On March 11^th 2011 an earthquake of a magnitude of 9.0 hit the East of Japan. The earthquake did considerable damage but what followed did much more damage. A tsunami inundated about 560 sq km and resulted in a human death toll of over 19,000. Over 1 million building were destroyed or partly collapsed.

Eleven reactors at four different nuclear plants were operating at the time of the quake, all of them shut down when it hit. Subsequent inspection showed no significant damage to any of the reactors from the quake. The reactors were not affected by the quake it self but were vulnerable to the tsunami. There was power from the backup generators that were running the residual heat removal system cooling pumps at eight of the eleven units. The remaining 3 at Fukushima lost power when the site was flooded by the tsunami. The flood disabled 12 of 13 backup generators on site and also the heat exchangers for dumping reactor waste heat and decay heat into the sea. The 3 units were unable to maintain proper cooling methods and water circulation functions. The electrical switchgear was too disabled. Many weeks were spent trying to remove and restore the heat removal from the reactors. Radioactive material was released into the ocean and the air because of deliberate venting to reduce gas pressure, deliberate discharge of coolant water into the sea, and uncontrolled events. The emission into the sea is the most important individual emission of artificial radioactivity into the sea ever observed. Fukushima has some of the strongest currents causing dispersion to the Pacific Ocean.

Many inter-governmental agencies responded to the disaster; International Atomic Energy Agency, World Meteorological Organization, Comprehensive Nuclear Test Ban Treaty Organization. Most were concerned about the radiation exposure and populations around the world had lost faith in the use of nuclear power. Many countries have opted out of using nuclear power. International experts have said that workforce of thousands will take decades to clean the area.

The precise cost of the abandoned cities, towns, agricultural lands, businesses, homes and property located within 310 sq. miles have not been established. Estimates of the total economic loss range from $250-$500 billion dollars. 159, 128 people had been evacuated from the zones lost their homes and all their positions. Many of the people have not been compensated and some are still paying mortgage on homes that will never again be habitable.

There have not been any reports of people with radiation exposure because it is still early. However, when radioactive chemicals are released they are not only released in the air but in the water systems, and soil which will affect the population for years to come. Those who were closer to the incident are more likely to develop leukemia, thyroid cancer and breast cancer. There are barriers to accessing healthcare because the effects of radiation can take years to develop. It would be most beneficial to screen patients for early detection of cancers because of the exposure. This is an ongoing problem because there are the zones that are still affected by the radiation as stated above, the soil and water systems are contaminated. I could not imagine being a healthcare provider in such a huge disaster. Fukushima started as an earthquake where residents needed help with ruined homes and then for the tsunami to wreck more homes and kill more of the population and lastly constant radiation exposure in some areas. It was like 3 major disasters all within hours. I am unsure if in the future we are more prepared for a nuclear disaster. It has happened before Fukushima and I think unfortunately it is all about trial and error and having the proper policies and procedures in place.

References

Association, W. N. (2015). Fukushima Accident . Retrieved from World Nuclear Association : http://www.world-nuclear.org/info/safety-and-security/safety-of-plants/fukushima-accident/

Responsibility, P. f. (2015). Costs and Consequences of the Fukushima Disaster . Retrieved from Environmental Health Policy : http://www.psr.org/environment-and-health/environmental-health-policy-institute/responses/costs-and-consequences-of-fukushima.html

