On the road in Japan: bringing medical care to the lost and lonely

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Published: 29 April 2011 9:27 CET

By John Sparrow in north-eastern Japan

The man was severely stressed. He was almost at the end of his tether but all he would say was that he felt unwell. He had dizzy spells, he said.

In a school in north-eastern Japan’s Iwate prefecture that now shelters tsunami survivors, a nurse with a Red Cross medical team knew he was holding something back. So she started to chat.

“How are you getting on here?”

“It isn’t easy,” he confessed.

“Why is that?”

He took his time but finally revealed his problem. He was a stoma patient with a colostomy pouch, and here in the crowded evacuation centre, without privacy in the open space, he was losing his battle to manage it.

The poor man had tried; he had even tried not to eat, but in the end had found no solution. So now he trudged home to change the pouch in the ruins of his devastated house. Averse to making his predicament public, he was afraid if he changed it in the centre those around him would notice the smell.

Another day, another case for a mobile medical team from Tokyo’s Omori Red Cross hospital, and a crisis for the man is reduced to the routine it should have been in the first place. But when your home is destroyed, your loved ones missing, when your livelihood is gone, when the community in which you have spent your life is trashed by a wave in just minutes, you may have little left but your dignity. You must not, at any cost, lose your self respect.

The seven-person team – two doctors, three nurses, a driver and an administrator – figure that into the way they work, making themselves approachable, showing empathy, being good listeners. Head nurse Sayoko Tojo comments, “Many people are suffering from stress. They may shut out the world and when someone says something to them they say nothing back. You get the impression they are afraid and we must be alert to their problems.”

The Omori team is one of hundreds mobilized from Japanese Red Cross Society hospitals around the country. Besides running clinics in the larger evacuation centres, they are reaching out, visiting smaller and more remote areas, and providing the public with medical care where it has otherwise ceased, particularly to the lonely and house-bound elderly.

Beyond any doubt, state health services have been so disrupted they have broken down in places, and the challenges facing the Red Cross teams are as great outside the evacuation centres as they are within them. People in need are not only those directly affected by March’s earthquake and tsunami.

Dr Yasuo Fujita, Director of the Emergency and Critical Care Centre at Akita’s Red Cross hospital, puts it more strongly than that. Having organized response in some of the worst-hit corners of Iwate, he says, “The people with the biggest problems are in their own homes, cut off from care because it isn’t round the corner any more. You need a car to reach the nearest hospital. It’s why our mobile teams are so needed.”

A 91-year-old man the Omori team has found in a mountainous region behind the port town of Kamaishi, is a case in point. Dependent on his 80-year-old wife, and unable to walk unaided, he had been cared for by a visiting nurse who also supplied his medicine. He hasn’t seen her since the tsunami. It might have occurred a long way away but the giant wave has had impact even in mountain communities.

Near the devastated town of Otshuchi, the team makes a scheduled call on a community centre now sheltering tsunami survivors. A Red Cross unit stops here every second day and local residents turn up as well because this is their only surgery.

The patients are mostly elderly, some are bent and frail, and their complaints for the most part are routine. There are coughs and colds, allergies, a case or two of hay fever, a diabetic and some disturbingly high blood pressure. Common drugs, it appears, have been in short supply since local doctors went missing.

A woman is shown into the busy room where Dr Yoichiro Tanaka has found a space between some packing cases. She’s in her eighties and has problems with her back.

“When did you last see a doctor?” he asks.

“Oh…well…I had an appointment with a doctor the day of the tsunami. I was supposed to go to the hospital.”

The doctor looks up, and waits for her to continue.

“Well,” she says, “the tsunami destroyed the place.”