Analysis of Necessary Support in the 2011 Great East Japan Earthquake Disaster Area
Abstract
:1. Introduction
2. Materials and Methods
2.1. Setting and Participants
2.2. Data Analysis
2.3. Ethical Considerations
3. Results
3.1. The Main Category: “Goods”
3.2. The Main Category: “Establishing a System in Advance of a Large-Scale Disaster”
3.3. The Main Category: “Information”
3.4. The Main Category: “Human Resources”
3.5. The Main Category: “Others”
4. Discussion
4.1. The Main Category: “Goods”
4.2. The Main Category: “Establishing a System in Advance of a Large-Scale Disaster”
4.3. The Main Category: “Information”
4.4. The Main Category: “Human Resources”
4.5. Limitations
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristics | n | (%) | |
---|---|---|---|
Sex | |||
Male | 6 | (1.8) | |
Female | 298 | (89.8) | |
Unknown | 28 | (8.4) | |
Age | |||
20–29 years | 43 | (13.0) | |
30–39 years | 90 | (27.1) | |
40–49 years | 86 | (25.9) | |
50–59 years | 81 | (24.4) | |
60–69 years | 26 | (7.8) | |
70–79 years | 3 | (0.9) | |
Unknown | 3 | (0.9) | |
Occupation category | |||
Welfare facility | 102 | (30.7) | |
Hospital | 94 | (28.3) | |
Government | 44 | (13.3) | |
School | 25 | (7.5) | |
Education/Research | 15 | (4.5) | |
Community activities | 15 | (4.5) | |
Feeding facility | 6 | (1.8) | |
Other dietitian positions | 9 | (2.7) | |
Other occupations | 6 | (1.8) | |
No work | 14 | (4.2) | |
Unknown | 2 | (0.6) | |
Damage of workplace | |||
None | 99 | (29.8) | |
Partially damaged | 181 | (54.5) | |
Completely destroyed | 9 | (2.7) | |
Unknown | 43 | (13.0) |
Category (Number of Codes) | Subcategory (Number of Codes) | Number of Codes and Specific Code Examples (Per Each Prefecture) | ||
---|---|---|---|---|
Iwate Prefecture | Miyagi Prefecture | Fukushima Prefecture | ||
Food (65) | Food (25) | 6 codes -Dietary support for living rather than nutritional counseling was important in the situation without food. -Preparing stockpile food for staff. | 12 codes -Food did not reach us until day 7, and I was at a loss. -Ingredients of rice ball | 7 codes -Food shortages occurred in disaster areas and areas where survivors were accepted. -There was a limit to the number of ingredients I could buy. |
Vegetables (10) | 1 code -Vegetables | 4 codes -Vegetables | 5 codes -Bread was provided as a relief supply, but survivors were not very pleased. Vegetables were few, and volunteers brought them. | |
Food to supplement nutrients (5) (e.g., dietary supplements) | 3 codes -The dietary supplement arrival was late. -Something to supplement nutrition-deficient nutrients such as vitamins. | 1 code -Even if relief supplies arrived, it was only bread or noodles. Micronutrients were not supplied. | 1 code -There were a lot of rice balls and bread at emergency shelters. Many survivors seemed to be constipated. | |
Protein source (5) | – | 1 code -Protein source | 4 codes -Perishable foods (protein sources such as fish and meat) -Retort food to be protein sources -Milk | |
Rice/Bread (4) | 2 codes -Rice/Bread | – | 2 codes -Rice -Bread | |
Mass feeding for survivors (4) | – | 2 codes -A high frequency of mass feeding for survivors was better than supplying the supplement. -Support for “Hot meal mass feeding for survivors” | 2 codes -Mass feeding for survivors (this differs among respective emergency shelters) | |
Cookless food (4) | 2 codes -PET bottle of Japanese tea | 1 code -Ready-to-eat food | 1 code -Cookless food | |
Canned food (2) | 2 codes -Canned food | – | – | |
Seasoning (2) | 1 code -Salt, soy sauce, miso, and sugar | – | 1 code -Spices such as ginger, garlic, or green onion | |
Luxury food (2) | 1 code -Luxury food such as coffee | – | 1 code -Something to drink (milk, Yakult, or others) | |
Retort pouch food (1) | 1 code -Retort pouch food | – | – | |
Food with long storage period (1) | – | 1 code -Food with long storage period | – | |
Gasoline (59) | Gasoline (40) | 14 codes -It was inconvenient because the gasoline shortage continued and I could not use my car. | 9 codes -Gasoline | 17 codes -There was a shortage of gasoline in the disaster areas and the areas that accepted survivors. -Gasoline was the most necessary because it was an area where I could not move around without a car. |
Gasoline for commuting (9) | 2 codes -There were times when I could not go to work because gasoline was running short. | 1 code -Gasoline for commuting | 6 codes -Because of a gasoline shortage, it was difficult to secure our staff. I desired an oil tank. | |
Gasoline for manufacturers to transport goods (6) | 5 codes -I did not receive deliveries due to a gasoline shortage. -The stoppage of distribution due to a gasoline shortage caused confusion of information. | – | 1 code -Because of a gasoline shortage, there were approximately three companies that were unable to deliver. | |
