to long-term challenges

(1) Redeployment of medical resources through the integration and reorganization of municipal hospitals, etc. (Reconstruction, intensification and functional sharing of hospitals in the affected areas from MIYAGI)

(2) Construction and enhancement of medical cooperation systems in the community (Medical cooperation systems in the community utilizing ICT)

(3) Countermeasures for securing human resources for healthcare (in cooperation with the universities and other bodies concerned)

[Children freely enjoying the great outdoors]

206


(b) Supplying whole body counters(i) BackgroundIn FUKUSHIMA, the level of concern about the impact of radiation on health was extremely high and resulted in increased anxiety among the residents after the accident at the Fukushima Daiichi Nuclear Power Plant of Tokyo Electric Power Company. In order to assess the health impacts of radiation and remove the fears felt by the residents, Fukushima Prefecture Governor developed a plan for a Fukushima Health Management Survey for all the residents of FUKUSHIMA and began to implement the plan in some parts of the Prefecture.With the need to measure the status of internal radiation exposure in order to assess the health impact of the radiation, the Governor decided to prepare radiation measuring instruments including whole body counters that could measure the level of radioactive substances accumulated in the human body as well as thyroid test monitors that could measure the level of radioactive iodine deposited in the thyroid gland. However, as whole body counters and thyroid test monitors were extremely expensive and it was difficult for Fukushima Prefecture to independently provide sufficient equipment for all the residents, the Prefecture asked JRCS for assistance.Having operated the Fukushima RCHP in Fukushima City, JRCS decided to provide the equipment at this hospital. Simultaneously, JRCS decided to provide certain test equipment for Fukushima Medical University in order to facilitate the implementation of the Fukushima Health Management Survey.

(ii) PurposeThe purpose of this project is to facilitate the conduct of the Fukushima Health Management Survey for the residents of FUKUSHIMA who have fears regarding radiation contamination problems associated with the

(iii) Target areas / populationThe target areas of this project are the Ishinomaki Medical Region centered around Ishinomaki City in MIYAGI and the Kesennuma Medical Region centered around Kesennuma city in MIYAGI. The Ishinomaki Medical Region covers Ishinomaki City, Higashi-matsushima City and Onagawa Town, and the Kesennuma Medical Region covers Kesennuma City and Minami-sanriku Town. The population of each Medical Region is 200,867 people for Ishinomaki and 84,785 for Kesennuma.

(iv) Implementation periodRegarding support for the reconstruction of the Medical Region by JRCS, the overall plan will be prepared by the end of FY2013 and the support will be completed by the end of FY2015.

(v) Implementation detailsThe direct support implemented for rebuilding medical regions was the subsidization of construction, extension or reconstruction, and renovation of the facilities of medical institutions. The main reason to select subsidization as a form of support was that it was considered to be important that the determination of the specifications of the medical devices needed and the selection of suppliers should be determined by the parties involved on the spot. In preparation for subsidization, JRCS carried out adjustments and examination of the planning in advance with the relevant parties.The target medical institutions supported within the framework of the rebuilding of the Ishinomaki and Kesennuma Medical Regions are the following 4 facilities: “(1) Temporary Ishinomaki City Nighttime Emergency Center”, “(2) Temporary hospital ward of Ishinomaki RCHP”, “(3) Onagawa Community Medical Center” in the Ishinomaki Medical Region, and “(4) Minami-sanriku Public Clinic (Sizugawa Publ ic Hospita l )” in the Kesennuma Medical Region. The support for these medical institutions was implemented in response to the request of Miyagi Prefecture after repeated consultations and adjustments with the prefecture governors.JRCS is planning to provide continuous support for constructing the Shizugawa Public Hospital.

[Reconstructed Onagawa Community Medical Center]

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the safety standards were detected in food harvested in Fukushima Prefecture, which led widespread concerns about food safety.In response to this situation, in November 2011, Fukushima City tried its best to relieve the concerns of the citizens by establishing radiation monitoring centers in the City as well as conducting radioactivity measurements of the materials used for meals in schools and nurseries, agricultural crops and processed foods produced and manufactured in the City. However, with this system, Fukushima City could respond only to some of the enormous number of requests for radioactivity measurement made by the residents. To develop a system to fully respond to the requests for radiation measurement that are expected to increase in the future, Fukushima City governor planned to deploy food radiation measuring equipment in the City Hall and its branches and asked JRCS for assistance.In addition, JRCS received requests for assistance for food radiation measuring equipment from Fukushima Prefecture to compensate for the deficiencies in the equipment in Nihonmatsu City and Kawauchi Village, which was not covered by rented equipment from the Consumer Affairs Agency and the available equipment provided by using the supplementary budget of the Prefecture. JRCS also received requests to provide food radiation measuring equipment from the Miyagi Prefectural Board of Education.

(ii) PurposeThe purpose of this project is to relieve people’s concerns about food safety and provide reassurance about both the physical and mental health aspects to the residents in FUKUSHIMA and MIYAGI who have concerns associated with radiation problems. To this end, JRCS implemented the donation of food radiation measuring equipment, complementing the support provided by the national and prefectural governments.

(iii) Target areas / populationThe targets of this project are Fukushima City, Nihonmatsu City and Kawauchi Village in FUKUSHIMA, and Miyagi Prefectural Board of Education.

(iv) Implementation periodFor the requests received in November 2011, all of the equipment was provided from February to May 2012. The examination of radioactive substances in food using this equipment is being continuously conducted.

accident at the Fukushima Daiichi Nuclear Power Plant caused by the GEJET.

(iii) Target areas / populationThe target area of this project is Fukushima Prefecture and the residents of Fukushima Prefecture are the target population.

(iv) Implementation periodThe discussions on the assistance for acquiring whole body counters and other test equipment with Fukushima Prefecture governor started in September 2011, and JRCS provided whole body counters in March 2012 and a set of test equipment in August 2012. Since April 2012, a sequence of examinations using the equipment has started.

(v) Implementation detailsIn this program, JRCS provided a whole body counter and 2 thyroid test monitors for Fukushima RCHP, and a set of the test equipment necessary for the Health Management Survey for Fukushima Medical University in Fukushima City. Regarding the selection and procurement of the equipment, including whole body counters, JRCS procured the same equipment as that prepared by FUKUSHIMA from the viewpoint of ensuring the consistency of tests throughout the Prefecture.

(c) Donation of food radiation measuring equipment(i) BackgroundFUKUSHIMA had started to conduct measurements on the air dose rate and internal radioactivity substances level in order to relieve the concerns of residents in the prefecture regarding the health impact of the radiation. Under these conditions, radioactive substances exceeding

[Whole body counter to measure internal radiation exposure]

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(iii) Target areas / populationThe target areas are the entire area of the three affected prefectures of IWATE, MIYAGI and FUKUSHIMA, and the target population is the elderly aged 70 and older who registered residents in each of these area.

(iv) Implementation periodIn this program, the ceiling for the amount of subsidy in each prefecture was set up and the project should be terminated when the actual amount was expected to exceed the limit. Therefore, the termination was expected to be on March 30, 2012, but in FUKUSHIMA, the program was terminated on February 29, 2012, one month earlier than the date originally expected. The implementation period of this project in each prefecture was as follows.

(v) Implementation detailsIn this program, JRCS was responsible for all the costs of vaccination against pneumococcus on behalf of those who were actually vaccinated. The vaccine used for the vaccination in this project was said to have an immune effect on 23 out of approximately 90 types of pneumococcal organism in total, which was effective for approximately 80% of pneumonia caused by pneumococcus.The number of people who received the vaccination against pneumococcus at the end of this project reached approximately 440,000. The breakdown of the number of vaccinees in each Prefecture was approximately 130,000 in IWATE, approximately 130,000 in MIYAGI and approximately 180,000 in FUKUSHIMA.

(v) Implementation detailsIn this program, JRCS procured and provided a total of 109 items of food radiation measuring equipment to 3 municipalities in FUKUSHIMA and the Miyagi Prefectural Board of Education. The breakdown was 77 items of equipment for Fukushima City, 23 for Nihonmatsu City, 6 for Kawauchi Village, and 3 for the Miyagi Prefectural Board of Education.

(d) Subsidizing vaccination against pneumococcus for the elderly(i) BackgroundThe elderly who were affected in the GEJET were forced to spend their life in unfamiliar places throughout FUKUSHIMA including shelters, prefab temporary housing and private sector housing taken over by the Prefecture. In these environments, there was concern about a decline in the body’s resistance and an increase in respiratory diseases such as pneumonia among the elderly as the winter season approached. Pneumonia is the third leading cause of death among Japanese and more than 95% of the deaths from pneumonia are among the elderly aged 65 and older. Furthermore, the commonest infectious organism in community-acquired pneumonia in the elderly aged 65 and older is pneumococcus. The Japan Medical Association also submitted a written statement promoting vaccination against pneumococcus to the Ministry of Health, Labour and Welfare in the early stages after the disaster, and called for the need for vaccination.

(ii) PurposeThe purpose of this program is to prevent pneumonia caused by the pneumococcal organism and its aggravation in the elderly by subsidizing vaccination against pneumococcus for the elderly.

[Food radiation measuring equipment]

IWATE: November 8, 2011 - March 30, 2012MIYAGI: October 15, 2011 - March 30, 2012FUKUSHIMA: November 18, 2011 - February 29, 2012

[Vaccination against pneumococcus]

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Figure 8-12 Performance of the relief and recovery assistance programs for the GEJET　Field of support Name of the project Details of the project Target (those who received the support) Performance / Number

of beneficiaries

Improving the living conditions of affected people

Donation of electrical household appliance packages

Donation of a package including a refrigerator, a washing machine, a TV set, a microwave, a rice cooker and an electric hot water distributer

Households living in temporary housing 135,166 households

Distribution of winter amenity item for those living in temporary housing

Donation of a Kotatsu table heater, an insulation sheet, heating pads

Households living in temporary housing and the meeting rooms for those living in temporary housing

729 temporary housing137,438 items

Improvement of the equipment in the meeting rooms

Donation of long tables, a set of Zabuton (floor cushions), a whiteboard and an AED

Meeting rooms and lounges in temporary housing

806 meeting rooms34,597 items

Installation of flower planters outside temporary housing Temporary housing 34 times

2,130 planters

Psychosocial care activitiesImplementation of psychosocial care activities including attentive listening and individual consultations

Shelters / temporary housing15 shelters and

temporary housing / 120 times

4,335 people

Nordic walking Walking led by instructors (JRCS volunteers)6 Municipalities to the south of Miyako City in IWATE, Nihonmatsu and Aizuwakamatsu Cities in FUKUSHIMA

116 times1,224 people

Community busOperational support for free community buses connecting temporary housing, hospitals and the municipal offices, etc.

Residents living in temporary housing 2 buses9 services / day

Health class Organization of health classes, training sessions in first aid / AED Temporary housing in FUKUSHIMA

11 temporary housing / 30 times

1,025 people

Support measures for problems in summer Donation of refrigerant sprays, cool towels, and insect sprays, etc. Shelters 145 shelters

239,575 items

Construction of a temporary meeting room Construction of a temporary meeting room Kawauchi Village in FUKUSHIMA 1 meeting room

Donation of apparatus for measuring blood pressure and physical check-ups Medical devices needed for each municipality Meeting rooms and lounges in temporary

housing2 spaces / rooms

118 items

Security kitExclusive cylindrical container for information including medical information and patient registration cards (copies)

Municipalities in MIYAGI 57,720 kits

Implementation of various exchange meetings Relaxation, exchange meetings for the residents of evacuated areas Each relevant area in the three affected area 313 times

12,053 people

100 Japanese character essay contestPoem and 100 (Japanese) character essay contests on the experience of the GEJET as well as the nuclear power plant accident

Member schools of the Junior Red Cross in FUKUSHIMA

76 schools4,739 poems and

essays

Health survey project for the residents of Namie Town

Implementation of health examinations for the residents of Namie Town now taking refuge and living in Iwaki City away from its temporary town office established in Nihonmatsu City

Residents of Namie Town taking refuge and living in Iwaki City

275 households389 people

Social welfare servicesDistribution of nursing beds Donation of nursing beds Social welfare facilities 161 facilities

959 bedsSupport for group homes for the elderly Donation of electrical household

appliances and living room furniture Temporary group homes 62 group homes2,239 items

Provision of welfare vehicles Donation of welfare vehicles Social welfare facilities 207 facilities338 vehicles

Construction of public housing for the elderly Construction of public housing for the elderly Shinchi Town and Soma City in FUKUSHIMA 5 areas

Dispatch of caregivers Support for dispatching caregivers Special elderly nursing homes in Rikuzen-takata City in IWATE

2 homes67 caregivers

Children's education support

Provision of equipment for school clinicsDonation of scales for body height and weight measurement, vision analyzers, audiometers, stretchers, and beds

Elementary, junior high and high schools in IWATE and MIYAGI

160 schools1,799 items

Prefabricated school gymnasiums Construction of temporary school gymnasiums Otsuchi Town, Ofunato City in IWATE, Iitate Village in FUKUSHIMA 3 gymnasiums

Construction of nursery schools Construction of nursery schools Yamada Town in IWATE, Naraha Town in FUKUSHIMA 3 nursery schools

Construction of school gymnasiums and provision of goods for gymnasiums

Donation of tools and equipment for school gymnasiums

Elementary and junior high schools in Otsuchi Town in IWATE, Sendai City and Higashi-matsushima City in MIYAGI

11 schools899 items

Donation of training autfits for football teams

Donation of practice jerseys for soccer Soccer teams in the affected areas 121 teams3,655 uniforms

Donation of AEDs Soccer teams in the affected areas 92 teams102 AEDs

210


Field of support Name of the project Details of the project Target (those who received the support) Performance / Number

of beneficiaries

Children's education support

Support for school kitchens centers Donation of large refrigerators, kitchen utensils, eating utensils and vehicles

Kamaishi City school lunch center in IWATE, Ishinomaki City school lunch center in MIYAGI, Otsuchi Town and Minami-soma City in FUKUSHIMA

16 centers8,933 items

Provision of materials and equipment for schoolsDonation of lights, reflective safety sashes for satchels, AEDs and personal computers

Rikuzen-takata City Board of Education in IWATE, high schools in coastal areas, elementary and junior high schools in Nihonmatsu City in FUKUSHIMA

58 schools

Donation of school buses Operational support for school busesYamada Town and Otsuchi Town in IWATE , Okuma Town and Katsurao Village in FUKUSHIMA

13 schools / 32 buses (18 donated, 11 rented, 3 contracted

operations)

Organization of Safety Classes Health Safety Classes, support for field trips, mobile movie theater

Yamada Town Municipal Kindergarten in IWATE, Okuma Town Municipal Kindergarten in FUKUSHIMA

8 times740 kindergarteners

Indoor playground Implementation of Smile Parks Preschoolers in Fukushima City and Soma City in FUKUSHIMA

7 times40,890 participants

(total number of visitors)

Summer camp Organization of a summer campPupils and Students of elementary and junior high schools in the three affected prefectures

1 time3,451 pupils and

studentsAssistance for the disaster victims by Junior Red Cross and Red Cross Volunteers Corps

Implementation of training sessions and exchange meetings

JRCS Open-air Class in IWATE, JRCS training centers in MIYAGI and FUKUSHIMA

5 times206 people

Wanpaku Genki (Mischievous Activity) School Implementation of nature experience classes in groups

Elementary school pupils living in temporary housing in MIYAGI

1 time41 pupils

International exchange programInternational exchange program with junior high and high school students from Thailand

Junior high and high school students in MIYAGI

1 time14 students

Medical services

Medical support Development of the Minamisanriku Public Clinic

Construction of the clinic of Shizugawa Public Hospital Minami-sanriku Town in MIYAGI

1 clinic25,070 people (total number of patients)

Renovation of Kesennuma Municipal Motoyoshi Hospital

Renovation of Kesennnuma Municipal Motoyoshi Hospital Kesennuma City in MIYAGI

1 hospital23,724 people (total number of patients)

Renovation of Onagawa Community Medical Center

Renovation of Onagawa Community Medical Center Onagawa Town in MIYAGI

1 medical center48,549 people (total number of patients)

Development of Ishinomaki City Nighttime Emergency Center

Construction of Ishinomaki City Nighttime Emergency Center Ishinomaki City in MIYAGI

1 center7,480 people (total

number of patients)

Development of the temporary ward of Ishinomaki RCHP

Construction of the temporary ward of Ishinomaki RCHP Ishinomaki RCHP

1 hospital ward12,127 people (total number of patients)

Vaccination against pneumococcus Support for free vaccination against pneumococcus

The elderly aged 70 and older living in the three affected prefectures 437,856 people

Assistance for Nuclear Power Plant Accident Victims

Provision of instruments for measuring radiation exposure

Donation of whole body counter and thyroid test monitors, etc

Fukushima Medical University

A set of testing equipment

2 million people(Number of persons

subject to the survey)

Fukushima RCHP

1 WBC7,990 people (Number of

persons tested)2 thyroid test monitors

5,311 people (total number of persons tested)

Donation of food radiation measuring equipment Food radiation measuring equipmentMiyagi Prefecture Board of Education Fukushima City and Nihonmatsu City in FUKUSHIMA

68 points109 equipment items

Government of Kuwait

Funds for the recovery projects for the affected areas

Recovery of community infrastructure, medical support, educational support, support for agriculture, forestry and fisheries, support for small and medium-sized companies

IWATE, MIYAGI, FUKUSHIMA

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ssistance Program


(2) Project teamOn August 1, 2011, a project team for responding to this matter was assembled (a total of 4 members) inside the JRCS Headquarter

(3) Holding a presentation ceremonyOn October 12, 2011, the first delivery of crude oil sent from Kuwait arrived in Japan and a presentation ceremony hosted by METI was held. JRCS President Konoe, METI Minister Edano, JX Nippon Mining and Metals President Kimura (Vice-President of the Petroleum Association of Japan), representatives of each of the affected three prefectures, Kuwait Petroleum Corporation CEO al-Zanki, and the Ambassador Extraordinary and Plenipotentiary of the State of Kuwait to Japan al-Otaibi attended the ceremony.

After the ceremony, a reception was held with the participation of the former Prime Minister Hatoyama, Diet members and other relevant parties in addition to those who attended the ceremony. JRCS President made a speech stating that JRCS would try hard to give assistance for rebuilding the lives of the affected people in cooperation with the three prefectures.

4. Assistance from Kuwait(1) Background to the request and the overall

flow of the assistanceOn April 18, 2011, through the Minister of Economy, Trade and Industry (METI), Japan received an offer from the Minister of Oil, Kuwait that Kuwait to provide 5 million barrels of oil (equivalent to approximately 80 thousand kilo liters, approximately 40 billion yen) as free as assistance for the affected people of the GEJET. This donation was the maximum amount received from a single country.METI decided that is would be appropriate for the JRCS, who had a good track record in the support of the affected people of disasters both in Japan and abroad, to utilize the money equivalent to the oil donated in order to implement effective projects and asked JRCS to implement the assistance programs for the affected people of this disaster. The Director-General, Trade Policy Bureau of METI asked the President of JRCS for the implementation of recovery assistance programs for the affected areas, and JRCS replied, under the name of the President, to the Director-General, Trade Policy Bureau that JRCS would willingly implement the projects requested.Subsequently, JRCS had repeated consultations with METI and other relevant organizations and decided that the targets of support should be the three Prefectures of IWATE, MIYAGI and FUKUSHIMA that had an extremely large amount of damage among the affected 15 Prefectures in this disaster.The flow of the assistance from Kuwait was as follows.

The President of JRCS notified the Governors of the three Prefectures to be supported of the implementation of recovery assistance programs, and received answers of acceptance from all of the three Prefectures.

Kuwait Petroleum Corporation (KPC)

Oil companies (JX and three other companies)

Framework of the support from Kuwait (Free provision of crude oil)

Japanese Red Cross Society

Payment of the amount equivalent to the price for the crude oil provided for free

Provision of crude oil as a raw material

Support for the recovery projects implemented by the local governments for the affected people (transfer of recovery support funds)

Prefectures of IWATE, MIYAGI and FUKUSHIMA

Establishment of funds that can be draw down

Establishment of a committee

Implementation of recovery projectsImplementation report on the projects

Advice

1. Project for recovering the community infrastructure2. Project for medical support3. Project for welfare and nursing support4. Project for educational support5. Project for support for agriculture, forestry and fisheries6. Project for support for small and medium-sized business7. Project for employment support8. Project for support for the victims of the nuclear power plant accident

Japanese Red Cross SocietyChapters of Iwate, Miyagi and Fukushima

Third party committee on the management of the funds

[Scene at the presentation ceremony]

1. Kuwait Government provided for free 5 million barrels of crude oil through the Japanese Government.

2. Oil wholesale companies in Japan received this crude oil and transferred the amount equivalent to the price to JRCS.

3. JRCS gained agreement with METI and implemented assistance programs for the disaster affected people in the Prefectures of IWATE, MIYAGI and FUKUSHIMA (transfer of donation from overseas to each affected prefecture).

4. Each of these prefectures received the donation from JRCS as funds that can be spent down and allocated them to the assistance programs for the affected people implemented according to the priority, emergency level and actual situation of each affected area.

212


Regarding the details of the recovery projects, the summary of the master plan was sent to each Prefecture from JRCS.

(5) Total amount of recovery support funds and amounts allocated to the three affected prefectures

The amount equivalent to the price of the crude oil donated was transferred to JRCS from oil wholesale companies

1 in 7 installments, and the last transfer was

completed on November 22, 2011.The amount of recovery support funds was approximately 524 million dollars in total, which was equivalent of approximately 40 billion yen.

The allocation of the funds to the target three prefectures was determined in consideration of the specificity of the nuclear disaster in addition to the scale of the damage and the fairness of distribution. The amounts allocated to each of the three prefecture were approximately 8.4 billion yen to IWATE, 16.2 billion yen to MIYAGI, and 15.4 billion yen to FUKUSHIMA.

Figure 8-13 Amounts allocated to the three PrefecturesIWATE MIYAGI FUKUSHIMA Total

Allocation for the response to the nuclear power plant accident

--- --- 3,000,000,000 3,000,000,000

Uniform allocation 6,177,671,190 6,177,671,190 6,177,671,190 18,533,013,570

Prorated allocation (index for the secondary allocation of Gienkin )

2,223,961,629

（12%）

10,007,827,328

（54%）

6,301,224,614

（34%）

18,533,013,571

（100%）

Total 8,401,632,819 16,185,498,518 15,478,895,804 40,066,027,141

The details of the major projects in the three Prefectures were as follows.

IWATE (approximately 8.4 billion yen)

Recovering the community infrastructure

Development of railway vehicles and station buildings of the Sanriku Railway, etc.

Educational support

Restoration of private schools, renaissance of local performing arts, etc.

(4) Framework of the supportJRCS gave assistance for the recovery projects implemented by the local governments for the affected people, utilizing as capital funds the amount equivalent to the crude oil provided for free by Kuwait.The intention of Kuwait was that “the Kuwait Government thinks it the first priority to give assistance to the people who are still forced to live a hard life in the affected areas, and asks JRCS to implement effective projects”, and the specification of the form of the projects was left to the discretion of JRCS.In September 2011, JRCS visited the three prefectures. JRCS also consulted in advance with METI and the Kuwait Government, and after having determined the framework of its recovery assistance programs, judged it appropriate to leave the implementation of specific projects to the discretion of each local government who understood well about the actual situation of the affected areas, and decided to allocate the funds received by JRCS to each of the three prefectures.As the range of these projects was set up to be broad, the projects could be available for a variety of support programs for the affected people.

[JRCS President Konoe who made a speech at the reception]

1. Project for recovering the community infrastructure2. Project for medical support3. Project for welfare and nursing support4. Project for educational support5. Project for support for agriculture, forestry and

fisheries6. Project for support for small and medium-sized

business7. Project for employment support8. Project for support for the victims of the nuclear

power plant accident

(1) A total of four companies including JX Nippon Oil & Energy Corporation, Idemitsu Kosan Co., Ltd., Cosmo Oil Co., Ltd., and Showa Shell Oil K.K.

Total amount of funds for recovery support: 40,066,027,141 yen (equivalent to 524,008,400 dollars)

213

Chapter 8

　

Recovery A

ssistance Program


it necessary to have a system where the opinions of a third party could be reflected in the planning and performance of the projects in order to facilitate more appropriate and effective implementation of the recovery assistance programs, and established a committee consisting of a third party from each Chapter in the Prefectures.With the start of the committee in the Fukushima Chapter in February 2012, the three affected prefectures launched the recovery projects in light of the advice of the committee.

(7) Transfer of the funds to the three affected prefectures

On January 6, 2012, JRCS transferred all the recovery support funds on the establishment of a fund in each prefecture for receiving the recovery support funds as well as the completion of the procedures for submitting the supplementary budget.

(8) Implementation status of the recovery support funds

Based on reports from the three prefectures as of March 31, 2012, the implementation status of the recovery support funds in FY2011 is shown in Figure 8-14.

Figure 8-14 Implementation status of the recovery support funds in FY2011

IWATE MIYAGI FUKUSHIMA Total

Allocation of funds for recovery support

8,401,632,819 16,185,498,518 15,478,895,804 40,066,027,141

Amount of implementation in FY2011

29,632,000 0 612,825,516 642,457,516

Accumulated total amount of implementation

29,632,000 0 612,825,516 642,457,516

Balance payable 8,372,000,819 16,185,498,518 14,866,070,288 39,423,569,625

Amount of the initial budget in FY2012

4,701,383,000 7,341,392,000 7,180,044,000 19,222,819,000

(NOTE) As of April 1, 2012

Each prefecture should submit a report on the implementation status of the project to JRCS every half year, and JRCS should sum up these reports and submit to METI.In light of the characteristics of the funds that should be used for recovery support, it is desirable to implement

Support for fisheries

Subsidy for recovering salmon and trout resources, etc.

Support for small and medium-sized business

Support for the early recovery of small and medium-sized companies, etc.

MIYAGI (approximately 16.2 billion yen)


Subsidy for the maintenance and management of temporary housing, etc.

Support for fisheries

Subsidy for recovering aquaculture facilities, securing fishery seeds, etc.

Support for small and medium-sized business

Subsidy for recovering the equipment and facilities of small and medium-sized manufacturers and traders, etc.

FUKUSHIMA (approximately 15.4 billion yen)


Subsidy for the maintenance and management of temporary housing, etc.


Subsidy for the repair and protection of cultural properties, etc.

Support for small and medium-sized companies

Subsidy for recovering the equipment and facilities of small and medium-sized companies, etc.

Employment support

Support for encouraging the temporary engagement in agriculture of farmers at their places of evacuation, etc.

For implementing these projects, JRCS discussed and approved the supplementary budget for the fiscal year 2011 in December 2011.

(6) Establishment of a Third Party Committee (coordination with the Chapters of the three prefectures)

In the three affected prefectures of IWATE, MIYAGI and FUKUSHIMA, a fund that could be spent down was established to ensure the transparency of fund management, and the money for recovery support transferred from JRCS was received through this fund to be allocated to the projects for supporting the affected people.JRCS had determined that the implementation of specific projects was to be left to the discretion of each local government who understood well about the actual situation of the affected areas, but judged

Supplementary budget for the budget of revenues and expenditures of the general account in FY2011Amount of the supplementary budget: 40,066,028,000 yen (both revenues and expenditures)Recovery assistance programs for the GEJET

(Unit: yen)

214


time required for a project would be generally 3 years at longest, but it might be allowed even if the project takes more than 3 years because of its nature.

5. Accounting and audit（１） GEJET Operation Expenditure Report Period covering from 11 March 2011 to 31 March 2013

As of the end of March 2013

Report Prepared by: Tatsuya SugiyamaNotes: #1 General expenditures include costs related to travel, communication, utilties, etc. #2 Others includes services support from the IFRC 　(*) Projects completed per financial records.

the measures for support for the affected people as soon as possible, but some projects may take a certain amount of time from the start to the end. JRCS assumes that the

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sion

of i

tem

s fo

r sch

ool k

itche

n ce

ntre

s (*

)29

2,22

029

2,21

90

8-(2

)P

rovi

sion

of g

oods

for g

ymna

sium

s (*

)10

7,79

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065

08-

(3)

Nur

sery

sch

ool a

nd a

fter-c

lass

cen

tres

(Yam

ada,

Iwat

e)42

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015

3,58

010

1,57

710

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07

8-(4

)C

onst

ruct

ion

of a

fter-c

lass

cen

tre (O

funa

to, I

wat

e)24

,000

250

8-(5

)H

ealth

and

saf

ety

supp

ort (

*)3,

333

3,33

30

8-(6

)S

choo

l bus

ope

ratio

ns s

uppo

rt(*)

203,

868

202,

170

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8132

,309

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8-(7

)P

rovi

sion

of s

choo

l ite

ms

(*)

48,7

9248

,792

08-

(8)

Trai

ning

out

fits

for f

ootb

all t

eam

s (*

)39

,578

39,0

550

8-(9

)P

rovi

sion

of i

tem

s fo

r sch

ool c

linic

s (*

)23

,496

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950

8-(1

0)O

rgan

izat

ion

of in

door

pla

ygro

und

(Sm

ile P

ark)

348,

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174,

736

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7394

,375

297

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1)S

umm

er C

amp

1,13

0,02

658

1,15

060

960

98-

(12)

Pre

fabr

icat

ed s

choo

l gym

nasi

ums

289,

227

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0644

,200

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(13)

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Cro

ss Y

outh

Pro

ject

81,4

8623

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559

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78-

(14)

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ablis

hmen

t of "

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ldre

n's

Wor

ld"

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(15)

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am B

loss

om"

Pro

ject

(*)

3,00

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817

08-

(16)

Mis

cella

neou

s10

,800

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9. C

omm

unity

Bas

ed D

isas

ter

Pre

pare

dnes

s9-

(1)

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visi

on o

f DP

mat

eria

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rage

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litie

s1,

501,

000

355

6666

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apac

ity b

uild

ing

ofJR

C in

the

area

of

dis

aste

r man

agem

ent

10-(1

)"D

evel

opm

ent o

f dis

aste

r res

pons

e ca

paci

ty, t

ools

and

faci

litie

s "

2,00

0,02

21,

712,

777

1,69

5,31

61,

677,

796

17,5

20

11. O

ther

Pro

ject

s11

-(1)

AE

D a

nd o

ther

nec

essi

ties

for v

olun

teer

cen

tres

15,9

1616

,487

886

870

16

12. P

roje

ct u

nder

form

ulat

ion

12-(1

)Fu

ture

pot

entia

l pro

gram

mes

.3,

669,

676

00

13. P

roje

ct m

anag

emen

t and

sup

port

13-(1

)H

R, c

onsu

ltanc

y, a

udit,

eva

luat

ion,

sup

port

by IF

RC

1,

788,

453

892,

510

151,

154

54,6

9496

,828

△36

8

Tota

l Exp

ense

s59

,788

,266

41,7

49,6

412,

733,

546

780,

356

1,67

8,26

531

,744

91,8

8212

8,82

822

,470

215

Chapter 8

　

Recovery A

ssistance Program


and expenditures of the donation from overseas for the GEJET prepared by JRCS. This statement was prepared to disclose the status of revenues and expenses of the donation among the accounting transactions of JRCS, and the Audit was different from a financial statement audit on the overall performance of JRCS.It was an unprecedented experiment for an organization in Japan to receive an audit based on the International Standards on Auditing 800.The period subject to the audit of FY2011 for the statement of income and expenditures of the donation from overseas for the GEJET was from March 16, 2011 through March 31, 2012.The statement of income and expenditures of the donation from overseas for the GEJET was prepared according to the guidelines for preparing the statement of income and expenditures of the donation from overseas for the GEJET, and the audit opinion stated whether the statement was prepared in accordance with the guidelines for preparing the statement of income and expenditures of the donation from overseas for the GEJET.

(2) Audita. Audit based on the International Standards on

Auditing(a) Background to the implementation of accounting

audits for donation from overseas based on the International Standards on Auditing

In response to the fact that a letter of agreement to call for the implementation of an accounting audit was signed for the donation through overseas Red Cross and Red Crescent Societies and that it was necessary to fulfill accountability both in Japan and abroad concerning the implementation of recovery assistance program donation from overseas JRCS decided to receive an audit based on the International Standards on Auditing and entered into a contract with Ernst & Young SHINNIHON LCC.

(b) Summary of the audit workAn audit based on the International Standards on Auditing 800 (Audits of financial statements prepared in accordance with special purpose frameworks) (the Audit) was implemented for the statement of income

Figure 8-15 Summary of the operations of the Audit

Items subject to audit Statement of Income and Expenditures of the donation from overseas for the GEJET

Standards for preparing the statement of income and expenditures

Guidelines for preparing the statement of income and expenditures of the donation from overseas for the GEJET

Practice standards for the audit

International Standards on Auditing 800 (Audits of financial statements prepared in accordance with special purpose frameworks)

Format of the audit report

Stating an opinion about whether the statement of income and expenditures of the JRCS donation from overseas for the GEJET was prepared in accordance with the special purpose frameworks (guidelines)

Identification of plans / risks

Evaluation of strategies / risks Implementation Review / report

・Confirmation of the planning and progress of the projects

・Discussion with the President

・Evaluation of internal controls and identification of the risk of fraud at the overall level

・Evaluation of the status of internal controls・Development of procedures for the evaluated risks・Preparation of the audit strategy statement

・On-the-spot investigations (MIYAGI / FUKUSHIMA)

・Evaluation of the operational status of internal controls

・Implementation of substantive procedures (external confirmation, reading of evidentiary documents, etc.)

・Examination on how to present the statement of income and expenditures

・Review of the Audit work・Overall review / approval・Review procedures・Acquisition of the written representations from the management

・Audit report

Figure 8-16 Flow of the procedures of the Audit

All

figur

es a

re in

thou

sand

Jap

anes

e Y

en (J

PY

)

Bud

get:

Cumu

lative

Spen

ding:

Mar. 2

011 -

Mar.

20

13

Spen

ding:

Ja

n. - M

ar.

