2015 Volume 16 Issue 1 Pages 48-52
The medical service continuously offered in a remote tsunami disaster-stricken area has been revalued. After the 2011 tsunami disaster destroyed the sole community hospital in Yamada town, emergency patients had to be transported to the distant center hospital. The logistics of such transport had been extremely challenging. Amongst 4,749 cases of the emergency ambulance dispatched in the past six years, 131 cases were treated by cardiopulmonary resuscitation under control of the regional first-aid station. Whereas 66 out of 77 cases (86%) were received by the community hospital nearby and three patients survived before the disaster (survival rate, 4%), in the post-tsunami emergency transport, 46 out of 54 cases (85%) were transferred to the center hospital located 25 km away from the town but no patient survived. Because 81% of the first-aid cases treated by cardiopulmonary resuscitation were the elderly over 70 years old, the need for home emergency service for the bedridden elderly grew in the town. In contrast to the facility-based medical service, the door-to-door medical delivery service could be supplied from the early stage of the disaster, and the numbers of the elderly who received the home visits by a doctor and nurses increased by 1.5 fold after the disaster in the town. The average annual mortality rate of the elderly who received the home visits was 34%, and the palliative care for dying individuals at home was in need. As a result of the continuous visit service after the disaster, 85% of these infirm with age are currently able to stay at home in the town at the end of their lives. Community hospital staffs are encouraged to participate in the management of health care and it is necessary to correspond to the transformation of society which we are now facing.
