Credit NHK News – Fukushima evacuation zone March 2011
# 8316
We are approaching the third anniversary of the Great East Japan Earthquake and Tsunami of 2011, and despite massive recovery operations, living conditions remain difficult for many in the hardest hit prefectures. As we’ve seen before with other major disasters, the emotional and physical challenges during the recovery phase can often equal or even exceed those experienced during the actual event.
Adding to the already enormous stress levels from this disaster are the almost daily reports of radiation readings in and around the damaged Fukushima power plant, and concerns over the safety of food, water, and even the air they breathe. Concerns that are likely to persist for years to come.
Today it is being widely reported that the number of post-tsunami deaths due to stress and displacement have exceeded – at least in one prefecture – those experienced during the initial earthquake and tsunami. This from the Japan Times:
Fukushima stress deaths top 3/11 toll
Uncertainties amid nuclear crisis acutely felt by elderly
Kyodo
Feb 20, 2014
FUKUSHIMA – Stress and other illnesses related to the 2011 quake and tsunami had killed 1,656 people in Fukushima Prefecture as of Wednesday, outnumbering the 1,607 whose deaths were directly tied to disaster-caused injuries, according to data compiled by the prefecture and local police.
A prefectural official said many people “have undergone drastic changes in their lives and are still unable to map out their future plans, such as homecoming, causing increased stress on them.”
Around 136,000 people are still displaced in the prefecture, which has had to cope with the devastating effects of the natural disasters and meltdowns at the Fukushima No. 1 nuclear station.
According to this report, roughly 90% of those killed by indirect causes were 66 years of age or older. A little over a year ago, in Disaster’s Hidden Toll, we looked at the long-term, largely unseen, effect on nursing home patients who were forced to evacuate to temporary facilities.
A study showed a 2.4 fold increase in deaths during the 8 months following the earthquake. Deaths not caused by the quake, tsunami, or radiation release itself – but likely brought on by the stress of having to live in make-shift emergency shelters.
A unusually large number of these excess deaths were due to pneumonia or bronchitis, which many attribute to insufficient emergency shelters provided for the elderly and frail.
We’ve looked at other post-disaster health impacts in the past, such as in Post Disaster Stress & Suicide Rates. One disaster discussed was a 1999 7.3 earthquake that struck in Chi-Chi, Nantou county in central Taiwan killing more than 2,300 people.
A study that subsequently appeared in the Taiwan Journal of Medicine (Disease-specific Mortality Associated with Earthquake in Taiwan Hsien-Wen Kuo, Shu-Jen Wu, Ming-Chu Chiu) found `a considerable increase in the number of suicides after the earthquake’.
PTSD (Post Traumatic Stress Disorder) can often occur in the wake of a disaster or traumatic experience. Symptoms may include anxiety, depression, suicide and PTSD may even lead to drug and alcohol-related disorders.
Victims of personal violence, rescue and medical workers, victims of disasters, terrorism, physical or psychological trauma, and/or a combat zone are all at risk of suffering some level of PTSD.
I’ve written about post-disaster psychological first aid (PFA) several times in the past, including in Post Disaster Stress & Suicide Rates, PTSD Awareness Day, and Promising Practices: Psychological First Aid. Last August the World Health Organization released a comprehensive Guidelines For Post-Trauma Mental Health Care book on the treatment of PTSD, acute stress, and bereavement:
Publication details
Number of pages: 273
Publication date: 2013
Languages: English
ISBN: 978 92 4 150540 6Downloads
Overview
These WHO mhGAP guidelines were developed to provide recommended management strategies for conditions specifically related to stress, including symptoms of acute stress, post-traumatic stress disorder and bereavement.
The guidelines were developed by an independent Guidelines Development Group and inform a new mhGAP module on the Assessment and Management of Conditions Specifically Related to Stress.
While there is much variability in the levels of stress created by different disasters (exacerbated by both the severity and duration), cultural attitudes towards suicide, and in the effectiveness of individual coping skills, there seems little doubt that major disasters can cause both temporary and long-term mental health problems.
The CDC’s website contains a number of resources devoted to coping with disasters.
Coping With a Disaster or Traumatic Event
Trauma and Disaster Mental Health Resources
The effects of a disaster, terrorist attack, or other public health emergency can be long-lasting, and the resulting trauma can reverberate even with those not directly affected by the disaster. This page provides general strategies for promoting mental health and resilience. These strategies were developed by various organizations based on experiences in prior disasters.
And from the National Center For PTSD, you’ll find abundant resources - including videos - on how to provide Psychological First Aid.
Lastly, while the psychological impact of a major disaster cannot be fully prevented, individual, family, and business preparedness can go a long ways towards reducing both the physical and emotional impact of any disaster.
Having a modest supply of food, water, and medicine – and a workable family or business disaster plan – can go a long ways toward reducing both stress and hardship.
Basic Preps: Emergency Weather Radio, First Aid Kit, Battery Lantern, Water storage
Those that follow FEMA’s, and Ready.gov’s advice to Have A Plan, Make A Kit, and Be informed will be better equipped to deal with any eventuality. Which is why I promote basic preparedness at every opportunity in this blog.
A few of my (many) blogs on that subject include:
In An Emergency, Who Has Your Back? When 72 Hours Isn’t Enough When Evacuation Is The Better Part Of Valor NPM13: Pandemic Planning Assumptions