2013

Acc

ount

sS

uppl

ies

Land

,vehic

les＆

equip

ment

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spor

t＆

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rage

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sonn

elGe

nera

l Ex

pend

iture

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ers

Pro

gram

Pro

ject

1. D

istri

butio

n of

Em

erge

ncy

Rel

ief

Sup

plie

s1-

(1)

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chas

e an

d R

eple

nish

men

t of E

mer

genc

y R

elie

f Sup

plie

s46

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2. E

mer

genc

y m

edic

al s

ervi

ces

and

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ical

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PS

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ssis

tanc

e (*

)2,

987

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egio

nal H

ealth

care

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port

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neum

onia

vac

cina

tion

for t

he e

lder

ly (*

)3,

619,

420

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00

3-(2

)P

rovi

sion

of A

ir P

urifi

ers

580

580

0

4. A

ssis

tanc

e fo

r nuc

lear

pow

er p

lant

di

sast

er v

ictim

s4-

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le B

ody

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nter

and

thyr

oid

glan

d m

onito

ring

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220

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lear

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aste

r Pre

pare

dnes

s P

roje

ct1,

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rovi

sion

of f

ood

radi

atio

n m

easu

ring

equi

pmen

t (*)

222,

626

222,

626

0

5. R

ehab

ilita

tion

of h

ealth

infra

stru

ctur

e

5-(1

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onst

ruct

ion

of a

tem

pora

ry n

ight

-tim

e em

erge

ncy

med

ical

cen

tre (I

shin

omak

i)10

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onst

ruct

ion

of a

tem

pora

ry h

ospi

tal f

or s

econ

dary

med

ical

car

e (Is

hino

mak

i) (*

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071

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00

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onst

ruct

ion

of a

tem

pora

ry h

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tals

as

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cond

ary

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ical

car

e (M

inam

isan

riku)

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e di

sast

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genc

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al c

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ity o

f Ish

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C H

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nd e

mer

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alth

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ning

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tre (I

shin

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4612

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stru

ctio

n of

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tal (

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ehab

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tion

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unity

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ical

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ter (

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hizu

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rman

ent p

ublic

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l (M

inam

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ial W

elfa

re C

are

cent

re (M

inam

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agi)

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000

00

6. Im

prov

ing

the

livin

g co

nditi

ons

of

affec

ted

peop

le in

eva

cuat

ion

cent

res

and

tem

pora

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stal

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ate

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tal

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sing

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s (*

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butio

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item

s fo

r gro

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omes

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ly (*

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sion

of v

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les

for s

ocia

l wel

fare

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itutio

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ervi

ces

of c

areg

iver

for t

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lder

ly (*

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uppo

rt fo

r soc

ial w

elfa

re c

entre

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ublic

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sing

for t

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ushi

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lic h

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ng fo

r the

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erly

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ushi

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ort

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r sch

ool k

itche

n ce

ntre

s (*

)29

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029

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)P

rovi

sion

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oods

for g

ymna

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ada,

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onst

ruct

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of a

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lass

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tre (O

funa

to, I

wat

e)24

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8-(5

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ealth

and

saf

ety

supp

ort (

*)3,

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3,33

30

8-(6

)S

choo

l bus

ope

ratio

ns s

uppo

rt(*)

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170

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,309

3,46

57

8-(7

)P

rovi

sion

of s

choo

l ite

ms

(*)

48,7

9248

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08-

(8)

Trai

ning

out

fits

for f

ootb

all t

eam

s (*

)39

,578

39,0

550

8-(9

)P

rovi

sion

of i

tem

s fo

r sch

ool c

linic

s (*

)23

,496

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950

8-(1

0)O

rgan

izat

ion

of in

door

pla

ygro

und

(Sm

ile P

ark)

348,

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174,

736

94,6

7394

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1)S

umm

er C

amp

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0,02

658

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98-

(12)

Pre

fabr

icat

ed s

choo

l gym

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ums

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227

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202

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0644

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68-

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Red

Cro

ss Y

outh

Pro

ject

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8623

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559

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Est

ablis

hmen

t of "

Chi

ldre

n's

Wor

ld"

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2158

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0358

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78-

(15)

"Dre

am B

loss

om"

Pro

ject

(*)

3,00

02,

817

08-

(16)

Mis

cella

neou

s10

,800

419

5151

9. C

omm

unity

Bas

ed D

isas

ter

Pre

pare

dnes

s9-

(1)

Pro

visi

on o

f DP

mat

eria

l and

sto

rage

faci

litie

s1,

501,

000

355

6666

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apac

ity b

uild

ing

ofJR

C in

the

area

of

dis

aste

r man

agem

ent

10-(1

)"D

evel

opm

ent o

f dis

aste

r res

pons

e ca

paci

ty, t

ools

and

faci

litie

s "

2,00

0,02

21,

712,

777

1,69

5,31

61,

677,

796

17,5

20

11. O

ther

Pro

ject

s11

-(1)

AE

D a

nd o

ther

nec

essi

ties

for v

olun

teer

cen

tres

15,9

1616

,487

886

870

16

12. P

roje

ct u

nder

form

ulat

ion

12-(1

)Fu

ture

pot

entia

l pro

gram

mes

.3,

669,

676

00

13. P

roje

ct m

anag

emen

t and

sup

port

13-(1

)H

R, c

onsu

ltanc

y, a

udit,

eva

luat

ion,

sup

port

by IF

RC

1,

788,

453

892,

510

151,

154

54,6

9496

,828

△36

8

Tota

l Exp

ense

s59

,788

,266

41,7

49,6

412,

733,

546

780,

356

1,67

8,26

531

,744

91,8

8212

8,82

822

,470

216


report that the statement of income and expenditures of the donation from overseas for the GEJET was prepared, in all material respects, in accordance with the guidelines for preparing the statement of income and expenditures of the donation from overseas for the GEJET.For FY2012, JRCS continued to receive the Audit.

(c) Audit resultsThe Audit was implemented for the statement of income and expenditures of the donation from overseas (for the period from March 16, 2011 through March 31, 2012) prepared by JRCS.As a result of the Audit, an opinion was stated in the

Auditor’s opinion

217

Chapter 8

　

Recovery A

ssistance Program


the labor, management status of cash, and delivery procedures and usage status of electrical household appliances packages and welfare vehicles in the destination areas, related to the recovery assistance programs for the GEJET.

(3) Implementation of a third party evaluationa. Background and purposeJRCS decided to implement an evaluation of the recovery assistance programs for the GEJET and to sum up the performance of the projects with the aims of (1) Appropriate implementation of the projects and the verification of their effects, (2) Utilization for the external disclosure of information and reporting as well as the proposals, and (3) Internal sharing and preparations for the future.In addition to the self-evaluations conducted on the performance of the projects, JRCS implemented an external evaluation by a third party in order to ensure the objectivity of the results of the self-evaluations and verify their neutrality and validity. As the recovery assistance programs by JRCS may continue for a long time, JRCS is planning to conduct the evaluation every fiscal year.For this third party evaluation, JRCS entrusted the evaluation to the Japan Research Institute, Limited. For the projects implemented in FY2011, JRCS received a report

2 on October 31, 2012. For the

projects implemented in FY2012, the evaluation is being continued.

b. Implementation of internal audits (Recovery Task Force)

In the JRCS Recovery Task Force for the GEJET, self-evaluations for the recovery assistance programs were implemented in order to find out and correct any facts that might pose an obstacle to the improvement of operational procedures and the appropriate implementation of operations related to the recovery assistance program.Based on these evaluat ions , the Compl iance Management Office, the internal audit division of JRCS, implemented an internal audit to confirm that the decision-making processes and the administrative procedures were appropriately conducted in accordance with the predefined rules for the implementation of the recovery assistance program for the GEJET.

In the on-site offices of the Recovery Task Force established in each Chapter of the three affected prefectures, internal audits were implemented for

Date: Tuesday, August 2, 2011Period subject to the audit:Friday, March 11, 2011 - Thursday, June 30, 2011Operations subject to the audit:・Operations implemented by the Recovery Task

Force for the GEJET・Operations implemented by the relevant

departments (Recovery Task Force, General Affairs Department, Human Resources Department, International Department, and Medical Services Department) in relation to the operations mentioned above

Auditor: 3 staff of the Compliance Management Office (including Deputy Director General for the audit)Items to be audited:・Progress of discussions about the recovery

assistance programs in the council for the program・Appropriate implementation of the recovery

assistance programs based on the discussions and agreements with the affected prefectures

・Preparation of the necessary documents on resolutions and books of accounts related to the recovery assistance programs

・Project reports to the overseas Red Cross and Red Crescent Societies based on the agreements

Results of the audit:The finding of the internal audit was that there was a flaw in an article on personal information protection in the outsourcing agreement.

Date: Monday, December 19 - Tuesday, December 20, 2011Auditee: On-site offices of the Recovery Task Force for the GEJET established in MIYAGI and FUKUSHIMA, Organizations who received the electrical household appliancesAuditor: 1 staff of the Compliance Management Office (Director for the audit)Items to be audited:・Appropriate labor management of the on-site

stationed staff・Periodic report to / discussion with the Recovery

Task Force about the implementation of operations・Appropriate handling of personal informationResults of the audit:

Each item audited was generally appropriately implemented and there were no written findings.

(2) A report of “A third party evaluation of the recovery assistance programs for the GEJET (projects implemented in FY2011)” prepared by the Japan Research Institute, Limited (October 31, 2012)

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(c ) Actions implemented and the methods of examination / analysis

In this evaluation, the following actions were implemented and summed up in the report.

• Review of the JRCS internal evaluation for the recovery assistance programs

• Recognition survey of the beneficiaries (affected people) on the recovery assistance programs

• Recognition survey of the relevant organizations including municipalities on the recovery assistance programs

• Recognition survey of the general public on the recovery assistance programs

• Survey on the operations of the recovery assistance programs

• Analysis of the details of the above surveys• Evaluation based on the results of the analysis

b. Evaluation targetsIn the evaluation for the projects implemented in FY2011, the following recovery assistance programs implemented by JRCS were evaluated as the targets.

I. Individual project evaluations(i) Detailed evaluation(ii) Brief evaluation

II. Overall evaluation(i) Evaluation by support sector(ii) Evaluation by form of support(iii) Evaluation by region(iv) Evaluation based on studies in the affected areas(v) Evaluation based on recognition of the recovery

assistance programs outside the affected areas(vi) Evaluation of policies / strategies, and organizations /

operational frameworks

c. Evaluation methods(a) Approach and evaluation criteria for the individual

projects evaluationsIn the individual projects evaluations, output (project outcome) and process (the course of a project carried out) were focused on, and a total of 7 items including 2 items of outputs and 5 items of process were evaluated.

Items evaluated

Output Quantitative aspectsQualitative aspects

Process

Promptness / SmoothnessEfficiencyEffectivenessTransparency / ValidityFairness

(b) Approach to the overall evaluationAn overall evaluation for the recovery assistance programs was implemented based on the following perspectives.

(i) Policies/strategies and operational frameworks of the projects

(ii) Rationality of the selection of the projects implemented

(iii) Allocation of resources (aspects of both finance and human resources)

(iv) Promotion Management of the projects

Gienkin (Cash grant scheme)

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1. Gienkin ; Cash grant scheme(1) Collection of Gienkin through the Japanese

Red Cross Society (JRCS)JRCS started Gienkin (Cash grant scheme) on March 14, 2011, together with the Central Community Chest of Japan and NHK (Japan Broadcasting Corporation, including the NHK Public Welfare Organization). The collection of Gienkin was implemented in accordance with the “JRCS Regulations for Handling Gienkin for Disasters”, and generally the chapters in the affected prefectures play the main role in collecting the Gienkin , but as the damage was extremely extensive in the Great East Japan Earthquake and Tsunami (GEJET), it was determined that the Headquarters should coordinate the nationwide collection of Gienkin .The collection of Gienkin was implemented in the several ways including: 1. Normal transfer (Japan Post Bank/Japan Post), 2. Bank transfer, 3. Use of a credit card, convenience store or Pay-easy, 4. Use of the Family Mart “Fami Port Donation” system, 5. Contribution by Ecopoint, 6. Collection at the reception counters of the JRCS offices.The collection period was first set until September 30, 2011, but it was extended in a step-by-step manner due to the continuous contribution of huge sums the Gienkin funds and it was decided on March 31, 2013, that the collection period for Gienkin collection would be extended until March 31, 2014.

(2) Initial response to the collection of GienkinThe JRCS decided to start collecting Gienkin on March 12, 2011, the day following the disaster, and actually started collecting Gienkin on March 14 after some coordination work with the relevant organizations, including financial institutions.For the collection of Gienkin , the JRCS Organizational Development Department had initially responded to all telephone inquiries, and this resulted in a situation in which the staff was tied up on the telephone to answer questions. A call center was set up in the Headquarters on March 16 to respond to the inquiries and staff members were deployed, exclusively in handling the inquiry calls. In addition, a toll-free hotline call center was opened outside the JRCS on April 27, 2011. On

Chapter 9　Gienkin (Cash grant scheme)

Figure 9-1　Main actions related to the collection of 　　　　　　Gienkin and the responses by the JRCS

Date Actions and responses

March 11, 2011 A massive earthquake of magnitude 9.0 occurred off the SANRIKU Coast.

March 12

Decided on the collection of Gienkin at the Headquarters and informed the chapters of this.Informed the relevant financial institutions concerning the collection of Gienkin .Informed the relevant news media including NHK of the collection of Gienkin .

March 14 Started the collection of Gienkin .

March 16Deployed full-time staff to respond to telephone inquiries about the Gienkin . (Establishment of a call center)

March 22 Started to sort the postal transfer forms. (Establishment of a sorting center)

March 24Establishment of a full-time system for the operation of cash receipts. (Establishment of a cash receipt center)

March 30Deployed staff members to respond to inquiries by e-mail about the Gienkin . (Establishment of an e-mail center)

April 6 Started to input the postal transfer forms. (Establishment of an input center)

April 7Through press releases and a website, apologized for and corrected an error in the summary values announced on April 5.

April 8

Participated in the first meeting of the distribution committee to decide on the fair proportional distribution of the Gienkin and determined the rate of distribution.

April 13Started the transfer of the first distribution of Gienkin to each affected prefecture.

April 14 Started to dispatch the receipts for the Gienkin .

April 27Established a hotline call center outside the JRCS to respond to inquiry calls about the Gienkin .

May 13 Started to issue receipts for the Gienkin in irregular cases.

June 6Participated in the second meeting of the committee to decide on the fair proportional distribution of the Gienkin .

June 17Started the transfer of the second distribution of the Gienkin to each affected prefecture.

August 29Increased the number of staff to issue receipts for the Gienkin in irregular cases. (Establishment of a receipt handling center)

December 8Participated in the third meeting of the committee to decide on the fair proportional distribution of the Gienkin .

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generally collected and distributed under the Gienkin Collection and Distribution Committee established by the affected areas governments, Gienkin collecting organizations, news media and other relevant parties.

(2) Handling of Gienkin in the GEJETAs the GEJET had inflicted widespread damage over multiple prefectures, and some governments suffered such devastating damage to their administrative functions that their response to Gienkin was delayed, JRCS began to collect Gienkin without waiting for the establishment of Gienkin Collection and Distribution Committees by the affected local governments. Delayed establishment of Gienkin Collection and Distribution Committee in each affected local government caused a situation in which the distribution method of Gienkin was not determined and JRCS and other Gienkin collecting organizations continued to hold the collected Gienkin . In addition, it was required to discuss the same distribution criteria in the affected areas so as not to develop distribution criteria that were different for each affected prefecture.Thus, as a result, the JRCS asked the Cabinet Office to make an adjustment at the national government level and the MHLW requested the Cabinet Office to become the Secretariat to establish a “Committee to decide on the ratio for the fair distribution of Gienkin” consisting of intellectuals, the affected prefectures, Gienkin collecting organizations (JRCS, Central Community Chest of Japan, NHK and NHK Public Welfare Organization) in preparation for the distribution of Gienkin to each affected prefecture and coordinated by MHLW. On April 8, the first meeting of the Committee was held.Collected Gienkin was transferred to each affected prefecture based on the distribution ratio for the fair distribution determined by the Committee.Each affected prefecture established a Gienkin Collection and Distribution Committee and discussed the allocation of Gienkin , and transferred it to each targeted municipality in each prefecture. In the prefectures most affected, such as FUKUSHIMA, MIYAGI and IWATE, the Gienkin Collection and Distribution Committee was established in FUKUSHIMA on April 1, in MIYAGI on April 13, and in IWATE on April 18.

March 30, a mail center was also opened to respond to inquiries by e-mail and full-time staff members were deployed to respond to these e-mails.From April 14, issuance of the receipts for the Gienkin was started. On August 29, a receipt handling center was established to smoothly issue the receipts for the Gienkin received not only via postal and bank transfers, but also by registered mail.In a situation where the Distribution Committee had hardly been established in the affected local governments, the rate of distribution was determined in the first meeting of the Gienkin Collection and Distribution committee to decide on the ratio for the fair distribution of Gienkin , held on April 8 and the first transfer of Gienkin to each affected prefecture was started on April 13.In the initial response period where huge sums of Gienkin were contributed over such a short period, some errors occurred in the summary values of the Gienkin collected. A total value of approximately 30 billion yen more than the actual amount received had been announced on the JRCS website, and the error was apologized for and corrected through a press release dated April 7 as well as on the website. 2. Handling of Gienkin(1) Role of the JRCSThe role of the JRCS is to collect the raised Gienkin together with the Central Community Chest of Japan as a Gienkin collecting organization and to deliver the full amount of Gienkin to each affected prefecture.Regarding the collection of Gienkin and its distribution to the affected people, it is stipulated in the Basic Disaster Management Plans prepared by the Central Disaster Management Council that “regarding the use of Gienkin , affected local governments with Gienkin collecting organizations and a Distribution committee and should determine its use after sufficient discussions”. It is also stipulated in the Operational Plan for Disaster Prevention

1 of the Ministry of Health,

Labour and Welfare (MHLW) that “affected prefectural and municipal governments should organize a Gienkin Collection (Distribution) Committee consisted of relevant support organizations, determine its distribution criteria in view of the total amount of Gienkin and the situation of the affected areas, and quickly and appropriately distribute it with the help of news media”.According to the above stipulations, Gienkin should be

(1) Operational Plan for Disaster Prevention of the MHLW, Title 2 “Disaster Emergency Response Measures”, Chapter 4 “Welfare-related Measures”, Section 7 “Collection of Relief Supplies and Gienkin”, Item 3.

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3. Collection status of GienkinJRCS received huge sums of Gienkin at the reception desks at the Headquarter and each chapter. The status of Gienkin collection was disclosed on the website of the Headquarters and has been updated as needed.The collection status of Gienkin received at JRCS by March 31, 2013, is shown in Figure 9-4.Exceptionally huge sums of Gienkin were collected immediately after the disaster. (In March 2011, nearly 100 billion yen was collected as Gienkin in 20 days from the occurrence of the disaster until the end of the month.)Since then, Gienkin has been collected continuously and the sum reached approximately 326.4 billion of yen by the end of March 31, 2013.Gienkin received from overseas through many foreign embassies in Japan is included in this sum, and some senior officials or ambassadors to Japan came directly to the Headquarter to hand over the Gienkin .

Figure 9-4　Sum of Gienkin received (Amount received each month and the cumulative amount)

(Note 1) The total amount was added up at the end of each month.(Note 2) The amount of Gienkin received through the Central Community Chest of Japan and NHK (including NHK Public Welfare Organization) is not included in the amounts shown in the above figure.

Figure 9-3　Status of holding the first meeting of the Gienkin　　　　　　　Distribution Committees in 15 affected prefectures

Name of prefecture

Date of the meeting

Name of prefecture

Date of the meeting

HOKKAIDO No meeting held GUNMA Apr. 15 *AOMORI Apr. 14 SAITAMA Jul. 21 *IWATE Apr. 18 TOKYO May 13MIYAGI Apr. 13 CHIBA Apr. 19YAMAGATA Apr. 22 KANAGAWA No meeting heldFUKUSHIMA Apr. 1 NIIGATA Apr. 19IBARAKI Apr. 25 NAGANO Apr. 13TOCHIGI Apr. 21* Document-based discussions in GUNMA. The first meeting was only held from the second distribution in SAITAMA.

(Amount received each month: million yen)Amount received in the month Cumulative amount

【Intellectuals】Mr. Tsutomu Hotta, Director of the Sawayaka Welfare Promotion CenterMs. Fumiko Nishizaki, Professor of the Faculty of Law, Seikei UniversityMr. Hiroshi Takahashi, Executive Director and Secretary General of the Furusato Kaiki Support Center (Support Center for Return to the Home Land)

【Local governments】HOKKAIDO, AOMORI, IWATE, MIYAGI, YAMAGATA, FUKUSHIMA, IBARAKI, TOCHIGI, GUNMA, SAITAMA, CHIBA, TOKYO, KANAGAWA, NIIIGATA, NAGANO

【Gienkin collecting organizations】JRCS, Central Community Chest of Japan, NHK and NHK Public Welfare Organization

Figure 9-2　Members of the Committee to decide on 　　　　　　　　the ratio for the fair distribution of Gienkin

March

2011

April 2011

May 2011

June

July

August

Septem

ber

Octobe

r

Novem

ber

Decem

ber

Januar

y 2012

Febr

uary

March

AprilMay

June

July

August

Septem

ber

Octobe

r

Novem

ber

Decem

ber

Januar

y 2013

Febr

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March

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(2) Holding the second meeting of the Committee to decide on the ratio of Gienkin

As a result of the primary distribution method where the amount obtained by multiplying the base distribution amount by the number of applicable households and residents was transferred to each affected prefecture upon request, only a part of the Gienkin was distributed and a large amount of Gienkin was retained by the Gienkin collecting organizations.As of June 3, 2011, the total amount of collected donation at JRCS, Central Community Chest of Japan, NHK and NHK Public Welfare Organization was approximately 251.4 billion yen, but the amount that had already been transferred to the affected prefectures was only approximately 82.3 billion yen (of which, the amount that had been transferred to the Municipalities was approximately 72.4 billion yen).Consequently, on June 6, 2011, the second meeting of the Committee of Gienkin was held with the aim of the prompt distribution of Gienkin . In the committee, it was confirmed that the full amount of collected Gienkin should be transferred to the affected prefectures (a certain amount of Gienkin should be retained due to the unclear state of the damage, and the remaining amount should all be transferred), and that the means of distributing it to the affected people should be independently determined by each local government.It was concluded that the allocation of the Gienkin to each affected prefecture should be determined according to the degree of damage, with the indication of “1” for “a household with lost or missing family members, or houses completely destroyed or burned, or an evacuated household due to the nuclear power plant accident”, and “0.5” for a “household with the

4. Transfer and distribution status of Gienkin

(1) Holding the first meeting of the committee to decide on the ratio for the fair distribution of Gienkin

As mentioned above, the MHLW became the Secretariat to establish the committee to decide on the ratio for the fair distribution of Gienkin consisting of intellectuals, the affected prefectures, Gienkin collecting organizations (JRCS, Central Community Chest of Japan, NHK and NHK Public Welfare Organization), and the ratio of the distribution of Gienkin to each affected prefecture was determined.The first meeting of the committee was held on April 8, 2011. The policy for the initial distribution to the affected prefectures (primary distribution) was determined based on the damage situation in each prefecture estimated as of April 8 and the total amount of Gienkin collected.Specifically, it was determined that, in accordance with the base amount of “350,000 yen for a household with their house completely destroyed, burned or washed away, or with lost or missing family members”,

“180,000 yen for a household with their house half destroyed or burned” and “350,000 yen for a household located in the evacuation order zone or indoor confinement order zone affected by the nuclear plant accident”, the total amount multiplied by the number of applicable households and residents should be transferred to each affected prefecture.It was also determined that JRCS and other Gienkin collecting organizations should transfer the Gienkin to each affected prefecture based on the distribution ratio determined in the Committee at the request of the affected prefectures.

Figure 9-5　Distribution flow of the Gienkin

Committee to decide on the ratio for the fair distribution of (Secretariat: MHLW)

Contributors Affected Prefectures Affected Municipalities affected people

- Confirmation of the status of the damage- Issuance of affected people Certificates

* 　　　　 Collection and Distribution Committee(Established in the affected prefecture)Consisting of the affected prefectures, collecting organizations and news media, etc.

JRCSCentral Community Chest of JapanNHKNHK Public Welfare Organization

Determination of the distribution method

Gienkin

Gienkin

Gienkin

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Figure 9-6 Status of the distributed amount to each prefecture　

(As of March 31, 2013)

Name of the Prefecture Total amount transferred (Unit: yen)HOKKAIDO 10,289,072

AOMORI 753,592,840

IWATE 33,495,173,344

MIYAGI 175,769,337,248

YAMAGATA 9,714,568

FUKUSHIMA 123,054,025,024

IBARAKI 15,552,669,904

TOCHIGI 1,938,705,920

GUNMA 5,169,536

SAITAMA 157,277,096

CHIBA 7,694,386,080

TOKYO 224,902,864

KANAGAWA 96,419,168

NIIGATA 195,826,864

NAGANO 141,203,984

Total 359,098,693,512

(Note) The amount above is the total amount sent from both JRCS and the Central Community Chest of Japan.(Note) As of March 31, 2013, JRCS collected 326,471,943,265 yen, and the Central Community Chest of Japan collected 40,868,904,923 yen.

(5) Conduct of an aud i t based on the International Standards on AuditingJRCS had an audit conducted according to the same International Standards on Auditing as for the donation from overseas to ensure the transparency of the handling of the Gienkin .As a result of the audit, the opinion was stated in the report that the income and expenditure statement for the Gienkin for the GEJET prepared by JRCS (from March 14, 2011 through March 31, 2013) was duly developed in accordance with the preparation guidelines of the income and expenditure statement of the Gienkin for the GEJET in every important point.

house half destroyed or burned”, and that the amount to be transferred should be calculated by dividing the total amount of Gienkin proportionally based on the damage reported by each prefecture.

(3) Holding of the third meeting of the Committee of Gienkin

On December 8, 2011, the third meeting of the Committee to decide on the ratio for the fair distribution of Gienkin was held.In the Committee, the distribution of Gienkin retained by the Gienkin collecting organizations, the affected prefectures and the municipalities was discussed to allow it to be available when new damage was revealed.Consequently, it was determined that the full amount of the Gienkin should be distributed based on the rules of its second distribution.The decision made in the committee was as follows:

(4) Distribution amount of the GienkinThe amount of approximately 359.1 billion yen of the Gienkin was sent to the affected prefectures from JRCS and Central Community Chest of Japan by March 31, 2013.As mentioned above, based on the distribution ratio determined in the first meeting of the Committee of Gienkin , the primary distribution of Gienkin to each affected prefecture was initiated on April 13, 2011.In addition, on June 17, 2011, the transfer for the second distribution began based on the distribution ratio determined in the second meeting. Since then, a total of seven transfers of Gienkin based on the ratio of the second distribution were made on July 15 and August 12 in 2011, January 15, March 9, June 1 and November 9 in 2012 and by March 31, 2013.

【Gienkin collected by the end of September】Full amount of the Gienkin should be distributed based on the rules of its second distribution.

【Gienkin collected in and after October】Distribution of the Gienkin should be made based on the rules of its second distribution. However, it can be effectively utilized such as for distribution to the reserve funds for affected people including orphans of the GEJET.

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cooperation of volunteers, but as they became unable to provide a sufficient response, an e-mail response center was established on March 30. The e-mail center had a total of six staff (initially three staff), of which one staff member could respond in English. As with the incoming call center, a manual and some templates for an e-mail response were prepared to provide a standardized operation.

c. Response to inquiries outside the call centerFurthermore, because it was too much to respond to so many telephone inquiries with the internal incoming call center mentioned above, an external toll-free hotline call center was established on April 27 to enhance the response for incoming calls. In the external call center, a total of 15 staff (five staff to respond the incoming calls) worked on a combination of four patterns of shifts on weekdays, “09:00-13:00”,

“09:00-18:00”, “13:00-19:00” and “09:00-19:00”, and a shift of “09:00-17:30” on holidays to provide a seven-days-a-week response service. This external call center received a total of 42,729 inquiries about Gienkin and other disaster relief and recovery operations provided by JRCS.Regarding the contents of inquiries about Gienkin , a

5. Response system for the Gienkin(1) Response to inquiries about Gienkina. Establishment of an incoming call centerJust after the occurrence of the disaster, the JRCS Organizational Development Department was inundated with various inquiries including those about Gienkin , and the operational burden on the staff became extremely heavy. Therefore, from March 16, a dedicated team was established to respond to these telephone inquiries. A total of 14 staff (10 staff received the calls) worked in two shifts - early shift (09:00-18:00) and late shift (12:00-21:00) - to establish a seven-days-a-week response system, and prepared a manual for responding to phone calls to provide a standardized operation.In addition, from April 11, an English speaking staff was also added to enhance the system to be able to respond the inquiries from abroad.

b. Establishment of an e-mail centerJust after the occurrence of the disaster, inquiries on Gienkin , overseas inquiries and other e-mails addressed to the JRCS main e-mail address had increased and reached more than 14,000 e-mails for a while. At first, these e-mails were handled with the

Figure 9-7　Changes in the status of the Gienkin transferred / distributed

Amount retained by the collecting organizations (E) = (A) - (B)Amount retained by prefectures (F) = (B) - (C)Amount retained by municipalities (G) = (C) - (D)Total amount collected (A)

Amount sent to the prefectures (B)

Amount sent to the municipalities (C)

Amount distributed to the affected people (D)

(100 million yen)

5/27 6/3 6/10 6/17 6/24 7/1 7/8 7/15 8/12 9/9 10/14 11/11 12/9 1/13 1/27 3/9 6/1 7/13 8/10 9/14

4000

3500

3000

2500

2000

1500

1000

500

0

About five months after the disasterRate of transfer to the prefectures: 89.3%(Note: Rate at the time of the Great Hanshin Earthquake: 41.4%)

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checked it against the record of deposits received, and issued a receipt. As the record of deposits received through bank transfers or payment by credit card was compiled in a database, the request could be promptly checked against the record of deposits received based on the money transfer record (date, name and amount of the transfer) to enable the smooth issuance of receipts. On the other hand, regarding donations through postal transfer, registered mail or direct carrying-in to the office, the request was able to be checked against the record of deposits only after the organization of postal transfer forms, the preparation of a document necessary for money receiving operations (receipt record), and data entry of the necessary information or other clerical work, and it took much time and effort to check and prepare a receipt, resulting in delays in issuing the receipts.To streamline the organization of postal transfer forms and the preparation of the receipt record, a sorting center for postal transfer forms was established on March 22.

In addition, a data input center was established on April 6 to begin data entry for the sorted postal transfer forms. With these improvements in the operational system, the dispatch of receipts could start on April 14.

Figure 9-10 Cumulative total of receipt issuances　　Figure omitted

The improvements in the operational system mentioned above made it possible to prepare most receipts issued as a routine operation, but there were quite a few cases requiring irregular responses.

request for a receipt was the most frequent inquiry. In addition, during the period of tax returns from February through March, 2012, as there were many inquiries about tax deductions, the number of inquiries about Gienkin temporarily increased. Among the calls received at the incoming call center, there were not only inquiries or complaints, but also many messages of encouragement to the affected people and for the activities of JRCS. The number of telephone responses above includes such messages of encouragement.

(2) Issuance of a receipt for GienkinJRCS issued a receipt for Gienkin for those who wish it, and issued a total number of approximately 400,000 receipts by March 31, 2013.Regarding the issuance of a receipt, receiving a request for issuing a receipt from the donor through a phone call or the request form for issuing a receipt on the website, JRCS confirmed the money transfer record (date, name and amount of the transfer),

[ View of the sorting center for postal transfer forms (meeting room 302 of the Headquarters) ]

Figure 9-8 Number of telephone responses 　　　at the external call center

Figure 9-9 Breakdown of the contents of 　　　　 the inquiries about Gienkin

327

3,158

6,760

7,587

5,676

3,2992,456

2,2111,869 1,992

4,465

2,929

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000Number of calls received Cumulative number of calls received

Apr.2011May.2011Jun.2011Jul.2011Aug.2011Sep.2011

Oct.2011Nov.2011Dec.2011

Jan.2012Feb.2012

Mar.2012

0

1,000

2,000

3,000

4,000

Request for a receipt Request for splitting a receipt

Inquiry about tax deductions Others

Apr.2011May.2011Jun.2011Jul.2011

Aug.2011Sep.2011Oct.2011Nov.2011Dec.2011Jan.2012Feb.2012Mar.2012

(Note) Regarding the contents of the inquiries, those about Gienkin and the household appliance packages donated to the affected people as a part of the recovery operation accounted for more than 40%, and particularly in July and August, inquiries about household appliance packages accounted for over half of the inquiries.

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was the money credited to the JRCS account.Due to the extremely large amount of Gienkin donated from overseas immediately after the disaster and if the details of the deposits had to be confirmed one by one for the account with a large number of deposits, the depositing procedures would be delayed, thus an exceptional measure was taken whereby the procedures to allow it to be entered in a due account through internet banking.Among the transfer money actually received, there were cases where a bank account other than for Gienkin was designated as the beneficiary, although it has a clear notification of use for Gienkin, or only the bank name was designated as the beneficiary. As there were many cases in which the banks could not make a clear decision on going through the depositing procedure, JRCS continued to receive inquiries almost every day from the banks for about 3 months after the disaster. In such cases, JRCS went through the procedure in tandem with the banks.Regarding deposits by credit card, as it was difficult to specify the category between Gienkin and a donation, or requests for the cancellation/correction of a transfer or a refund were made by the donors, deposits by credit card were the greatest cause of delays in specifying the collected amount of Gienkin .

b. Collection of Gienkin in cash (including in foreign currency and cash sent by registered mail)

There were many donors who directly brought cash to the Headquarters or sent cash by registered mail. To immediately deposit the collected cash in the bank account, a “Cash Center”, where the confirmation operation of the amount and denomination of the cash was outsourced, was established from March 24 through the end of September 2011. In addition, a system that allowed for the immediate delivery of the confirmed cash to the banks was established by asking the persons from the banks to come to the Headquarters every day until mid-August, five months after the occurrence of the disaster.However, it took a long time to handle cash since some foreign currencies were not accepted by the banks or some coins were so dirty that the banks refused to receive them and the JRCS staff consequently cleaned them and brought them again to be deposited in the bank account.

For example, when the issuance of split receipts or a receipt in English was requested, appropriate individual attention was required.From May 13, the response to such requests for irregular receipt issuance started. However, as the work was initially divided among the staff involved in the operation of issuing receipts and no systematic response was established, the operational burden increased. Then on August 29, a receipt center was established and personnel dedicated to responding to irregular cases were deployed in order to systematically handle such cases.

(3) Receiving and totaling of the Gienkina. Confirmation of depositsJust after the occurrence of the disaster on March 14, 2011, a dedicated account for receipt of Gienkin was opened and the collection of Gienkin was initiated. During a half year from the occurrence of the disaster until the end of September, huge sums of Gienkin were donated not only in Japan, but also from overseas, reaching approximately 289.9 billion yen, equivalent to some 90% of the approximately 326.4 billion that was collected by March 31, 2013.In such situations, the number of deposits received in a day was extremely large (approximately 12,000 deposits per day on average), and as it exceeded the upper limit of using internet banking, the deposits could not be confirmed. In addition, after updating the account book, the book immediately became full again, and it was not appropriate as a means for the confirmation of deposits. Furthermore, with the system down in some banks, situations in which the collected amount of Gienkin could not be confirmed continued for approximately 2 weeks after the occurrence of the disaster.To resolve these problems and ensure confirmation of the deposits, JRCS asked banks that could not confirm the deposit in the ordinary way to send a regular report in the form of data every day.Moreover, regarding the money received from overseas through bank accounts, it was not automatically credited to the bank account like a domestic transfer, but it was necessary to confirm whether the money could be credited in the JRCS bank account through internet banking. Therefore, only after JRCS staff had confirmed the contents of the deposit one by one, determined that the contents were appropriate as a deposit addressed to JRCS, and followed the procedures to allow the deposit to be entered in a due account through internet banking,

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d. Operation of adding up the collected GienkinAs JRCS received a huge amount of Gienkin from home and abroad, considering it needed to immediately announce the received amount even as an approximate calculation, JRCS announced the total sum of the received amount of Gienkin in the form of a daily report by adding up the amount deposited in the major accounts dedicated to receiving Gienkin .

