On June 17, 2019, I was given the chance to participate in a session of the Next Generation Academy (次世代塾, jisedai juku), a year-long program organized by the Kahoku Shimpo and hosted at Tohoku Fukushi University. In each session of the Next Generation Academy, two lecturers give talks about their experiences during the 3/11 disaster. Each session focuses on a different aspect of the disaster and recovery process. The session I was able to attend focused on “Search and Rescue”, namely rescuing survivors and giving them medical treatment. The two speakers this time were Osamu Onodera, assistant chief firefighter at Wakabayashi Fire Department and Takako Shibuya, chief nurse at Ishinomaki Red Cross Hospital.
“A Life or Death Situation: Looking Back on Eight Years Ago”
First was Mr. Onodera’s speech. Mr. Onodera currently works as a firefighter for the fire department of the Wakabayashi Ward in Sendai. Wakabayashi Ward is one of the two wards of Sendai bordering the ocean, and was severely affected by the 2011 tsunami. During the time of the disaster, Mr. Onodera worked for the Arahama District (located in Wakabayashi) division of the Sendai Municipal Firefighting Aviation Unit. Arahama was basically eviscerated by the tsunami; nearly every household in the district was destroyed.
After the start of the earthquake, Mr. Onodera went home, gathered his belongings, and immediately set out for Arahama. The Sendai City fire department has a policy requiring all workers to be on call during an emergency. Within 9 hours of the start of the earthquake, 97.3% of the city’s fire department was in action.
As he headed to his workplace in Arahama, Mr. Onodera recalls that it started snowing, so much so that it obscured his vision. The sky turned pitch black and the horizon started moving. It was at this point he realized a tsunami was coming. Mr. Onodera was riding a motorcycle at the time. He says, “If I had been driving a car, I would have been swallowed up when turning. As I was riding, I saw countless cars engulfed by the waves in my back mirror.” Even so, Mr. Onodera recalls a feeling of guilt?he felt as if he were running away.
He then recollected incidents of rescuing survivors. He mentions how he saw the water level rise around him, rising to levels easily above his height, watching rubble sweep past him, how when driving, he couldn’t see the roads. He called out while riding through mud, water, and wreckage.
From the day after the disaster, Mr. Onodera would help with search and rescue of survivors. His department would use a helicopter to scan the land. Once, on the surface of the waves, he saw three people, almost completely unconscious, suffering from hypothermia. He would go into the waves, held by a rope, while his fellow firefighters made a path of tatami mats swept away in the tsunami. While looking for survivors, he saw the wreckage of elementary and middle schools obliterated in the disaster. Mr. Onodera specifically remembers saving a mother and her child on that day. Looking at child, merely seven months old, he was reminded of his youngest child, who was the same age.
Mr. Onodera gave us specific calls to action within his speech. He brought up four points that he felt were key: to not underestimate situations, to prepare such that you can respond in an emergency, and to work to provide mental healthcare and prevent PTSD. He asked us to reflect on situations where we underestimated the amount of work something would take and it resulted in us making a mistake. He asked us to think about how we should prepare for a disaster, what kinds of tools are necessary. He asked us how we would work to provide psychological care. Finally, he asked us how we would work to reach out to others. What kinds of resources we would need to prepare concretely in case of a disaster.
He ended his talk by emphasizing the importance of continuing to talk about 3/11. While many who were children in 2011 will not remember the disaster, and the signs of damage from the tsunami in cities disappear, we cannot let it be forgotten. Not just for the sake of the preventing future tragedies, but also for the sake of remembering those who lost their lives.
“The Frontline of Emergency Rescue”
Ms. Shibuya’s speech served as a follow up to Mr. Onodera’s. While he discussed rescue during the earthquake and tsunami, Ms. Shibuya discussed patients’ treatment afterwards. Many places affected by the 3/11 disaster had few hospitals. For example, in Ishinomaki, the city where Ms. Shibuya worked, there was only a single hospital. As a result, people flooded into the few hospitals available. She describes the scene in the lobby during the disaster as looking like the infirmary on the frontlines of a battlefield.
The first patient to arrive at Ishinomaki Red Cross Hospital came a mere 30 minutes after the tsunami started. The hospital received their first patient with serious injuries about an hour later. From then, the deluge of people was unending. While many people could not make it on the day of the tsunami itself, the numbers of people increased dramatically, peaking on March 13th, two days after the tsunami. People would even be flown in by helicopter.
The causes of hospitalization were many.The two major causes were the consumption of contaminated water, resulting in internal injury, and hypothermia. However, the hospital had prepared for many more external injuries from the earthquake. Thus, they were not as prepared to treat the patients.
Because the hospital was one of the only places nearby for many with power, it became a makeshift shelter. Ms. Shibuya noted that the hospital became so crowded, it was impossible to tell who were patients and who were simply refugees. Many people would come and receive treatment, and then have no home to go back to. The hospital staff had not prepared for this influx of people; while they tried to set up places for people who were not injured, but had lost their homes, the hospital was quickly overcrowded.
One problem when treating patients was that they were often suffering from hypothermia upon their arrival. It was not possible to operate on or otherwise treat patients who were suffering from hypothermia or unconscious. In order to deal with this problem, the staff used triage: the “red” group attended to people suffering from hypothermia, using blankets and hot water amongst other methods to warm patients’ bodies. Patients would then receive treatment, and if their condition stabilized, they would be redirected to the “yellow” group.