Gasoline to go shopping/to go pick up goods(4) | – | 2 codes -Even if there were relief supplies, I had no way to go there (gasoline). -In order to go pick up foods or relief supplies, it would be helpful if arrangement to get gasoline was a priority. | 2 codes -Gasoline to go shopping | |
Special diet(45) | Food for a person having difficulty in chewing/swallowing (15) | 7 codes -It was difficult to deal with forms of food other than regular meals (soft, mixed, or minced) because the machine could not be used due to blackout. -Rice porridge | 4 codes -High-calorie meals in a facility for the elderly | 4 codes -Food for persons with difficulty swallowing (because there was a shortage, we provided less quantity). -We alternated shifting from concentrated liquid diets to medicine. |
Concentrated liquid diet (14) | 7 codes -Enteral nutrition (concentrated liquid diet) was in short supply about 1 month after the earthquake, but there was no support for it. -Distribution of concentrated liquid diet was reduced, so it was not certain when and how many would be delivered. | 4 codes -Jelly for hydration in a facility for the elderly | 3 codes -Concentrated liquid diet | |
Fortified food (7) | 2 codes -Fortified food | 2 codes -Fortified food | 3 codes -Fortified food | |
Food for infants (4) | 4 codes - Milk powder -Infant food in the early phase after the disaster -Water for infant in the early phase after the disaster | – | – | |
Hypoallergenic food (3) | – | 1 code -My 1-year-old daughter has an egg allergy, so I was at a loss for her diet. I was afraid to eat the meal to be distributed and was avoiding it. | 2 codes -Initially, we could not be deal with survivors with meal problems (e.g., food allergy). | |
Food for patients (2) | – | 1 code -Low-salt diet | 1 code -There were few supplies that could be provided as fortified food to people with kidney disease, heart disease, liver disease, and diabetes. | |
Water (39) | Water/Water truck (30) | 8 codes -Procurement of water was difficult. A water truck came on day 4. Still, staff went to draw water from the purification plant. | 8 codes -Permanent water truck -I got in the line for the water truck because I had little water stocked. But I had a hard time carrying 2 L of water per person. | 14 codes -We had to secure water ourselves and did not receive water supply assistance. -To procure water, facility staff had to leave to procure water several times a day. |
Drinking water/Water for the meal (4) | – | 2 codes -Drinking water -Water for the meal | 2 codes -Drinking water or oral rehydration solution such as OS-1 (Dehydration did not occur because it was in winter, but it would have been serious if it was in summer.) | |
Cleaning water (2) | – | 2 codes -Cleaning water except for drinking water -It was difficult to secure water, so it was a challenge to wash dishes and cooking tools. | – | |
Water for toilet (2) | – | – | 2 codes -A limit was set to water in the toilet. Considering sanitation, we needed water support. | |
Water for bath (1) | – | – | 1 code -I could not take a bath because water was not coming out at my house. | |
Sanitation (18) | Disposable tableware and cling film (14) | 2 codes -Disposable tableware, cling film and polyethylene bags | 10 codes -I prepared disposable tableware, but it was an issue because disposable dishes were running out quickly due to water failure. | 2 codes -Disposable tableware/cling wrap |
Hygiene (2) | 1 code -Hygiene | 1 code -Hygiene | – | |
Portable toilet/Diapers (2) | 1 code - Diapers | 1 code -Portable toilet | – | |
Weatherization (17) | Kerosene (7) | 6 codes -Kerosene (Because it was cold.) | – | 1 code -Kerosene |
Blanket/Bedding/Clothes (4) | 1 code -Blanket | 3 codes -Bedding (Especially a mattress. I slept directly on the floor, and I thought that my back would hurt and it would cause bedsores.) -Clothes | – | |
Heat source (3) | – | 3 codes -Heat source | – | |
Heater (2) | 1 code -Heater (1) | – | 1 code -Heater and fuel for emergency | |
Stove (1) | – | 1 code -Kerosene stove | – | |
Cooking environment (16) | Gas (7) | 1 code -Gas cylinder for heating | 5 codes -Measures to secure heating source (especially necessary for cooking) | 1 code -Support of gas |
Gas stove (5) | 2 codes -Gas stove | 1 code -I wanted a gas stove that can use propane gas because the heat source was insufficient. | 2 codes -I wanted a cooking stove because I was not able to use gas. | |
Cooking equipment/Cooking tool (4) | – | 1 code -Cooking tool | 3 codes -Cooking equipment -Refrigerator | |