6. Public relations activities and public opinion related to Gienkin

(1) Public relations activitiesa. Public relations activities via the websiteJRCS disseminated information on its website to make the public aware of the status of Gienkin collection as well as the JRCS collecting activities.Regarding the status of the Gienkin collection, the number of donors and the total amount were announced on the website and updated every day.In addition, JRCS explained that the total sum of Gienkin would be distributed to the affected people and tried to make information clearly with a newly prepared website page showing the specific flows of Gienkin .Furthermore, after the establishment of the Committee to decide on the ratio for the fair distribution of Gienkin , a press release was issued and posted on the website whenever Gienkin was sent to each prefecture.At the same time, to report the activity status of JRCS and to smoothly respond to various questions, banners for “Activity report”, “Gienkin” and “Activity funds” were set up on the home page of the JRCS

c. Reception of foreign checksRegarding foreign checks, it sometimes takes at least one month from its reception to check encashment, or some received checks are dishonored. Therefore, because the amount received cannot be finalized until its actual encashment, and moreover, a handling fee is charged even if a check is dishonored, JRCS generally makes it a rule not to accept foreign checks. However, actually foreign checks were continually mailed to JRCS, and a total of 1,085 foreign checks, which was approximately 90% of the total of the 1,161 checks received as of March 31, 2013, were received during a half year from the occurrence of the disaster through to the end of September. These contributed to the delay in the finalization of the amount received.For this reason, until the end of October, seven months after the occurrence of the disaster, one temporary staff member dedicated to the operations related to the encashment procedures for foreign checks was deployed.

Figure 9-11 Difference between “Gienkin”, “overseas donations” and “membership fees”

GienkinOverseas relief funds

Activity funds

Individuals andcorporationsat home andoverseas

affectedpeople

The will be transferred in full in cash to the affected peopleof the disaster via the distribution committee.

Red Cross and Red Crescent societies throughout the world

From the employees(members) in Japan

Donations, etc.

Membership feeDonation

Central CommunityChest ofJapan and other collectingorganizations .

JRCS

distributioncommittee distributioncommitteeGienkin

Support projects providedby the Red Cross SocietySupport projects providedby the Red Cross Society

Disaster relief activities, etc.Humanitarian activities of JRCSDisaster relief activities, etc.Humanitarian activities of JRCS

AffectedMunicipalitiesAffectedMunicipalities

Established in each affected Prefecture

The funds will be used for livelihood support for the affected people including the distribution of electrical household appliances.* When a disaster occurs abroad, overseas donations collected in Japan are transferred to the Red Cross and Red Crescent Societies in the affected country via JRCS.In the case of the 2010 Haiti Earthquake, approximately 2.1 billion yen of overseas donations were used for emergency relief and recovery operations in Haiti.

The funds will be used for medical support, psychosocial support and the distribution of relief goods including blankets at the time of a disaster, for the promotion of emergency aid seminars and for the nurturing of volunteers and Red Cross Youth in times when there are no disasters to deal with.

Gienkin

Gienkin Gienkin

Flow of and Overseas donations in the GEJET

Donation from overseas

Gienkin

Flow of the Red Cross Society activity funds

[Cash Center established on 7F of the Headquarters]

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number of complaints each time such reports were broadcast on television.Then, as the system of Gienkin became widely known to the public, there was an increase in TV coverage explaining that the reason for the delayed distribution of Gienkin was the loss of administrative functions of the governments of affected area.

(2) Misunderstandings about JRCS’s activitiesa. Misunderstandings about JRCS’s activitiesThe JRCS activities in relation to Gienkin collection were generally not well understood and there were many cases of criticism based on such misunderstandings.Specifically, in the June 2 issue of the weekly magazine

“Shukan Shincho” (released on May 26), an article with the title “The affected people are crying! Negligence of JRCS who have not distributed 130 billion yen of Gienkin” appeared, and a misleading report was made that the delayed distribution of Gienkin to the affected areas was due to the negligence of JRCS.Regarding this matter, JRCS sent a letter of protest dated May 27 to SHINCHOSHA Publishing Co., Ltd., which expressed sincere regrets, stating that

“the article was written without verifying the actual situation of JRCS activity from the occurrence of the disaster until today nor considering the situation of the affected local governments, and its contents were based on misinterpretation of the facts, resulting in slander and abuse against JRCS and damage to confidence in the JRCS”. This letter of protest was also posted on the website.

Figure 9-13 Letter of protest posted on the 　　　　　　　　　website of the JRCS headquarters

Figure omitted

As the situation in which Gienkin had hardly reach the affected people continued, false information that

“JRCS charges 20-30% of the amount of Gienkin as a handling fee” was disseminated through TV coverage or SNSs which caused a further dissemination of the false information by means of communications media even by the intellectuals who had received such information.In the September 1, 2012, edition of JRCS News issued every month by JRCS, an opinion survey

2 was

website and the toll-free number for inquiries was also clearly shown.

Figure omitted

b. Newspaper advertisementsJRCS ran newspaper advertisements to show its appreciation for cooperation on the Gienkin and to ask for continuous support for the affected areas.Regarding the campaign of newspaper advertisements in May 2011 as a part of an activity month for JRCS, the contents of the “Appeal for activity funds” that had been scheduled was changed to an “Appeal for Gienkin” in order to ask for cooperation on Gienkin collection.A newspaper advertisement with Ms. Norika Fujiwara, an actress, the Red Cross public-relations ambassador, in a JRCS rescue uniform at the center surrounded not by entertainers but by JRCS staff was placed in the morning edition of the Nikkei shimbun (newspaper) dated May 1, 2011. In addition, on May 2 and 3, acknowledgement of Gienkin was also placed in the Nikkei shimbun along with articles including an interview with the President of JRCS and an introduction to JRCS activities. In addition, other newspaper advertisements about Gienkin were placed in four national newspapers.Furthermore, certain other newspaper advertisements were placed in national newspapers, block newspapers, and the most widely-circulated local newspapers in each prefecture dated September 11, 2011, March 11 and September 11, 2012 in order to fulfill accountability about the Gienkin by explaining to the public about its status of money transfer to the affected prefectures and the status of the activities of JRCS in the affected areas.(Regarding the newspaper advertisements, details were described in “Chapter 11 Public Relations Activities”.)

c. Television coverageWith regard to Gienkin , JRCS was interviewed directly or by telephone for various TV channels. At first, as there were many critical TV reports about the situation of the delayed distribution of Gienkin to the affected people the JRCS Call Center received a

(2) People who were surveyed: affected people who received Gienkin from the local governmentAttributes of the targeted respondents: Men and women in their 20s to 50s who live in the three affected prefecturesNumber of people surveyed: 309 (232 in MIYAGI, 61 in FUKUSHIMA, 15 in IWATE)Period of the survey: February 17-18, 2012Survey organization: Dents Public Relations Inc.Method of the survey: Internet survey

Figure 9-12 Screen of the “Status of Gienkin collection and 　　　　　　　　　distribution” on the website of the JRCS headquarters

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conducted of the affected people who had received Gienkin , and the following results were obtained.According to the survey, more than 70% of the respondents answered that they had not known that JRCS and other Gienkin collecting organizations had sent the money without taking any handling fees, and it was revealed that the activities of JRCS were not fully known.

b. Response to the misunderstandings related to JRCS activities

As it is considered that such misunderstandings were partly due to the various kinds of donations collected by JRCS, including “Gienkin”, “Overseas donations” and “Activity funds”, JRCS tried its best to simply explain about each type of donation.On April 28, 2011, an article entitled [Differences between “Gienkin ”, “Overseas donations ” and

“Activity funds”] was posted on the website to make information on the differences in the use of “three type of contribution” known.On June 14, an article entitled “To transfer Gienkin to the affected people as soon as possible”, with the contents of the reason why the distribution of Gienkin was delayed and of the situation of how JRCS handled the Gienkin , was posted on the website in order to give a better understanding of JRCS activities.In addition, on July 13, JRCS prepared a leaflet entitled “100% of Gienkin will be sent to the affected areas” and distributed it to the chapters, facilities and collaborators, and on the same day, it was also posted

on the JRCS website.For the individuals who sent out false information, JRCS sent a letter stating that the information was wrong, however, it was a fact that no effective action was taken with regard to the SNSs.

7. Discussion about the future methods of handling Gienkin

(1) Review of the Basic Disaster Management PlanFollowing the GEJET, the Basic Disaster Management Plan was partially amended in the meetings of the Central Disaster Management Council held in December 2011 and September 2012.Regarding the “reception of Gienkin”, it had only been described that “the local government together with the Gienkin collecting organizations should organize Gienkin Distribution Committee and determine the use of Gienkin after thorough discussions” in the Basic Disaster Management Plan at the time of the disaster, but after reviewing in the Central Disaster Management Council twice, it was amended and it is now stipulated that “the local government together with the Gienkin collecting organizations should organize and Gienkin Distribution Committee, and determine the use of Gienkin after thorough discussions. In this regard, the local government should try to ensure the prompt distribution of Gienkin by determining in advance the basic distribution method. In addition, in the case of a widespread disaster with damage occurring in multiple prefectures, JRCS

Figure 9-14　Results of the opinion survey of the affected people regarding Gienkin

Source: JRCS News, September 1, 2012 edition

The proportion of households who “immediately used” and those “used only little” was almost equal, and this was almost the same even if there was the presence or absence of damage, or where there was a difference in its degree. The “immediately used” amount was mostly to contribute to daily living expense and repair costs for housing.

Three out of four people surveyed did not know that JRCS distributes the full amount of the Gienkin to the affected people

Approximately half “immediately used” the funds for daily living expenses and the repair of their houses

JRCS and other Gienkin collecting organizations distribute the full amount of the Gienkin to the local governments without taking any handling fee, but when this question was asked in the survey, more than 70% of respondents answered that they “didn’t know”. In particular, more than 80% of the affected people in their 20s answered that they “didn’t know”

Use of Gienkin

JRCS and other Gienkin collecting organizations distribute the full amount of the Gienkin to the local governments without taking any handling fee. Did you know this?

Did you immediately use the Gienkin received? (only one answer)

I didn’t know it.74.1%

Don’t know2.3%

Others6.8%

Used only a little44.7%

I knew it.25.9%

Immediately used most of the Gienkin22.7%

Immediately used about half of the Gienkin23.6%

Free opinions from the respondents

●Please continue your activities for those who are in constrained circumstances.●I was really grateful to be able to provide household appliance packages to the

people in temporary housing.●As there are many people who don’t understand the activities of JRCS, it would

be important to frequently provide correct information.

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and other Gienkin collecting organizations should determine in advance the basic concept of the Gienkin collection method and its distribution criteria as they are required to promptly distribute the donated Gienkin to the local governments”.

（2) Submission of a request paper to MHLW from JRCSAs mentioned above, JRCS received various opinions and criticisms regarding the handling of Gienkin for the GEJET.It is considered that there are various reasons contributing to the delayed distribution of Gienkin including: (1) the existing system of handling Gienkin could not always fully respond to a large-scale widespread disaster, (2) many local governments were affected and lost their administrative functions, (3) there was a lack of common understanding regarding the handling of Gienkin not only among the citizens, but also among the national and local governments as well as the Gienkin collecting organizations.As JRCS could not solve these problems by itself, JRCS discussed with the Central Community Chest of Japan and NHK, who worked together collecting Gienkin , and summarized the results and submitted them to the MHLW as a document on “Discussion about the handling of Gienkin (request)” dated March 22, 2012.The outline of the request paper is shown in Figure 9-15.

Figure 9-15　Outline of the request paper 　　　　 submitted to the MHLW

1. Executive summary・Behind the background to the delayed distribution

of Gienkin to the affected people, there is a question as to whether a common understanding regarding the Gienkin existed among the relevant parties.

・Applying the lessons of this time, in case that a similar large-scale disaster occurs, it is necessary to establish a system for the distribution of Gienkin as soon as possible. To this end, it is also necessary for governments and the relevant parties to get together to hold discussions to prepare for the future.

・To achieve the purpose, the relevant parties should share a common understanding about Gienkin and discuss the following:a. Effective innovative ways for the fair and prompt

distribution of Gienkin .b. Specific criteria for the distribution of Gienkin .

c. Public relations methods and the disclosure of information.

d. Issue of costs related to the administration of Gienkin collection.

2. Specific items to be studied・Problems recognized as a result of the handling of

Gienkin this time and the direction to be taken for improvement –

(1) Necessity to have a common understanding for Gienkin among the relevant partiesIt is necessary to hold appropriate meetings to discuss the fundamental items including the characteristics and positioning of Gienkin , to form a common understanding of Gienkin among the relevant parties.

(2) Importance of establishing a certain legal status for Gienkin , and to ensure that the government and the private sector smoothly play their own rolesWhen a large area of the country becomes damaged due to a disaster, it is necessary for the government agencies to organize a meeting to coordinate the overall handling of Gienkin for the targeted victims and the distribution criteria. It is desirable to clearly stipulate in the Basic Disaster Management Plan and the Disaster Relief Act the procedures concerning the handling of Gienkin , and the roles that the relevant ministries and agencies, local governments and private Gienkin collecting organizations should play.

(3) Determination in advance to a certain degree the basic rules for Gienkin distributionIt is desirable to roughly determine in advance the basic rules for Gienkin distribution (eligible persons, criteria for distribution ratio)

(4) Need for innovative ideas on how to promptly distribute the Gienkin I t i s des i rab le to d i scuss f ac i l i t a t i on o f administrative work related to Gienkin distribution as well as to improve the operational procedures for its allocation.

(5) Public relations and the disclosure of information concerning Gienkin (ensuring transparency)Further efforts and innovative ideas are required regarding public relations related to the system of Gienkin . In particular, it is necessary for the future to decide on how to disclose required information, including the amount of collection and the status of the transfer of Gienkin to the recipients based on a certain degree of common understanding among the relevant parties, considering the possibility of the need for close cooperation with financial institutions.

(6) Other aspectsIn a situation in which various groups or organizations collected Gienkin other than JRCS, the Central Community Chest of Japan and NHK (including NHK Public Welfare Organization), it is necessary to discuss their eligibility as those organizations. In addition, as there is a significant administrative costs related to the handling of Gienkin , there should be a discussion on how to manage the administrative costs.

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(3) Discussions of Gienkin with the MHLWa. Report of the Office of After-care Service

Promotion in the MHLWThe MHLW verified its response to the GEJET and summarized the future countermeasures mainly by the Office of After-care Service Promotion in the MHLW (consisting of four research specialists from the private sector).For the preparation of the above report, a hearing with JRCS was conducted on April 4, 2012. In this hearing, the feedback on the results of hearings on Gienkin collection and other activities with municipalities conducted by the Office of After-care Service Promotion was provided.In addition, JRCS explained the details of the above document entitled “Discussion on the handling of Gienkin (requests)” and asked the MHLW what was wanted from the JRCS.The Office of After-care Service Promotion prepared a document entitled “Response of the MHLW to the GEJET (report)” in July 2012, based on the hearings with JRCS and other parties concerned. In the report, the following six topics were selected from the responses of the MHLW to the GEJET, and the “major responses provided” and “problems, reflections and future countermeasures” were summarized: (I) Response systems in the MHLW (cooperation system among the central ministries, their local agencies and local governments, response to the Nuclear Emergency Response Headquarters and local nuclear emergency response Headquarters, the state of public relations, etc.); (II) Securing medical doctors, nurses and other human resources requested by the affected areas; (III) Transfer of the aged, sick and disabled to shelters (including the large-scale transfer over the border of the evacuation zone and the area under an evacuation order due to the Fukushima Daiichi Nuclear Power Plant Accident), distribution of the necessary medical drugs and medical devices to the shelters; (IV) early distribution of Gienkin ; (V) Recovery of children and child-rearing including psychological care; (VI) Recovery of employment (verification of the results of the job creation funds project, etc.).Regarding Gienkin , the following were described as future countermeasures: “When a similar large-scale disaster occurs in the future, the MHLW will actively become involved in the distribution of Gienkin and support the Gienkin collecting organizations in order to ensure the earliest distribution of Gienkin

to the affected people”; “The MHLW asked that the Gienkin collecting organizations make clear and specify their responsibilities related to the collection and distribution of Gienkin , consult with the MHLW about ways to receive support from the Government of Japan (GoJ), and then to clearly define the results as regulations that they will establish for the handling of Gienkin ”; “The MHLW requested the Gienkin collecting organizations to determine in advance the collection methods and distribution rules for Gienkin”;

“The MHLW will actively support the Gienkin collecting organizations when they determine the collection methods and the distribution rules for the affected prefectures”.

b. Request from the MHLW to JRCSBased on the report summarized by the Office of After-care Service Promotion, the Chief of the Social Welfare and War Victims’ Relief Bureau of the MHLW sent notification of “an appeal for the efforts to address the challenges related to Gienkin (request)” to JRCS.The contents of the appeal requested by the MHLW are shown in the Figure 9-16.

Thank you for your disaster recovery assistance at the time of the earthquake disasters.Regarding the distribution of Gienkin in GEJET, we understand that we have received various opinions from people in many fields and recognize the many challenges.The MHLW has summarized the responses to the GEJET and future countermeasures in the Office of After-care Service Promotion Consisting of experts from the private sector (July 20). In this report, we have verified the challenges related to Gienkin through the opinions of JRCS and other Gienkin collecting organizations and the prefectures as well as through the hearings, and have proposed the countermeasures shown in the attached document. In addition, a similar proposal was submitted as a final report of the committee for policy planning on disaster management of the Central Disaster Management Council (July 31).In this regard, based on the above discussions, we would like to ask you to take the following countermeasures.We are willing to support your discussions on these matters.

(Responses of the MHLW to the GEJET (extract))

1 Make clear and specify the JRCS’s responsibilities related to the collection and distribution of Gienkin ,

Figure 9-16　Appeal for the efforts to address the　　　　　　　　 challenges related to Gienkin (request)

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Based on the fundamental policy mentioned above, JRCS organized an “Opinion exchange meeting on the handling of Gienkin at the time of a large-scale widespread disaster” with the cooperation of the

c. Response of JRCS to the reguestAs a reply to the request of the MHLW, JRCS submitted to the Social Welfare and War Victims’ Relief Bureau of the MHLW a document entitled “Basic policy on the handling of Gienkin”.JRCS’s basic policy on Gienkin handling is shown in Figure 9-17.

consult with the MHLW about ways to support the GoJ, and then clearly define the results in regulations for handling Gienkin that you will establish.

2 Determine in advance the collection methods and distribution rules for Gienkin in order to ensure the early distribution of it to local governments in the case of a broader disaster. In this regard, pay attention to the following points:(i) For the Gienkin collection, discuss the methods to

ensure that the intentions of the donors are well reflected in the result;

(ii) Discuss a highly transparent system for Gienkin collection including the certification that you are entrusted with Gienkin and the provision of information about the status of Gienkin distribution;

(iii) Determine in advance some rules around Gienkin with the prefectures; and

(iv) Discuss the administrative costs that you and the local governments should bear.

(1) Regarding the basic framework for the flow from Gienkin collection and reception to its distribution it would be appropriate to be based on a system that has been employed before.

(2) Therefore, particularly when a disaster affects large areas with widespread damage, it would be desirable that JRCS, the Central Community Chest of Japan and other Gienkin collecting organizations should determine in advance the rules concerning the criteria for Gienkin distribution to the prefectures and arrive at an agreement among these organizations in order to ensure that the relevant parties can promptly initiate the operations of Gienkin distribution.

(3) However, considering the public nature and role of Gienkin , its distribution cannot be determined by the Gienkin collecting organizations alone, but it is necessary for the national and local governments, the Gienkin collecting organizations and other parties concerned to have discussions and arrive at an agreement based on a common understanding.

Figure 9-17 Basic policy on handling Gienkin

National Governors’ Association. The first meeting was held on November 21, 2012, and the second meeting on December 26, 2012.The local governments (Iwate, Tokyo, Niigata, Shizuoka, Hyogo and the Secretariat of the National Governors’ Association), the MHLW, and the Gienkin collecting organizations (JRCS, Central Community Chest of Japan, and NHK) participated in these meetings and exchanged opinions on the handling of Gienkin .Based on the opinions expressed in these meetings, JRCS verified and analyzed the handling of Gienkin in the GEJET, and then, based on the lessons obtained from the results, prepared a report entitled “Challenges and future directions in Gienkin collection for disasters (report) - based on the verification and general overview of the GEJET -” which summarized the future challenges and directions. This report was posted on the website of the Headquarter and submitted to the MHLW, Cabinet Office, National Governors’ Association, Japan Association of City Mayors, and National Association of Towns & Villages. It was also distributed to each prefecture through the Secretariat of the National Governors’ Association.JRCS will try to disseminate the contents of it and encourage continuous discussions on this matter among the relevant parties, including the national and local governments as well as the Gienkin collecting organizations.

Challenges and future directions for Gienkin collection in the event of disasters (report)

- Based on the verification and general overview of the GEJET –

Executive summary

IntroductionJRCS, the Central Community Chest of Japan and NHK initiated the reception of Gienkin on March 14, 2011, and the number of it rose to more than 3.2 million and the amount reached 363.6 billion yen by the end of December 2012. Of these, JRCS received Gienkin from 2.88 million donors and the total amounted to more than three times the amount collected in the Great Hanshin-Awaji Earthquake.Regarding the handling of Gienkin , various discussions were held and opinions offered, while many words of appreciation were sent from the affected people.Because it is a natural obligation for JRCS as an organization entrusted with the handling of Gienkin to

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nature and position of Gienkin among the citizens, who are the donors to Gienkin , as well as the personnel of the GoJ, local government and Gienkin collecting organizations became an obstacle to responding adequately to the requests for prompt processing of the procedures in an emergency.

II. JRCS’s fundamental policy for handling GienkinThe basic characteristic of Gienkin itself is that it is not a public fund, however as the overall system of Gienkin from the collection to transfer and distribution has a strong public nature and role, it is understood that Gienkin should primarily be distributed to the affected people in the form of cash benefits.Regarding Gienkin , there are few specific legal regulations due to its nature as a goodwill donation and only a partial description is indicated in the Basic Disaster Management Plan. However, the GoJ, local government and Gienkin collecting organizations are required to share a common understanding and recognition, work in close coordination, and each play their appropriate role, regardless of the existence of any regulations.It is desirable to respect as far as possible the intentions of the donors, but it is impossible to individually confirm the intensions of each donor at the stage of receiving Gienkin . Thus, methods and procedures for receiving donations should be established separately for relief activities and recovery operations apart from those for Gienkin . In addition, requests for money transfers to specific local governments should be handled through the procedures mentioned above.JRCS considers that it is most important for each organization and group operating as part of the system of Gienkin collection to share a basic recognition and prepare in advance the necessary system and policy for responses during times when no disasters are expected.Regarding the handling of Gienkin , the three principles of promptness, transparency and fairness are the most important and should be respected to the extent possible.The basic framework on Gienkin handling should be the same as the conventional one, in which the Gienkin collecting organizations collect Gienkin and transfer it to the affected prefectures (Gienkin Distribution Committees), the Committees determine the criteria for its distribution and then the Municipalities

make efforts to ensure the prompt and effective use of Gienkin , JRCS verified and analyzed its handling of Gienkin in the GEJET, and then summarized the future challenges and directions based on the results.With the assistance of the MHLW and the National Governors’ Association, JRCS listened to the opinions of the prefectural governments of Iwate, Tokyo, Niigata, Shizuoka, and Hyogo as well as the Gienkin collecting organizations (Central Community Chest of Japan, NHK), and prepared this report. JRCS wishes to continue further discussions among a broader range of parties concerned with the future of this issue.

I. Handling of Gienkin in the GEJETIn the GEJET, because the disaster affected a very wide area and coincided with the Nuclear Power Plant Accident, coordination of the handling of Gienkin was essential. JRCS asked the GoJ to coordinate through a central meeting with the relevant parties, and it was decided that the MHLW would play the coordination role as the secretariat. On April 8, the first meeting of the Committee to decide on the ratio for the fair distribution of Gienkin was held and the criteria for primary distribution was determined.Following this decision, JRCS and other Gienkin collecting organizations transferred Gienkin to the affected prefectures on April 13, but this had already taken about a month after the occurrence of the disaster. Subsequently, it took a considerable number of days for the transfer of it from the affected prefectures to the municipalities, then to the affected people via the municipalities, resulting in a situation in which various opinions and criticisms were directed at the JRCS and other Gienkin collecting organizations.JRCS had conducted reviews of its handling of Gienkin based on the experience of the Great Hanshin-Awaji Earthquake, but the GEJET was on a much larger scale and was a more widespread disaster than the Great Hanshin-Awaji Earthquake, and the system of Gienkin distribution at that time had not imagined such a devastating disaster.The fact that many of the local governments were seriously affected, there were a huge number of affected people and the activities of rescue and relief operations immediately after the disaster took the top priority and made it very difficult to follow the established procedures for Gienkin distribution.Various ideas and opinions about essential questions such as what is Gienkin and how to consider the

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distribute it to the affected people.The target areas of Gienkin transfer (distribution) should in principle be the prefectures in which the municipalities subject to the Disaster Relief Act are located, but when the damage affects larger areas and is more widespread, the prefectures in which municipalities affected by the same disaster are located should be included regardless of the application of the Disaster Relief Act. It is necessary to establish a Gienkin Distribution Committee in the affected prefectures, but if it is difficult to establish such a committee at the early stages due to the large and broad scale of the disaster, it could be considered that the Gienkin collecting organizations should promptly collect Gienkin and transfer it to the affected prefectures based on their independent judgment.The Gienkin collecting organizations should determine the criteria for the prompt transfer of Gienkin to the Gienkin Distribution Committees in the affected prefectures, divide it proportionally based on these criteria, and transfer it to the distribution committees or the affected prefectures.It is the role of Gienkin Distribution Committees in the affected prefectures to determine the specific criteria for Gienkin distribution to the affected people, but it is desirable to establish a certain policy for Gienkin and share it as a form of guidance or guidelines.As various kinds of coordination are required in a larger and broader disaster, it is desirable to establish in advance a system whereby a meeting consisting of intellectuals, local government officials and representatives of the Gienkin collecting organizations is organized to assess the issues related to Gienkin , to make any necessary adjustments and promptly coordinate the response at the request of the relevant parties.Across-the-board distribution of Gienkin , the utilization of the Livelihood Welfare Fund Loan System, the necessity of coordination with the relief fund system under the Act on Support for Reconstructing the Livelihood of affected people, relationships between the disaster condolence grant system and other systems should be discussed.Since Gienkin collecting organizations bear the responsibility for reflecting as many opinions of the donors of Gienkin and other citizens as possible in its distribution and to appropriately report on the status and results of Gienkin distribution, it is important for the representatives of the Gienkin collecting

organizations to participate in the Gienkin Distribution Committees as members of such committees.It is also necessary to discuss a backup for the Basic Resident Registration and other basic data, streamlining of the issuance procedures for issuing the Disaster Victim Certificate, improvement of the Gienkin processing system, as well as gaining the cooperation of general and life insurance companies, and the possibility and availability of the support and cooperation of volunteers from the viewpoint of support for Gienkin processing in the municipalities.As the Gienkin collecting organizations bear a significant amount of the administration and other miscellaneous costs related to Gienkin handling, this should be a future issue to be considered in the overall discussions.The Gienkin collecting organizations also bear the responsibility for appropriately reporting on the status of Gienkin collection and its distribution to the Gienkin donors and other citizens and should obtain their understanding.JRCS tried to appropriately manage operations related to the handling of Gienkin by establishing a call center, improving the system for Gienkin collection and management, establishing a sorting center for postal transfer forms, improving the deposit operation system for cash donations, improving the responses to e-mails and donations through overseas credit cards, and establishing a cash receipt center. JRCS also made efforts to post information on its website, disseminate information to domestic and overseas media, and provide periodic announcements through newspapers and other media.These operations were conducted by temporary staff numbering more than 100 people at the peak time, volunteers, and support staff from the International Red Cross in addition to regular JRCS staff.Regarding the system of Gienkin , the role of collecting organization and the Gienkin distribution committees established by the affected prefectures and municipalities, the status of Gienkin collection, the criteria for Gienkin distribution, and provision of information regarding the status of Gienkin distribution, it is necessary for the GoJ, local government and Gienkin collecting organizations to work together to determine in advance the details and terms when there is no expected disaster or at the onset of a disaster.It is essential for the Gienkin collecting organizations to be subject to a rigorous audit by a third party

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concerning the provision of the necessary information related to the appropriate management and transfer of Gienkin as well its collection and distribution, and to disclose information on the results in order to ensure accountability. JRCS was subject to an audit on its handling of Gienkin based on the International Standards on Auditing and has made the results available to the public on its website and through the newspapers.JRCS has tried to response promptly to request for the inquiries from donors and the issuance of receipts by proceeding with data entry for the Gienkin received (approximately 2.88 million cases), while JRCS has promoted the improvement of the system to manage information related to Gienkin and developed a system of uniform management through adoption of functions by which donors can confirm the actual performance of their donations by themselves. In addition, to facilitate Gienkin donations, JRCS will work on constructing a cooperative framework with financial institutions for the establishment of a Gienkin collection system with its reception points nationally unified as well as the provision of its transfer data. Furthermore, in cooperation with GoJ and local government, JRCS intends to enhance the system of public relations concerning Gienkin handled by JRCS.

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1. Liaison/coordination with the International Federation of Red Cross and Red Crescent Societies (IFRC), the International Committee of the Red Cross (ICRC) and the National Red Cross and Red Crescent Society (NS) etc., in the initial response

(1) Relationship between the Japanese Red Cross Society (JRCS) and the IFRC before the disaster

In order to comply with its international obligations as a member of the International Red Cross and Red Crescent Movement (RCRC), the JRCS has actively conducted the international relief activities overseas, putting its medical activities at the center. The JRCS has expanded its active areas around the world including India, Iran, Indonesia, Zimbabwe, and Haiti since 2000.On the other hand, the JRCS has been preparing for various earthquakes that may be expected to occur in many areas in Japan. For example, the contingency plan for earthquake in Tokai area (prepared in 2010) demonstrates the response policy regarding the relationship with the IFRC and the NS as follows.

Figure 10-1 Contingency Plan earthquake in 　　　　　　Tokai area (2010) (Excerpt) 　

◆Possibly necessary supports・The JRCS shall accept donations from overseas, but

not be specific about the way the money is spent in principle.

・The JRCS shall accept IFRC representatives where necessary to ensure close coordination with the RCRC

・The JRCS shall accept reporting staff from the IFRC where necessary to inform the RCRC of the information on the general situation of the disaster, the JRCS relief activities, and other matters.

・The JRCS shall accept media relations staff from the IFRC where necessary to respond to requests for interviews by major media around the world.

・The JRCS shall accept tracing request from the ICRC where necessary to identify the needs for tracing services of foreign nationals in the affected areas, as well as facilitate the development and practice of a safety confirmation plan.

・As for dispatch of staff other than from the IFRC, the JRCS shall accept only those that are coordinated by the IFRC in principle.

◆Unnecessary support, etc.・The JRCS shall not require Field Assessment

Coordination Teams (FACT).・The JRCS shall not require goods support in principle.・JRCS shall not issue/launch the emergency appeal.

◆Relationship with the IFRC・The JRCS shall indicate necessary support and

unnecessary support to IFRC as soon as possible after the natural disaster. In addition, the JRCS shall post its own role in the disaster response and the situation of disaster response conducted by the JRCS and administrations, and others on the Disaster Management Information System (DMIS) website, contributing to the Information Bulletins that the IFRC announces.

The JRCS disaster response plan was shared with the IFRC many years ago. The JRCS just held a drill by the JRCS Headquarters in 2009 and confirm its effectiveness and asked staff who is of public relations sector of IFRC to participate in it. And the JRCS International Department was preparing for a conference held in Tokyo in April 2011, in response to the IFRC’s request to “discuss the possible role of the IFRC for a large-scale disaster in Japan.” Eventually, the Great East Japan Earthquake and Tsunami (GEJET) occurred immediately before the planned conference, so it could not be carried out.Although the scale of the GEJET was far more than the disaster that was simulated in the contingency plan for earthquake in Tokai area, multiple evidences and records from the related persons or the IFRC reveal that the JRCS acted in accordance with the plan just immediately after the disaster.

(2) Liaison/coordination with the IFRC, ICRC and NS after the disaster

a. Action from immediately after the disaster of March 11 to the morning of March 12

At 14:46 on March 11 the disaster occurred. Immediately after the disaster, the International Department at the JRCS Headquarters started activities for liaison, coordination, and information sharing, positioning the International Relief Division as a key player.

<March 11>At 15:00, the Director of the International Relief Division

called the manager of the IFRC Asia Pacific Zone Office (AP Zone) in Kuala Lumpur, Malaysia. At the same time, the JRCS posted the first information on the DMIS website of the IFRC. (This website provided information access for the Red Cross officials throughout the world.)

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Chapter 10Relationship with the International Red Cross and Red Crescent M

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b. Acceptance of a “High Level Mission Team (Investigation Team)” from the IFRC

Immediately after the disaster, an ever-increasing number of offers of assistance from the NS around the world came one after another. Behind this, people in various countries, who were shock by the terrible pictures of the disaster through media and YouTube, placed their confidence and expectations on NS as the channel to support the affected people. To respond these expectations and carry out the mission as RCRC, the NS around the world had to support Japan in visible ways.In light of the position of the NS around the world, at 2:00, March 12, the day following the disaster, the JRCS announced to the AP Zone that it was ready to accept an Investigation Team aiming at only identifying the site situation, not conducting relief or medical activities on the site. As a result, the Investigation Team was developed; which was consisted of eight staff members. The members and schedule in detail were as follows.

　　　　At this stage, the JRCS responded “negative” to the IFRC’s question asking, whether or not it would conduct Appeal Requests for relief activities.

At 16:00, the JRCS requested the AP Zone to dispatch staff members to handle the overseas media relations.

At 17:00, the JRCS posted on the DMIS for the second time. It noted again that it was not requesting international supports (donations, relief goods, and manpower) at this stage.

At 19:15, the JRCS posted on the DMIS for the third time.At 20:56, the AP Zone informed the JRCS of the dispatch

of Mr. Patrick Fuller, Communication Manager, Asia Pacific, to Japan in a day.

At 23:39, the JRCS posted on the DMIS for the fourth time.

<March 12>At 02:02, the Director of the International Relief Division

contacted the AP Zone. The content was as follows.

　　・　The JRCS was ready to accept the support by a liaison team as an IFRC team consisting of representatives of the Participating in National Red Cross and Red Crescent Societies (PNS).

　　・　The JRCS requested that the team would be consisted of around six staff members including representatives of the IFRC and PNS.

　　・　The JRCS asked the IFRC to determine the members by liaison/coordination with the PNS.

