* Japanese Red Cross Society
** Japanese Red Cross College of Nursing
JRCS health consultation program for people evacuated from Namie to Iwaki to start.
October 15, 2012
At the request of the municipal government of Namie Town in Fukushima Prefecture, the JRCS will begin to conduct a “Health Consultation Program for People Evacuated from Namie to Iwaki” on October 15, 2012. After the Fukushima Daiichi Nuclear Power Plant accident occurred last year, the municipal government function of Namie was set up in Nihonmatsu, Fukushima Prefecture. However, many people from Namie are now living in Iwaki City and are not receiving enough administrative services. They live in private rental housing in Iwaki rented by the Fukushima Prefectural Government. Especially, those people have very few places to get together, which often isolates them.
For the people from Namie to be provided appropriate public health services and necessary care, it is an urgent task to understand their health conditions in the first place. In this health consultation program, nurses from JRC hospitals and the JRCCN and public health nurses will interview people from Namie living in Iwaki. The scheduled period is one year.
* Japanese Red Cross Society
Health consultation program for people evacuated from Namie to Iwaki starts.
October 15, 2012
At the request of the municipal government of Namie Town in Fukushima Prefecture, the JRCS began to conduct a “Health Consultation Program for People Evacuated from Namie to Iwaki” on October 15, 2012. The JRCS will make a door-to-door visit to about 2,000 survivors from Namie living in Iwaki and interview them. The results will be summarized focusing on the survivors’ health needs. Then they will be provided to the municipal government of Namie.
On the same day, an opening ceremony of the health consultation program office took place. One of the nurses from the Japanese Red Cross Kitami Hospital, a member of the first team, received a set of apparatus including manometer and stethoscope in a bag. The JRCS expects the results to help Namie create a system to maintain and enhance health of the Namie people, to prevent them from isolating themselves and to rebuild their community.
JRCS health consultation program for people evacuated from Namie to Iwaki starts!
Duty period: 2012/10/15 - 2012/11/15
Nurse: Yuki Yatomi, Japanese Red Cross Kitami Hospital
Health Consultation Program for People Evacuated from Namie to Iwaki began on October 15, 2012. Nurses will make door-to-door visits to people from Namie to have a medical interview with the survivors from Namie to assess their health conditions. At the same time, the nurses will provide psychological care and health consultation for the people who are now living in an unfamiliar place to them. Ms. Kikuko Urata, Director General of the Nursing Department of the JRCS, speaks about the program: “We would like to stand by the people from Namie and always listen to them. Also, we hope to make use of the findings to prepare for possible disasters in the future and alleviate their sufferings as much as possible.” Mr. Yuki Yatomi is a nurse from the Japanese Red Cross Kitami Hospital and a member of the first team for the program. He says, “I would like to value relationship with each person from Namie and provide care both physically and psychologically.”
JRCS nurses support anxious survivors.
Duty period: 2012/10/15 - 2012/11/15
Nurse: Yuki Yatomi, Japanese Red Cross Kitami Hospital
Prof. Minako Morita of the JRCCN expects much from the results of the health consultation program, saying, “We can already see a good outcome from the consultations as the survivors are telling us about their sufferings and what support they want to receive.” “Based on the needs revealed by the program results, the JRCS and the municipal government have to collaborate with each other to find out what they can do for the survivors.” Although the program has just started, she is looking further into the future.
Mr. Yatomi says: “The survivors say it feels like they have been staying at someone else’s house. They also tell us about their conflicts with local people. I feel their serious situation. I am always careful not to miss even one word from the survivors to understand their feelings and what they want to convey most to me when they tell their stories.”
Psychological care for people evacuated from Namie: Method to relax introduced.
Instructor: Sumi Takagishi, Vice President of the Japanese Red Cross Wakayama School of Nursing
Sumi Takagishi, Vice President of the Japanese Red Cross Wakayama School of Nursing, introduced a method to relax and reduce stress to the people from Namie as part of the health consultation program. The people from Namie are living dispersedly in Iwaki City. Therefore, it is difficult for those people to get together and it is a concern that this isolates them in many cases. The activity is also designed to serve as an opportunity to reunite them.
The participants practiced a physical contact approach in pairs by touching each other’s shoulders. They seemed to relax physically and psychologically. Some people even said to each other: “Although we experienced hardship and it’s tough to live in an unfamiliar place, let’s live together positively again.”
Are you receiving regular medical check-ups?
Duty period: 2012/11/15 - 2012/11/30
Nurses: Ikuko Takahashi, Japanese Red Cross Akita Hospital
Takako Miura, Japanese Red Cross Ishinomaki Hospital
The nurses recommended walking for some of the survivors from Namie who are concerned about lack of exercise and increase in weight. They also prepared a leaflet for the purpose of health enhancement, which includes questions such as: “Are you receiving regular medical check-ups?” When the nurses joined a “communication salon” where the people from Namie got together for communication, they provided health consultations and blood pressure measurements. They also joined a recreation program.
Ms. Takahashi looks back on her duty period of the program: “The people of Namie accepted our visits. I felt their trust and expectations for the Red Cross.” Ms. Miura says: “I want to apply this experience to my work back at my hospital.”