Electricity (16) | Electricity/Electric power (11) | 4 codes -Because home appliances are all-electric, I could not cook, wash, and disinfect during a blackout. So, I was concerned about food poisoning. | 6 codes -Even if information is obtained on the Internet, printing is impossible (electricity, paper, and machine). -Electric power for using cooking tools | 1 code -Electricity/Electric power |
Battery (3) | 1 code -Generator (including battery worked by hand) | 2 codes -Battery | – | |
Lighting (1) | – | 1 code -Lighting | – | |
Candle (1) | 1 code -Lighting (candle) | – | – | |
Supplies (9) | Supplies from the government (5) | – | – | 5 codes -Supplies from the government |
Supplies (4) | – | 2 codes -Supplies | 2 codes -I desired much support from Western Japan. | |
Goods shortage due to the nuclear accident (9) | Food shortage due to the nuclear accident (3) | – | – | 3 codes -Because of a rumor, it was awkward that I could not have food delivered (concentrated liquid diet) in Fukushima. |
Supply shortage due to the nuclear accident (3) | – | 1 code -Because our facility was 20~30 km from the nuclear power plant, supplies were not distributed. | 2 codes -Supply shortage due to the nuclear accident | |
Safe water due to radioactive contamination (2) | – | – | 2 codes -As water was contaminated with radioactivity, water became increasingly precious. Water was needed for dialysis as well as for cooking. | |
Gasoline shortage due to the nuclear accident (1) | – | – | 1 code -Gasoline shortage due to the nuclear accident | |
Others (4) | Daily commodities/Concerning housing (2) | 1 code -Daily commodities/Concerning housing | 1 code -Earthquake resisting device is necessary. | – |
Communication equipment that can be used even in emergency (1) | – | – | 1 code -Communication equipment that can be used even in emergency | |
Money (1) | – | – | 1 code -Money to buy what I need for cooking other than relief supplies. |
Category (Number of Codes) | Subcategory (Number of Codes) | Number of Codes and Specific Code Examples (Per Each Prefecture) | ||
---|---|---|---|---|
Iwate Prefecture | Miyagi Prefecture | Fukushima Prefecture | ||
A system and preparation for distributing relief supplies (36) | A system for distributing relief supplies in a fair and appropriate quantity and timing (34) | 4 codes -A system for distributing relief supplies in a fair and appropriate quantity and timing | 14 codes -Even if we were able to harvest vegetables, etc., we could not open the market and could not adjust our distribution. | 16 codes -My desired goods could not be obtained as I expected (there were few vegetables, and there were many processed foods that were not versatile foods). |
Stockpile (2) | 1 code -Stockpile | 1 code -Stockpile | – | |
Creating a system for cooperation and communication in a disaster (28) | Creating a system for cooperation and communication in a disaster (28) | 5 codes -Creating a system for cooperation and communication in a disaster | 8 codes -It is necessary to cooperate daily and to train so that information can be utilized at all times. | 15 codes -Creating a system for cooperation and communication in a disaster |
Countermeasures for vulnerable people (14) | Appropriate response to vulnerable people (8) | 2 codes -Even though it required energy, everyone was fair and personal responses were few. | 4 codes -Nursing stations or nursing room (in emergency shelters) -Correspondence of people who are eating a lot of processed foods. | 2 codes -A system to support survivors unable to raise their voices. |
A system for delivering special diet to people who need it (6) | – | 4 codes -People with food allergies (especially wheat) returned to their homes early because they could not eat from stockpiles. | 2 codes -Only food for general use was distributed. I wanted them to consider that there are infants, children, mildly sick people, and elderly people in emergency shelters. | |
Cooperation among dietitians/Support for activities (14) | A system for cooperation among dietitians (8) | 3 codes -I wanted continued support for 1 week at least. | 3 codes -A system for cooperation among dietitians | 2 codes -Information tool for communication among neighbor dietitians |
Activity contents/place as a dietitian (6) | 2 codes -It is necessary for dietitians to create a system that is positioned similarly to other occupations. | 3 codes -Support to serve as a dietitian. We cannot act arbitrarily in the government (dietitian’s work is not described in the disaster prevention plan, manual, etc.). | 1 code -I was disappointed that there was no contact from the JDA even after 1 month (other professional associations provided support information including volunteers every day). | |