At 4:00, the JRCS posted on the DMIS for the fifth time. At this stage, it noted that “the JRCS do not require international supports, but will accept donations from the NS.” (At 23:33, March 11, there was an internal notice to announce the opening of a donation account for overseas; Sumitomo Mitsui Banking Corporation, Ginza Branch, no. 8047705, savings account.)

Although the full picture of the disaster situation was uncertain immediately after disaster, the JRCS tried to share the information by closely contacting with the IFRC and convey its position clearly at the time.In the meantime, the JRCS International Department was inundated with telephone calls from the NS around the world. Most of them were inquiries asking whether the JRCS could accept the dispatched staff or relief goods. The staff of the International Department corresponded to one by one, conveyed the policy of the JRCS at the time, and asked for understanding of those countries.

<Members of the Investigation Team>Mr. Martin Faller

(Head of East Asia Regional Delegation, IFRC)Ms. Donna McSkimming

(Head of International Programs, Australian Red Cross)

Mr. Pat Laberge(Senior Manager, Asia Program, Canadian Red Cross Society)

Mr. Ren Hao(Deputy Director-General, Department of External Liaison, Red Cross Society of China)

Ms. Eunhee Cho(Deputy Head of International Relations Office, Republic of Korea National Red Cross)

Mr. Torris Jaeger(Director of Internaitonal Disaster Management, Norwegian Red Cross)

Mr. Hakki Ersoy(Head of Disaster Response Unit, Turkish Red Crescent Society)

Ms. Nan Buzard(Senior Director of International Response & Programs, American Red Cross)

＊From the JRCS, three staff members of the International Department accompanied the Team.

<Schedule>March 14 (Mon)-15 (Tue), 2011: Arrived in JapanMarch 15 (Tue): Had a briefing at the JRCS

HeadquartersMarch 16 (Wed): Left TOKYO

Visited the Miyagi Chapter’s Headquarters for Disaster Control (HDC)

March 17 (Thu): Inspected affected areas and evacuation centers in KAMAISHI, OTSUCHI　Left the affected areas, Arrived in TOKYO

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d. Acceptance of other related officials of the IFRC and ICRC

The ICRC dispatched many experts who specialized in tracing services and radiation hazards to Japan at the very early stage after the disaster. They provided advice to the JRCS and conducted activities coordinated by the JRCS.In addit ion, two staff members of the media relations visited Japan from March 26 to 31 from the Norwegian Red Cross and two also visited from April 5 to 10 from the Netherlands Red Cross to report the current situation of the affected areas.The Red Cross officials such as the IFRC and the ICRC who visited Japan within a month, from March 11 to April 8, are shown on Figure 10-2.

e. Providing information at the initial stageSince the day of the disaster occurred, the JRCS has provided the NS with a large amount of information on the disaster situations and the response the government and the JRCS conducted.As a first step, the JRCS shared the information with the NS by posting 21 times on the IFRC DMIS in English, based on prompt reports on disaster relief activities that were prepared by the JRCS Disaster Management and Social Welfare Department.Furthermore, it provided Information Bulletins five times in total (March, 11, 12, 15, 22 and 28) via the IFRC. The basic information was provided by the JRCS, prepared by the IFRC, and then uploaded on the IFRC website.Moreover, the JRCS conducted telephone conferences with the PNS in the supporting countries through the coordination of the IFRC. The conferences were held four times in total: the first conference was held at19:00, March 14 (Japan Standard Time) and in March 21, 29 and April 8. The first telephone conference was

The investigation team compiled the results of their inspection findings and recommendations for future support activities and submitted it to HDC at the Headquarters. This report listed the support required for relief and early recovery that were specified through this investigation. The contents are described as follows.

c. Acceptance of the IFRC representatives Immediately after the disaster, it was revealed that RCRC would provide a large amount of donations through a telephone conference or individual contact. When accepting international assistance, based on the

“Principles and Rules for Red Cross and Red Crescent Disaster Relief” the IFRC representatives should monitor the donation. Therefore, the JRCS were to accept the IFRC representatives as representatives of donors.

Mr. Martin Faller (March 13-24)Mr. Michael Annear (March 21-April 1)Mr. Bjorn Eder (the first week of April 2011-May 18, 2012, and October 1, 2012- Scheduled to be end of May 2013)

[Mr. Bjorn Eder, an IFRC Representative in Japan]

[The investigation team visited the Miyagi Chapter HDC in the Miyagi Prefectural Government Office]

<Relief and Support>The distribution of relief goods, logistic support, support for the sanitation sector, tracing services, cash benefits, volunteers, expansion of the scale of the medical Domestic Emergency Response Unit (dERU), psychosocial support, link between international support and domestic support, and support for families who accept evacuees.

<Early recovery/medium-and long-term support >Temporary housings, medical care, education section, and support for vulnerable groups

March 18 (Fri): Had a briefingMarch 19 (Sat): Departed for their home countries

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Figure 10-2　The Red Cross officials such as the IFRC and the ICRC who visited Japan (March 11-April 8, 2011)

Organization Name Official position/mission Length of stay

ICRC

Mr. Tobias Epprecht Head of Regional Delegation in Kuala Lumpur, ICRC Mar.18-25

Mr. Craig Strathern Diplomatic Adviser, ICRC Mar.17-23

Ms. Beatriz Meunier Protection Pool Manager, ICRC Mar.13-30

Mr. Gregor MalichHead of Nuclear Radiation Biochemistry Operational Response Project, ICRC

Mar.16-29

Mr. Steve DonnellyTechnical Advisor of Nuclear Radiation Biochemistry Operational Response Project, ICRC

Mar.28-31

Mr. Steffen Birrer Information and Communication Staff, ICRC Mar.17-21

Mr. Jaime Briz de Felipe Administrator staff, ICRC Mar.17-31

Mr. Arthur Milimo Tumwa

Date Processing Staff in Protection Division, ICRC Mar.13-31

Mr. Jean-Marc Zbinden

Project Manager of Architect, ICRC Mar.17-23

Ms. Mariko Harada Delegate, ICRC Mar.18-29

IFRC/PNS

IFRC Representatives in Japan

Mr. Martin Faller Head of East Asia Regional Delegation (Beijing), IFRC

Mar.13-24The first week of April

Mr. Bjorn Eder Representative in Japan, IFRC

The first week of April 2011-May 18, 2012Oct. 1, 2012-the scheduled end of May, 2013

Mr. Michael Annear Head of Disaster Management Unit in Asia Pacific Zone, IFRC Mar.21-Apr.1

PMER (Reporting) Mr. Andy McElroy

Head of South East Asia Regional Program Coordinator (Bangkok), IFRC

Mar.23-Apr.4

Mr. Tom AlcedoMr. John Manley

American Red CrossAmerican Red Cross Apr.4-the end of June

Persons in Charge of Media

Mr. Patrick Fuller Media Staff in Asia Pacific Regional Delegation, IFRC Mar.13-24

Mr. John Sparrow Media Relations Staff, IFRC Mar.27-Apr.23

Mr. Francis Markus Media Staff of East Asia Regional Delegation (Beijing), IFRC Mar.14-24

Ms. Katherine Mueller Media Relations Staff, IFRC Mar.21-the first week of

April

Persons in Charge of Logistics service

Mr. David Horrobin Logistics Service Staff, IFRC Mar.20-Apr.3

Mr. Lines Hughes Logistics Service Staff, IFRC Mar.20-Apr.3

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After Ten DaysTadateru Konoé

On 11 March at 2:46PM a huge earthquake of magnitude 9.0 on the Richter scale struck off the coast of Sanriku (lat. 38.0 N, long. 142.9 E). The quake reached level 7 on the Japanese seismic scale, which is the highest level on the scale, in the most affected area. A Tsunami alert was immediately issued for the Pacific side of the whole Japanese archipelago. The first wave of the tsunami reached the Japanese coast within 30 minutes and swept its north-eastern coastline over an area extending for 500km. The height of the waves exceeded 15 meters in some areas. Tsunami waves repeatedly reached the Japanese coast several times afterwards. Large aftershocks are still continuing now, ten days later from the first hit, followed by a Tsunami alert in each time.

The Northeastern coast of Japan has long been prone to Tsunamis and known for the most advanced preparedness for it in the world. Such preparedness includes solid and high banks, shelters for evacuation, warning systems and evacuation drills for the anticipated worst case scenario. What happened this time was far beyond the most extreme predictions.

The first strike caused heavy and widespread damage to all kinds of infrastructure and basic services, including communication lines, transportation, electricity, water supply and sewage system. This damage is still impeding the relief activities from being fully operational even after ten days.

Before we had grasped the overall consequences of the earthquake, the tsunami quickly swept many coastal cities and left them in ruins. It was so cruel that by the time the tsunami reached them, they had already lost contact with others because of the earthquake. Fire broke out in many areas, which added another burden for the affected people to cope with for another few days. Many of these affected cities are located in the deep recesses of an indented coastline with sheer cliffs, known as a Rias coastline. This terrain made the access to the affected area difficult either by land or sea. None of the administrative functions could work properly, therefore no relief could be extended to the areas for a few days and no information on these communities’ fate reached the outside world. Mobile phones and even the radio network system designed for disasters could not function, because of the blackout and the damage to the relay stations of the radio network.

The Government of Japan immediately set up an Emergency Task Force and started collecting information and dispatching Self Defense Forces teams, medical teams, fire brigade units and ambulances. Japanese Red Cross also dispatched its own 14 disaster relief teams to the three affected prefectures within first five hours. As of 21st March, 122,530 blankets and 20,760 boxes of relief goods have been distributed. On the day of the earthquake, even in Tokyo, the train service was affected by the quake and authorities had to suspend the whole service until next day. Consequently, many people suddenly lost their usual means of commuting in Tokyo and had to spend all night stranded at stations and other places. Heavy traffic jams inevitably followed and forced us to wait patiently, spending long hours to cover a distance taking ten minutes in normal times. Highways to the affected areas are now open to emergency vehicles for relief, but the shortage of fuel is still affecting the situation.

The Japanese Red Cross Society is running several large scale Red Cross Hospitals in north-eastern Japan and naturally those are being used to function as base-camps to receive the evacuees and to launch mobile health activities. The city of Ishinomaki, which is located in the coastal area of Miyagi Prefecture, still counts 10 thousand people missing. The Red Cross Hospital in Ishinomaki is the only hospital in the city which was able to survive

conducted for 20 minutes. The JRCS explained the issues including the disaster situation, the response status of the government, Self Defense Forces (SDF) and local municipalities, etc., the response status of the JRCS, the policy on the acceptance of overseas support, the cooperation status with the IFRC and the ICRC, etc., several issues of current needs, and logistic service. And then a question and answer session was held with the PNS.Since March 29, in addition to this, the JRCS International Relief Division provided an Information Update. with NS by e-mail four times in total (March 29, April 4, 12, 22).On April 13, the first issue of the Operation Update (status reports of the activities by the JRCS) was posted on the JRCS website English version. Since

then, it has been issued every three months in addition to Annual Reports, both comprised of narrative and financial reports

f. Letter from the president to NS around the worldOn March 22, the JRCS president sent a letter as the President of the IFRC to NS around the world. This letter, entitled “After Ten Days”, described an outline of the disaster, the response conducted by the government and the JRCS, the international response activities including the acceptance of the High Level Mission Team. And at the end, it made a commitment that “we feel a strong the spirit of Togetherness due to the sympathy, encouragement and offers of support to Japan from National Societies around the world and will make an all-out effort by maintaining this spirit.”

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in the earthquake and tsunami and stay operational. Naturally, it was filled with the injured and the evacuees, on top of many existing in-patients. The hospital had to adopt strict triage in order to maintain an appropriate level of medical service, but of course, such decisions entail a huge dilemma for the people, particularly the aged, who have nowhere to return to and nobody to depend on. In order to sustain the critical function of this Ishimomaki Red Cross Hospital which has been operating around the clock, many doctors and nurses have been sent from other Red Cross Hospitals nationwide to back up Ishinomaki. The tsunami put the local population in a ‘life or death” struggle situation. Yet paradoxically, not many were injured directly by the Tsunami. Therefore, the well-organised Disaster Medical Assistance Team (DMAT) could work efficiently as it was originally designed for the earthquake. Many challenges remain such as caring for many in-patients who had to evacuate their original hospitals, the patients who were soaked in water by the tsunami and endangered by the harsh wintery situation afterwards, those who lost the means to get necessary medicines for chronic diseases and those who need psychological care.

One week later, according to the police authority as of 21st March, 8,649 people are dead, 13,262 people are still missing and 2,644 people are wounded. 14,637 buildings are collapsed. There are 2,113 evacuation centres up-and running and accommodating 349,349 people. From the beginning of our operation, there are big operational challenges, such as limited information due to the paralyzed communications, transportation and administration lines, the lack of fuel which has impeded the smooth distribution of relief goods, the limited sites suitable for evacuation centres, and the wintery weather condition which have prevented the evacuees from getting back on their feet. The involvement of volunteers has also had to be limited since the access to the affected area was not safe. These challenges have been gradually overcome day by day, following the recovery of essential services, the provision of more fuel and the establishment of more evacuee centres. Japanese Red Cross will continue to make maximum effort, primarily in its medical relief by mobilizing the resources of nationwide Red Cross hospitals collectively. We are also going to extend our relief work to the evacuation centers gradually by mobilising the power of volunteers.

An International liaison/support team was sent to Japan, consisting of the International Federation, American Red Cross, Australian Red Cross, Canadian Red Cross, Red Cross Society of China, Korean Red Cross and Turkish Red Crescent. The team made a field visit to the affected area, accompanied by Japanese Red Cross staff. Its findings confirmed the wide variety of potential needs such as relief items, cash disbursement, tracing/psychological support, logistics support for relief, medical service for evacuation centres and volunteer intervention. We understand that a rough draft of our master plan for upcoming relief and recovery activity should be shared with you sooner than later. ICRC has been also helping us in establishing the special website for Restoring Family Links for this particular disaster.

However, the critical situation at 4 nuclear power reactors in Fukushima prefecture have been casting a shadow over the aforementioned positive developments in relief activities. Despite various professional efforts, the situation is still unstable. The people living in the vicinity of 30 km around the nuclear power reactors were forced to evacuate the area in case of further deterioration in the situation. And indirectly, since these nuclear power plants are not small producers of electricity for the Tokyo and surrounding area, their troubles have been causing a shortage of electricity there. In order to overcome this shortage, so-called ‘rolling blackouts’ of electricity have been implemented in the targeted area in Tokyo and the surrounding area. Due to this scheduled suspension and the effort to save energy, public transportation has been partly suspended. Because of the concentration on needs for fuel and foods in the affected areas of north-east Japan, certain goods are temporarily in shortage in Tokyo and the surrounding area. In addition to the standard Red Cross Hospitals, Japanese Red Cross has specialised hospitals in Hiroshima and Nagasaki in the area of medical services for the radiation-exposed. They are on stand-by to contribute whenever required. The pressing need right now is obviously relief for the evacuees. Japanese Red Cross has been deploying relief teams in shifts, and at the same time, we are also trying to attend to other needs on real time basis.

This disaster is without doubt unprecedented in terms of the scale of damage and its comprehensive nature. In such situation, I can never feel that our relief effort is good enough. Rather, I strongly feel that we should do more in terms of the scale, timeliness and efficiency. Such frustration must be felt by all, not only by our beneficiaries, but also by those engaging in relief day and night including ourselves. From this perspective, it is unfortunate that not all offers of support from overseas could be utilized earlier, but I hope you can profoundly understand the uniqueness and complexity of this disaster, which combines the elements of earthquake, tsunami and problems at the nuclear power plants.

I hereby would like to state sincerely that all the condolences, encouragements and the offers of support from all over the Movement worldwide move us deeply and remind us of the Spirit of Togetherness that is at the heart of our Movement. On this firm basis of solidarity, we in the Japanese Red Cross Society will resolutely continue our efforts for the sake of the affected population in Japan.

Our challenge will be prolonged for years and large amount of financial resources will be needed for the relief and recovery of the affected population. I sincerely appreciate all of your support in the past, the present and the generous help offered for the future.

Mar. 22th, 2011 Tadateru Konoe

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This approach, however, was not fully enforced in the midst of the turmoil in the JRCS Headquarters and it created some confusion for a while.

a. Confusion around the remittances from overseasThe record of an in-house notification on the opening of an account for international donations at 23:33 on March 11 remains, but the contents of the responses to inquiries which were announced to the NS and the public were not consistent until March 16. This created great confusion when confirming their remitters, because the remittances from the NS and the public were mixed in one account and there were many cases in which different languages were used to make remittances in different countries.

As above, the information on the donation account informed by the JRCS has been consistent since March 16. However, it was very difficult to correct the wrong information once it was posted on the internet and spread across the world. The confusion remained due to the mixing of some remittances from the NS, national governments, and overseas Japanese embassies.Furthermore, without note of caution when filling in overseas remittance requests, some NS put their names on the remittance information in their own language. So in some cases the receipt could not be confirmed. These problems caused a significant delay in receipt confirmation for some societies.To avoid these problems, the JRCS requested the NS to put the name of remitter on the bank remittance advice as well as on the information of the remittance account in English, and to notify JRCS by e-mail after following the procedures for the money transfer, if possible.

2. Acceptance response to the declaration of relief

(1) The Policy of support acceptanceIn response to the declaration of offers of relief, the JRCS did “not launch the emergency appeal”, but “accepted donations from overseas, but which were not be specified as to the way the money is spent in principle” and “not accept goods support”, based on the contingency plan for earthquake in Tokai area as above.Besides this, the JRCS also did not accept medical teams through ERU, which is a medical relief tool of the IFRC.However, the JRCS later accepted some of the relief goods for various reasons and coordinated their distribution with the affected Chapters.

(2) Acceptance of international donationsThe JRCS initially expected a large amount of international donation from the NS throughout the world, and concerned that it could not fully implement various projects worth of such a large amount of donation. Then it explored another direction to use the donation as Gienkin (cash grant sheme). However, the donation was all used for projects of the JRCS because of the reasons below.

Thus, the JRCS accepted them by opening an account for the donations from overseas in the following way. This account was to be used by only NS in principle.The Japanese Ministry of Foreign Affairs (MOFA) also received an avalanche of support offers of money, goods and staff. Therefore the MOFA called for foreign governments, though overseas Japanese embassies, to send money —not goods or staff members— to the JRCS via the Red Cross Society of their own country, if they considered providing support.

・Considered the relief phase at the time, the NS strongly requested to use the donations for relief goods support.

・The NS strongly requested the JRCS to take responsibility for the use the donations and report on their use.

・The NS expressed concern that it could not report on their use in the name of the JRCS, when all the NS donations were send to the Contributions Distribution Committee, a third party as Gienkin.

・Individuals and companies abroad who offered support to the JRCS were introduced to the National Society in their own country as well as a dedicated account for receipt of Gienkin

・The contributions from overseas governments (via embassies in Japan) were accepted not as international donations, but as Gienkin in principle.

<The contents of the notification up to March 15>Both donations from the NS and from individuals/companies abroad could select the type of donation (Gienkin or the donation from overseas).<The contents of the notification since March 16>A special account was opened only for remittances from the NS. These donations were dealt with as international donations; the information on this account was not to be announced to the public. On the other hand, the donations from overseas governments, Japanese embassies, individuals, and companies were to be accepted through another account as Gienkin .

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From March-April, the JRCS accepted international donations by concluding a simplified agreement. the JRCS concluded agreements on the formal acceptance of donations after gaining approval in the first PNS Meeting for GEJET in May 2011.

b. Agreement with the NS on the acceptance of the donations from overseas

When international donations were sent using their own agreement forms, various narrative reports and financial reports were additionally requested, which required a need to develop a common agreement.

Figure 10-3　Acceptance Status of Donation from Overseas (prompt reporting)1. Amount accepted　　　　　　　　　As of Mar. 29, 2013 (Unit: JPY)

Name of the country Amount1 Afghan Red Crescent Society 4,879,1502 Albanian Red Cross 1,682,4003 American Red Cross 23,050,962,1794 Andorran Red Cross 29,0585 Argentine Red Cross 4,382,0456 Armenian Red Cross Society 102,8747 Australian Red Cross 2,175,995,6648 Austrian Red Cross 486,967,8199 Red Crescent Society of Azerbaijan 13,453

10 Bahamas Red Cross Society 405,20011 Bangladesh Red Crescent Society 8,681,21112 Belarus Red Cross 3,481,20013 Belgian Red Cross 129,623,60614 Belize Red Cross Society 779,89615 Bolivian Red Cross 104,42916 The Red Cross Society of Bosnia and Herzegovina 11,597,29917 Brazilian Red Cross 13,234,66418 British Red Cross 1,828,504,02219 Bulgarian Red Cross 14,926,31520 Burkinabe Red Cross Society 1,464,94521 Cambodian Red Cross Society 1,584,77222 The Canadian Red Cross Society 4,017,332,58723 Chilean Red Cross 14,779,794

24Red Cross Society of China 904,038,322　Hong Kong Branches 1,669,068,154　Macau Branches 44,305,000

25 Colombian Red Cross Society 1,277,72126 Cook Islands Red Cross 175,09827 Costa Rican Red Cross 11,889,22328 Croatian Red Cross 85,775,14029 Cyprus Red Cross Society 5,618,81230 Czech Red Cross 47,342,500

31Danish Red Cross 53,362,250Danish Red Cross(Faeroe Islands Red Cross) 681,500

32 Dominica Red Cross Society 335,29133 Ecuadorian Red Cross 2,590,86034 Estonia Red Cross 3,302,93635 Finnish Red Cross 119,570,00036 French Red Cross 1,850,669,146

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Name of the country Amount37 Red Cross Society of Georgia 4,031,55038 German Red Cross 3,329,505,39039 Honduran Red Cross 367,39840 Hungarian Red Cross 6,688,59441 Icelandic Red Cross 19,113,28742 Indonesian Red Cross Society 79,118,24443 Red Crescent Society of the Islamic Republic of Iran 7,653,00044 Irish Red Cross Society 65,045,68145 Italian Red Cross 389,027,86246 Jamaica Red Cross 45,034

47 Red Cross Society of the Democratic People's Republic of Korea 8,090,000

48 The Republic of Korea National Red Cross 2,977,101,03149 Lao Red Cross 636,56350 Latvian Red Cross 18,391,43051 Lithuanian Red Cross Society 12,205,18252 Luxembourg Red Cross 23,705,000

53 The Red Cross of The Former Yugoslav Republic of Macedonia 1,529,982

54 Malaysian Red Crescent Society 171,120,73655 Maldivian Red Crescent 2,718,13556 Mexican Red Cross 72,535,78657 Micronesia Red Cross 8,223,91258 Red Cross of Monaco 5,156,58259 Mongolian Red Cross Society 12,301,96060 Red Cross of Montenegro 956,66161 Myanmar Red Cross Society 4,309,16162 Nepal Red Cross Society 3,580,21663 The Netherlands Red Cross 752,925,54764 New Zealand Red Cross 51,257,09365 Nicaraguan Red Cross 200,52766 Norwegian Red Cross 161,780,20467 Pakistan Red Crescent Society 8,340,62668 Palau Red Cross Society 2,428,89469 The Palestine Red Crescent Society 840,56370 Red Cross Society of Panama 1,092,94971 Peruvian Red Cross 2,519,29172 Philippine Red Cross 167,000,00073 Polish Red Cross 12,42074 Portuguese Red Cross 6,169,63075 Qatar Red Crescent Society 67,526,83876 Romanian Red Cross 11,443,45477 The Russian Red Cross Society 163,836,12478 Rwandan Red Cross 8,183,90279 Salvadorean Red Cross Society 3,258,18080 Samoa Red Cross Society 1,752,76981 Red Cross of the Republic of San Marino 1,017,10082 The Red Cross of Serbia 191,253,450

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Name of the country Amount83 Singapore Red Cross Society 652,648,38584 Slovak Red Cross 2,872,21985 Slovenian Red Cross 19,304,22186 South African Red Cross Society 10,829,00087 Spanish Red Cross 404,746,36588 The Sri Lanka Red Cross Society 395,16989 Swedish Red Cross 51,600,00090 Swiss Red Cross 1,999,210,67291 Taiwan Red Cross Organization 6,774,484,00092 The Thai Red Cross Society 748,362,34293 Tonga Red Cross Society 11,534,77894 Trinidad and Tobago Red Cross Society 5,999,45995 Uganda Red Cross Society 108,04796 Ukrainian Red Cross Society 7,100,00097 Red Crescent Society of the United Arab Emirates 15,968,61998 Uruguayan Red Cross 1,872,93899 Vanuatu Red Cross Society 297,234

100 Vietnam Red Cross Society 608,584,747101 Al-Waleed bin Talal Foundation 8,376,000102 Belgian Embassy representatives 9,107,700103 European Commission Humanitarian. Aid Office 943,464,578104 Irish government 121,450,000105 Japan-America Society of Hawaii 237,317,787106 New Zealand government 60,730,000107 Kuwait government 157,420,000108 Stavros Niarchos Foundation 20,212,500

109 International Federation of Red Cross and Red Crescent Societies 4,902,319

110 International Federation of Red Cross and Red Crescent Societies Office to the UN 232,932,738

111 Indivisuals, corporations, other organizations 854,302,995Subtotal (A) 59,363,649,285

２．Amount of the concluded agreementName of the country Amount

1 Australian Red Cross * 4,403,7002 Taiwan Red Cross Organization 189,418,167

Subtotal (B) 193,821,867Total (A+B) 59,557,471,152

　　　　　　　　　　* The agreement was concluded in foreign currency. 　　　　　　　　　　　　　　　　 Converted to Japanese Yen (JPY) from TTM of March 29, 2013

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Figure 10-4　List of Reports on the GEJET1. Information Bulletin prepared and distributed by the IFRC immediately after disaster

Title Date of issue NotesInformation Bulletin No. 1 Japan: Earthquake and tsunami Mar. 11, 2011

Prepared and issued by the AP Zone, and made publicly accessible on IFRC website. The JRCS website did not provide a link to the Information Bulletin.

Information Bulletin No. 2 Japan: Earthquake and tsunami Mar. 12, 2011Information Bulletin No. 3 Japan: Earthquake and tsunami Mar. 15, 2011Information Bulletin No. 4 Japan: Earthquake and tsunami Mar. 22, 2011Information Bulletin No. 5 Japan: Earthquake and tsunami Mar. 28, 2011

2. Reports prepared and distributed by the JRCS (1) Informal Updates

Title Date of issue NotesInformal Update No.1 Mar. 29, 2011

Distributed to NS and IFRC via e-mail. Described about the current situation and the JRCS response and posted on in the main text of the e-mails.

Informal Update No.2 Apr. 4, 2011Informal Update No.3 Apr. 12, 2011Informal Update No.4 Apr. 22, 2011

(2) Operation Updates Title Date of issue Notes

Operations Update No.1 Japan: Earthquake and Tsunami Apr. 13, 2011

Distributed to NS and IFRC, posted on the JRCS website (English version), and made publicly accessible.

Operations Update No.2 Japan: Earthquake and Tsunami May 6, 2011

Operations Update No.3 Japan: Earthquake and Tsunami May 20, 2011

Operations Update No.4 Japan: Earthquake and Tsunami Jun. 29, 2011

Operations Update No.5 Japan: Earthquake and Tsunami Aug. 10, 2011

Operations Update No.6 Japan: Earthquake and Tsunami Nov. 18, 2011

Operations Update No.7 Japan: Earthquake and Tsunami Feb. 1, 2012

Operations Update No.8 Japan: Earthquake and Tsunami Aug. 10, 2012

(3) 6-Month Report, 12-Month Report Title Date of issue Notes

6 Month Report Japan:Earthquake and Tsunami Aug. 31, 2011 Narrative Reports and Financial Reports. Distributed to NS and IFRC via e-mail, posted on the JRCS website (English version), and made publicly accessible.12 Month Report Japan:Earthquake and Tsunami Apr 27, 2012

(3) Report to the donor NSAs for international donations, the JRCS was not to deal with them as the donation from overseas as mentioned before, but to use them for its own relief projects and recovery support projects, as well as to report on their use to the PNS based on the international standards.Therefore, the JRCS employed temporary staff to prepare activity reports to overseas NS in late April and improved the system. Since then, various reports have been issued up to the present and sent to each PNS via e-mail. They were also posted on the JRCS website English version available for inspection by everyone.

(4) Usage plan for the donations from overseas in the emergency phase

As it was revealed that a large amount of donations would be sent from the Red Cross and Red Crescent Societies in other countries, thus the JRCS developed a provisional relief plan with a budget of 30 billion JPY to allot the donations to the emergency response for the 100,000 of affected people during three months of the period. This provisional relief plan was announced to the PNS in the international telephone conference of March 21.

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(2) Contents of the activitiesActivities conducted by the RCRC regarding the GEJET were as follows

a. Establishment of the JRCS tracing service website by the ICRC

On March 11, the day of the disaster, the JRCS received an e-mail inquiry from ICRC as to whether it needed a website for Red Cross tracing service. Thus, the JRCS requested ICRC to establish a multilingual website in the name of the JRCS Director General of the International Department within that day. The website was available in an English version within March 11 and in a Japanese version on the next day. As of May 20, 2011, 5,996 people registered, of which 1,786 were Japanese.

b. Acceptance of the RFL staff from the ICRC　(March 13 - 31, 2011)The JRCS accepted three RFL staff members, one from ICRC, one from the Geneva Headquarters, and one from the Bangkok regional office.

c. Implementation of the RFL on-site needs survey　(March 20 - 25, 2011)For a needs survey on RFL activities on-site, two staff from the JRCS Headquarters and one volunteer were dispatched to MIYAGI, and conducted interview surveys at the sites such as the Miyagi Chapter, the prefectural

(4) Others Title Date of issue Notes

Conclusion of the Partnership Meeting for the Great Japan Earthquake, 09 May 2011, Tokyo May 24, 2011

Agreement concluded at the first pertnership meeting for the GEJET Japan Recovery Assistance Program (May 9, 2011), sent to conference participants via e-mail.

Summary Report on the Partnership Meeting for the Great Japan Earthquake, 09 May 2011, Tokyo Jun. 9, 2011

Meeting summary report at the first pertnership meeting for the GEJET Japan Recovery Assistance Program (May 9, 2011), sent to NS and IFRC via e-mail.

Summary Report on the 2nd Partnership Meeting for the Great East Japan Earthquake and Tsunami, 18 May 2012, Tokyo Jul. 18, 2012

Meeting summary report at the second pertnership meeting for the GEJET Japan Recovery Assistance Program (May 18, 2011). Sent to NS and IFRC, posted on the JRCS website (English version), and made publicly accessible.

Great East Japan Earthquake and Tsunami (GEJET): FY 2011 Independent Auditor's Report and the Income and Expenditure Statement

Jun. 29, 2012

The English audit report and the income and expenditures account statement, sent as e-mails to PNS and IFRC, etc. and made publicly accessible on the JRCS website (English version).

3. Report prepared and by the IFRC and posted on the JRCS website.

Title Date of issue NotesEvaluation Report: Preparing for and Responding to Large Scale Disasters in High Income Countries: Findings and Lessons Learned from the Japanese Red Cross Society’s Response to the Great East Japan Earthquake and Tsunami

Feb. 13, 2012 * posted on the IFRC website on June 1, 2012

IFRC activity evaluation report. Posted the report on IFRC website and made publicly accessible on the JRCS website. The date of the post on the JRCS was September 3, 2012.

3. Tracing service activity(1) About Restoring Family Links (RFL) projectAs for tracing services by RCRC, the ICRC plays a leading role in establishment of systems at times of armed conflict and ordinary times with the NS, as a part of RFL. RFL is one of the RCRC’s humanitarian activities defined by the Geneva Conventions.The RFL system of the ICRC produces results when the safety of family members cannot be confirmed for a long time due to their status as refugees and evacuees, or the disruption of the national communication infrastructure due to conflicts. The JRCS response to the GEJET raised a question of how the system could adapt to the disaster management system in Japan where its own systems have already established such as disaster prevention system and a safety information system that are improved by municipalities, mass media, IT-related public companies. Japan also has backup and recovery capacities that enable communications by telephone and internet services restart just within a week after a disaster.Moreover, in the case of this disaster, the Tokyo Electric Power Company Fukushima Daiichi Nuclear Power Plant Accident occurred at the same time. Each embassy took measures for many foreign nationals who managed to escape to evacuate to outside FUKUSHIMA by March 20, 2011.

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and individuals.Based on the contingency plan for earthquake in Tokai area, the JRCS did not receive requests for tracing service in the aftermath of the disaster, but directed people to the website for the JRCS safety confirmation, which was immediately established by the ICRC.Eventually, the number of people registered on the JRCS tracing service website reached nearly 6,000. In addition to this website, the JRCS dealt with tracing service with the help of safety information made by prefectures, Metropolitan Police Departments, NHK (Japan Broadcasting Corporation), and the Person Finder of Google which had 600,000 registered within two weeks after the disaster.In the JRCS Headquarters and affected areas, i n f o rmat i on was shared w i th in terna t i ona l organizations and non-governmental organizations such as the United Nations International Children's Emergency Fund (UNICEF ) , I n t e rna t i ona l Organization for Migration (IOM), and the Japan Association for Refugees.

(3) Actions of other organizations related to safety confirmation

The Person Finder, in which affected people post news or safety information in times of a large scale disaster, was opened by Google after the Haiti earthquake of January 2010 and New Zealand earthquake of February 2011. The Person Finder Japanese version started to operate within two hours after the disaster. In Japan, at first 30 Google’s company staff including engineers involved in maintenance and improvement, and later the nearly 100 company staff and several thousand volunteers joined to the operation such as posting names and information on the Person Finder. Because of this, 600,000 cases of information were posted on the site over about two weeks.Immediately after the disaster, even though the JRCS explored the possibility of sharing its own safety information on the investigation site with the Person Finder of Google, it was not realized.Afterward, the ICRC tracing service staff explored the possibility of cooperation with Google in future. But it concluded that it was impossible to share with the Google at this time, because there was a difference between the Red Cross's approach to handling personal information and Google's approach in light of the information platform on Person Finder.

HDC, the Miyagi International Association, the Sendai Disaster Multilingual Support Center, and evacuation centers, etc.As a result of this needs survey, JRCS recognized that there was still scope to go into the field and conduct tracing service at this stage.

d. Development and donation of RFL kits in the fieldWith advice and provision from the ICRC, the JRCS developed equipment kits to start on-site safety confirmation activities, and used them.

e. Implementation of volunteer leader training as preparation for starting tracing service activities on site (March 27, 2011)

A one-day volunteer training was conducted by three staff from ICRC acting as a facilitator and interpreter for six volunteers and three staff members of International Department at the JRCS Headquarters.

f. Implementation of the safety confirmation pilot project using internet search functions (April 6-15, 2011)

Based on the previous needs survey, the JRCS decided to implement the project in ISHINOMAKI, MINAMISANRIKU, HIGASHIMATSUSHIMA and ONAGAWA. One member from the International Department at the Headquarters and two volunteers were dispatched to MIYAGI. The cooperation of four local volunteers could be gained for 10 days for the project.

g. Handing over the project to the volunteer center in the Miyagi Chapter (April 20, 2011)

Since the team of the trac ing serv ice p i lo t project composed of the staff dispatched from the Headquarters returned to Tokyo on April 15, 2011, the project was handed over to the volunteer center in the Miyagi Chapter.When one and a half months had passed since the disaster, the project ended on April 27, 2011 after judging that emergency needs on-site had become much fewer.

h. Response to inquiries of tracing service from NS and others conducted since the beginning of the disaster

Since the beginning of the disaster, the JRCS had responded to enquiries on safety confirmation from organizations such as the NS, foreign embassies in Japan, MOFA, relevant agencies, affected prefectures,

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(In 2012)・　　In February, children from a Taiwan elementary

school traveled to the affected areas and performed their local arts.