    Just over two years ago, on April 15, 2013, two pressure cooker bombs exploded near the finish line of the Boston Marathon, killing 3 people and injuring an estimated 264 others. Although unexpected, the time and location of the event was favorable in regards to healthcare response. For one, hospitals were already on standby for marathon runners and numerous medical professionals (doctors, nurses and emergency medical staff) were onsite at the marathon to address the needs of the marathon runners. Secondly, the 1449 EST explosion happened to also be the time of the mid-shift staffing change at surrounding hospitals, nearly doubling the number of medical staff on site.  However, the chaos surrounding the disaster made challenges inevitable.
    One of the major barriers that the trauma hospitals faced was treating unidentified victims. Within minutes of the April 15th bombing, nearby hospitals were inundated with unconscious victims without purses, wallets or family members to identify them. At Brigham Hospital, staff assigned unidentified victims six-digit numbers. However, this system created confusion for the doctors and nurses who continuously had to double and triple check that the test results and medications were going to the right patient. The chaos surrounding the unidentified victims was only exacerbated when frantic and upset family members swarmed hospitals searching for their loved ones. As a result, Brigham Hospital
now identifies anonymous patients using states, colors or the military alphabet.
    One of the most interesting facts that emerged from this disaster in regards to healthcare was the influence of social media. According to a report by The Boston Globe (2013), the hospital staff was alerted to the bombings when a physician at the scene sent a tweet. A fellow colleague and anesthesiologist was alerted of the tweet immediately notified the chief of emergency medicine and the chief of surgery, who promptly responded by canceling elective surgeries, clearing ER rooms and calling in staff members. Thus, social media is now understood to possibly be the most effective early warning system, especially in trauma as every minute counts in preparing trauma teams and operating rooms.
    Social media has not only become a means to communicate and relate information, but it has evolved to be an essential multipurpose tool for various industries. However, in medicine, social media could make the difference between life and death.

Reference

Kowalczyk, L. (2013, July). The Boston Globe. Retrieved April 26, 2015, from http://bostonglobe.com/lifestyle/health-wellness/2013/07/27/boston

I recall the images that came across my television after the 2010 Haitian earthquake. The country was yet again devastated after another natural disaster. This time it was a magnitude 7.0 earthquake and approximately 54 subsequent aftershocks that would bring an already dysfunctional country to its knees. The quake affected 3 million people and killed approximately 220, 000. To understand how the earthquake affected the county and its people it’s important to understand Haiti’s history. The country which has a long standing history of natural disasters, corruption and a nonexistent infrastructure magnifies any disaster many times over. The beginning of the fall of Haiti’s infrastructure began when Haiti became independent from France. In order to become its own republic the country took out loans from US, German, and French banks to pay the French reparation from 1825-1947. After this came a time of governmental corruption whereby tens of thousands of Haitians were beaten and tortured until 1986 when those in power exiled from the country with an estimated $900 million.

Since then the country has dealt with poverty, overcrowding and deforestation. The country in 1950 had a population of 3 million people and today that figure stands at nearly 9 million people. This coupled with the fact that Haiti is now 98% deforested as its impoverish people have cut down the forest to cook with. This deforestation which makes the makes the soil unstable makes the country incredibly vulnerable to any assault by Mother Nature.

When the earthquake hit it destroyed 70% of buildings in the country’s capital city Port-au-Prince due in large part to unregulated construction standards. Sixty percent of the health care system was destroyed in an instant. In addition, 10% of Haiti’s medical staff were either killed or subsequently left the country. It was a catastrophic event. Medical aid came from around the world and one agency that is still there to date is Doctors Without Borders (DWB).  DWB has been in the country for the last 24 years aiding to fill pre-existing health care gaps due to the poor health care system. After the earthquake they set up temporary shelters and set up inflatable hospitals.

Today there is still a large need for medical aid and funding. While a great deal of donation money has gone directly to building hospitals in Haiti, quite a few still stand empty because of inadequate planning to ensure properly trained staff, sufficient drugs, maintenance, and medical supplies. It seems that a country with money without infrastructure is no better off than it was before. While I am well aware that the US health care system is not without its faults, it makes me appreciative of the layers of infrastructure that surround it in order to check and balance varying agencies along the way. It has been personal mission of mine to provide medical aid in Haiti and I hope to do so in the very near future as a Registered Nurse.

Henley, J. (2010, January 14). Haiti: A log descent to hell. The Guardian.