JRCS nurses who were also affected by the earthquake sympathetically listen to survivors’ stories.
Duty period: 2012/12/03 - 2012/12/14
Nurses: Shizuka Yahagi, Japanese Red Cross Sendai Hospital
Emiko Ichinohe, Hachinohe Red Cross Hospital
Both nurses were also affected by the Great East Japan Earthquake as were the people evacuated from Namie. The two nurses felt sympathy for what those people had to say when they visited them. The health consultations revealed that some survivors were not able to visit hospitals, because they did not know where they could consult about their health problems. Other dilemmas of the people from Namie came to light from the health consultations.
Ms. Yahagi says, “They are still experiencing hardships. I want to tell other people about the reality of Namie, Fukushima.”
For support in a timely manner.
Duty period: 2012/12/13 - 2013/01/17
Nurses: Tadashi Osawa, Japanese Red Cross Maebashi Hospital
Kazunori Keino, Japanese Red Cross Maebashi Hospital
Both nurses visited the people from Namie and also provided health consultations by asking them, “Do you have any problems? We’ll listen to anything that you want to tell us.” The nurses reported about the results at a regular meeting held with the municipal government staff of Namie including public health nurses and persons in charge of support for the survivors. They discussed provision of support in a timely manner to the survivors.
Mr. Keino looks back on his duty period of the program: “When I met a family that I had visited during the health consultation program at other location, I was very glad, and realized how nice it is to have ties with other people.” Mr. Osawa says: “The people are suffering hardships because of the nuclear accident. I take it as a particular problem and want to continue to support the survivors.”
JRCS nurses provide a list of hospitals to encourage survivors from Namie to see a doctor.
Duty period: 2013/01/17 - 2013/02/14
Nurses: Sumiko Takizawa, Nagano Red Cross Hospital
Maki Nishikawa, Japanese Red Cross Nagoya Daiichi Hospital
In Iwaki, Fukushima Prefecture, there are still about 1,000 families that have evacuated from Namie. The JRCS has visited 381 families since the beginning of the program. Before coming to Iwaki the survivors had been relocated for evacuation 4 to 7 times on average. It is obvious that the more locations they had lived in, the more it cost them money-wise. In addition, there are quite a few people who got sick from physical or mental fatigue. The nurses found that many evacuees could not find suitable hospitals in their neighborhood to visit, because they were unfamiliar with the area. Therefore, they prepared a list of hospitals so that they could hand it over to the evacuees quickly when they needed it.
JRCS nurses strongly felt the evacuees’ fear.
Duty period: 2013/02/14 - 2013/03/14
Nurses: Mami Moriyama, Japanese Red Cross Kyoto Daini Hospital
Aki Fujii, Japanese Red Cross Kyoto Daini Hospital
Miyuki Suzuki, Ise Red Cross Hospital
Ms. Moriyama interviewed the evacuees who had fears and concerns but were reluctant to talk to her about those fears because they felt that nothing would be changed due to the evacuation expected to be prolonged. She says that this experience made her willingness to support them become much stronger.
Ms. Fujii says: “I want the nationwide broadcasters to report more on the slow progress of the reconstruction.” Ms. Suzuki say: “I want to continue to be involved in support for the reconstruction by collaborating not only with hospitals but also with the communities.”
Mixed feelings of people from Namie for returning to their home town.
Duty period: 2013/03/13 - 2013/03/28
Nurses: Masako Hirota, Shobara Red Cross Hospital
Taeko Hinokuma, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital
Duty period: 2013/03/27 - 2013/04/11
Nurses: Kazuko Kawamura, Japanese Red Cross Yamaguchi Hospital
Mayumi Yamauchi, Matsuyama Red Cross Hospital
The evacuation area rearranged by the government has been effective since April 1, 2013 for Namie and the entry restriction to Namie has been relaxed in some areas. However, it is expected to take several years at minimum before the town is back to the state where people can live. “I want to return to Namie, but I cannot.” “Maybe I want to live in Iwaki permanently, but I would suffer the burden of double mortgage loans.” “Even if the evacuation orders are lifted, my house in Namie is messy with mouse droppings…” The people from Namie have many fears over their return to Namie.
Importance of ties between people.
Duty period: 2013/04/11 - 2013/04/25
Nurses: Noriko Sawatani, Japanese Red Cross Nagasaki Genbaku Hospital
Mitsuhiro Yoshida, Japanese Red Cross Nagasaki Ganbaku Isahaya Hospital
The survivors from Namie lost their homes and communities due to the nuclear accident. Their rental houses are scattered throughout Iwaki City, which makes it difficult for them to communicate with each other. A sense of isolation or mental damage also affects them physically.
Ms. Sawatani says: Their current situation made me feel strongly that people need community.” Mr. Yoshida looks back on his duty period during which he tried to make bonds between the people, saying: “I felt this issue is not only about Namie but needs to be considered in a broader context.”
Continued support is necessary.