・　　In July, at the ministerial-level international conference, the JRCS President attended and gave a lecture as the President of the IFRC.

・　　In July, the United Nation Office for the Coordination of Humanitarian Affairs (OCHA), the Japan International Cooperation Agency (JICA), and the JRCS held a meeting to learn from this large scale disaster and JRCS staff took the rostrum as panelists.

・　　In July, the JRCS announced the Audit Report for Fiscal Year 2011.

・　　In September, the JRCS staff gave a presentation at the Red Cross Red Crescent Asia-Pacific Forum held in Beijing and the Red Cross meetings for sharing the lessons from the large scale disaster in advanced countries including Australia and Canada.

b. Response to the inspections of the affected areas by NS, etc.

Over the years after the disaster, the JRCS have received more requests for inspection of the affected areas from the NS that collected international donations, etc.In response to these requests, the International Department arranged inspections in close corporation with the GEJET Recovery Task Force in consideration of the sentiments of the affected people and the transport conditions.

4. Response and accountability to donors

(1) Acceptance of inspections and visitorsAt the stage of the recovery support activities after the emergency relief period, many people such as the NS and government officials visited Japan and listened to explanations on the JRCS activities and traveled to inspect the affected areas. Moreover, some of them also participated in the ceremony hold accompanied with the completion of recovery support projects.Furthermore, since around autumn of 2011, the JRCS was invited to join meetings including symposiums that were held by United Nations, embassies, NGOs and NS, and was required to share the lessons learned through the experience of this disaster as a Red Cross.

a. Acceptance of inspections and visitors (excerpt)The major events were shown as follows.(In 2011)・　The Danish Crown Prince (Patron of the Danish

Red Cross), the Chairman of the Taiwan Red Cross Organization, and the Chairman of the Singapore Red Cross Society, as well as many executive officers of the Red Cross and the Red Crescent Societies from Pakistan, Canada, France, the Netherlands and others visited the JRCS Headquarters.

・　The Commissioner of the European Union for International Cooperation and Humanitarian Aid visited the Headquarters and announced over nine million euros of aid.

・　Foreign dignitaries such as the Belgian Crown Prince and Princess, and the Irish Deputy Prime Minister visited the JRCS Headquarters. The German President attended a ceremony given by the JRCS.

・　In October, the JRCS dispatched staff to Belgium, the Netherlands and Canada aiming at conveying the responses.

・　From September to October, the IFRC evaluation team visited Japan and researched in the Headquarters and the affected areas.

・　In November at the IFRC General Assembly in Geneva, the JRCS created an opportunity for sharing the lessons from the evaluation of the IFRC with the NS, and the JRCS President presented a letter of appreciation of support from the NS.

[A letter of appreciation that was handed to each supporting NS from the JRCS in November 2011]

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Figure 10-5　List of Acceptance of Visitors from Overseas in 2011Date of arrival Name of the society Name Official position Destination to visit

Apr. 26-28

American Red Cross

Mr. Gail J. McGovern PresidentMIYAGI

RIKUZENTAKATAKAMAISHI

Mr. David Meltzer Vice President

Mr. Tom Alcedo Head of Country Representative, Indonesia

The Red Cross Society of the Democratic People’s Republic of Korea

Mr. Yoo Chong-Ha President MIYAGIRIKUZENTAKATA

KAMAISHIMr. Kim Juja Head of International Relations

May 9-11 Partner National Red Cross and Red Crescent Societies (PNS Meeting) See Figure 10-7 　

MIYAGIIshinomaki RCHP

RIKUZENTAKATAOFUNATO

May 13-14 Taiwan Red Cross Organization

Mr.ChenCharng Ven Chairman

IWATETONO, KAMAISHI, OTSUCHI

Ms.Lin Hsiu Fen　（Rebecca) Deputy Secretary General

Ms. Hsu Hsiao Tzu　（Lisa) Deputy Director of the Disaster Relief Department

Ms.Chang Yu Chu　（Gloria) Public Relations, Development Department, Desk Officer

Jun. 14-17

IFRC Mr.Jagannath Chapagain Head of the AP Zone

MIYAGISHICHIGAHAMA

European Commission, Directorate General for Humanitarian Aid and Civil Protection

Mr.David B. Verboom

European Commission, Directorate General for Humanitarian Aid and Civil Protection, Head of the East and South East Asian Regional Office

Jul.13-14 Red Cross Society of China, Hong Kong Branches

Lady WuDirector cum Chairman of the International and Relief Service Management Committee

MIYAGIHIGASIMATUSHIMA, ISHINOMAKI

*Visited Japan in order to the study about the activities of JRCS such as ERU, etc., and visited the affected areas.

Ms. Bonnie So Deputy Director of Office

Ms. Eva Lam Senior Health Coordinator, International Relief Service

Jul.19-22 Singapore Red Cross SocietyMr TEE Tua Ba Chairman The Headquarters Briefing

*Affected areas inspection given by the embassyCol. Theampoh LIM Secretary General

Jul. 19Indonesian Red Cross Society Mr. Jusuf Kalla Chairman

The Headquarters BriefingIndonesia Embassy Mr.Muhammad Lutfi Ambassador

Aug. 22-23 Qatar Red Crescent SocietyMr. Saleh Ali M Al-Muhanadi Head of the Department

MIYAGISENDAI, ISHINOMAKIDr. Amer Rayad Melhem Coordinator of Disaster

Management, and others

Sep. 6-13 Taiwan Red Cross Organization

Mr.James Wu Secretary General IWATEYAMADA, OTSUCHI

FUKUSHIMAPrefectural government

MIYAGIPrefectural government,

MINAMISANNRIKU, KESENNUMA

Ms.Lin Hsiu Fen Deputy Secretary General

Ms.Hsu Hsiao Tzu Deputy Director General of the Disaster Relief Department

Ms.Cindy Wang Secretary

Ms.Eri Ando Interpreter

Sep.8 Ty Inc. Mr. Ty Warner President Ishinomaki RCHPHome for Infants, Japanese Red Cross Medical Center

Sep.11-13 Pakistan Red Crescent SocietyMs. Bakhtiar Nilofar President MIYAGI

SENDAI, Ishinomaki RCHPTemporary housing around ISHINOMAKIMr. Amjad Pervaiz Head of the Resources

Development Department

Sep.26-30 Swiss Red Cross

Mr. Martin Fuhrer Head of the International Department at the Swiss Red Cross

MIYAGIIshinomaki RCHP, Onagawa Town HPMr. Felix Bollmann Head of the Swiss Foundation

Mr. Peter Zihlmann Head of the Caritas Swiss Relief and Recovery Department

Oct. 13 Irish Government

Mr. Eamon Gilmore Deputy Prime Minister/Minister for Foreign Affairs and Trade

The Headquarters Briefing

Mr.Colm O floinn Secretary General of Foreign Affairs Department

Ms. Cathy Madden Deputy Government Press Secretary

Ms. Mary Connery Private Secretary of the Deputy Prime Minister

Mr. John Neary Ambassador of Ireland in JapanMr. Donal Kenneally Counselor of the Ireland Embassy

Oct. 17 The Canadian Red Cross Society Mr.Edward Tanaka PresidentMIYAGI

Ishinomaki RCHP, MINAMISANRIKUHANAMAKI, RIKUZENTAKATA

Oct.23-24 German Red CrossDr. Rudolf Seiters President

The Headquarters Briefing Dr. Johannes Richert Head of the International Services,

Domestic Relief Department

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Date of arrival Name of the society Name Official position Destination to visit

Oct.31-Nov.2 PNS (Monitoring Visit) See Figure 10-8 　 IWATEMIYAKO, OTSUCHI

Nov.8-11IFRC “Guidelines for Urban Earthquake Disasters” preparation and investigation team

Mr. Nitin Verma IFRC Outside Consultant, Disaster Management Sector Specialist MIYAGI

Ishinomaki RCHPThe Miyagi ChapterMs. Meghna Chawla IFRC Outside Consultant, Media-

Related Specialist

Dec.5-7 Taiwan Red Cross Organization

Ms.Lin Hsiu Fen　（Rebecca) Deputy Secretary General IWATEYAMADA, OTSUCHI

MIYAGIKESENNUMA

Ms.Hsu Hsiao Tzu　（Lisa) Deputy Director General of the Disaster Relief Department

Figure 10-6　List of Acceptance of Visitors from Overseas, 2012Date of arrival Name of the society Name Official position Destination to visit

Jan.24-28

Swiss Red Cross Mr. Lorenz Indermühle Desk OfficerMIYAGI

ONAGAWACaritas Switzerland Ms. Yvonne Affolter Program Coordinator

Feb.12-16 Taiwan Red Cross Organization

Ms.Lin Hsiu Fen Deputy Secretary GeneralIWATE

YAMADA/OTSUCHIMIYAGI

MINAMISANRIKUFUKUSHIMA

SOMAMs.Hsu Hsiao Tzu Deputy Director General of

Disaster Relief Department

Feb.12-16 French Red Cross

Mr. Olivier Brault Secretary GeneralMIYAGI

Ishinomaki RCHPFUKUSHIMA

AIZUWAKAMATSU, Smile Parks, Temporary housing

Mr. Jean-François Riffaud Head of the Communication and Fundraising Department

Feb.26-Mar.3

Taiwan Red Cross Organization

Mr.Chen Charng Ven Chairman

IWATEYAMADA/OTSUCHI

MIYAGI, MINAMISANRIKUFUKUSHIMA, SOMA

Mr.Lee Hung Chun Taiwan Red Cross Organization Consultant

Ms.Lin Hsiu Fen (Rebecca) Deputy Secretary GeneralMr.Chen Shih Jen Secretary General

Mr.Sun Wei Li(Paul) Public Relations and Development Department

Ms.Hsu Hsiao Tzu(Lisa) Deputy Director General of the Disaster Relief Department

Ms.Rung Yu Jiun Public Relations and Development Department

Ms.Chang Yu Chu(Gloria) Public Relations and Development Department

Ms.Yang Ting Ting Relief DepartmentMs.Chen Shih Yi(Christine) Relief Department

Taipei Economic and Cultural Representative Office in Japan

Ms.Lin Yu Hui Assistant Director (Third-Class Secretary)]

Ms.Shen Laiyi 　Mr.Wang Hong Ming　　

Tai Wu Elementary School Folk Singers

Choir of Elementary School and Junior High School Students, Head Coach, Documentarian (22 persons in total)

Apr.13-15

Swiss Foundation Mr. Tony Burgener Managing Director

MIYAGIOnagawa Regional Medical Center

Swiss Red Cross Mr Martin Furer Head of the International Department

Caritas Switzerland Ms. Yvonne Affolter Program Coordinator

Embassy of Switzerland

Mr.Urs Bucher Swiss Ambassador in Japan

Mr. Edger Dörig Minister of Embassy of Switzerland

Mr.Alexander Renggli Head of the Culture and Public Relations Department

May 14-18 PNS, IFRC, ICRC PNS, IFRC, ICRC, Head, Disaster Officer, etc.

Fukushima Decontamination Information PlazaFukushima RCHP

FUKUSHIMA Watarai Kindergarten

FUKUSHIMA Nankodai Regional Decontamination Site

IINO District Office of IIDATEFukushima Radiation Monitoring Center

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Date of arrival Name of the society Name Official position Destination to visit

May 17-18 PNS Meeting See Figure 10-9

MIYAGIMINAMISANRIKU Temporary Clinic

ISHINOMAKI Social Welfare Office named “Laborare”

Ishinomaki RCHP

Jun.4-5

Swiss Red Cross Mr. Hannes Heinimann Head of the Disaster Relief Division

MIYAGIONAGAWA Regional Medical

CenterJTI Foundation

Mr Stefan Rissi Managing Director

Mr Nenad Ljubicic Program Manager

Japan Tobacco Headquarters Mr. Daisuke Fujimaki CSR staff

Jun.6 PNS, IFRC 　 PNS, IFRC, ICRC, Head, Disaster Response staff, etc.

IWATEWithin RIKUZENTAKATA

RIKUZENTAKATA temporary government building

Takinosato temporary housing complex

Jul.2-5 Taiwan Red Cross Organization

Ms. Ching-Feng, Wang Chairman MIYAGIMINAMISANRIKU town officeMinamisanriku temporary clinic

Tagajo temporary housingArahama regions

Ms. Hsu Hsiao Tzu　（Lisa) Deputy Director of the Disaster Relief Department

Ms. Ando Rie Interpreter

Jul.23-26 The Netherlands Red Cross Ms. Pauline Krikke Arnhem City, Netherlands, Mayor

MIYAGIMINAMISANRIKU town office

FUKUSHIMAFukushima Decontamination

Information PlazaTemporary housing and others

Aug.8 Taiwan Red Cross Organization

Ms. Ching-Feng, Wang The Netherlands Red Cross Board Member

FUKUSHIMASOMA BABANO disaster

municipal housing

Ms. Wang Kuan Chen Chairman

Ms. Chen Yi L Secretary General

Ms. Chen Shih Yi　（Christine) Social Welfare Department

Ms. Hsieh Yu Hsuan　（Florence)

Relief Department Public Relations Department

Ms. Ando Rie Interpreter

Aug.21

Government of Alberta, Canada Ms. Michelle Tetreault Prime Minister Strategy Division MIYAGI

The Miyagi ChapterIshinomaki RCHP

Tagajo temporary housingAlberta Japan Office

Mr. Norihiko Saito Commercial Officer

Ms. Mary Beth Takao Commercial Officer Assistant

Sep.4 Commonwealth Bank of Australia

Mr. Martin Spann Tokyo Branch, Branch Manager The Miyagi ChapterIshinomaki RCHP

Temporary Minamizakai the 7th (Dainana) housing complex

Ms. Kumiko Sands Personnel Department/General Affair Department, Manager

Sep.13-14 Swedish government officials

Mr. Martin Gerdin Karolinska Institutet Doctoral course

FUKUSHIMAFukushima RCHP

MIYAGIIshinomaki RCHP

Ms. Åsa Ljungquist Senior Adviser

Dr. Susannah Sigurdsson Senior Adviser

Dr. Magnus Simonsson Doctor, Consultant

Dr. Leif Stenke Doctor, Doctor of Philosophy, Assistant professor

Dr. Johan von Schreeb Doctor, Doctor of Philosophy

Dr. Niklas Kviselius Science technology Attach

Dr. Setsuko Hashimoto Program Manager

Sep.25-26 Taiwan Red Cross OrganizationMs. Ching-Feng Wang Chairman OSAKA

SAKAISAKAI Peace Contribution Award

CeremonyMs. Helen Huang Communication Development

Department

Nov.6-8ＩＦＲＣ Mr. Bjorn Elder Representative IFRC in Japan IWATEMORIOKA, MIYAKO, YAMADA

Middle of Jan.-middle of Feb 2012 IFRC Evaluation Team

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(2) Monitoring visitFrom October 31 to November 2, 2011 the JRCS invited 25 representatives of NS, reported the progress of recovery support projects, and explained that the 30 billion-scale of recovery overall plan was changed to 53 billion-scale. In addition, they inspected the activities of relief projects in IWATE.In October 31 , a t the meet ing at the JRCS Headquarters, Mr. Jerry Talbot, a leader of GEJET Evaluation Team, evaluated that the medical activities and the psychosocial support of the JRCS were effective and met the needs of the affected areas. On the other hand, he pointed out the problems, such as the efficient use of ERU of the IFRC and the strengthening of disaster-response volunteers. As the matters that NS around the world should think of, he said, “the preparation of measures in advance is important and the support acceptance agreements between the IFRC headquarters or NS is also necessary. NS should consider the role of RCRC at the time of a nuclear power plant accident.”In November 1, the inspection group visited MIYAKO and OTSUCHI, IWATE and saw inside temporary housing and assembly halls as well as Nordic Style Walking projected by the JRCS Volunteer Corps. as an occasion for communication among and fitness for the residents. After the inspection tour, the comments from the participant members were; “we saw that the JRCS staff was operating close to affected people” and

“we realized that the JRCS activities spread among the residents” and so on.

5 Holding of various meetings and conferences

(1) The first pertnership Meeting for GEJET (PNS Meeting)

In May 9, 2011, the JRCS held the first Partnership Meeting for GEJET, inviting 43 people from 20 PNS, representatives of embassies, and foreign ministry departments. From JRCS, the President, the Vice President, and 19 major executive staff attended. The Vice President of the IFRC, Dr. Mohammed Al Maadheed and the Secretary General Mr. Bekele Geleta also participated in the meeting.This meeting was intended to meet all NS together that sent “international donations” and discuss how to use the international donations expected to amount to approximately 30 billion JPY in total.In the meetings, the medical activities and volunteer activities of the JRCS after the disaster were reported on, and the fact that the total of 30 billion JPY was relied on for the recovery activities plan was explained, and the agreement of the participants was gained. Moreover, the written agreement on the formal acceptance of funds was approved, presenting a common form to be used.Furthermore, they also discussed responses to possible large scale disasters in future around the world. In connection with the problem of the serious nuclear power plant accident caused by the earthquake and tsunami, the participants asked about the relief activities in FUKUSHIMA and the response to possible nuclear power plant accidents in future.

“There are over 400 nuclear plants in about 30 countries around the world. In the light of this accident, the strict measures are needed”, said the JRCS President, and raised the question that RCRC also needs to bring up the issue of nuclear power plant accidents in international conferences.The agreement contents in the meeting was compiled as the “Conclusions” and shared among the participants with a summary report at a later date.After the meeting, from May 10 to 11, a two days inspection tour of the affected areas was conducted. Since traveling by train was still limited at that time, they chartered a bus from Tokyo. The total of 33 people from the NS, IFRC, and embassy officials participated in the tour. Eight staff of the JRCS International Department accompanied them. They inspected in ISHINOMAKI, MIYAGI (Red Cross Hospital and others), RIKUZENTAKATA, IWATE (e.g. a brief explanation was provided by the mayor, and inspection of temporary housing was conducted).

[The Partnership Meeting for GEJET]

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Summary ReportOn the Partnership Meeting

09 May 2011, TokyoGreat East Japan Earthquake

The meeting took place on the 9th May 2011, at the Japanese Red Cross HQs in Tokyo with the participation of 43 representatives from 18 National Societies, IFRC, ICRC, Embassies and MoFA as well as 19 persons from the senior management of JRCS, including the President and Vice-President. The IFRC was represented at the Governance level by Dr. Mohammed Al-Maadheed, Vice President and at the management level by Mr. Bekele Geleta, Secretary General. A two day field trip followed the meeting.The objectives of the meeting were;

•　To have a common understanding of the context of disaster response in Japan and the role of JRCS•　To share the activities undertaken by JRCS during the emergency phase with the participants•　To share and discuss JRCS priority action plans for the early and mid-term recovery phases•　To consolidate assistance to be provided by partner National Societies and external supporters

The conclusions of the meeting have been shared with all participants by email.

Proceedings1.　The meeting was convened at 9:30 by the Chairperson, Dr. Yamada, Executive Director General of JRCS,

followed by a minute of silent prayer.2.　Mr. Tadateru Konoe, President of JRCS, made the opening remarks. He stated that the support from the

Movement worldwide has moved us all deeply and reminds us of the Spirit of Solidarity that is at the heart of our Movement. On this firm basis of solidarity, the JRCS will resolutely continue its efforts for the sake of the affected population.

3.　A 15 minute video depicting the emergency response activities of the JRCS was shown.4.　The focus of the first session was on the JRCS emergency response. Mr. Kimura, Director General of

the Disaster Management and Social Welfare Department, explained the mandate of JRCS and gave the participants an update of the achievements in emergency health (mobilization of over 700 medical teams from 92 JRCS hospitals, the medical activities of Ishinomaki Red Cross Hospital), PSP, mobilization of volunteers and relief goods and response to the nuclear power plant accident, as well as constraints in the early days, including the difficulties in communication and the shortage of gasoline.

5.　The second session was on the JRCS fundraising and unique cash distribution system that has been developed historically. JRCS alone has raised over 160 billion yen (or USD 2 billion).

6.　Mr. Hattori, Director General of the Organization Development Department, explained the criteria for eligible beneficiaries and the amounts of cash to be distributed in the first round as decided at the central Grant Distribution Committee held on the April 8. As of May 1, JRCS had transferred 65 billion yen (or USD 790 million) to 12 prefectures for the first round of cash distributions.

7.　The third session went through the Relief and Recovery plans of JRCS. This session was divided into two: a.　Dr. Ando, Senior Technical Advisor on Health, explained JRCS intended activities for the rebuilding

and strengthening of Medical infrastructure and services in the Ishinomaki region, Miyagi prefecture. The major projects are: 1) Restoring a night-time emergency medical center 2) Rehabilitating a 150 bed secondary hospital run by Ishinomaki city municipality 3) Strengthening disaster response capacity, including reconstruction of the damaged RC nursing school.

b.　The latter part of the third session was on the measures to be taken to improve living conditions for those who stay at evacuation centers and in transitional houses. Mr. Misawa, Director General of General Compliance Office, explained JRCS major initiatives: 4) Provision of evacuation center packages (water tanks, washing machines, TVs, air cleaners) 5) Provision of a home appliance package to transitional houses (refrigerator, washing machine, TV, rice cooker, microwave oven, water heater) 6) Provision of vehicles and nursing care beds to improve social welfare services 7) Educational support to children

8.　The fourth session was devoted to discussing cooperation matters with partner Societies. Mr. Nishijima, Deputy Director General of General Affairs Department, presented issues relating to reporting, ear-marking and audit, followed by the presentation of Mr.Tasaka, Director General of the International Department, on MoU, monitoring and evaluation.

9.　Each session was accompanied by a session for questions and answers, facilitated by Mr.Martin Faller, Head of Federation Regional Delegation for East Asia.

10. The final session was a group discussion leading up to the conclusion of the meeting. Participants expressed appreciation for the opportunity to meet and supported the presented JRCS framework for early and mid-term recovery action plans and its mode of operation.

11. Dr. Yamada, Chairperson, closed the meeting at 18:30.(Conclusion of the meeting attached herewith)

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CONCLUSIONS

The participants to the Partnership meeting for the Great East Japan Earthquake held on 9 May 2011 in Tokyo:

◦Expressed their gratitude to JRCS for hosting the conference and inviting its partners to deliberate,

◦Recognised the challenges presented by the disaster and appreciated the tremendous work accomplished by JRCS,

◦Developed a common understanding of disaster response in Japan and JRCS unique relationship with the Government of Japan, which defines the role of the National Society and the actions which it is expected to take in response to disasters

Concluded the following:◦ACTION PLANS: JRCS framework action plans for early and mid tem recovery were discussed and supported

by the participants and their comments and concerns addressed.

◦ALLOCATION OF SUPPORT FROM SISTER NATIONAL SOCIETIES: The JRCS prefers non-earmarked funding, but is open to find solutions together with National Societies to meet their specific requirements. A standard format for a MoU was given by the JRCS in the official hand-out folder to the participants.

◦MONITORING: The JRCS fully recognises the need for monitoring and invites sister Societies to participate in joint monitoring missions on a regular basis.

◦REPORTING: Reporting on the progress of operations in response to the Great East Japan Disaster will be provided as per agreements with the partners and in Operations Updates, and will include assistance provided by partner NS and external supporters.

◦EVALUATION: The JRCS with support of IFRC will conduct mid-term and final evaluations and invites the partners to participate in this process and the evaluation reports will be shared with parties concerned.

◦LESSONS LEARNED: JRCS and its partners will review the course of action it chose to take in this operation, identify lessons learned and integrate them into global planning for future disaster response. Fundraising experience and innovative communications activity would be focused.

◦DISASTERS IN HIGH INCOME COUNTRIES: The Federation should develop a cooperation model and tools for increasing the collective capacity of its components to respond to disasters in high income countries.

◦THE NUCLEAR CHALLENGE: The situation at Fukushima Daiichi nuclear power plant reinforces the need for the Movement to develop a knowledge base and a model for responding to nuclear incidents.

◦INTERNATIONAL DISASTER RESPONSE LAW: Within the global context, agreement should be reached on improving legal preconditions for international cooperation in disasters, and IDRL should be promoted wherever it needs to be strengthened.

◦RESTORING FAMILY LINKS: The participants recognized the need to address RFL when planning for and responding to disasters.

◦COMMITMENT: The participants appreciated the outcome of the meeting and committed to continuous support for implementation of the JRCS framework response plan.

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had achieved 63 percent of the recovery support project plan” (Germany); “the high reputation of the JRCS's ordinary activities might have been able to collect such a large amount of Gienkin and donations from overseas” (Iran); and “It was great that RCRC operated as a family. RCRC will also share this experience of the GEJET” (Malaysia).

(4) Holding a Red Cross meeting regarding nuclear disaster measures

a. GEJET drove RCRC to focus again on nuclear disastersIn November 2010, before the GEJET, the JRCS President, who is also the President of IFRC, made a speech at the World Summit of Nobel Peace Laureates in HIROSHIMA as a representative of the Nobel Peace Laureates Group. He stressed that “once a nuclear power plant accident occurs, the humanitarian impact can be as serious as that of a nuclear weapon or even greater than that” and “people working on humanitarian support will be forced to deal with nuclear accidents. What is more, such accidents can affect people all over the world.” He also raised the question that RCRC should review its role regarding nuclear disasters as a humanitarian aid organization as well. Whereas the ICRC has led the issue of nuclear weapons in the past, and has to be going to do in future, making a new trend such as; the IFRC should lead the response to the issue of nuclear disasters as one of disaster management and measures in peace time. Thus the IFRC Secretariat hastily became a key player in adopting resolutions on nuclear disasters within half a year by the time of since the IFRC Assembly Conference of November 2011.

b. Resolutions of the IFRC General Assembly and their Follow up

For the adoption of these resolutions, the JRCS called for an international conference as the first meeting on this issue and proposed to host the meeting. In response to the proposal, the Red Cross Meeting on Nuclear Hazard

(3) The second PNS MeetingAfter one year from the first Meeting, the second PNS Meeting was held in May 2012. On May 18, over 40 people from 13 PNS and the IFRC participated in the meeting at JRCS Headquarters in TOKYO. Before the meeting, they had an inspection tour of FUKUSHIMA and MINAMISANRIKU and ISHINOMAKI, MIYAGI, and saw how the recovery support projects have helped the affected people.The JRCS President delivered an address of thanks to the PNS by saying “I express my thanks for your warmest support and encouragement, and your solidarity” and continued “let the Red Cross as a whole review the measures for large scale disasters by sharing the experience of the GEJET”.When explaining the comments from the IFRC Evaluation Team, Mr. Bjorn Eder, the IFRC country representative in Japan, pointed out that even an advanced country like Japan has vulnerability to natural disasters causing the disruption of communicat ions and transportat ion , and the breakdown of electricity and fuel supplies. He appealed that “the NS may not have prepared for the nuclear power plant accident, but we have to imagine the things that are beyond imagination”, and NS should conduct relief activities for victims even in a nuclear power plant accident.He also mentioned about the large amount of international donations offered to the JRCS, and said

“just RCRC in the affected country alone should not respond to the large scale disaster even though it occurred in an advanced country, which is recognized among NS”. He added that needs to develop response rules of the IFRS are required.In response to these evaluations and suggestions, the JRCS Director General of Disaster Management and Social Welfare Department said that it would immediately consider the matters such as the roles and contents of disaster-response volunteer and psychosocial support activities, the acceptance system for overseas support, and the response policy, equipment, and training structure for nuclear disasters, and other issues. He said JRCS would create a system to flexibly respond to future large scale disasters, reinforce the disaster management capacity, and develop response plans using the advantages of the Red Cross networks.Some of the comments from representatives of the NS are as follows; “we were impressed that the JRCS

Partnership Meeting for the Great East Japan Earthquake and Tsunami May 18th 2012, Tokyo Japan[All the participants of the second PNS Meeting in May 2012]

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Centering on the new person in charge deployed at the IFRC Secretariat and an advisory group composed of societies who are highly interested in this issue, these challenges will be prepared to address.There was another comment indicat ing that determination of the Red Cross’s policy for nuclear disaster response could become a base when providing information to national governments or other international organizations. And from this perspective, it is important for RCRC to disseminate some kind of international guidelines for support of affected victims.

Measures was held at the JRCS Headquarters in TOKYO in May 2012, involving over 50 people from the NS of 16 countries and regions that have nuclear power plants or are highly concerned about this issue.After the three days of discussions, participants reaffirmed that the proposition to “support the victims of nuclear disasters” was one of the challenges to be addressed by not only some of the specialized agencies, but also RCRC that is not a government or business operator but a neutral and grassroots organization in that country. And they agreed as follows: this effort shall be on an extension of disaster management, a core activity operation of RCRC; it would be practical on a cost-benefit basis if it can apply to any measures including the explosion of a bio-chemical factory, not for only measures peculiar to nuclear disasters; it shall promote the sharing and accumulation of information and knowledge among NS by taking advantage of RCRC networks; and it shall strengthen collaboration with governments and related international organizations.The challenges that RCRC focuses on in particular are described below.

(1)Improvement of the knowledge, skills, and equipment of the RCRC staff and volunteers. Because people who involved in activities have to take care of themselves in order to surely provide continuous supports.

(2)Awareness-raising activities for local residents.(3)Recovery: psychosocial support, health monitoring,

support for victims focusing on the vulnerable, such as elderly people and children.

Figure 10-7　List of Participants at the First PNS MeetingName Name of the society Official position

American Red CrossMr. Mark Preslan Director for Asia and the Middle East

Mr. John R. Manley Senior Advisor, International Services

Australian Red CrossMs. Donna McSkimming Head International Program

Mr. Maximilan Santner Head of International Aid

British Red Cross Mr. Paul Jenkins Head of Partnership Development

The Canadian Red Cross Society Ms. Pat Laberge Senior Manager, Asia Programme

Red Cross Society of China

Ms. Zhang Ming Director of External Liaison Department

Ms. Qiu HailingHead of International Management Division, External Liaison Department

Finnish Red Cross Ms. Kristiina Kumpula Secretary General

French Red Cross Mr. Jean-Francois Riffaud Head of Communication and Fundraising

German Red Cross Mr. Dr. Johannes Richert Director Internatl. Services/ Natl. Relief Division

Hong Kong Red CrossMs. Ping Betty Lau Head of International & Relief Service (Acting)

Ms. Pui Wah Alice Ho International & Relief Service officer

Red Crescent Society of the Islamic Republic of Iran Mr. Shahabeddin MohammadiDirector General, International Affairs Department

The Republic of Korea National Red CrossMs. Eunhee Cho Deputy Head of International Relations

Mr. Wonyong Choi Director of Resource Mobilisation and Development Bureau

he Netherlands Red Cross Ms. Suzanne Serrarens Director of Operations

New Zealand Red Cross Mr. Andrew Mckie Manager International Operations and Emergencies

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Name Name of the society Official position

Qatar Red Crescent Society

Dr. Mohammed Mr. Al-Maadheed

Vice President Vice President of IFRC

Dr. Fawzi Oussedik Head of International Relations Dept. and IHL Dept.

Singapore Red Cross SocietyMr. Benjamin William Director, Special Duties

Mr. Theam Poh Lim Director, Operations

Spanish Red Cross Ms. Mercedes Babe Director, Inetnational Cooperation Department

Swedish Red Cross

Mr. Bo Hermansson Board Member

Mr. Martin FuhrerHead, International Department


Mr. Jams Wu Secretary General

Ms. Rebecca Lin Deputy Secretary General

Ms. Lisa HsuDeputy Director Disaster Relief Department

Ms. Christine ChenDesk Officer Disaster Relief Department

IFRC

Mr. Bekele Geleta Secretary General

Dr. Simon MissiriSenior Advisor/Head, Resource Mobilisation and Government Relations Dept.

Mr. Pierre Kremer Head of Communications Department

Mr. Alfred John Panico Acting Head of Operations

Mr. Martin Faller Head of Regional Delegation for East Asia

Mr. Bjorn Eder Representative in Japan

Mr. Michael Gillies Smith Communication Delegate

ICRC

Mr. Tobias Epprecht Head of Regional Delegation, Kuala Lumpur

Mr. Yoshinobu Nagamine Head of Office ICRC Tokyo

Mr. Hitomi Makabe Communication Officer, ICRC Tokyo

Embassy of Ireland Mr. Donal Kenneally Deputy Head of Mission and Counsellor

Embassy of Greece Mr. Nikolaos Tsamados※ Ambassador

Delegation of European Union (EU) to Japan Mr. Gijs Berends First Secretary

Ministry of Foreign Affairs of Japan

Ms. Setsuko KawaharaDirector, Humanitarian Assistance and Emergency Relief Division International Cooperation Bureau

Ms. Sayuri MurakiOfficer, Humanitarian Assistance and Emergency Relief Division International Cooperation Bureau

* Did not participate in the Meeting, but attended the inspections in the affected areas.