Preparation for provision of meals in emergency shelters (10) | Cooking environment in emergency shelter without lifeline (5) | 1 code -Cooking environment in emergency shelter without lifeline | 3 codes -It was necessary for dietitians to make rounds in each emergency shelter to advise about sanitation and taking turns cooking. | 1 code -Cooking environment in emergency shelter without lifeline |
Menu suggestions for meals in emergency shelters without a gas and/or water supply (5) | 1 code -Menu suggestions for meals in emergency shelters without a gas and/or water supply | 3 codes -Menu suggestions for meals in emergency shelters without a gas and/or water supply | 1 code -Menu suggestions for meals in emergency shelters without a gas and/or water supply | |
Rapid recovery of lifeline (9) | Rapid recovery of lifeline (9) | – | 6 codes -Lifeline recovery was slow, and it was hard to cook. | 3 codes -I think that there was not enough water, and its recovery was a little late. |
The JDA should establish a system in advance (6) | The JDA should establish a system in advance (6) | 1 code -Even as the JDA, we need a position to assist cooking, etc., immediately. | 3 codes -Skill to prepare for independent management day to day. Training to be quick-witted. -It would be helpful if the JDA could coordinate food provision. -Booklet that can be kept at hand. | 2 codes -The JDA should build a network that can promptly share information (e.g., add e-mail address at the time of member registration). -Even as part of the JDA, it was necessary to go around directly to the hospitals or to listen to their comments from the site. |
Support for survivors who evacuate at home(4) | Create a support system for survivors who evacuate at home (4) | 1 code -It was difficult to extend relief supplies to survivors who evacuated to their own homes. | 1 code –Correspondence to survivors who evacuated at home | 2 codes -There was no nutrition assistance for survivors with sick who evacuated at their homes. -It was better to have support in the form of public relations about how to eat because people had mostly carbohydrate-rich meals at home. |
Rapid assistance from the government (2) | Rapid assistance from the government (2) | 1 code -Rapid assistance from the local government | – | 1 code -Rapid assistance from the government |
Category (Number of Codes) | Subcategory (Number of Codes) | Number of Codes and Specific Code Examples (Per Each Prefecture) | ||
---|---|---|---|---|
Iwate Prefecture | Miyagi Prefecture | Fukushima Prefecture | ||
Information for living in a disaster area (60) | Information (30) | 8 codes -Information (I spent about 3 days without knowing anything because the newspaper did not come due to the blackout.) | 18 codes -I was worried that information on the damage situation would not come. -Almost no information obtained. I should have checked where and what information I could obtain. | 4 codes -Support to make up for lack of information |
Details of support contents received (8) | 2 codes -Details of support contents received | 2 codes -Details of support contents received | 4 codes -It was very difficult to obtain foodstuffs from our outsourcing company. I wanted information as to where I could find special diet that was available. | |
Information on the neighborhood (8) | 1 code -Information on the neighborhood | 2 codes -I wanted to join the support if I could get information. -I could not understand the situation of disaster. The reason is that I was unable to move around because the surrounding area was covered with water due to the tsunami. I wanted information. | 5 codes -Information on the neighborhood. Opening hours of gas stations and stores. Information on the water station (I got the upper limit per person after arriving). -Information on other areas because I was unable to think about the situation of other areas. | |
Accurate information (7) | 2 codes -Accurate information | – | 5 codes -Accurate information | |
Information from the government (5) | – | 1 code -Information from the government | 4 codes -I wanted a clear response that the government is unable to assist us. I could get no response from the government, even though they asked us about our troubles and needs because the facility side just said that and the government side just listened. | |
Recovery information on lifeline (2) | – | – | 2 codes -Recovery information on lifeline | |
Accurate information on the safety of radioactivity (8) | Information on the effects of radioactivity on food and drinks and the action to be taken (6) | – | – | 6 codes -Accurate information on the safety of radioactivity (some people asked for advice about the following: They inquired with the national counseling desk but the answers varied according to each organization). -After becoming aware of the nuclear accident, I was very anxious that it was not good to eat the stored root vegetables. I was dependent on only instant foods for a while because the store was closed. |
