The Tohoku Journal of Experimental Medicine

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On March 28, 2025, a 7.7-magnitude earthquake struck central Myanmar (GLIDE #EQ-2025-000043-MMR), compounding the country’s existing political instability, economic fragility, and infrastructural weaknesses. Although seismic events have recurred throughout history, limited knowledge exists regarding how working-age adults (18-60), who play a central role in recovery, mobilize personal, cultural, and community resources to cope with adversity and reconstruct their lives. This is a protocol clarification for a remote access qualitative study using semi-structured interviews with 30 purposively sampled participants, half from heavily impacted zones (Sagaing, Mandalay) and half from nearby regions experiencing secondary disruption (Yangon). Using a remote system, interviews will be audio-recorded, transcribed verbatim, and analyzed thematically following Graneheim and Lundman’s approach. This study aims to identify key coping strategies, including social support networks, spiritual practices, and local initiatives of working-age adults in Myanmar, and to compare how exposure severity shapes adaptive responses. Anticipated themes based on existing disaster and resilience literature include community-led resilience, hope through faith, and resource-sharing practices. Findings are expected to offer in-depth, culturally grounded insights that can inform disaster recovery programs, psychosocial support services, and policy frameworks aimed at strengthening resilience in Myanmar and similar low-resource, low-accessibility, crisis-affected settings.

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The doctor shortage is a general healthcare problem on many remote islands, which differ geographically from the mainland. Revealing the factors for recruitment and retention of doctors on remote islands may help develop countermeasures. We systematically investigated the factors related to recruitment and retention of doctors specifically on remote islands. The literature available from PubMed, CENTRAL, and Embase up to May 2024 was reviewed. Eligible studies were original articles with cohort, case-control, cross-sectional, and interventional designs that focused on recruitment and retention of doctors on remote islands. For this study, the “island” was defined as an area and region surrounded by water and separated from the “mainland”. The risk of bias was evaluated using the Newcastle-Ottawa Quality Rating Scale. We identified nine eligible original articles, including six cohort studies and three cross-sectional studies on recruitment and retention of doctors reported in Hawaii, Tasmania, and Maluku. In four studies on recruitment, the identified factors were island background, medical education on islands, and quality of life on islands. In six studies on retention, the identified factors were island background, medical education on islands, quality of life on islands, opportunities for professional training, family-related factors, working conditions, and financial incentives. These findings would be useful for policymakers and healthcare planners to secure doctors on remote islands. Further studies are warranted.

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