Letter to the Editor| Volume 82, ISSUE 9, P1248, September 2011

Evacuation from the restricted zone of the damaged Fukushima nuclear power plant: Facing with the reality

      On March 11th, 2011, the most powerful earthquake and tsunami since records began struck the northeast coast of Japan, severely damaging the nuclear power plant in Fukushima. On March 12th, the government ordered evacuation within a 20-km radius around the nuclear power plant. Most residents had already left by then; however, approximately 1500 patients remained in hospitals or nursing facilities. In the early morning of the 14th, these patients were transported to the Soso Healthcare Center (a screening point located 24 km north of the damaged power plant) by buses, police vehicles and Japan Self Defense Forces transport. However, the limited capacity of the hospitals in Fukushima caused difficulty in reallocating these patients to the appropriate facilities. Many patients had to wait for more than 24 h, in the transport vehicles, in the cold weather without water or food. Unfortunately, at least 21 elderly patients died from hypothermia or dehydration.
      As the situation in the 20–30-km zone around the plant deteriorated, the government instructed on March 15th that residents in this zone should remain indoors. However, there was still great confusion and fear of the effects of radiation, causing vital supplies such as food, water and gasoline as well as medical supplies to not be received in most of the area. The shortage of supplies had severe impacts on the hospitals and care facilities where approximately 1700 patients remained. The local government eventually decided to move all of the patients out of the zone, which was completed by the evening of March 20th
      Initially, a value of 13,000 counts per minute, as measured by a Geiger–Müller counter, was used to indicate the need for evacuee decontamination. However, because of the disrupted water supply, very low temperature, and the need to cope with thousands of evacuees, this was increased to 100,000 counts per minute. At least 13 screening points were established by the night of March 14th, and more than 20,000 people had been screened by the 16th
      Although a radiation emergency medical system had been developed, few had expected the magnitude of the damage to the nuclear power plant. Doctors and health care specialists voluntarily gathered in Fukushima to set up a radiation emergency medical management panel, which coordinated activities. Although these efforts were started with minimum resources, they were at the core of the subsequent medical responses dealing with the most difficult situation in Fukushima.

      Conflict of interest statement

      No conflicts of interest to declare.