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Figure 10-8　List of Participants in the Monitoring VisitsName Name of the society Official position

Mr. Thomas James Alcedo American Red Cross Country Representative, Indonesia

Ms. Donna McSkimming Australian Red Cross Head of International Programme

Ms. Katy Attfield British Red Cross Head of Disaster Management, International Division

Mr. Hossam Elsharkawi The Canadian Red Cross Society Director, Emergency & Recovery, International Division

Ms. Marina Hovannesjan German Red Cross Head of Aisa Unit

Mr. T C Chan Hong Kong Red Cross Member of the Hong Kong Red Cross Council and International & Relief Service Management Committee

Ms. Bonnie So Hong Kong Red Cross Deputy Secretary General

Mr. Young Hyun KimKorean Red Cross

Secretary General

Ms. Yun-Kyeong Han Officer, International Relations Department

Mr. Datuk Wira Dr Hj Bahari Bin Datuk Abu Mansor

Malaysian Red Crescent Society

National Vice Chairman of Malaysian Rec Crescent / Chairman of Malaysian Red Crescrent Natioanl Disaster Management and Ambulance Service Committee

Mr. Datuk Hj Bahari Bin Hj Taib Deputy Chairman of Malaysian Red Crescent National Disaster Management and Amblance Service Committee

Mr. Rozalla Iskandar Bin Mohamad Rosni Disaster Management Preparedness Officer

Mr. Andrew Mckie New Zealand Red Cross Manager, International Operations and Emergencies

Mr. Robert Hsieh


Deputy Sercretary General

Ms. Lisa Hsu Deputy Director of Disaster Relief Department

Ms. Christine Chen Desk Officer of Disaster Relief Department

Mr. Dr.Ivan Usichenko

Ukrainian Red Cross Society

President of Ukrainian Red Cross Society

Ms. Valentyna Pryshko Head of Volyn Regional Organization

Ms. Serhiy Glukhenkyy Head of Vinnitsa regional organization

Mr. Gijs Berends Delegation of European Union (EU) to Japan First Secretary

Mr. Alain Aeschliman

ICRC

Head of Operations for Asia Pacific

Mr. Yoshinobu Nagamine Head of Offie, Tokyo

Ms. Hitomi Makabe Communication Officer

Mr. Martin Faller IFRC Head of East Asia Reginal Delegation

Mr. Enkas Chau IFRC Operations Coordinator, Disaster Management Unit, AP Zone

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Figure 10-9　List of Participants at the Second PNS MeetingName Name of the society Official position

Mr. Maximilan Santner Austrian Red Cross Head of International Aid

Ms. Breanne EnglandThe Canadian Red Cross Society

Manager, International Emergency Response Funds

Mr. Nathan Huculak Communication Advisor

Mr. Wang Repeng

Red Cross Society of China

Secretary General

Ms. Qui Hailing Head of International Cooperation Division

Ms. Qinghua Li Head of Disaster Management Division

Mr. Oliver M. Brault French Red Cross

Geneal Director

Mr. Jean-Francois Riffaud Director Communination and Fundraising

Ms. Natia Loladze

Red Cross Society of Georgia

President

Ms. Nana Keinivili Partron

Ms. Nino Drasalia Member of bord in GRCS Tbilisi branch

Ms. Tatia Loladze GRCS Volunteer

Dr. Johannes RichertGerman Red Cross

Director Communination and Fundraising

Mr. Christian Hoerl Deputy Head of International Cooperation Dept.

Ms. Alice Lai Hong Kong Red Cross Deputy Head of International & Relief Service Department

Ms. Yoon Jung Chang The Republic of Korea National Red Cross Officer of President's Office

Mr. Datuk Wira Dr Hj Bahari Bin Datuk Abu Mansur

Malaysian Red Crescent Society

National Vice Chairman of Malaysia Red Crescent / National Disaster Management and Ambulance Services Committee Chairman

Mr. Hi Tahir Bin Ahmand Johor Branch Director

Ms. Hajjah Shamsiah Binti Abdul Kadir HR/Admin Manager

Mr. Ahamad Abd Talib National Excective Board

Ms. Suhana Mohamed Salleh Fund Raising Manager

Mr. Daniel Goni Diaz

Mexican Red Cross

President

Ms. Maria Isabel Rojo De Goni President Volunteer Ladies Coordination

Mr. Francisco Javier Briseno Ramirez Vice- President

Ms. Maria Lusia Sanchez de Briseno Vice Presodent Volunteer Ladies Coordiantion

Ms. Wilma ter Heege The Netherlands Red Cross Disaster Response Coordinator, Disaster Response Unit

Mr. Chun Yew Wong Singapore Red Cross Society Head International Services

Ms. Yu Jiun Rung Taiwan Red Cross Organization Senior Desk Officer of Disaster Relief Dept.

Mr. Martin Faller IFRC Head of Regional Delegation, IFRC East Asia

Ms. Karen Poon IFRC Opetation Coordinator, Disaster Management Unit, AP Zone

Mr. Bjorn Eder IFRC Representive in Japan

Mr. Michael Annear IFRC Head of Disaster Management Unit, AP Zone

Ms. Elizabeth Konstantinova Delegation of European Union (EU) to Japan Second Secretary, Political and Economic Section

The following were observers↓

Mr. Magendran Rajagopal

Malaysian Red Crescent Society MRC Kuala Lumpur Branch Volunteer

Mr. Mohamed Azan Bin Mohamed

Mr. Wong Sang Choon

Mr. Yusri Abdul Malek

Mr. Lee Keng Fatt

Mr. Rodrigo Emilio De Villasante Herbert

Mexican Red Cross

Counselor, Board of Directors

Mrs. Jessica Consuelo Moncada de Herrera 　

Mr. Antonio LópezBato Giral Counselor, Board of Directors

Mrs. Martha Patricia Reza Rodriguez 　

Mr. Marcelino eliseo Alvarez Gonzálz Counselor, Board of Directors

Mr. Masaki Watabe United Nations Office for the Coordination of Humanitarian Affairs Head of Kobe Office / Humanitarian Affairs

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institution, structure, and social status. Furthermore, the evaluation team collected feedback regarding the disaster response of the Red Cross and Red Crescent Societies in other countries using the internet. The report includes responses from 18 societies.Since then, the Evaluation Research Team conducted interview surveys with the AP Zone and the East Asia Regional Delegation. Then, exchanging comments with NS, and discussing and monitoring on the findings between the IFRC and the evaluation team were conducted. Based on this, on November 22, 2011, the first draft report was submitted to the IFRC and the JRCS. On November 30, the Evaluation Team leader and the IFRC representative in Japan announced the research summary at a workshop on large scale disasters in advanced countries held in Geneva. The JRCS translated this into Japanese in order to deepen the understanding of the evaluation research and gain feedback within its own society. On December 30, the JRCS submitted its opinions to the Evaluation Research Team and completed the final report by them reflecting this feedback on January 11, 2012.20 recommendations were presented to the JRCS, NS across the nation, the IFRC.In addition, in Japan, interview surveys were conducted covering 28 people involved in the JRCS, 11 people involved in municipalities, NGO and others in the affected areas, six government officials, etc. The interview survey was also conducted abroad involving 17 people of the IFRC and the ICRC, and 5 of the NS. The number of subjects interviewed reached 67 people in total.The JRCS investigated the recommendations from the IFRC along the lines of items such as the departments, the response measures, and the period of implementation. The JRCS International Department submitted them to the IFRC, with explaining the summary of the outlines at the second PNS Meeting in May 2012.

6. Implementation of the evaluation by the IFRC evaluation team

(1) Background to the evaluation researchGiven that in the GEJET an unprecedentedly large scale of relief and recovery activities have been conducted, and a large number of people made donations via many Red Cross and Red Crescent Societies, as well as that an increasing number of advanced countries are being affected by large scale disasters, the JRCS and the IFRC conducted evaluation research to clarify the lessons from this large scale disaster and to promote the preparation for and response to large scale disasters in advanced countries. Besides the GEJET, this research included other National Societies in advanced countries that had recently experienced and responded to large scale disasters in their own countries.

(2) Outline of the evaluation researchThe research period was set for six months from March 11 to September 11, 2011. The evaluation team included the following.

In accordance with the operation guidelines, staff members that were necessary for the evaluation research were added. The JRCS International Department staff coordinated the operation and accompanied the team for on-site research where necessary.In October 2011, since the framework of the evaluation was presented by the evaluators, a research plan and setup were established. The evaluation team launched interviews with the staff in October and conducted on-site research in IWATE (chapter, prefectural government, YAMADA and OTSUCHI), and the MIYAGI (chapter, prefectural government, and Ishinomaki RCHP). The JRCS provided various kinds of related documents to the evaluation team, which helped to deepen the understanding about the situation of the JRCS and the surrounding

◎ Evaluation Research Team・Mr. Jerry Talbot (Team Leader)

(Former Secretary General of the New Zealand Red Cross)・Mr. Chris Staines

(Senior officer, Quality and Accountability Tsunami Unit, IFRC)

・Ms. Mika Wada(Coordinator and interpreter of the Japan International Cooperation Center)

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Figure10-10　Recommendations made by the IFRC Evaluation Team

Items Summary

Relationship in Government and the other organization

1. That JRCS take a lead to develop a framework for cooperation with the appropriate government authorities at central and local levels, NGOs and other relevant organizations to better share information, understand each others’ plans and foster coordination of activities in the future.

2. That national societies continuously nurture a close working relationship with the disaster management authorities at all levels to enable effective and efficient liaison when large scale disasters strike and decision-making bodies come under heavy pressure.

Disaster response

3. That JRCS develop a contingency plan for large scale disasters after considering the following issues:・the relationship with GoJ in implementing the disaster management plan (see

recommendation 1)・a strategy to scale up and meet abnormally large needs in the case of mega

disasters and/or when two or more chapters are seriously affected. ・the possible role of JRCS health institutions, such as hospitals, in providing a

forward disaster management coordination center in large scale disasters・the need for capacity in making assessments, including in situations where

municipalities are rendered dysfunctional (see recommendation 5)・JRCS role and responsibility in case of large scale industrial accidents (see

recommendation 8)・the need for a JRCS recovery policy (see recommendation 14)・a strategy for the most effective deployment of human resources within the

Society, including those with practical experience and expertise in overseas large scale disasters and those familiar with Movement policies and standards (see recommendation 18)・the need to strengthen the corps of JRCS trained volunteers to give added outreach to the communities and provide surge capacity to deliver emergency relief services (see recommendation 13)

・the basis on which additional resources (e.g. funds, international tools, supplies and personnel) may be mobilized from within the Movement (see section 5), and

・stronger coordination with the government, NGOs, the private sector and other organizations (see recommendation1).

4. That national societies undertake adequate contingency planning for large scale disasters, including arrangements to access resources and assistance from within the Movement, to respond to events which, while highly unlikely, may have catastrophic effects in their country.

Assessment

5. That JRCS build capacity within its domestic disaster response personnel to conduct assessments on the basis of IFRC developed methodologies in order to better target assistance and reach the most vulnerable. Trained assessment teams should be available to be deployed at short notice to help municipality authorities assess the needs of their communities, especially in areas where JRCS can deliver services. JRCS should also review its volunteer base at municipal level and consider more systematic training and organisation for disaster intervention.

6. That IFRC develop tools for post disaster needs assessment in high income countries and systematically share best practice.

IFRC disaster response tool

7. That IFRC assure the flexibility of the ERU model and make national societies aware of this so that ERUs can be more expeditiously made available and integrated into existing national society structures and systems in high income countries.

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Items Summary

Nuclear Accident

8. That the RCRC Movement continue to partner JRCS both in giving assistance to the affected population after the Fukushima Daiichi Nuclear Power Plant accident and in contributing to the development of a strategy (ideally expanded to an approach that includes all NRBC industrial accidents) to address the humanitarian consequences of such disaster events.

9. That a strategy for the Movement be developed to elaborate domestic and international roles in dealing with the humanitarian consequences of nuclear accidents, drawing on the extensive experiences of humanitarian interventions after the Chernobyl and Fukushima Daiichi nuclear accidents.

Registration and Inquiry

10. That the Movement continuously reviews and updates its restoring family links and tracing services to take advantage of evolving technology and the social media.

Psychosocial Support Programme

11. That JRCS undertake investigations to establish needs and the feasibility of providing long-term, volunteer delivered psychosocial support programming in support of individuals and communities affected by the GEJET as part of the recovery programme.

12. That national societies both plan to send and to receive trained psychosocial support personnel to support their expatriate communities when large scale disasters strike, given the presence of many different nationalities in most high income countries. The deployment of such personnel must depend upon usual travel protocols being respected including the agreement of the host national society.

Volunteers13. That JRCS strengthen and diversify its trained volunteer base and have effective

systems in place for their efficient mobilization and deployment. As well, effective systems should be developed to manage a surge in the recruitment of new volunteers in times of disaster.

Recovery Programming

14. That JRCS develops a national recovery policy and a plan to build relevant capacity as part of its disaster management strategy.

15. That national societies in high income countries adopt disaster recovery policies, taking account of their unique national context, the disaster risks present and drawing on the work being undertaken by IFRC in developing an IFRC recovery policy.

Managing offers of assistance without

an appeal

16. That IFRC consult with partners to consider and develop a coherent operational framework for national societies in high income countries to use when accepting spontaneous donations from partner national societies. This should regulate ways in which assistance can be efficiently and effectively channelled via the Red Cross Red Crescent to reach the beneficiaries and specify the responsibilities of the operating national society in accounting for the use of these resources. The development of this operational framework must take account of existing policies and procedures and may result in the need for amendments to and/or new policies.

17. That IFRC undertake a study on the adequacy of the secretariat’s direct and indirect cost recovery during GEJET and determine a new formula for such “no appeal” situations, if needed.

Making best use of personnel with

experience of large scale disasters

18. That national societies in high income countries consider how best to organise access to relevant experience and knowledge about international disaster management best practice available within their national societies and plan to deploy their human resources accordingly in the emergency phase of domestic large scale disasters.

Building Good Partnerships

19. That national societies, including JRCS, prioritise the importance of having and building capacity and competence in communicating critical post disaster information via the internet and social media

IFRC Coordination and Support

20. That national societies and IFRC plan for the placement of an IFRC representative and technical delegates, as needed, in times of large scale disasters in high income countries when there is widespread Movement support. The placement of an IFRC representative is for coordination and experienced technical delegates with substantive consultative skills should be made available as needed and integrated into the host national society structure. The delegates assigned need to respect and work with colleagues according to the host national society’s established standard operating procedures.

Public-Relations Activities

Chapter 11

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When a disaster occurs, the Planning and Public Relations Office (PPRO) of the Japanese Red Cross Society (JRCS) has three major roles to play as follows:

PPRO was required to respond to a wide range of inquiries from various circles in Japan and abroad, including not only the activities of the Society, but also the disaster and the damage caused. In particular, partly because news of the earthquake and images of tsunami were quickly distributed throughout the world via the Internet, inquiries from overseas media came pouring in.

1. Early response (From the day of the disaster to the end of March)

(1) Response to news gathering by phone and visits to JRCS

During the two weeks after the disaster, PPRO was busy responding to inquiries from Japanese and overseas media as it constantly received them almost around the clock with three shifts a day. but due to the lack of personnel, the International Department at the Headquarters and the International Commnittee of the Red Cross (ICRC) Mission in Japan (ICRC-Tokyo) and volunteers capable of responding to such inquiries in English support the responding activity. News gathering by overseas media over the telephone continued during the nighttime due to the time differences. 　(2) Dispatch of Public-Relations (PR) officers to

the affected areasOn the day when the earthquake occurred, two PR officers visited MIYAGI as part of the Headquarters’ initial deployment. On the following day, March 12, a news-gathering team consisting of one PR officer, a video cameraman, and a still cameraman left for TOHOKU in their own car and joined the Headquarters’ initial deployment. The team headed for the Ishinomaki Red Cross Hospital (RCHP) earlier than any other to collect

news materials on relief operations.The two officers who were part of the initial deployment also worked as members of the Headquarters Disaster of Control (HDC) in affected area, and since it was difficult to locally obtain a vehicle and fuel for PR purposes independently, they could not move around on their own and therefore could not fulfill the mission required of PR officers.On the other hand, together with the JRCS President, the news-gathering team headed northward from ISHINOMAKI along the coastal areas such as RIKUZEN-TAKATA, KAMAISHI and OTSUCHI that had suffered the severest damage from March 13 to 14. It brought the images and photographs taken immediately after the areas were hit by the earthquake and tsunami directly to NHK’s Morioka Broadcasting Sation, and in addition, it provided news materials to the mass media in TOKYO.

On March 20, together with the Iwate Chapter, two PR officers at the Headquarters organized a media tour because the relief work by JRCS was not widely reported as all Japanese media focused on covering the affected areas. This led to the wide coverage of JRCS’s relief operations by local media.

(3) Response to news gathering by overseas mediaImmediately after the earthquake occurred, oversea media started to constantly make inquiries to JRCS by dialing the PPRO’s direct phone numbers at the

Chapter 11　Public-Relations Activities

・Promptly communicate information on the activities of JRCS domestically and overseas

・Respond to news gathering by Japanese and overseas media

・Keep records of JRCS’s activities

[On March 14, this photograph, taken in OTSUCHI, IWATE, was distributed to Japan and overseas media earlier than any other.]

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Chapter 11

　

Public-R

elations Activities　


(5) Issuance of press releasesPPRO issued press releases on the work of medical teams, psychosocial care teams, and nursing care teams as well as activities such as the distribution of household appliances packages whenever new developments emerged. A total of eleven press releases were issued by the Headquarters from March 12 to the end of the month. Each chapter and facility also issued press releases to the local media when, for example, medical teams left for the affected areas or held a meeting to give briefings on their activities after their mission was completed. These efforts led to the publication of many newspaper and magazine articles and the broadcasting of many TV and radio programs on the earthquake and tsunami.

2. Domestic PR activitiesEven two mouth later of the disaster day, PPRO was extremely busy with earthquake-related work, and in addition, it needed to perform for the Red Cross Movement Campaign in May (JRCS has special event around the country Red Cross and Red Crescent day on 8 May every year). At the end of the month, PR officer were added one domestic and one international to PPRO personnel. At first, infomation was communicated mainly through JRCS’s website and news releases, but after a certain period of time passed, PPRO began to put all relevant information onto DVDs and distributed them to the mass media.In May 2011, the Great East Japan Earthquake and Tsunami (GEJET) Recovery Assistance Task Force was established, and PPRO worked with PR officer allocated to the Task Force.

(1) Response to news gathering by phone and visits to the Headquarters

In May 2011, when requests from mass media for news gathering by phone and visits to the Headquarters Settled down gradually, PPRO began to record the number of such requests. until the end of April 2012, it accepted over 110 such requests in one year. Many of the inquiries concerned Gienkin , and while briefings were given chiefly by a PR officer, the Deputy Directors General in charge of PR responded to requests for recording and filming for radio and TV programs. PPRO often asked professionals such as doctors and nurses to answer technical questions about the medical needs in the affected areas.

Headquarters or calling International PR officers on their mobile phones. On the afternoon of March 12, an International Federation of Red Cross and Red Crescent Societies (IFRC) PR officer in Kuala Lumpur arrived in TOKYO, followed by one from Beijing on March 13. Subsequently, IFRC dispatched two PR officers alternately. These two IFRC officers took turns to respond to news gathering at the Headquarters and in the affected areas and distributed the news materials they had obtained.In March, the IFRC-dispatched officers went to the affected areas for news gathering twice. In accompaniment of them, International PR officers from PPRO made arrangements for news-gathering locations and served as interpreters. They also gathered news materials together with the IFRC officers.

(4) Website (including the updating of its English pages)

Immediately after the occurrence of the earthquake, many people who wished to donate as Gienkin or their blood started to access JRCS’s website. The huge number of accesses exceeded the processing capacity of the server on the second day after the disaster, making the Society’s website inaccessible (The number of accesses to the website from March 12 to 21 reached 2,907,861, 40 times that for the pre-earthquake ten-day period from March 1 to 10, 2011, when it was 73,894

1.). An emergency

measure was taken by installing more servers, preventing the website from becoming inaccessible. Later, Amazon offered to lend cloud servers free of charge using its Web services, and JRCS prepared for further waves of access by accepting this offer. the amount of Gienkin received was updated and disaster relief work were reported on its website every day with many materials such as photographs sent from the affected areas as possible. On the day of the disaster, JRCS also launched a page at its special English-language site to explain how to make a donation, and the number of accesses to the page from March 11 to 31 reached 317,442. In the acute phase, International Department staff supported to translate quick disaster reports into English from Japanese instead of the staff at the PPRO who usually update the website.

(1) This is based on Google Analytics.

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(4) Identification of the JRCS supporters (Use of JRCS Logos)Many of the corporations and associations collecting Gienkin requested permission to use JRCS’s logos for their campaigns, and there had already been many cases in which Red Cross emblems and logos were used without permission. Since it was highly likely that the needs of assistance would be larger and longer-lasting than ever, and in due recognition of the importance of their cooperation, JRCS officially introduced as of April 2011 the JRCS Supporter Logo. This new Logo, designed by a combination of the JRCS Logo and the brief introduction of Gienkin , was then widely used for packaging of commodities, publications and advertisement via media such as homepage, etc.

(Note)100percent of your donation will go to the affected people of the GEJET through JRCS

(5) Mail addressed to the HeadquartersPrior to the occurrence of the earthquake, the Headquarters of JRCS received around 100 mailed items a week, but during the post-earthquake two weeks, huge numbers of mail items from Japan and abroad were delivered to the Headquarters, exceeding 5,000 a week. Most of these mail items concerned offers to work as volunteers in the affected areas, provide relief supplies, etc., or contribute Gienkin as well as providing information on the current condition in the affected areas. Since it became difficult for the Organizational Development Department, which was responsible for responding to these mails, to answer each of the huge number of phone calls and mail items due to the limited number of personnel, it was decided that responding to these mail items concerning Gienkin should be outsourced to external organizations. The number of mail items received by the Headquarters decreased gradually after April, averaging about 300 mail items a week in August.

(2) Dispatch of PR support teamsThe number of PR officers at the Chapters in the three affected prefectures was so small that it was extremely difficult to meet all requests from the media within and outside the affected areas for news gathering. Therefore, from April 18 to May 16, Chapters in the unaffected areas took turns to send two PR support personnel each to the Iwate, Miyagi, and Fukushima Chapters weekly in order to enhance their ability to gather and provide news materials. The dispatch of such personnel from the Chapters in unaffected areas was not specifically provided for in the Headquarters’ guidelines for disaster relief system but after consultations with the Secretaries Generals of the Block Representative Chapters, the dispatch officially began with a notice from the Headquarters to all Chapters. The Headquarters asked the 1st to 6th Blocks to adjust the number of personnel to be dispatched among them, and eventually, a total of 24 personnel were dispatched with the cooperation of these blocks.

Figure 11-1 Dispatch of PR Support 　　　　　　　　 Personnel from Each Block

(Unit:persons)

Block Subtotal Chapters RCHP Blood Centers

The 1st Block 4 2 --- 2

The 2nd Block 4 3 --- 1

The 3rd Block 6 3 1 2

The 4th Block 4 3 --- 1

The 5th Block 4 --- 2 2

The 6th Block 2 2 --- ---

Total 24

(3) WebsiteIn addition to updating quick reports on the activities of JRCS daily, PPRO offered three dedicated banners for the top page of JRCS’s website--activity reports, Gienkin and activity funds-- in June 2011 so that visitors could have easy access to the information they wanted. In July, in order to provide easy-to-understand information on JRCS’s activities in the affected areas, it launched a special page in which icons were displayed to enable visitors to understand the content of the activities through illustrations.

［Example of the JRCS Supporter Logo]

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years after it opened its account.In addition, JRCS PR officers sometimes appeared on live online programs using Ustream, a video sharing service.After the earthquake, in an effort to make JRCS’s policy for its response to the earthquake and specific activities widely known to, PPRO continued to issue the JRCS News monthly and its in-house magazine once every two months.

Figure 11-2　Overview of the Activities of the Red Cross PR Ambassador, Ms. Norika Fujiwara, in the Affected Areas (as of November 21, 2012)Detailed list omitted

(8) Bulletins for members and the in-house magazine

a. JRCS NewsDesigned for Red Cross members, Bulletins, JRCS News, has a monthly circulation of about 120,000. In its pages, it reported on JRCS’s activities related to the GEJET to those who supported JRCS’s operations.

Detailed list omitted

b. In-house magazine “JRCS’s activities”In order to introduce JRCS’s initiatives for various projects, 60,000 copies of the in-house magazine “JRCS’s activities” are issued bimonthly to over 64,000 people who work for JRCS chapters and facilities nationwide. In its pages, the in-house magazine took up and reported on activities related to the GEJET.

Detailed list omitted

(6) Activities of the JRCS PR Ambassador On March 30, 2011, the Red Cross PR ambassador, Ms. Norika Fujiwara, an actress, visited the Headquarters to make a donation and attended the meeting of the HDC held on the day to declare her determination to provide support as JRCS’s PR ambassador. Later she encouraged the Headquarters’ personnel.After participating in the distribution of preparing hot meals cooked food at evacuation centers in ISHINOMAKI in April 2011, she visited the affected areas six times during the period up to November 2012. Thus she joined JRCS’s various relief and recovery support programs and engaged in activities such as encouraging the earthquake victims.

(7) Communication through social mediaSending messages via media such as Facebook and YouTube had been considered as a means of communication since before the earthquake, but the specific methods for doing so had not been determined. Following the earthquake, JRCS opened its official YouTube channel on June 23, 2011. The Society presented a video entitled “Great East Japan Earthquake and Tsunami: 40 days in the affected areas,” which was played 4,308 times during the period up to December 2012, and later it showed earthquake-related videos such as “Records of the initial deployment at the Ishinomaki RCHP,” which was played 64,024 times during the same period, as well as materials other than earthquake-related ones, including TV commercials and videos to promote First Aid. As of November 2012, 27 videos were available on the channel. JRCS launched its Facebook account on September 7, 2011, and has since updated it each day. It has presented not only its earthquake-related activities, but also its personnel and a wide range of other activities, and the number of people who clicked the Like button on the JRCS Facebook page exceeded 10,000 times two

(C)Ichigo Sugawara［Ms. Fujiwara helped preparation hot meals at an evacuation center in

ISHINOMAKI, MIYAGI on April 13］

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Figure 11-3 DVDs Recording the GEJETDate of publication Title Outline Language Recording time

March 2011JRCs is close to the earthquake victims (Great East Japan Earthquake and Tsunami)

The DVD contains images recorded by the filming team who visited the affected areas immediately after the earthquake occurred. It contains video recordings of medical relief work, the distribution of supplies, the HDC at the Headquarters, and so forth.

Japanese 14 minutes

May 2011Great East Japan Earthquake and Tsunami: 40 days in the affected areas

In addition to the footage mentioned above, the DVD contains images provided by the Norwegian Red Cross whose officers visited the affected areas in March, those of an official ceremony held in April to present household appliance packages as well as other events. It also shows video records of medical services, relief supplies, psychosocial care, nursing care teams, volunteers, the installation of water stations, etc.

Japanese and

English14 minutes

October 2011 Great East Japan Earthquake and Tsunami: Path for reconstruction

The images contained in the DVD look back upon the half-year following the earthquake. In addition to the footage mentioned above, this DVD covers the response to the nuclear accident, the construction of temporary medical wards, the presentation of nursing care beds, Nordic walking, educational support, and so forth.

Japanese and

English13 minutes

February 2012One year after the GEJET: Walking with the earthquake survivors with hope

The images contained in the DVD look back upon the past year and present the current condition of the affected areas through comments by the victims. Other events recorded include the distrubution of household appliance packages, psychosocial care, the construction of temporary medical wards, and “Smile Parks.”

Japanese and

English7 minutes

May 2012What is the Red Cross?: Looking at the starting point of its education

This DVD records the efforts of students from the Japanese Red Cross Ishinomaki School of Nursing, who were affected by the earthquake yet were filled with a sense of mission as students studying at the school, to treat injured persons even though neither water nor supplies were available. It also presents the JRCS disaster nursing education.

Japanese 22 minutes

September 2012Second summer in FUKUSHIMA: Advancing with children who lead the future generation

This DVD contains images of the current condition of FUKUSHIMA, including food radiation measuring equipment, whole body counters, the reconstruction of public housing, and summer camping.

Japanese and

English7 minutes

［An example of photo panels］

地域コミュニティセンターの建設Construction of Community Centre

Community Centre opened in the prefabricated housing compound. (Koriyama, Fukushima)

仮設住宅群の中にコミュニティセンターがオープンした。（福島県郡山市）

Nursery service is also provided at the community centre. (Koriyama, Fukushima）コミュニティセンター内には託児所も設置された。（福島県郡山市）

(9) Visual records and productionsa. DVDsIn addition to the video entitled “JRCS Activity over the past year,” which is produced in March of each year, PPRO produced DVDs recording the GEJET (see Figure 11-3). Copies of these DVD were distributed not only to all JRCS chapters and facilities, but also to JRCS Representatives, donors, foreign embassies in Japan, Japanese embassies abroad (through the Ministry of Foreign Affairs (MOFA)), and other stakeholders, and the videos were also shown via the YouTube channel.

b. Photo panelsIn April 2011, PPRO started to produce photo panels to introduce JRCS’s business activities as required.A total of 64 photo panels had been produced by the end of December 2012. In addition to meetings of the Board of Representatives and the Board of Governors, PPRO exhibited them at the entrance hall on the first floor of the Headquarters and lent them to the organizers of various events and for other opportunities.

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(2) Press conferencesOn March 13, 2011, the President, who was visiting the affected areas, gave a press conference at the Miyagi prefectural government office, but this was not widely covered by the mass media. Later, as it received inquiries from many news organizations, PPRO considered holding press conferences early to convey JRCS’s opinions and receive questions, but the Headquarters was watching trends in public opinion concerning the distribution of Gienkin , and under these circumstances, by the President we decided to postpone the planned press conferences. At the Partnership Meeting for GEJET (PNS meeting), which took place in TOKYO on May 9, the first press conference was called to explain to the mass media about reconstruction support projects using international donations. Since there was strong criticism about the delay in the distribution of Gienkin , many questions about Gienkin were at the press conference although it was originally intended to be an opportunity to talk about donation from overseas.On May 11, at the Foreign Correspondents’ Club of Japan, the President explained to foreign news reporters about JRCS’s activities in the affected areas and the utilization of donation from overseas.On September 9, the President, the Director General of the GEJET Recovery Task Force, and the Director General of the Organizational Development Department jointly gave a press conference to explain about JRCS’s

3. Effective use of the mass media (1) Press releases from the HeadquartersWhenever there were new developments such as the presentation of household appliance packages, the withdrawal of medical teams, and the start of new projects, the Headquarters issued press releases to invite mass media to cover these developments. These releases were usually distributed through the correspondents’ club at the Ministry of Health, Labour and Welfare (MHLW), and if the subject was financed by international donations, they were also distributed to the correspondents’ club at MOFA as well as to the correspondents’ clubs at the government offices of the three affected prefectures through the chapters.The number of press releases issued after April 2011 is as shown in Figure 11-4 (only those related to the GEJET).

Figure 11-4 Number of Press Releases 　　　　　　　　Issued in 2011 (88 in Total)

4月 175月 156月 107月 88月 59月 810月 811月 812月 9

17

15

10

8

5

8 8 89

0

2

4

6

8

10

12

14

16

18

Apr May June July Aug Sep Oct Nov Dec

Figure 11-5 Overview of Press Conferences Given after March 11, 2011Date Venue Purpose Briefer Articles published

March 13, 2011 Correspondents’ club at the Miyagi Prefectural Government

JRCS announced that it would strive with all its resources to provide medical relief as areas centered on ISHINOMAKI had suffered enormous damage.

PresidentSeveral companies covered the press conference in their Web news.

May 9, 2011 PNS meeting for the GEJET(Held at the JRCS Headquarters)

Explanations were given concerning reconstruction support projects financed by donation from overseas.

Deputy Director General in charge of PR and Director General of the GEJET Recovery Task Force

Mainichi Shimbun (a newspaper) reported the donation of house appliances package, and Kyodo News (a newspaper) reported on the flow of Gienkin .

May 11, 2011 Foreign Correspondents’ Club of Japan (FCCJ)

The President emphasized his hope that other countries in the world will be able to learn from Japan about measures to cope with disasters, including preparations for nuclear accidents, and at the same time presented JRCS’s initiatives from emergency relief to support for recovery and reconstruction.

President Reuters distributed news of Gienkin and donation from overseas.

September 9, 2011 JRCS Headquarters

The President and other executives explained about the extension of the deadline for the acceptance of Gienkin and their distribution while details of the reconstruction support projects financed by donation from overseas.

President, the Director General of the PPRO, the Director General of the Organizational Development Department, and the Director General of the GEJET Recovery Task Force General

Six newspaper publishers covered the extended deadline for Gienkin (Asahi, Yomiuri, Mainichi, Jiji Press, Kyodo News and Japan Times).

March 7, 2012 Foreign Press Center/Japan (FPCJ)

The President looked back upon the year since the earthquake, presented JRCS’s activities, and stressed the need to prepare for nuclear accidents.

President

Reuters quoted the President as saying that “One year has been wasted,” a comment its news reporter drew from him in a separate interview with him.

July 10, 2012 JRCS Headquarters PR officers announced JRCS’s plan to host summer camping and invited news reporters to cover it.

Director General of the PPRO, the Deputy Director General in charge of PR, and Director General of the GEJET Recovery Task Force

The press conference was covered by news media such as the Hokkaido Shimbun (a newspaper) and Wing Travel Daily.

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(4) TV and radio commercialsBy March 11, 2011, PPRO had completed the production of TV and radio commercials for the Red Cross Movement Campaign in May and prepared to send the chapters the number of copies they required. Since the contents of the commercials, which asked the audience how many M6.0 or larger earthquakes occurred in one year, was likely to infringe on the TV stations’ standards, PPRO decided to produce new acceptable commercials to replace the current ones. But since it was difficult to produce new ones using TV personalities (AKB48) again, PPRO revised the current ones using difference scenes and narrations so that the revised ones emphasized JRCS’s attitude towards disasters.East Japan Marketing & Communications, Inc., an ad agency, kindly covered part (5 million) of the reproduction costs for the commercials.

(5) Poster advertisingThe results of nationwide questionnaire surveys conducted annually indicated that JRCS’s annual PR posters made its disaster relief activities well recognized among the public, and the PPRO placed its greatest expectations on them as a means of communication. The new poster was therefore designed to emphasize JRCS’s mission to alleviate the suffering of people by placing the personnel chosen from RCHP nationwide in JRCS’red relief uniforms. The new posters had already been printed, and their distribution to all chapters completed by February so that they were ready for Red Cross Movement Campaign in May, and therefore, they could not be replaced by new ones. However, the GEJET occurred, and to the eyes of people who watched JRCS’s red uniforms via television and newspaper, they would have looked as if they had been produced after the earthquake, and this made these posters seem like a well-timed advertisement that further helped spread the image of the JRCS as a provider of disaster relief. PPRO adjusted the colors of the lettering “It is human beings that save human beings” and distributed the adjusted poster images so that they could effectively be used for subsequent leaflets, newspaper advertisements, and other marketing tools.

activities while looking back upon the half year since the earthquake.On March 7, 2012, the President was invited to speak about the past year at the Foreign Press Center/Japan.On July 10, the Headquarters held a press conference to brief the media on summer camping and invite news reporters to cover this event.

(3) Newspaper advertisingAs usual, in conjunction with the Red Cross Movement Campaign in May, PPRO ran an advertisement in the national edition of the Nihon Keizai Shimbun (a newspaper) twice, one on May 1, 2011 and the other on May 12 of the same year, using the design for the annual PR poster. On May 11, it placed in the newspaper an advocacy advertisement, which also aimed at explaining about Gienkin and activity funds. But in all these advertisements, taking into consideration the possible responses from society at that time, the Headquarters thanked contributors for their Gienkin and emphasized, while restraining its appeal for cooperation in raising activity funds, that all their money would be delivered to the victims.Furthermore, on May 2 and 3, it published through the national edition of the Nihon Keizai Shimbun an article that included an interview with the President and an introduction of JRCS’s activities as well as its appreciation for Gienkin .As the situation continued in which the Gienkin funds did not quickly reach the victims, however, the wrong information spread through TV, social media or other media that JRCS took part in the Gienkin as a handling commission.In order to settle this situation and explain to the nation about the distribution of Gienkin and JRCS’s activities in the affected areas in an effort to fulfill its accountability, the Headquarters placed a PR article in national and regional newspapers as well as local ones with the largest circulation in each prefecture on September 11, 2011 and March 11 and September 11, 2012. This was based on a comment by a Board of Governors from a prefecture, who said, “Since national papers do not have such a large circulation in provincial areas, it is necessary to place items ads in local papers to make JRCS well known to the entire nation.”In addition, the International Herald Tribune, which is widely read throughout the world, offered to insert JRCS’s advertisements in its issues free of charge, and JRCS accepted the offer.

