Photo/Illutration A caregiver helps an elderly woman evacuated from Suzu, Ishikawa Prefecture, have a meal at a nursing home in Nagoya in December 2024. (Asahi Shimbun file photo)

The massive earthquake that ravaged northern parts of the Noto Peninsula on Jan. 1, 2024, caused significant disruptions to essential services such as the water supply, sewage and electricity in regions with high elderly populations amid the harsh winter cold.

Consequently, a “wide-area evacuation” was necessary, relocating not only hospital inpatients but also residents of elderly care facilities to medical and welfare facilities farther away.

This response was essential to preserve lives that could be saved. However, the abrupt change in living environments caused a decline in health for many evacuees, tragically resulting in fatalities at the evacuation destinations.

Furthermore, the transition from welfare facilities to medical institutions frequently led to a lack of exercise among the evacuees.

Such wide-area evacuations can also have adverse effects on the management of facilities and the overall well-being of local communities in areas affected by disasters.

Facilities that had their residents relocated experienced a drop in revenue, resulting in departures of staff members.

When trying to resume operations, the challenge of securing staff meant that the facilities could not accommodate the desires of evacuees wishing to return to their original homes. This vicious cycle led to some facilities in the Noto region being forced to close or only partially reopen after extended interruptions.

The impact of these evacuations extends to hospital management, which grapples with the recurring cycle of residents from welfare facilities falling ill, requiring hospitalization, and subsequently returning to the facilities.

Given the integral role that medical and welfare facilities play in the regional economy, any disruption to their operations poses significant challenges to recovery efforts.

This situation raises a critical question among those involved in disaster response: What was the right course of action?

The advantages and disadvantages of the wide-area evacuation approach must be thoroughly examined and assessed to better understand its impact.

The Disaster Medical Assistance Team (DMAT) played a pivotal role in transporting patients and residents during the crisis.

DMAT comprises a network of pre-registered volunteers, including doctors, nurses and operational staff from across the country, who mobilize to provide emergency medical and health care support in disaster-stricken areas.

In Noto, DMAT was instrumental in the transport of 1,600 evacuees.

Similarly, welfare staff support activities saw a significant expansion in response to the Noto earthquake. Inspired by DMAT’s framework, the Disaster Welfare Assistance Team (DWAT), initially established during the 2011 Great East Japan Earthquake, was activated for the first time from all prefectures.

DWAT primarily focused on visiting evacuation centers, providing essential support. Additionally, there were concerted efforts to dispatch staff to assist in the ongoing operation of welfare facilities.

The DMAT administration office plans to conduct a thorough review of the wide-area evacuations implemented during the disaster. It is crucial that this review is carried out in collaboration with welfare professionals.

To gain a comprehensive understanding, extensive interviews should be conducted not only with facilities that participated in the wide-area evacuations but also with those that opted to continue operations locally, exploring strategies to support decisions against relocating to distant areas.

The staff dispatched to disaster zones are seasoned professionals from various regions. Enhancing their support leads to broader challenges within the local medical and welfare systems, such as the critical shortages of nursing and caregiving personnel.

Disasters expose the vulnerabilities of society. It is vital to remember that the responsibility for designing and managing disaster response systems rests with the government.

--The Asahi Shimbun, Feb. 27

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