Malnutrition rife in quake zone
KESENNUMA, Miyagi—Due to deteriorating hygiene caused by power blackouts, suspension of the water supply and poor nutrition from food distributed at evacuation centers, protecting disaster victims’ health has become a serious issue in areas devastated by the Great East Japan Earthquake.
“Let me check the bedsores on your back,” said Hiroka Wakimoto, a doctor from a Kyoto hospital, who was making a house call to treat a 67-year-old bedridden stroke victim in Kesennuma, Miyagi Prefecture, on Saturday afternoon.
After talking to the patient, Wakimoto washed her bedsores with tap water and applied topical cream.
An electrically powered air mat that would have prevented bedsores was not functioning due to a power blackout at her house that went on for two weeks. A family member said the telephone was disconnected and it was impossible to consult a hospital during that time.
In light of the extraordinary circumstances that also saw many local physicians suffer effects of the disaster, doctors from across the country who belong to the Japan Primary Care Association, including Wakimoto, have visited devastated areas on a rotational basis. Currently, seven doctors have continued to make professional visits to households with elderly patients.
According to Kentaro Hayashi, a doctor who plays a coordinating role in the association, many elderly people complain about their poor health condition because they cannot go to the hospital to see their regular doctors. Some have experienced a worsening of chronic diseases such as high blood pressure and complain of insomnia, he said.
Due to suspension of the water supply, some neglected to brush their teeth or clean their false teeth, which caused oral bacteria to grow unchecked. Some elderly people are suffering from aspiration pneumonia caused by their poor ability to swallow.
Hayashi said, “It’s necessary to continue long-term support [for these patients] until local doctors can resume normal treatment.”
Poor nutrition is also a serious problem. According to a survey by a nonprofit organization and other entities, targeting shelters in 230 locations in Miyagi Prefecture from April 11 to 17, 55 percent of the surveyed shelters supplemented basic rations of rice or bread with vegetable, fish or meat dishes on average once a day or less. The survey said 12.5 percent of the shelters distributed no such dishes.
Yachiyo Sakamoto, deputy manager of the clinical nutrition department at Okayama University Hospital, pointed out that many people’s consumption of vitamins, minerals and protein has been insufficient. “I think it’s necessary to utilize supplements to make up for the loss of nutrients,” she said.
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Caution to prevent infection
According to Jichi Medical University Prof. Kazuomi Kario, an expert on cardiovascular internal medicine, if people do not get enough sleep due to mental stress or other reasons, they risk the onset of high blood pressure.
Dehydration invites stroke and cardiac infarction because it thickens the blood.
People also must be cautious about infections such as influenza and infectious gastroenteritis. Experts point out that inhaling bacteria and chemical substances from dried sludge scattered in the air when people remove rubble and clean damaged houses can cause pneumonia.
Masaru Yanai, chief doctor of the respiratory medicine department at Ishinomaki Red Cross Hospital, advises people to avoid places with a lot of dust and to wear a mask while working.
Besides physical aspects, damage to mental health needs to be addressed. Kozo Ueda, director of Kobe-Kyodo Hospital, said evacuees suffered much stress because of the lack of privacy at shelters and aftershocks. “It’s indispensable to create a proper environment for evacuees to let off steam by complaining naturally among themselves while doing cooperative activities like cooking meals and other things,” he said.
Masanori Tonegawa / Yomiuri Shimbun Staff Writer, Apr. 26, 2011
* http://www.yomiuri.co.jp/dy/national/T110425003912.htm