Unfortunately, some people came in with relatives or friends in critical condition. These patients were those who would die whether they were treated or not (the “black” group). Despite being on the brink of death, they would not be rejected. Because they would not outright refuse entry to these patients, they would die on the premises of the hospital. The sheer number of patients received also backed up treatment. Some people who may have survived had they received treatment earlier died while waiting in the hospital. Not only that, but because the staff only had limited supplies, the amount of resources spent on each patient were also limited.
Furthermore, the nurses and other doctorial staff, despite having no training in embalming, became responsible for properly preserving and presenting the bodies of the deceased. The staff received body bags from the police to place the bodies in and nothing else. The photos Ms. Shibuya displayed of the makeshift coffins for those who had lost their lives was harrowing. 79 people had died within the first week of the disaster. The bodies of those passed along with the relatives of patients caused massive congestion in the hospital.
Another problem was with food supplies. The hospital did not have enough supplies, telling people to bring food with them if possible. Moreover, while emergency services were on the first floor, meals were served on the fourth floor. Elevators were not allowed to be used. As a result, the injured and disabled had to be carried or walk to the fourth floor.
In a similar manner to Mr. Onodera, many of the nurses, doctors, and other hospital staff were also victims of the disaster. Unable to leave their posts, some could only hope that their families had survived. Some would search for their relatives while also working.
One subject that came up both in Ms. Shibuya’s speech as well as the subsequent question and answer session was that of what an everyday person could do to be useful in disasters. If people do not know the basic skills of survival they cannot respond properly. As Ms. Shibuya was put in a position where she had to perform a wide variety of jobs outside of her specialty, she emphasized the importance of imagination.
She gave three concrete things that are required for the average person to be useful in an emergency situation. First, you have to have the will to help someone and the ability to face their situation directly. To be able to acknowledge their injury no matter how grievous, and to be realistic about their chances of survival. Secondly, there are a variety of basic tasks that one can do for someone suffering from an injury in an emergency situation. As Ms. Shibuya had mentioned the difficulty of treating people suffering from hypothermia, warming them up, or giving them CPR if necessary is helpful. Any specialized knowledge one might have from their life experiences can be useful. The third and final thing was to seek help from professionals if possible. If nothing else, remaining with an injured person can help relieve their stress.
After the speakers concluded, the students separated into groups for a breakout session. I was given the opportunity to participate in one of these discussion groups. In our group, a number of topics came up. One that was notable to me, as a student studying psychology, was the integration of mental health services. As previously mentioned, one of the major takeaways Mr. Onodera included in his talk was that of the need to focus on mental health. One of my group members, who lived in the area and witnessed the disaster, noted that while there were, for example, elementary school counselors, they were few in number. Not only were there not that many counselors, but the counselors would travel around to different communities, making it hard to receive consistent treatment. It was just something that happened to occur rather than an organized effort.
Overall, through our discussion, we came up with three major points: the need to revise disaster drills, the need for self-education, and the need be aware of the people around you. Building off of the theme in Ms. Shibuya’s talk of avoiding being useless in a disaster situation, we felt it is necessary to try and motivate people to seek out information for themselves. If you actively attempt to find information, not only can be of greater use to your community in a disaster situation, but that proactive attitude in and of itself can be useful in emergencies. Therefore, we decided it is important to try and grow that kind of motivation in young adults. This growth is especially important considering that specialists like Ms. Shibuya had to spend time organizing and working with people who did not specifically need their help. If we could get people to be able to have a higher baseline of knowledge of emergency situations, we could potentially save more lives, as the specialists would be able to focus on tasks requiring their expertise.
We also felt that, while it may be unfeasible to get a large population of mental health professionals to reside in one location, individuals living in afflicted areas can help their communities. If we can train individuals in basic therapeutic skills, and if those individuals can overcome their own fear in disasters to help and listen to the people around them, then they can be a mental health resource in an emergency. While, in the long term, we believed it was important to try and allocate mental health resources to disaster-afflicted communities, such an approach is not practical for immediate, on-sight disaster relief.
If there was one theme that came out of the student discussions it would be the concept of “preparedness” (備え, sonae). This “preparedness” both refers to the individual as well as society. On the individual level, we came to the conclusion that people need to make an active effort to increase their knowledge of the disaster; through doing this, every individual can become more prepared in an emergency situation. Merely learning the information is not enough?if you cannot implement it in a real life disaster, your knowledge is useless, so we agreed that it is important to get people to continually think about what they would do so they can put it into practice. This preparation can also help build confidence and reduce stress in the event a natural disaster actually occurs. Survivors can also work to help people become prepared through sharing their stories.
On a societal level, frequent reevaluation of emergency procedures is important. If we can look back on the disaster, we can use it as a learning experience and change emergency procedures to be more effective. Because this experience exists in the collective Japanese memory, we now have a better idea of what future disasters may look like. While the 3/11 disaster was frequently referred to as “beyond our wildest imagination” (想定外, souteigai), we cannot let the next disaster be beyond our expectations. We can use the media to help people have a baseline knowledge of emergency preparation. We have a significant amount of information about the disaster. Not only do we have the data collected by organizations like IRIDeS, but we also have the experiences of the survivors. We cannot let all of these resources go to waste.
I believe that the Next Generation Academy is doing important work in raising awareness of the issues that caused the tragedy in 2011. Hopefully, the students I worked with and I myself will be able to take the warnings and lessons that Mr. Onodera and Ms. Shibuya imparted to us. Preparing ourselves is the first and most important thing that we can do. I feel that, at least, through this experience, I have been able to start that work.