On August 11, 2009 an earthquake occurred with its epicentre at Suruga Bay, with a maximum intensity 6- ,recording a magnitude of 6.5, and a temporary tsunami warning was also issued. By understanding the problems that were clearly brought to our attention from this earthquake with an epicentre in Suruga Bay, in the Tokai District where the occurrence of Tokai Earthquake is being apprehended, we hope to cope with the situation and devise a countermeasure for the Tokai Earthquake. Furthermore, the regions subject to this report has experienced municipal merger, and the problems at the time of disaster has also come to surface in light of this effect. This report is from the viewpoint of both community medicine and disaster medicine.

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Background. Based on the response following a maximum intensity, 6-lower, earthquake (Japanese intensity scale) with the epicentre in Sugura Bay on the Japanese eastern seaboard, it was constituted that a different response is necessary for residents and tourists. Therefore, grasping a clear understanding of the existence of communities such as areas with second homes is crucial, and disaster response in such areas requires an approach different from that for disaster response in normal areas (non-tourist districts).
Objectives. To propose improvements in response to the anticipated earthquake, the so-called Tokai Earthquake, on the Japanese eastern seaboard based on verification of an administrative government′s response in terms of medical treatment, etc. in a tourist district (resort area) during the August 2009 earthquake.
Method. An interview survey was conducted with 1 staff member of the disaster management office of a major tourist district (resort area) in the Tokai district.
Results. Future issues included ‘confirming damage, providing instructions to day-trippers and ensuring evacuation in second home areas is difficult’ and ‘confirmation in areas where the presence of permanent residents is unknown, such as second home areas, is difficult’. Converse statements included, ‘communication with the prefecture was trouble-free, and the public wireless transmission system and hotline functioned’.

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Background. e will understand the overall aspects of countermeasures to be undertaken for disasters that may occur on a greater scale by studying the countermeasures for the earthquake with epicentre in Suruga Bay (which occurred in August 2009 with the seismic intensity scale of slightly less than 6) undertaken by the prefectural municipalities, anticipating a Tokai earthquake. We will then make the most of this understanding as a guideline to solve issues in our disaster prevention measures and to establish constructive countermeasures for the Tokai earthquake.
Objectives. We will inspect the government′s countermeasures, including medical care, for the aforementioned earthquake that occurred in August 2009. Based on the result of this inspection, we will propose countermeasures for the so-called Tokai earthquake. From our standpoint as a prefecture, we will understand the challenges found in the above earthquake and set goals for the future.
Method. We interviewed a staff member of the Disaster Prevention Department of Prefecture d.
Results. The following opinions were obtained: ‘Although this previous earthquake was not on an extremely large scale, if a Tokai earthquake occurred at the exact time of the occurrence of this previous earthquake, public medical institutions, except for those for emergency, could face shortages of medical care providers including physicians’. ‘Prefecture d provides the aid for making houses earthquake-proof, and we are working hard at its dissemination’. ‘Because medical experts, including medical care providers, may become victims themselves in the areas affected by the earthquake, it does not hurt to establish a system in which nationally organised medical experts can come from other areas of Japan to provide support.’
Conclusion. There are 37 municipalities in Prefecture d (as of July 2010). As with other urban and rural prefectures, each municipality in Prefecture d has its own unique community background and differences in medical resources. Expecting an enormous disaster caused by the so-called Tokai earthquake, staff members in Prefecture d are especially striving to share information among the relevant organisations in order to fulfil a variety of needs (such as medical care) of each municipality. They are also examining the necessity of developing experts specialised in disaster medical care.

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The eruption of Mount Unzen-Fugendake in Nagasaki Prefecture, which occurred about 10 years ago, and its ensuing volcanic activity, which then lasted approximately for five and half years, left X city with large human and physical damages, and 44 fatalities (including three missing persons). The author believes that this eruption can be a good reference case for us to particularly study measures against frequently occurring natural disasters such as volcanic eruptions, earthquakes, storms, and floods in Japan as well as around the world, so that we may study how primary healthcare and medical service providers, namely the local administration and medical society, responded at that time and how the experience has been reflected in the local community. With such a conviction in mind, we visited the local municipality and directly conducted a hearing survey with the administrative officers (mainly those who experienced the disaster back then). The survey principally consisted of the following question items: (1) the status of healthcare and medical activities at the evacuation shelters and temporary housing at the time of the eruption; (2) the activities of public health nurses; (3) the measures taken after the disaster (e.g., disaster prevention programs and request for relief supplies; and (4) the ideal state of the medical personnel or medical system demanded by the local community.

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