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(7) Free placement of advertisements in magazines and other media

Several organizations such as Airport Transport Service Co., Ltd., foreign embassies, and the American Club offered to place in their magazines free-of-charge advertisements informing that JRCS was collecting Gienkin and JRCS accepted their offers and published its advertisements in these magazines.

(6) Free use of other advertising mediaAs all TV commercials started to be replaced by the Advertising Council (AC) Japan’s ones immediately after the earthquake occurred, several companies offered to place JRCS’s advertisements in various advertising media other than television free of charge, and having accepted such offers, PPRO provided PR materials such as posters and Web images.Among these companies, East Japan Marketing & Communications, Inc., an ad agency to which the Headquarters outsourced its PR operations, put up JRCS’s posters in all trains on the JR Yamanote Line and at all JR stations in the Greater Tokyo area for three weeks from March 24.At that time, JRCS informally asked the AC Japan to air its TV commercials as AC’s, but this did not materialize because AC Japan deals with small organizations.

［A widely displayed in-train advertisement put up in all trains on JR Yamanote Line］　　　　　　　　　　　　　　　

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A poster put up at three concourses of Tokyo Metro Co., Ltd. from April 4 to 11, 2011 following Montblanc Japan’s offer to place JRCS’s poster advertisements free of charge

An advertisement inserted in the national edition of the Nihon Keizai Shimbun on May 1, 2011

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A PR advertisement placed in the national edition of the Nihon Keizai Shimbun on May 2, 2011

A PR advertisement placed in the national edition of the Nihon Keizai Shimbun on May 3, 2011

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An advertisement run in the national edition of the Nihon Keizai Shimbun on May 12, 2011

An advertisement put in four national newspapers on May 16, 2011

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A leaflet aimed at promoting a correct understanding of Gienkin , which was issued on July 13, 2011

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An advertisement placed in national and regional newspapers as well as local ones on September 10, 2011

An advertisement placed in national and regional newspapers as well as TOHOKU’s local ones on September 15, 2011

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An advertisement inserted in the Mainichi Shimbun on March 10, 2012

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An advertisement placed in the Asahi Shimbun and the Nihon Keizai Shimbun, both national papers, on March 11, 2012

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An advertisement placed in regional and local newspapers on March 11, 2012

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An advertisement placed in the national edition of the Nihon Keizai Shimbun on May 1, 2012

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５月４日付日経朝刊　赤十字Vol.1　７段　４校　担当：営業／第２部・黒田　企画制作／脇田　制作／ついんぴいく・鈴木

　●…救護・支援活動に当たられ

た１年を振り返っての実感は。

　今回の震災は、日本赤十字社の

歴史上最も大規模な救援活動にな

りました。直後の医療救護だけで

も６カ月間続き、派遣スタッフは

延べ７千人以上。診察した人も

８万７千人に上ります。当初の予

想を上回る長期の活動になりまし

たが、日本赤十字社の持つ全国の

病院ネットワークをフルに活用。

また全国の赤十字ボランティアや

支援者の力も借りながら、懸命に

活動を進めてきました。まさに日

赤の総力を挙げての１年だったと

感じています。

　●…寄せられた義援金も今まで

に経験のない規模でした。

　どのように配分するかは大変な

難題でした。今回の場合、大きな

被害を受けたところだけで15都道

県、避難先も含めると全47都道府

県に居住する被災者に目を配る必

要があります。共通の基準をつく

らないと、どうしても不公平に

なってしまう。最終的に国の調整

のもとに各被災県や募金団体など

が集まり基準をつくりましたが、

行政の機能がまひしていた自治体

も多く、配分するまで時間がか

かってしまったのは事実です。た

だ現時点では、亡くなられた方、

家屋をなくされた方、原発事故関

係で避難された方には平均で１件

当たり約１０９万円など、約45万

件を対象に約３０５８億円がすで

に届けられています。

　●…海外からも多くの支援が寄

せられました。

　経済大国である日本でさえ、こ

れだけの大災害時には世界からの

支援に頼らざるを得ません。日本

赤十字社にも95カ国から救援金が

集まり、クウェート政府からは原

油５００万バレルも贈られました。こ

うした善意に対しては、ただ「あ

りがとう」だけでなく、それが実

際に有効に使われたという証しを

示さなければいけません。その意

　甚大な被害をもたらした東日本大震災発生から１年余り。ようやく再生への一歩

を歩み出した被災地では、日本赤十字社の復興支援活動が今なお懸命に続けられて

いる。その陣頭に立つ日本赤十字社の近衞忠煇社長に、これまでの被災者支援の取

り組みと、さらなる復興に向けての意気込みを語ってもらった。

日本人は3.11を決して忘れない

広告特集企画・制作＝日本経済新聞社クロスメディア営業局

日本赤十字社社長

　国際赤十字・赤新月社連盟会長

近衞忠煇氏に聞く

日赤の総力挙げての１年

さらなる復興・再生へ

息の長い支援活動を

味で今回、「国際広報」の重要性

を再認識しました。救援金や支援

をいただいている以上、被災地の

実態を知ってもらうことが重要と

判断し、広報の専門家を国際赤十

字から派遣してもらいました。彼

らが現地で取材した映像をイン

ターネットで配信してくれたこと

で、海外からの信頼が得られたと

考えています。

　●…今回は地震、津波に原発事

故が重なりました。

　日本赤十字社は広島と長崎に原

爆病院を持ち、チェルノブイリ事

故のときには救援にも行っていま

す。われわれも全く知識がなかっ

たわけではありませんが、あれだ

け大きな事故。住民はもちろん、

救護に当たる病院スタッフさえ避

難させられてしまう。初動対応が

遅れ、あらゆる面で備えが不十分

でした。しかしだからこそ、この

経験を世界で共有していくことが

大切です。この５月には原発保有

国が集まり赤十字の国際会議も開

かれる予定なので、その中で今回

の教訓を踏まえて積極的に情報発

信していきたいと考えています。

　●…原発事故対応への取り組み

の現状は。

　日本赤十字社としては、一時帰

宅された住民に対する健康管理の

お手伝いや、ホールボディーカウ

ンターなどの購入・提供などを

行っています。ただ残念なこと

に、福島県民を中心とした健康管

理や環境修復に対する政府の基本

体制がまだできているとはいえま

せん。それが決まらないと、われ

われとしてもどこから手を付けて

いいのかわからない。今はとにか

くできるところからやっていこう

という姿勢で取り組んでいます。

　●…震災の痛みが徐々に薄まる

につれ、悲惨な記憶が風化してし

まわないか心配です。

　１年以上たった今も、日本赤十

字社には週に約３億円の義援金が

寄せられています。今回「絆」と

いう言葉がクローズアップされた

ように、家族の絆、社会の絆、つ

まり人間は１人で暮らしているわ

けではないということを日本人一

人ひとりが実感する機会になった

のではないでしょうか。そして、

その絆が日本にあったことが世界

にも感銘を与えました。私は、被

災者はもちろん多くの国民が３・

11のこと、防災の大切さを決して

忘れないと信じています。日本赤

十字社としても被災地の復興、再

生という次のステップに向け、健

康づくりの視点から息の長い支援

活動を続けていく決意です。

日本赤十字社は義援金を100％被災地にお届けしています。手数料などは、一切いただいておりません。　これまでにみなさまからお預かりした義援金は、手数料などいただくことなく全額が、義援金配分委員会に送金され、市町村を通じて、被災者の方々に届けられています。　日本赤十字社は、災害時の緊急救援や被災地での支援活動、また義援金の受け付けにかかる諸経費を含め、日ごろから日赤を支援してくださる方々からの活動資金により対応しています。今後も息の長い復興支援をはじめとする赤十字活動を支えるためにも、活動資金が必要です。　今後とも、みなさまのご理解、ご協力をどうかよろしくお願いいたします。

詳しくは、ホームページまでhttp://www.jrc.or.jp

主な国・地域からの海外救援金受け付け状況

受付総額3521億円

都道県への送金額3492億円

市町村への送金額3397億円

被災者への配分額3058億円配分件数

122万 3312件

米国赤十字社ドイツ赤十字社韓国赤十字社中国紅十字会台湾赤十字組織カナダ赤十字社オーストラリア赤十字社フランス赤十字社英国赤十字社クウェート政府

229億 1113万円32億 5129万円29億 7699万円25億 4604万円24億 8648万円23億 9944万円21億 7599万円18億 5066万円18億 1952万円原油 500万バレル

義援金配分状況

食料、衣服、生活用品など日常の買い物

光熱費や教育費など日常の買い物以外の生活費

自動車などを購入するため

自宅の修繕や建築など、居住環境の整備

娯楽や余暇

その他

使わずに今もほとんど残してある

わからない

35.9%19.1%

8.4%35.3%

2.3%7.4%

22.3%1.3%

（3月29日現在）（3月30日現在）

※被災者300人アンケート調査（2月17～18日、日赤調べ）より

５月は赤十字運動月間 Vol.1

最初に受け取った義援金の使い道は？

５月５日付日経朝刊　赤十字Vol.1　７段　５校　担当：営業／第２部・黒田　企画制作／脇田　制作／ついんぴいく・鈴木

　被災者のいのちと健康を守るに

は、何より医療の復興が不可欠。

しかし被災地は震災によって医療

施設が壊滅状態にあり、地元の病

院が再稼働したら医療救援チーム

は引き揚げるという従来の仕組み

が機能しない。一刻も早く、被災

者が安心して診察が受けられる病

院・診療所の立て直しが急がれる。

　こうした中、日本赤十字社では

医療インフラの整備を展開中だ。

昨年12月には宮城県石巻市夜間急

患センターを開設したほか、今年

に入ってからは女川町地域医療セ

ンターの整備、南三陸町の仮設診

療所の建設、気仙沼市立本吉病院

の改修などを相次ぎ実施してい

る。

　原発事故被災者への対応につい

ては「健康支援」と「生活支援」

の双方から活動を進めている。

　まず健康面の支援では、福島赤

十字病院に放射線量の測定を行う

ホールボディーカウンター、甲状

腺モニターを導入。福島市の委託

を受け無料で県民の健康調査を実

施している。また、市民の食品安

全に対する不安解消を支援するた

め県内の各役場に食品放射能測定

器の提供も行っている。

　生活面の支援では、福島県内に

避難した自治体に対し、学校給食

用の運搬車や食器、冷蔵庫などの

用具・設備を支援。仮設住宅と市

の中心部をつなぐコミュニティー

バスの運行サービスなども協力し

ている。このほか、屋内の遊戯施

設「すまいるぱーく」を開設し、

放射線への不安から思い切り外で

遊べない子供たちを招待するなど

の取り組みも行っている。

　一口で「被災者」と言っても、

実態は様々。被災した時は同列で

も、健康で経済力のある人はどん

どん自立していく。一方で高齢者

　東日本大震災発生から１年余りが経過し、被災地では地域の再生に向けた様々な

活動が着実に進められている。こうした中、日本赤十字社では、被災者の手元に届

けられる義援金とは別に、海外から寄せられた救援金をもとに自治体等との連携を

図りながら「復興支援」を行っている。多岐にわたる日本赤十字社の取り組みの現

状を報告する。

広告特集企画・制作＝日本経済新聞社クロスメディア営業局

▲ 社会福祉施設に寄贈された福祉車両▼ 子どもたちに大人気の「すまいるぱーく」

▲ノルディックウオーキングで健康づくり　▲スクールバスで楽しく登校

日本赤十字社の

東日本大震災復興支援活動報告

世界中からの支援を

復興・生活再建のために

サポート体制きめ細かくや

障がい者などは取り残されがち

だ。最悪の場合、孤独死につなが

るケースもあり、こうした災害時

要援護者には手厚いフォローが欠

かせない。

　日本赤十字社では、高齢者など

への支援として岩手、宮城、福島

の３県に合わせて９５９台の介護

用ベッドを提供。高齢者グループ

ホームにもテーブルやベッドをは

じめとする備品、自動体外式除細

動器（ＡＥＤ）など約２２００点

を、また被災自治体や社会福祉施

設向けに、３３１台の福祉車両を

寄贈し、地域福祉サービスの復興

をサポートしている。

　仮設住宅で安心して暮らすため

に不可欠なのがコミュニティー。

日本赤十字社では仮設住宅の交流

の場である集会所や談話室に長机

や冷蔵庫などの備品を設置する一

方、コミュニティーづくりにつな

がる様々なソフト面でのケア活動

を行っている。

　例えば、各種健康イベントの開

催。住民同士が顔見知りになるた

めのきっかけづくりが目的だ。こ

れまでに赤十字ボランティアの

ネットワークと知識を生かした健

康教室やリラクゼーションなどを

開催している。また、スキーのス

トックを補助に散歩しながら会話

を楽しむノルディックウオーキン

グは、特に近所付き合いが希薄に

なりがちな高齢男性にも参加しや

すい活動だ。

　日本赤十字社は、苦しんでいる

人を救いたいという思いを結集

し、人間のいのちと健康、尊厳を

守る取り組みを続けていく。

　世界と被災地をつなぎ、生活再

建、教育・福祉サービス、医療の

基盤づくりなどの支援を通じて、

安全で安心な社会の復興に貢献し

ていく。

自治体、支援団体との協力支えに仮設住宅での「こころのケア」

●医療インフラ整備

●災害時要援護者への

手厚い支援

●コミュニティーづくり

●今後の復興に向けて

●原発事故対応

日本赤十字社は義援金を100％被災地にお届けしています。手数料などは、一切いただいておりません。　これまでにみなさまからお預かりした義援金は、手数料などいただくことなく全額が、義援金配分委員会に送金され、市町村を通じて、被災者の方々に届けられています。　日本赤十字社は、災害時の緊急救援や被災地での支援活動、また義援金の受け付けにかかる諸経費を含め、日ごろから日赤を支援してくださる方々からの活動資金により対応しています。今後も息の長い復興支援をはじめとする赤十字活動を支えるためにも、活動資金が必要です。　今後とも、みなさまのご理解、ご協力をどうかよろしくお願いいたします。

詳しくは、ホームページまでhttp://www.jrc.or.jp

５月は赤十字運動月間 Vol.2

A PR advertisement inserted in the national edition of the Nihon Keizai Shimbun on May 4, 2012

A PR advertisement inserted in the national edition of the Nihon Keizai Shimbun on May 5, 2012

286


An advertisement placed in national, regional, and local newspapers on September 11, 2012

An advertisement placed in the International Herald Tribune on May 19, 2011

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Figure 11-7 Contents of Press ReleasesDate Content

Apr. 8, 2011 Announcement on the start of the distribution of house appliances package

May 11 Announcement on the restructuring of the medical infrastructure

Jun. 10 Announcement on the whole picture of the 30 billion for international donation-financed projects

Sep. 9Briefing on the situation in the affected areas that was still severe even after half a year had passed and details of JRCS’s continuous support programs

Oct. 28Invitation of representatives from overseas Red Cross and Red Crescent Societies to visit the affected areas for news gathering

Feb. 3, 2012Information on subjects on which news materials could be obtained as the first anniversary of the earthquake drew near

Mar. 2Introduction of JRCS personnel who would answer questions in interviews on the day that marked the first anniversary of the earthquake

Mar. 2 Announcement on the extension of the deadline for the acceptance of Gienkin

Mar. 7Emphasizing the importance of being better prepared for nuclear accidents as the first anniversary of the earthquake drew near

May 17 Report on details of the conference of Red Cross Societies related to Nuclear disaster preparedness

Jul. 3 Invitation to summer camping for news gathering

Aug. 3Information on subjects on which news materials could be obtained one and a half years after the earthquake

Sep. 3 Announcement on the extension of the deadline for the acceptance of Gienkin

4. International public relationsIn December 2010, JRCS invited an IFRC PR officer to train its personnel in how to respond to a flood of inquiries from overseas media, and this training took effect when the March 11, 2011, earthquake occurred. From the day after the earthquake, two IFRC PR officers were stationed at the Headquarters until mid-May and one until the end of the month. Subsequently, PPRO obtained support from IFRC PR officers as required. This worked for international by establishing the following three priority goals:・Ensuring exposure through the mass media・Providing sufficient information to PNS・Stepping up efforts to communicate information via the

English-language website

(1) Use of the mass mediaa. Press releasesAt major points in time such as one month, three months, and one year after the earthquake, JRCS issued press releases to foreign media in Japan through the Foreign Press Center and the Foreign Correspondents’ Club of Japan and the world’s media through the Secretariat of the IFRC in Geneva and Red Cross and Red Crescent Societies worldwide. Figure 11-7 shows when press releases were issued and what their main subject was.

Figure 11-6　List of PR Officers from OverseasName Official position Period of stay in Japan

Mr. Patrick Fuller Communications Manager, IFRC Asia Pacific Zone OfficeMar. 12 to 24, 2011

Jun. 19 to 24Mar. 6 to 13, 2012

Mr. John Sparrow Communications Officer for GEJET, IFRC Mar. 27 to May 12, 2011

Mr. Francis Markus Communications Officer, IFRC East Asia

Mar. 14 to 24, 2011Jun. 19 to 24

Aug. 17 to 26Jan. 10 to 13, 2012

Feb. 3 to 16Mar. 6 to 12

May 10 to 17Aug. 5 to 16

Ms. Katherine Mueller Communications Officer for Pakistan Floods Operation, IFRC Mar. 21 to Apr. 12, 2011Mr. Olav Andreas Saltbones Communications Officer and Cameraman, the

Norwegian Red Cross Mar. 26 to 31, 2011Mr. Truels Seiner HenriksenMr. Arjan Blanken

Communications Officers, the Netherlands Red CrossApr. 5 to 10, 2011

Ms. Eva Smith Apr. 5 to 10, 2011May 20, 2012

Mr. Giovanni Zambello Communications Delegate, IFRC Europe Zone Apr. 9 to 22, 2011

Mr. Michael Jill Smith Media Advisor, Australian Red Cross (seconded to IFRC only during this period) May 6 to 28, 2011

Mr. Mark South Media Officer, British Red Cross Feb. 4 to 9, 2012* In addition, PR officers from the Taiwan Red Cross Organization visited Japan several times.

288


events took place. In such cases, many representatives from not only the Japanese media, but also those from the countries involved participated in these events, and JRCS international PR officers made arrangements for news gathering, guided these representatives, served as interpreters, and provided other services.　d. Number of articles on JRCS published in overseas mediaFrom March to May 2011, PPRO monitored major newspapers, websites, blogs, and other sites on the Internet, and as a result, the number of articles that covered JRCS was as follows:

March 38,639April 10,874May 5,268

Total 54,781(Based on a Meltwater News survey of 8,603 media)

Figure 11-8　Number of Articles in Major Newspapers, 　　　　　　　　　　Websites, and Other Media That Covered JRCS

Major newspapers Total for March, April, and May

The New York Times 60The Japan Times 74International Herald Tribune(Global Edition) 35

The Wall Street Journal-Europe 15

Daily Yomiuri Online 20Asahi. com 12The Guardian 3The Times 1BBC News UK 9CNN 14

(2) Communication of information to IFRC and National Red Cross and Red Crescent Societies across the nation

a. WebsiteIn July 2011, PPRO set up a special English-language website focusing on GEJET, which arranged information on the earthquake in an easy-to-understand manner so that it attracted considerable attention from overseas visitors.This special website carried 40 stories from May 25, 2011 to November 2012. These stories not only covered the operations of JRCS, but also included accounts that described the true feelings of victims, including their experiences, thoughts, and concerns. These were also posted on the IFRC’s website and sent to PR officers at

b. InterviewsImmediately after the earthquake, PPRO received innumerable requests from the mass media for news gathering and those for appearances on TV and radio programs via phone and Skype. The number of such inquiries from May 25, 2011, when data on it started to be taken, to the end of March 2012 was about 80. PR officers received many questions that were not necessarily related to JRCS’s activities, including the latest death toll and the damage caused, the current conditions in the affected areas, what was most needed at the time, and the perceived delay in the government’s response. They tried to relate these questions to JRCS’s activities as much as possible so that they could introduce those activities.

c. News gathering in the affected areasIn March 2011, PPRO’s personnel accompanied news-gathering teams from the Norwegian Red Cross and Euronews. In April, they accompanied a news-gathering team from the Netherlands Red Cross.In addition, PPRO received requests from several media such as CNN, BBC, ABC News, National Geographic, and documentary producers from Hong Kong for news gathering, and local Chapter staff and medical teams met such requests. Some of the media even requested JRCS staff to serve as interpreters and guide them in the affected areas, but in principle, except for teams of PR officers from sister societies, ordinary media were encouraged to make arrangements for interpreters, transport, and other requirements on their own and gather news materials independently. Based on this principle, PPRO coordinated news gathering in the areas where JRCS was working.As JRCS’s recovery operations progressed, ceremonies for the completion of buildings or similar and other

［The Ishinomaki RCHP accepted many requests from overseas media for news gathering.］

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images and information using their own tweets, enabling as many as 2.2 million people worldwide to receive information on the disaster in real time.

b. Flickr2

PPRO officers immediately forwarded the photographs sent to the Headquarters from the affected areas to IFRC communications officers in Kuala Lumpur, who added captions to the photographs and made other adjustments and transmitted the adjusted ones to IFRC communications offices in Geneva, where they were uploaded onto the Flickr community site. Thus PPRO officers worked with IFRC communications officers to make the damage caused by the earthquake known to the world. There were one million views of JRCS’s photographs during the two weeks after the disaster.

c． YouTubePPRO provided images from the above-mentioned DVDs to the public via IFRC’s YouTube account, and the images thus shown in May 2011 were replayed more than 8,500 times. In addition, through this account, PPRO presented the President’s message in English in September and a 30-second, short “thank you” message from beneficiaries in February 2012. A record of the initial deployment at the Ishinomaki RCHP with subtitles in English was also shown via the IFRC YouTube account.

(4) Information for foreign embassies in JapanSupport from overseas came in various ways such as donations contributed through a Red Cross and Red Crescent Society in each country as well as donations given through the Japanese embassy in each country, sent by foreign companies directly to JRCS, or received from foreign embassies in Tokyo. In July 2011, in addition to the President’s letter of appreciation for contribution, PPRO issued Operations Update through the Foreign Press Center and sent copies of the DVDs to foreign embassies in Japan (from about 130 countries) together with the receipt for Gienkin .

Sister Societies worldwide. The website also carried ten progress reports on JRCS’s operations, entitled “Operations Update,” which were compiled by the International Department for donors and Sister Societies, as well as accounting reports, interim assessment reports, and so forth. In addition, all news releases were put up on the website.

b. DVDsFrom May 2011 to September 2012, PPRO produced four DVDs including Japanese/English narration and presented them via IFRC’s YouTube channel. Materials used for these disks were also provided to overseas media through IFRC’s website. These DVDs were distributed at PNS meetings and to Japanese embassies in overseas countries through the MOFA.

(3) Communication through social mediaa. TwitterWhen the earthquake occurred, JRCS did not have its own official Twitter account. The reason it started to use Twitter was, however, that International PR officer had strongly recommended having a Twitter account when a conference of IFRC Asia Pacific communications officers took place in 2010, and that the officer had opened own accounts on an individual basis.This officer sent 1,000 tweets from the accounts in the first four days after the earthquake to show photographs of patients brought to the Ishinomaki RCHP and provide updated information on the damage caused by the earthquake and tsunami, which was supplied by NHK. Furthermore, IFRC communications officers spread these

(2) Flickr is a free community site where one can freely upload or download photographs and videos.

［Top page of the special earthquake website in English］

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b. Music industry’s cooperation in collecting Gienkin across the boundaries of individual companies

On March 25, 2011, four major record companies, Sony Music, Universal, Warner, and EMI, simultaneously started the digital distribution of charity CDs through iTunes stores worldwide. These CDs continued to top the iTunes stores’ album charts in 18 of the 22 countries where they were announced.In addition, in April saw the worldwide release by Sony Music of a set of two CDs with JRCS’s logo printed on them.Furthermore, Universal distributed and sold “Ai no Uta (song of love)” via the Internet for a limited period of time, from April 2 to September 30.The record companies, music publishers, and artists involved in these productions did not claim compensation for royalties and other income from the sale of these products, and all revenues, including commissions for iTunes stores, were donated to JRCS as Gienkin for the GEJET. These donations amounted to a little over 700 million yen.

(2) Motto Cross! PrizeThe “Motto Cross! Prize,” which has been hosted by JRCS since 2008, officially commends those of chapters and facilities at 250 locations nationwide that produce remarkable results in PR activities. The Ishinomaki RCHP attracted the attention of many media and other organizations as the only medial institution that worked in the Ishinomaki area. Under these circumstances, the hospital continued to actively communicate information to the entire world on the damage caused by the earthquake, the lack of food at the hospital, and the medical relief work performed there. In February 2012, in recognition of the unprecedented PR activities the

5. Other PR activities(1) Offers of cooperationBusinesses, distinguished people, and others made various offers of cooperation. Those related to supplies were taken over by the Supplies and Property Division of the General Affairs Department. All inquiries were forwarded to PPRO if definite decisions could not be made on how to respond to such offers, and there were cases in which even PPRO officers could not give an immediate answer. Due to the lack of personnel, PPRO officers were unable to respond fully to such offers and felt that it was necessary to strengthen JRCS system to work with the social contribution programs (CSR) of businesses, associations, and so forth.

a. MTV JapanThe name of JRCS was exposed to the public mainly through a concert held in CHIBA on June 25, 2011, as well as an MTV (Music program) Japan-hosted website, karaoke boxes, local concerts, and other media. JRCS logo was also printed on the panel at the back of the site where a popular singer gave a press conference when she visited Japan, and this led to wide publicity for JRCS.

［A scene from the press conference given by Lady Gaga during her visit to Japan］

［Back of the CD jacket］［Front of the CD jacket］

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crisis management.PPRO also asked them to carry out a survey of awareness among Gienkin recipients so that the survey results could be used for briefing materials for donors, and this led to effective external communications in the subsequent months.

(5) Events to collect Gienkin donationsAs part of its five-year campaign to commemorate the 150th anniversary of the foundation of the ICRC, JRCS had planned an event to make Red Cross activities known to the public, and since 2009 it had held it in Harajuku Omotesando area of TOKYO in May of each year. In 2011, out of recognition that it should actively support earthquake victims, the JRCS carried out an event to appeal for recovery support in cooperation with the store owners in this area from May 1 to 13. During the event, boxes for the collection of Gienkin were installed at the shops with the logo and campaign flags hoisted in the area, and on May 7 and 8 the campaigners called for Gienkin in the street and collected messages of encouragement for those in the affected areas (All messages thus collected were posted on the panels).These message panels were put up at evacuation centers in FUKUSHIMA (Azuma gymnasium) and at the Ishinomaki RCHP in early June.

hospital carried out at the time of disaster, JRCS added a special honor to the “Motto Cross! Prize” and presented a Platinum Prize to the hospital.

(3) Survey of PR effects in FY2011Each year, after the Red Cross Movement Campaign in May, JRCS conducts an online questionnaire survey of 2,000 persons on the effects of its PR. This survey is designed to assess the image of JRCS, the reach of its newspaper advertisements and TV commercials among readers and viewers, and their support ratings. The FY2011 survey items included how much cooperation the respondents extended in terms of Gienkin and whether those who cooperated in Gienkin also provided activity funds. Due to the effects of the GEJET disaster relief was the best known among JRCS’s activities, and 77% of respondents (up 14% compared to the previous year) said that they knew about it. The number of those who replied that they had seen an article on JRCS through media such as newspapers, TV, and the Internet rose sharply, from 37% in the previous year to 57%. However, the percentage of those Red Cross members who cooperated in Gienkin was less than 20% with 80% of donors not being a Red Cross member yet. Asked whether they wished to become a Red Cross member, they donate for activity funds, and support JRCS in the future, 60% of those who cooperated in Gienkin replied that they wished to support JRCS or that they might wish to do so.Just because it attracted greater public attention and gained greater public trust through the earthquake, JRCS realized that it needed further PR activities for its activity funds and approach to the general public to obtain more Red Cross members.

(4) More effective PR consultationsSince the launch of the “Motto Cross! Campaign,” PPRO had continued to seek advice from PR consultants, and prior to the earthquake it considered engaging them to come to our office once every two weeks in FY2011. Following the spread of unfavorable reports and wrong rumors after the disaster such as misunderstandings concerning Gienkin , however, PPRO asked PR consultants to come to our office three times a week (once a week after November 2011) and requested them to conduct surveys of trends in media coverage and sought advice on how to respond to the mass media, call press conferences, and maintain public relations at the time of

[Messages of encouragement for the earthquake-stricken areas from people walking along the street between HARAJUKU and OMOTESANDO in TOKYO]

Others

Chapter 12

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This chapter will be omitted because expressions that are peculiar to the internal materials of the Japanese Red Cross Society are frequently used.

Chapter 12　Others

Summary of Disaster Relief Services for the GEJET

Chapter 13

296


1. Review (Examination) by BlocksAt the Headquarters/Chapters and medica l institutions, etc., disaster relief services for the Great East Japan Earthquake and Tsunami (GEJET) were reviewed and finalized on a facility basis.The FY2011 joint disaster relief drills for medical services of chapters in each block were suspended in the wake of the disaster. However, the 1st, 2nd and 3rd Block carried out discussion meetings to examine the medical services for GEJET, replacing the regular joint disaster drills with medical services (Carried out in 2012 for the 1st Block). The 4th Block postponed the joint disaster relief drills and provided examinations through the Council for Medical Team Leaders. The 5th and 6th Block wrapped up medical activities within the Blocks at Meetings for Project Leaders.

(1) The 4th Block Council for Medical Team InstructorDate: (1st) October 13 (Thu), 2011 (2nd) December 5 (Mon) , 2011 ※At both 13:30-17:00Venue: Osaka Red Cross BuildingNumber of participants: (1st) 44 (2nd) 40 　　　 Medical team Instructors of the 4th Block

Chapters participated in the Council.Outline: The following matters were examined

at workshops (Medical Relief Workshop, Psychosocial Support Workshop, Volunteer Workshop, Headquarters of Disaster Control (HDC) and Logistic Support Workshop) established in the Council.

　　　 After that, we presented report summarizing the results of the study to the Headquarter as the recommendation of the 4th Block for JRCS’general overview.

(2) Joint Disaster Relief Drill for the 3rd Block Chapters (Seminar)

Date: From November 1 (Tue) , 2011 14:00 to November 2 (Wed), 2011 11:00

Venue: Ikoinomura Isoppu (TOYAMA)No. of participants: 59　　　 Participants included the staff engaged in the

medical services as the 3rd Block medical team staff, psychosocial care staff and those in charge of disaster relief services.

Outline: The following topics were reviewed and examined through service-specific group discussions.

Chapter 13　Summary of Disaster Relief Services for the GEJET

・Medical Relief Workshop　Reporting line for rescue operations, cooperation

between the chapters, logistical support system, judgment of when to withdraw, and the organization of medical teams.

・Psychosocial Support Workshop　Reporting forms and information sharing, need for

consultants (supervisors), understanding towards psychosocial care, psychosocial support for medical team members, problems identified in the chain of command for psychosocial care, etc.

・Volunteer Workshop　Standards to establish and administer a Volunteer

Center, cooperation system with the organizations concerned, compensation for the costs of volunteer deployment, etc.

・HDC Workshop Logistical Support Workshop　Unification of the reporting line, standards for

mobilization, rebuilding of the logistical support system, sharing of medical team support (use of dERU), securing information and communications, etc.

・Services provided by the Disaster Medical Assistance Teams (DMATs)

・Psychosocial care services・Medical service response to the earthquake based

upon the Tokai and Tonankai Earthquake Response Plan

・Readiness to receive support for the Medical Teams and other medical relief teams

・Support system for many staff providing support services over the long term from the initial stage to the recovery period

・Seminar and training contents for medical team staff

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2. Implementation of the “Overall Summary of the JRCS Disaster Relief Services for the GEJET”

(1) Background to Carrying out the Overall Finalization

The Disaster Relief Act and other related laws provide that JRCS shall cooperate with the national and local public entities in distributing medical and relief supplies, accepting Gienkin (cash grant sheme), and other services. The significant and extensive damage caused by the GEJET resulted in a loss of government functions. Beyond the sphere of the services that had been in place, JRCS was expected to provide more flexible services.In total 55 teams from JRCS across the nation were called out on the disaster day, engaged in a range of services, i.e., providing long-term and extensive psychosocial support programs, supporting the elderly who required nursing care, and carrying out Red Cross volunteer support. On the other hand, JRCS faced many problems that occur in a major disaster like this, including how to provide medical services in a nuclear accident, utilize the support (including donation from overseas) through the International Red Cross promptly allocate the monetary donations, and promote public relations, etc.To this end, opinions from the Headquarters and Chapters and evaluations by the affected areas and disaster victims were collected to be reflected in the Overall Summary of the medical services in order to identify which services were effective or problematic in the GEJET.

(2) Reasons to Carry out an Overall FinalizationThe Headquarters promoted the finalization and evaluation of the disaster relief services for the GEJET from October to December 2011, about half a year after the disaster occurred.

(3) Workshop to Examine 2nd Block Medical Services for the GEJET

Date: 　From November 15 (Tue), 2011 13:00 to 　November 16 (Wed), 2011 12:00

Venue: Hotel New Otani Nagaoka (NIIGATA)Number of Participants: 148 Participants included staff engaged in the

medical services as medical team and psychosocial care staff from the 2nd Block and the JRCS Medical Center, and staff from the Chapter/Hospital.

Outline: Focusing on medical services, the following topics were discussed at service-specific workshop. The results of the discussions were wrapped up and presented to the Headquarters.

(4) Joint Disaster Relief Drill of the 1st Block (Discussion Meeting)

Date: From July 18 (Wed), 2012 10:00 to July 19 (Thur), 2012 15:00

Venue: Forest Sendai (MIYAGI)Number of participants: 91 Participants included medical team staff from

the 1st Block Chapters, officials engaged in the medical services as psychosocial care staff, as well as those in charge of disaster relief services for the Chapter.

Outline： Considering the fact of the 1st Block servicing the affected areas, a more specific review was carried out to rearrange the medical relief system. The results were reflected in the joint disaster relief drill for the 1st Block Chapters, aimed at acquiring disaster preparedness for a possible major disaster in the future. Based upon the Overall Summary from the Headquarters and the documents and meeting minutes from Secretary General of Block Representative Chapters, topics regarded as necessary from the results discussed at the 1st Block Chapters were examined at service-specific Workshops.