Accurate information on the nuclear accident (2) | – | – | 2 codes -Accurate information on the nuclear accident | |
Telecommunications/Contact/Means of traffic (5) | Telecommunications/Contact/Means of traffic (5) | 2 codes -Telecommunications/Contact/Means of traffic | 3 codes -Communication system with other facilities | – |
Category (Number of Codes) | Subcategory (Number of Codes) | Number of Codes and Specific Code Examples (Per Each Prefecture) | ||
---|---|---|---|---|
Iwate Prefecture | Miyagi Prefecture | Fukushima Prefecture | ||
Manpower (20) | Manpower (14) | 1 code -I wanted a support person for paperwork. | 7 codes -In the case of the government, it is extremely difficult to maintain management of emergency shelters concurrently. I wanted physical support for emergency shelters from an early phase. | 6 codes -Manpower carrying water with polyethylene tanks -Elderly people’s hands were very full. Many people injured their lower backs due to carrying water. |
Human resources for mass feeding/cooking (3) | 3 codes -Human resources for mass feeding/cooking | – | – | |
Human resources for mental support (2) | 2 codes -Human resources for mental support | – | – | |
Human resources to distribute the relief supplies (1) | – | 1 code -Human resources to distribute the relief supplies | – | |
Dietitian/Registered dietitian (12) | Rapid dispatch of dietitian/registered dietitian (12) | 3 codes -Dietitian staffing is needed for the relief supply center. | 4 codes -It was late to start officially dispatching dietitians. | 5 codes -Member who can participate at all times (weekdays) |
People with disaster assistance skills (6) | People with disaster assistance skills (6) | 1 code -A place to respond to when we are in trouble. | 4 codes -People who brainstorm together regarding how to assist the survivors | 1 code -I think that it will be necessary to have competent support with coordinating support activities while identifying priority issues with the local government. |
Recruitment of human resources as a result of the shortage due to the nuclear accident (6) | Recruitment of human resources as a result of the shortage due to the nuclear accident (6) | – | 1 code -I was not able to express that I wanted support to come because it was close to the Fukushima Daiichi nuclear disaster area. | 5 codes -Because of Fukushima prefecture, the support was mainly goods. It was not a troubling thing, but I wanted the support of personnel more. The staff was also evacuated, so there was a human resource shortage. |
Category (Number of Codes) | Subcategory (Number of Codes) | Number of Codes and Specific Code Examples (Per Each Prefecture) | ||
---|---|---|---|---|
Iwate Prefecture | Miyagi Prefecture | Fukushima Prefecture | ||
Nothing special (25) | Nothing special (25) | 10 codes -It never crossed my mind to demand someone in particular. -It did not cause a major inconvenience for residents of the facility (in Morioka City). -Mass feeding offered to survivors by the local government were helpful. | 7 codes -I cannot recall because time has passed. -My family managed to get everything done somehow by ourselves. | 8 codes -Because I was provided with enough support, it was a great help to me. -The foods were all right, thanks to the efforts of suppliers. -Support was not particularly necessary because no great damage occurred. |
Others (5) | Others (5) | – | 3 codes -I was not able to be active because I was busy with housework and work and missing my family. -It helped us to prepare various things, thanks to the seminar by the Miyagi dietetic association before the earthquake. -This earthquake made me deeply understand that diet can save a life. | 2 codes -It was a priority to provide our meals because our hospital was completely destroyed. |
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Harada, M.; Ishikawa-Takata, K.; Tsuboyama-Kasaoka, N. Analysis of Necessary Support in the 2011 Great East Japan Earthquake Disaster Area. Int. J. Environ. Res. Public Health 2020, 17, 3475. https://doi.org/10.3390/ijerph17103475
Harada M, Ishikawa-Takata K, Tsuboyama-Kasaoka N. Analysis of Necessary Support in the 2011 Great East Japan Earthquake Disaster Area. International Journal of Environmental Research and Public Health. 2020; 17(10):3475. https://doi.org/10.3390/ijerph17103475
Chicago/Turabian StyleHarada, Moeka, Kazuko Ishikawa-Takata, and Nobuyo Tsuboyama-Kasaoka. 2020. "Analysis of Necessary Support in the 2011 Great East Japan Earthquake Disaster Area" International Journal of Environmental Research and Public Health 17, no. 10: 3475. https://doi.org/10.3390/ijerph17103475