・Promotion of medical services under the circumstances where the reporting line and coordination system did not function well

・Roles that medical teams should play ・Support for hospitals located in the affected areas・Logistical support system that allows for long-term

staff deployment・Psychosocial care services

・Members of the chapter HDC and the HDC at affected area and their roles

・Systems of deployment for support medical teams and hospitals

・Disaster Medical Coordinater・Supply of medical equipment/appliances, etc.・Liaison and coordination with the prefectures

and municipalities, and other disaster control organizations

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In providing an Overall Summary of the JRCS services, we adopted the “finalization type per Block” after reviewing the following three candidate methods: 1) “Finalization type per Block” where the Block Representative Chapter collect opinions from the chapters and facilities staff actually engaged in the medical services and send them to the Headquarters, 2) “Questionnaire type” where questions for each research item were asked to the staff at the chapters in the affected or non-affected areas and at the Headquarters, and the results were finalized using the questionnaire, and 3) “Examination workshop type” where examination members were selected for each service to compile the opinions.In this context, we notified the Secretary General of the block Representative Chapters of the “Overall Summary, etc. of Medical Services for the GEJET” as of October 14, 2011, to examine the medical services provided by each chapter based on the Guidelines for the Overall Summary of Medical Services, collect opinions for each block, and summarize the services.Specifically, the Block Representative Chapters collected opinions on the following topics from staff engaged in the medical services for each chapter, holding meetings on the finalization in each block to submit them to the Headquarters: 1) overall reporting lines for medical services, 2) medical relief services, 3) psychosocial support, 4) medical supplies, 5) volunteers, 6) problems related to aspect of the benefits for the deployed staff, including travel expenses, etc.

〇Problems that the medical teams face for the time being and their policy for deployment

　 (October 2011, the HDC at the Headquarters)〇Third-party evaluation・Evidence-based reports for the evaluation of disaster

medical services (October 2011; The Japan Research Institute/HDC at the Headquarters Project Team)

・Proposals to the JRCS on service evaluation from the International Red Cross (November 2011; International Department, Evaluation Team of the International Red Cross)

・Report on services for accepting Gienkin and Recovery Assistant Program (December 2011; General Affairs Department, The Japan Research Institute)

〇Summary of Medical Services at the Chapters/Facilities・October – December, 2011　The Block Representative Chapters collected opinions

from the Chapters/Facilities staff who had been actually engaged in the medical services in order to submit them to the Headquarters

・December, 2011　Harmonizing the views among the Block

Representative Chapters

Guidelines on Providing an Overall Summary of Medical Services　　　　　　　　　　　

An overall summary on the medical services for the GEJET shall be provided as follows.

1. PurposeWhat the Japanese Red Cross Society did and what it did not do in this disaster.We must examine our medical services, psychosocial care, volunteers, and their reporting lines etc., in relation to the institutional and administrative aspects, and identify the problems and lessons to be learned.To this end, the findings shall be reflected in the ideas and systems for future disaster medical operations.

2. Service PeriodOctober 11, 2011 Presentation of the Guidelines (Draft)

to the Block Representative ChaptersOctober 20 Notification from the Headquarters

to the Chapters (via the Block Representative Chapters)

December 15 The Block Representative Chapters presented their summaries to the Headquarters

In late December Meeting of the Directors of the Block Representative Chapter’s Responsible Departments (Sections) (Hearing on the summaries of the Blocks)

In January, 2012 Overall finalization by the Headquarters

3. Service MethodThe Block Representative Chapters shall collect opinions from the staff engaged in the medical services for each chapter, covering facilities in the Chapter territories, discussing the summaries for each block to submit the results to the Headquarters.Adding the summaries from the Service Teams of the HDC and Workshops at the Headquarters, we provided an overall finalization of the JRCS medical services.

4. Service FieldsWe decide to finalize the following items according to “5. Viewpoint of Finalization”.

(1) Overall medical activities including reporting lines(2) Medical services(3) Psychosocial care(4) Relief supplies(5) Volunteers(6) Other issues

5. Viewpoint of the FinalizationAccording to provisions and notifications of the JRCS Relief Rules, JRCS Disaster Control Plan, etc., we will examine them from the institutional aspects and evaluate the results to identify future problems and lessons to be learned.Please refer to the appendix for the related items. (Related items only; no questionnaire form will be provided separately.)

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The Project Teams of the Headquarters and Block Representative Chapters discussed and finalized their opinions on the summary from the Headquarters, Chapters and Facilities from December 2011 to February 2012. These were finalized as the “Overall Summary of the JRCS Medical Services for GEJET”. The Overall Summary was discussed by the Secretary Generals Meeting of the Block Representative Chapters held on February 29, 2012, where they agreed to maintain this direction in the future.

AppendixItems to be summarized for the fields

1. Overall Medical Services, including the reporting lines　(1) Support system of the Chapter HDC in the

affected areas (in the case that the disaster is wide, extending to several prefectures, and the Block Representative Chapter are also affected)

　(2) Requested deployment of medical teams (medical teams, psychosocial care teams, and others were requested for deployment)

Evaluation for the initial team deployment and reporting line coordination of the team deployment in change of the Block Representative Chapter (whose roles are not provided for in the Relief Rules, but are evaluated based upon the facts).

　(3) Desirable hospital support to Ishinomaki RCHP and request for deploying hospital support staff (to integrate contact points with the Headquarters)

　(4) How to deal with the malfunctioning of the government HDCs

　(5) Service Liaison Staff stationed at chapter HDCs as block role

　(6) Deployment of hub points for local medical services (disaster HDC functions, accommodation for the medical teams, etc.)

　(7) Logical transfer stations installed for medical services (to continue the services)

　(8) Communication secured for initial services (which route was available?)

2. Medical Services　(1) Number of medical team staff (Should a team

consist of 6 staff?)　(2) Service term for medical teams (at the initial

service and after the initial service) (Should it be three working days?)　(3) Withdrawal timing for the medical teams　(4) Necessity of Disaster Medical Advisors (DMA)

(at IWATE Chapter, RCHP doctors succeeded to some extent in serving as local DMAs, coordinating prefectual government and JRCS medical teams. Then, what should be the medical services effectively provided?)

　(5) Necessity of Logistics Teams, etc., for logistical support to the medical teams

　(6) Problems and measures for medical services under a radiation environment (as it is a new disaster situation, the problems were mainly compiled in the finalization process)

3. Psychosocial Care　(1) Dissemination program for the JRCS

psychosocial care services (lack of understanding within and outside the JRCS stood out).

　(2) Training details for psychosocial care staff (whether the short-term seminar for the staff was sufficient to develop their skills)

　(3) Services provided with or without medical teams (Evaluation shall be made for the services when a medical team consists of care staff, when accompanying a medical team, or when

provided by the care staff only).　(4) Service term in the case of those without

medical teams　(5) Necessity of care coordinators (Given the

Psychosocial Care Center is established by each chapter)

　(6) Psychosocial care for the deployed medical team staff

4. Relief supplies (relief supplies including blankets, and those needed for medical services)　(1) Securing methods of procuring supplies (the

procurement was difficult)　(2) Ensuring the space to temporarily secure relief

supplies (such as the need to set up logistics stations, etc.)

　(3) Measures to cooperate with Red Cross Blood Centers (RCBC) for transportation, etc.

5. Volunteers　(1) Standards for establishing Disaster Relief

Volunteer (DRV) Centers in the affected prefectures (as hub points that cover a wide area, controlling the services in the event of a disaster)

　(2) Administrative support system for DRV Centers in the affected areas

　(3) Services provided by DRV Leaders and by rank-and-file volunteers

　(4) Deployment of DRV to remote areas Due to the deployment to remote areas, the

Chapters showed differences in their willingness to provide the service.

　(5) Deployment of volunteers providing support and rehabilitation measures

　(6) Service period for volunteers (local DRV Centers, etc.)

6. Other issues　(1) Problems from the aspect of providing benefits to

the deployed staff, including travel expenses, etc.　(2) Public awareness and dissemination of Gienkin

through PR channels

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○ An interim report on the “Action Plan for Solving Problems faced by the Medical Relief Services in the GEJET; progress reporting”

　Briefings on the interim report on the progress status of the Action Plan were given to share information about the progress and methods to be implemented, etc.

○ Second report on the “Action Plan for Solving Problems faced by the Medical Relief Services in the GEJET; progress reporting”

　The second reporting was made on the progress in the situation of the Action Plan as of September 28, 2012, to present more specific efforts, the directions and solutions, etc. , in addition to the details discussed after the interim report in June.Figure 13-1 shows the following outline.

(3) Details of the Overall SummaryFor the “Overall Summary of JRCS Medical Services for the GEJET”, the items including the overall medical services such as reporting lines, medical relief, psychosocial care, relief supplies and volunteers, shall be divided into measures to be dealt with by the Headquarters (handled by the entire Society) and by the Block Representative Chapters/Chapters (handled by the Chapters)

(4) Awareness of the Problems and Challenges to be Tackled in the Future

The “Overall Summary of the JRCS Disaster Relief Services for the GEJET”

1 preconditions an external

awareness of the problems as the JRCS and challenges to be tackled in the future as described below.

(5) Development of Action Plans for Problems and their Solution

An Action Plan for the GEJET was developed by the Project Team of the Headquarters and the Block Representative Chapters.The following points were considered in developing the Plan.

① Clarifying the guidelines for the deployment/coordination system of the medical services

→Headquarters⇒Block Representative Chapters ⇒ Chapters

　However, in order to ensure the timeliness of medical services, this does not apply to such cases immediately after the disaster.

② Logistical support system for medical services　→Utilizing logistical transfer stations

③ Cooperation utilizing JRCS Networks　→Participation/cooperation of volunteers, etc.

④ Efficiently and effectively carrying out medical services on site

→Organizing and using medical coordinators and coordinating staff members

→Cooperation with various medical teams and designated government agents, etc. including DMAT

⑤ Others→Flexibly organizing medical teams depending

on the damage status (utilizing interns, pharmacists, etc.)

① Establishing a system to allow for a flexible response・ Flexibility to respond to unpredictable events・ Responding to various needs of the victims beyond

the scope of conventional services ・ Active information collection in the disaster-

stricken areas and surveys of their needs, through the involvement of disaster relief volunteers, etc.

② Developing further disaster preparedness capabilities・ Construction of communication systems that are

available even in the event of a major disaster・ Procurement and supply of various supplies,

including fuel, etc., that are available・ Maintenance, etc., of logistical support systems

including transfer stations for support staff ③ Liaison utilizing systematically JRCS Network

・ JRCS networks for the Headquarters, chapters, hospitals, blood centers, volunteers, and vehicles and equipment, etc.

・ Cooperation with volunteers and the International Red Cross and Red Crescent Movement (RCRC) for services mainly involving the JRCS staff

・ Sharing information on medical areas for the medical services, and the integration of services, etc.

(1) “Overall Summary of the JRCS Disaster Relief Services in the GEJET” by the Project Team of the Headquarters and Block Representative Chapters, February 29, 2012

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Figure 13-1 Second report on the “Action Plan for Solving Problems faced by the Medical 　　　　　　　　 Relief Services in the GEJET; progress reporting” 　　　　　　　　　①Overall medical services including reporting line

Items Challenges and problems Future policy Main staff responsible

Service period Methods of implementation

Support system of the Local Chapter HDC in the Affected Areas

・Support system needed by other Chapters, etc.

・Deployment of Chapter HDC in the Affected Areas when a disaster occurs

Headquarters FY2012・Revision completed on the Guideline for JRCS Disaster Relief Systems (April 2012)

・Revision of the Medical Team Staff Manual・Revision the Earthquake Response Plans

・Alternative functions needed when the Block Representative Chapters are affected

・Previously designation of the alternative functions of the Block Representative Chapters

Block Representative　Chapters

FY2012

Deployment of medical teams

・Reporting line should be clarified where instructions from the Headquarters are conveyed to each chapter via Block Representative Chapters

・Instructions on the deployment of medical teams was commonly recognized to flow from: Headquarters→Block Representative Chapters→Chapters→Facilities.Of note, the deployment of initial medical team should be excecuted, immediately.

HeadquartersChapters　Facilities

FY2012・Revision completed on the Guideline for JRCS Disaster Relief Systems (April 2012)

・Revision of the Medical Team Staff Manual・Revision of the Earthquake Response Plans

Role of hospital support

・Where to contact the Headquarters was not clear (i.e., many of the instructions on hospital support were directly conveyed to each hospital via the Medical Service Department and the Nursing Department; contact points for coordination or providing instructions at the HDC were not clear)

・Recognizing this, including hospital support staff, the contact points for disaster medical activities should be integrated into the service teams.

Headquarters　ChaptersFacilities

FY2012・Revision completed on the Guideline for JRCS Disaster Relief Systems (April, 2012)

・Revision of the Medical Team Staff Manual・Revision of the Earthquake Response Plans

How to deal with the malfunction of the government HDCs in affected area

・A system that allows coordination with other disaster control organizations and the management of medical services must be created for the HDC in the affected areas and the core disaster medical hospitals acting as hub points for medical teams involved in the medical relief services. This aims to provide the medical reliefs services based on the JRCS’s own judgment in the event of the malfunction of the government HDCs in affected prefectures.

・Reviewing strategies to promote coordination with the disaster control organizations

・Review of how the HDC function should manage the medical relief services in the affected areas and develop the human resources to be engaged in the services

Headquarters Chapters FY2012

Stationing service liaison staff involved in the deployment of medical teams, etc.

・Necessity of a coordination mechanism that allows for the smooth deployment of medical teams from the Chapter HDCs in the Non-Affected Areas to the Chapter HDCs in the affected areas

・Designing a coordination mechanism to deploy service liaison staff involved in the deployment of medical teams from blocks in the non-affected areas.

Chapters FY2012

・Briefing to each chapter/facility ⇒ Notice issued ⇒ Registration of the service liaison staff (FY2013)

・Describing the flow in the manual for the staff in charge of medical services at each chapter, including service liaison staff, regarding their services in the initial phase　

・The registration will be updated annually and shared among the Headquarters, chapters, and facilities.

Deployment of hub points for local medical services

・Necessity of establishing hub points for local medical services that are extremely safe, functional and mobile

・Deployment of large tents that are durable and resilient to changes in the weather conditions, as well as of prefabricated construction units for use as temporary medical stations

Headquarters After FY2012

・Deployment of tents from the Headquarters to each chapter (FY2012-2013) ⇒ Management and maintenance of the tents at each chapter

・Data on the kinds and numbers of large tents owned by each chapter will be included as a list in the manual in order to share the information.

・Executing an agreement with agents to lease Prefabricated Construction Units at the Headquarters office (FY2012) ⇒ Notifying each chapter of the details of the agreement (FY2013)

Logistics transfer stations installed for medical services

・Necessity of logistics transfer stations that support medical teams in providing medical services

・Stocking relief supplies at ordinary times, while establishing logistics transfer stations that can provide accommodation, bathing, meals and supplies of medical equipment/appliances, etc. to medical teams at the time of a disaster

Headquarters Block Representative Chapter

After FY2012

・Promoting improvements by coordinating between the Headquarters and the Local Chapters which have logistics transfer stations in view

・Notifying each chapter after the improvements, while trying to reflect the locations /outline of the stations in the new information system

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Communication secured for initial mobilization

・Necessity of securing communications that are available in the initial phase since the general phone lines, mobile phones and Japan Disaster Information system(J-DIS) by government did not work initially after the disaster

・Improving the environment for the use of satellite-based mobile phones, communications command vehicles, SEG TV, etc.

Headquarters Chapters FY2012

・Layout of the devices (FY2012) ⇒ Seminar/training program making use of the appliances owned by each chapter (After FY2013)

・Compiling a database of the satellite-based mobile phones inventory and sharing it among the Chapters and Facilities throughout the nation

・Based on the lessons learned with J-DIS, improving the JRCS original disaster information system that is designed to operate at the time of a disaster

Headquarters After FY2013・Discussions on how to configure, function and administer the system, not only by gaining advice and guidance within the JRCS, but also from outside experts and professionals

Others・Strengthening the Headquarters functions at the time of a major disaster

Enhancing the HDC functions of the Headquarters Headquarters FY2012

・Planning and implementing a training program with clearly articulated objectives

・Providing proficiency training on how the service staff should deal with equipment/materials

・Reexamination of medical equipment/materials owned by the Headquarters, and improve them as necessary

Improving HDC alternative functions of the Headquarters Headquarters After FY2012

・Providing a training program at the Headquarters after the improvement HDC alternative functions of the Headquarters

・Periodical testing in accordance with the Operation Manual

②Medical services



Organization of the medical team staff

・Organization of medical teams that match the needs of the affected areas

・To have a common recognition of, in principle, having a 6-staff team to flexibly respond to the needs of the affected areas, involving psychosocial care staff and pharmacists, etc.

HeadquartersChaptersFacilities

FY2012 ・Revision of the Medical Team Staff Manual・Revision of the Earthquake Response Plans

Service period for medical teams

・The service period for medical teams should be established considering the deployed staff’s strength, mental stress, and the impact on the services of the entity deploying the staff and fulfilling the needs in the affected areas

・Consensus on the period; medical teams, etc., in a major disaster shall be deployed within 3 days in the very initial phase, and within 1 week after this phase.


FY2012 ・Revision of the Medical Team Staff Manual・Revision of the Earthquake Response Plans

Period for the withdrawal of the medical teams

Nothing in particular

・Without any change, the consensus was that it should be based on the judgment of the Chapter in the Affected Areas


FY2012 －

JRCS Disaster Medical Coordinator

・Disaster Medical Coordinators (including staff) are needed with a good knowledge of the local disaster control plan and government functions

・Reviewing the roles, necessity, and human development of Disaster Medical Coordinators at the Chapter HDC in the Affected Areas authorized by the Headquarters and Core Disaster Medical Hospitals

ChapterDemonstrating a certain direction in FY2012

・Notification on the Standards/Requirements for Organizing the JRCS Disaster Medical Coordination Teams

・Preparation of an Operation Manual for JRCS Disaster Medical Coordination Teams

・Development of Seminar/Training Guidelines for the JRCS Disaster Medical Coordination Teams

Logistics Team providing logistical support for the medical teams, etc.

・Lack of logistics functions that provide extensive logistical support to the medical team services over a long period

・Discussions also include improving hub operations for local medical services and logistics transfer sites

Headquarters FY2012 ・Revision of the Medical Team Staff Manual・Revision of the Earthquake Response Plans

Medical services provision in a radioactive environment

・JRCS medical activities under a radioactive environment must be clarified

・The whole organization should discuss the JRCS response policy regarding nuclear accidents; as the result, any medical activities provided in a radiation environment shall require deployment in the behavioral standards and reporting lines etc., for the equipment and training system needed.

Headquarters FY2012・Notice issued on behavioral standards・Revision of the Medical Team Staff Manual・Deployment of protective equipment and materials (to be implemented in FY2013)

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Others・Rearrangement is needed for the formats of the service status reports and medical records of patients, etc.

・Towards the unification of formats, etc., with other institutions, reflecting them in the Medical Team Staff Manual

Headquarters After FY2012 ・Notice issued about medical service records and daybooks・Revision of the Medical Team Staff Manual

③Psychosocial care



Dissemination of JRCS psychosocial care services

・Roles and contents of JRCS psychosocial care are not clear

・Reviewing psychosocial care services, clarifying the position of the services, and reflection of the results in the Guideline

Headquarters FY2012 ・Revision completed for the Psychosocial Care Training Manual (for the instructors of medical service staff)

・Preparation of the “JRCS Psychosocial Care Service Manual” and distribution of the Manual to other organizations

・Putting it on the website・Lack of understanding within and outside the Society concerning JRCS psychosocial care services

・Dissemination of JRCS psychosocial care services within and outside the Society

Chapters FY2012

Seminar for psychosocial care staff

・Improvement needed in the contents of psychosocial care training with more hours

・Improvement and enhancement needed in psychosocial care training for the staff and instructors, after preparing more specific Guidelines on JRCS Psychosocial Care Services

Headquarters FY2012・Presentation and dissemination completed at the Psychosocial Care Services Seminar

・Revisions completed for the Psychosocial Care Services Seminar Guidelines and the seminar textbook

Deployment of psychosocial care staff and the types of services

・Deployment/service types of psychosocial care staff must be reviewed depending on the phase of the disaster medical services

・There are two types; one with medical teams, and the other with staff other than medical teams, flexibly chosen depending on the scale of the disaster, the service duration, and the needs of the affected areas.


FY2012 ・Dissemination of information at the Psychosocial Care Instructors Seminar and Psychosocial Care Seminar

Service period of staff belonging to psychosocial care teams

・Frequently changing local psychosocial care teams is not desirable for the victims in the affected areas

・The service period considered as appropriate is about one week. However, considering the characteristics of mental support, psychological care programs for disaster victims shall be continued with the relevant information handed over, etc.


FY2012 ・Dissemination of information at the Psychosocial Care Instructors Seminar and the Psychosocial Care Seminar

Psychosocial care coordinators

・Psychosocial care coordinators must be stationed at Psychosocial Care Centers

・Reviewing training for psychosocial care coordinators and guidelines to deploy staff in the event of a disaster

Headquarters After FY2012 ・Organization of Instructor Training Seminars and the development of coordinator candidates

Psychosocial care for medical team staff, etc.

・Psychosocial care needed for the staff engaged in disaster medical services

・Reviewing the roles and contents of the JRCS Psychosocial Care Program, and also providing psychosocial care to the staff

Headquarters FY2012 ・Requesting compliance with the Manual and cooperation through meetings, etc., throughout the nation

Others

・Expansion of the basis needed so that psychosocial care services are not concentrated on any specific person.

・Reviewing the roles and contents of psychosocial care programs provided by the JRCS, and expansion of the staff basis as well

－－・Coordination of the Training Seminars for Psychosocial Care Instructors and the Psychosocial care Instructors Seminar, scheduling of the seminar, etc.

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④Relief supplies



Methods and necessity of procurement of relief supplies.

・Difficulty of procuring emergency supplies in the initial phase even though agreements had been concluded with convenience stores, etc.

・Agreements concluded with trading companies and major supermarkets with a greater availability of emergency supplies


FY2012

・At the Headquarters, maintaining contact with partner companies signing the agreement as appropriate to ensure smooth procurement in the event of a disaster

・At the Chapters as well, maintaining contact with stores in the local areas as appropriate

・Understanding the quantity of relief supplies needed for a major earthquake, etc.

・Review of the items and the quantities of relief supplies to be stocked by the JRCS

HeadquartersChapters FY2012

・Understanding the quantities held by the Chapters (Quantities at the prefectural level)

・Developing the stock target quantities⇒Notification to the Chapters⇒Towards ensuring the target quantities

Securing space to temporarily gather relief supplies

・Space must be secured to stock a large quantity of relief supplies, and to temporarily replace emergency relief supplies, etc., after the disaster

・Reviewing the above, and securing warehouses needed along with the logistics transfer stations

Headquarters After FY2012 ・Discussion on securing space with the Chapters that have transfer stations or facilities

Coordination with BCs for transportation, etc.

・It is important to use inspection cars as Red Cross vehicles where the BC staff are engaged in transportation services.

・All JRCS efforts in the event of a major disaster shall be reflected in the plans and training.

Headquarters FY2012 ・To revise the Major Earthquake Response Plan and the Chapter Medical Services Plan

⑤Volunteers



Roles of JRCS DRV

・Among many volunteers providing services, the roles and contents of Red Cross DRV are to be clarified ・Review of the roles and

contents of DRV in medical relief services

Headquarters FY2012 ・Notice issued・Revision of the Manual for Red Cross DRV Coordination・Rearrangement needed for the

roles and contents of the work of DRV leaders and rank-and file volunteers

Setting up Centers

・Review needed on whether or not JRCS’s own Volunteer Centers should be established in connection with disaster control plans developed by national and local public entities and the volunteer centers of the Social Welfare Councils.

・Reviewing the roles of the above-mentioned volunteers, how the volunteer system should be established, as well as coordination with the Social Welfare Councils, etc.

Headquarters FY2012 ・Notice issued・Revision of the Manual for Red Cross DRV Coordination

Administrative support system for Center

・Administrative support system by staff or volunteer leaders that will be needed in establishing DRV Center

・Review of the above-mentioned Volunteer Center to be established, together with the administrative support system

HeadquartersChapters FY2012 ・Notice issued

・Implementation of the Training Seminar for DRV/Leaders

Deployment of to remote areas

・In deploying DRV there is a difference in policies from chapter to chapter, including extending favors

・Review on how it should be established on the premise of it being a self-service and self-contained operation, in principle

HeadquartersChapters FY2012 ・Notice issued

Deployment of disaster recovery support volunteers

・The name and roles of the disaster recovery volunteers were not clear and not sufficiently understood within and outside the Society

・Review of the roles and contents of the work of JRC disaster relief volunteers for the JRC medical relief service program as well

Headquarters FY2012 ・Notice issued・Revision of the Manual for Red Cross DRV Coordination

Service period for volunteers

・The service period of a volunteer should be determined by the individual concerned; however, this may lead to more complex coordination and allocation arrangements for each volunteer in the disaster-affected Chapters.

・Review of the administrative support system together with DRV center.

HeadquartersChapters FY2012

・Notice issued・Revision of the Manual for Red Cross Disaster Relief Volunteer Coordination

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⑥Problems regarding the aspect of benefits to the deployed staff, including travel expensed, etc.



Problems regarding the aspect of benefits to the deployed staff, including travel expenses, etc.

・The problem is that there is a difference in the benefits provided to the deployed staff; unified standards are needed for disaster medical services

・Identifying problems regarding the benefits provided to the deployed staff and preparation of the standards

Headquarters FY2012

[Insurance Coverage]・Choosing an insurance company and discussing the method of concluding an agreement⇒Preparation of an outline of insurance coverage⇒Briefing for the Chapter staff⇒Determining the insurance premium, etc., and notifying the Chapters of this⇒Preparing and distributing the Operation Manual [Travel Expenses for the Deployed Staff]

・Notice on the handling of travel expenses issued by the Disaster Management and Social Welfare Department to the Chapters/Facilities

3. Reinforcement Plan of Medical Relief Equipment for strengthening institutional disaster preparedness

(1) Background to the Finalization of the Plan for Maintaining Equipment/Materials

With regards to medical services in response to the GEJET, the problems suggested included how to secure the availability of communication methods even in the event of a disaster, improve transportation and conveyance systems such as dERU, and logistical support systems including transfer stations for the support staff.Preparing for a major disaster in the future, we developed a deployment plan regarding essential medical supplies and equipment with the priority on greater disaster prepared across the Society by implementing the plans from FY2012 one by one. In addition, we will start another review on those matters requiring discussion, including a system for collecting information, equipment to respond to radiation disasters, and the deployment of the medical services system.

(2) Reasons to Finalize the Plan to reinforce Equipment/Materials

Along with the above mentioned “Overall Summary of Medical Services for the GEJET”, a survey on the needs for medical equipment/materials by the chapters was conducted in the notice addressed to the Secretary General of the Block Representative Chapter Secretariats as of October 14, 2011, entitled

“Implementation of the Overall Summary of Medical Services for the GEJET”. As for specific items for deployment, opinions were collected from the chapters, finalized by the Block Representative Chapters in the form of a Request for Deployment (Draft) for (1) those that need to be newly

perchased through our experience of this disaster, (2) those that were perchased in the past and need to be updated, and (3) other necessary equipment and materials.At the same time as the overall summary, requests presented from the Block Representative Chapters were discussed by project teams in the Headquarters/Block Representative Chapters to reach consensus from December 2011 to February 2012. It was finalized as the “Reinforcement Plan of Medical Relief Equipment for strengthening institutional disaster preparedness”. This Plan was discussed and approved at the Secretary Generals’ Meeting of Block Representative Chapters on February 29, 2012.

(3) Contents of the Plan to Improve the Equipment/Materials

In this plan, the following four points were suggested as a basic policy for deploying the equipment and materials.

・To secure communication methods considering the importance of collecting information in the initial phase.

・In order to promote medical services in the initial phase, self-contained vehicles and doctor’s cars, etc., with a reporting line of the HDC in the affected areas.

・Until the JRCS medical team staff are assigned for service, a hub point shall be maintained, in addition to dERU, with Large tents that can withstand a severe environment, including inclement weather.

・A structure for storing medical equipment/materials for the HDC (pre-fabricated) shall be set up at a hub point with a view to offering stable accommodation for the medical staff and improving the medical equipment and materials. The aim of this is to ensure stable deployment for long term service by, specifically, providing a line system for each service area based on the block basis.

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delivering the equipment/materials to be deployed were summarized as follows.

a. Financial sources for deploymentsThe Plan for Deployment will be financed by the public aid fund from the JKA (Keirin Auto Race) and the donation from overseas. ※The Chapters have no obligation to share the introduction funds, other than for additional options or installation costs; however, they must share the maintenance and updating costs after the deployment.

b. Conditions for deploymentThe deployment items will be purchased in a lump sum by the Headquarters and then distributed to the chapters; however, the number of the deployment items shall be reviewed, considering requests from the chapter units and a balance between the chapters after preparing the written specification.※Considering the conventional dERU system operations, fund donations to the chapters shall be taken into account for those that require repairing or updating the accessories.

c. Deployment of equipment/materials on a block basisAfter discussions within the block, the deployment equipment/materials on a block basis shall be delivered to the designate chapters considering the geographical conditions, storage space, etc.In addition, the costs for maintaining and updating equipment and materials shall be determined after coordination among the blocks. (e.g., “those appropriated proportionately according to the size of the chapter”, “those divided equally”, “fund reserves” , etc.)

d. Deployment of the equipment/materials not designated for deployment for the whole Society

When improving the equipment/materials not designated for improvement for the whole Society, the chapters shall provide deployments after reviewing the needs and financial sources, as in the past.

Based upon the above basic policy, deployments were divided into those that “need immediate deployment across the Society (FY2012)” and those that “need review for deployment across the Society (after FY2013)” for finalization so that the necessary equipment and materials are available.The following shows the specific details.

a. Those that need immediate deployed across the Society (FY2012)

b. Those that need review for deployment across the Society (after FY2013)

※Reviewing and determining operational systems to be introduced from FY2012.

(4) How to deploy the equipment/materialsBased upon the above Plan for Deployment, Block Representative Chapters shall prepare specifications for the necessary items. The Headquarters shall examine such requests, and determine the quantity of the items to be delivered considering a balance among the chapters.In addition, specific financial sources and methods for

〇Improving the communication infrastructure required to collect information (such as a Disaster Information Collection System, communication system for professional use, etc.)

〇Equipment to respond to radiation disasters〇Other set up for transfer stations, training/seminar

facilities, etc.

〇Items to be newly deployed based on our experience of this disaster

①Large tents to first-aid stations②Vehicles for HDCs in affected area③Satellite-based mobile phones④Rapid response cars⑤Air conditioning equipment for medical stations⑥Formulation carts (carts)⑦Portable ultrasound systems⑧Prefabricated Construction Units for Local Medical

Headquarters (temporary medical stations)※Items mentioned in ⑧ to be secured through

agreements with business entities※Items mentioned in ②, ⑥, ⑦, ⑧ to be maintained

by each block〇Those that need to be updated for maintenance①Communication command vehicle②Trucks for transporting medical supplies (relief

supplies)③Ambulance vehicles④Medical set case (one set)⑤Vans for medical team staff⑥Updating and repairing of dERU

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Chapter 13S

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Figure 13-2 Outline of the Deployment Plan to Improve Medical Equipment/Materials to strengthen disaster preparedness　　　　　　　　　　　　　　

①Items newly deployed based on our experience of this disaster

Priority for deployment Items Number of

deployments Deployment period

1 Large tents to first-aid stations 99 First deployment

2 Vehicles for (local) HDCs 12

First deployment3 Satellite-based mobile phones 108

4 Rapid responce cars 27

5 Air conditioning equipment for medical stations 38

Second deployment6 Formulation carts (cart) 12

7 Portable ultrasound systems 6

②Those that need to be updated for maintenance

Priority for deployment Items Number of

deployments Deployment period

1 Communication command vehicle 43

First deployment2 Trucks for transporting medical supplies

(relief supplies) 40

3 Ambulance vehicles 28

4 Updating and repairing of dERU 8

5 Portable cases containing medical equipment/materials 808

Second deployment

6 Vans for the medical team staff 32

Notes

Chapter 14

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This chapter will be omitted from this report because it consists of personal notes.

Chapter 14　Notes

This document was compiled under the supervision of the Editorial Committee for Record Document Covering from Relief Activities to Recovery Support for the Great East Japan Earthquake and Tsunami. The Editorial Committee held its first meeting in September 2012 and subsequently called several sessions for communication and preliminary discussions.The Editorial Committee consisted of the following members. (The member marked with a double circle indicates the chair of the Committee.)

　All official positions are correct as of January 2013.

Afterword We strongly recognized that it was necessary to record the facts about all activities that we carried out when we faced the unprecedented disaster that came to be known as the Great East Japan Earthquake and Tsunami(GEJET) to leave what our personnel and volunteers who supported these activities experienced to posterity as historical material, and out of this recognition, we compiled a record of these activities so that it would be of assistance to future relief operations of the Japanese Red Cross Society. This document records the activities of the JRCS after the GEJET by theme. In order to put the live voices of persons concerned on record, we strove to collect accounts directly from them where possible when confirming the facts. In addition, the editors gathered information from each chapter in the earthquake-stricken prefectures, where possible, in order to include a wide range of accounts about rescue operations by each chapter and its facilities. The materials, such as photographs, videos, and related data, are recorded on a DVD that comes as a supplement to the document. As mentioned at the beginning, this is a faithful English translation of the Japanese version of the record, which was published on November 29, 2013, and some of the figures and other data included in this volume may be different from those which are included in the latest edition of the record. We would like to conclude the afterword by wishing that this record be used as an aid to the future development of the International Red Cross and Red Crescent Movement.

the three chapters in affected area:

Mr. Yoshio Hayano Secretary General, Iwate ChapterMr. Ryuichi Suzuki Secretary General, Miyagi ChapterMr. Takenobu Saito Councilor, Fukushima Chapter

Other chapters: Mr. Akira Goto Secretary General, Tokyo Metropolitan ChapterHospitals: Mr. Kazuo Matsumoto President, Society of Secretary Generals for Red

Cross (Maternity) Hospitals in Eastern Japan (Secretary General, Japanese Red Cross, Sendai Hospital)

Blood centers: Mr. Masaharu Matsuzaki General Manager, General Affairs, Kanto-Koshinetsu Block Blood Center

Headquarters: Mr. Shinichi Osada ◎ Manager, Planning and Public Relations OfficeMr. Ryoichi Hattori Director General, General Affairs DepartmentMr. Hisafumi Kimura Director General, Disaster Management and

Social Welfare DepartmentMr. Izumi Misawa Director General, Medical Services Department

and Director General, Department for Promotion of Support for Recovery from the Great East Japan Earthquake

Secretariat: Planning and Public Relations Office

Great East Japan Earthquake and Tsunami—Complete Record Document Covering from

Relief Activities to Recovery Support—

Published by the Planning and Public Relations Office of the Japanese Red Cross Society on March 11, 20151-3, Shibadaimon 1-chome, Minato-ku, Tokyo 105-8521Phone: 03-3437-7070Facsimile: 03-3432-5507Translated and printed by Media Research, Inc.

Great East Japan Earthquake and Tsunam

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—C

omplete R

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Relief A

ctivities to Recovery S

upport—