Duty period: 2013/04/25 - 2013/05/13
Nurses: Kaoru Wakabayashi, Oita Red Cross Hospital
Mizumi Matsumoto, Japanese Red Cross Kumamoto Hospital
More than two years have passed since the people of Namie evacuated their town that was damaged by a complicated disaster of the earthquake, the tsunami and the nuclear accident. Both nurses look back on their duty period and say: “Apparently they are returning to normal life, but quite a few people are still concerned about their future lives or suffer mental trauma from what they experienced at the time of the earthquake. The health consultation program will continue from June 2013. Long-term support for them in terms of health consultation and psychosocial care will be much more needed.”
JRCS starts “salon” activities for people from Namie to communicate with each other.
Duty period: 2013/07/01 - 2013/07/13
Nurses: Ai Kinoshita, Japanese Red Cross Wakayama Medical Center
Tomomi Tomiie, Takamatsu Red Cross Hospital
In July 2013, the JRCS started a “salon” program in Iwaki City, which is their new activity. The people from Namie feel isolated because they lost both homes and communities. They have also been forced to evacuate and live a hard life for a long period of time. The JRCS hopes to make the salon a place where the people can relax. Ms. Kinoshita tried to introduce this salon program to them when she made door-to-door visits for health consultation. Ms. Tomiie says: “We have to focus more on psychological care for them.”
Relaying the results for continued support to people from Namie.
Duty period: 2013/07/11 - 2013/07/23
Nurses: Michiko Hashimoto, Japanese Red Cross Mito Hospital
Kaoru Harada, Takatsuki Red Cross Hospital
The program is aimed at not only checking the health condition of the people from Namie, but also relaying the results for continued support on their health. The program tries to understand the health and living conditions of the people and provide support for mental health as well by listening attentively to the people. During the door-to-door visits, JRCS nurses encounter the people from Namie who were forced evacuate from their town by the earthquake, the tsunami and the nuclear accident, consequently facing various problems.
Ms. Hashimoto says: “They trusted us and talked about their personal matters, because the visits were made by the Red Cross staff.” Ms. Harada looks back on her activities, saying: “When I listened to each of the people, I tried to pay attention to what kind of support they needed. Then I relayed the information with a public health nurse from Namie so that the survivors could continue to receive support.”
Exercise to combat physical inactivity and chat at salon activities.
Duty period: 2013/07/23 - 2013/08/06
Nurses: Takako Kamimura, Nagaoka Red Cross Hospital
Toshie Uematsu, Japanese Red Cross Otsu Hospital
For health enhancement and communication promotion of the people from Namie, the “salon” program was started by the JRCS in the summer. Both nurses also joined one of the salon activities during their duty period. The participants did an exercise using a ball aimed at compensating for lack of exercise and releasing mental stress. They also enjoyed chatting and had a pleasant time.
When Ms. Uematsu made the door-to-door visits, she always encouraged the survivors to join the “salon” activities, hoping that the program would help them to recreate their community and compensate for lack of exercise. Ms. Kamimura looks back on her two-week duty period, saying that a long-term assistance for them is necessary.
”Tanabata” festival strengthens a tie with people in Iwaki.
Duty period: 2013/08/04 - 2013/08/17
Nurses: Tomoko Suzue, Tokushima Red Cross Hospital
Norie Nakayasu, Japanese Red Cross Takayama Hospital
Some people from Namie feel an intense stress because they are not allowed to return to Namie Town even if they want to. Some people are reluctant to go out due to loss of motivation in life, and they lack exercise.
During their duty period, a “tanabata” festival or a Japanese traditional star festival was held in Iwaki City. Some volunteers of the Namie people joined the festival and cooked “Namie fried noodle”, a specialty food of Namie Town. Both nurses helped them cooking at the stall.
Communication events such as this festival help the people from Namie and local people to strengthen their ties and also give opportunities for relaxing to the elderly evacuees who lost their motivation in life and often stay at home.
We want to continue to closely watch the elderly survivors’ health condition.
Duty period: 2013/08/15 - 2013/08/29
Nurses: Hinako Shimbo, Fukui Red Cross Hospital
Takeshi Murai, Japanese Red Cross Hadano Hospital
Many elderly evacuees from Namie told the nurses that they felt their lower bodies weakening due to lack of physical activity. Ms. Shimbo says: “They are going through hard life and suffering physical and mental damage as well. So, I am particularly concerned about the health conditions of the elderly people.”
Some survivors told Mr. Murai that they cannot think about anything at the moment due to the prolonged evacuation. Mr. Murai says in response to their concern: “We may be able to relieve them by showing that we care about them. We need to provide a long-term support for them.”
A system able to watch health condition in the long term.
Duty period: 2013/08/27 - 2013/09/10
Nurses: Miyuki Nishiyama, Japanese Red Cross Tottori Hospital
Yo Torioka, Japanese Red Cross Fukuoka Hospital
Some elderly evacuees were often withdrawn and felt isolated, because they have had no transportation means available to participate in various events. Some women rearing children told the nurses about their fear if they could get along with people in their new communities through their children.
Many evacuees from Namie Town feel isolated or anxious because they have difficulties in building a new relationship with their current community people. It is concerned that this may cause stress. The nurses felt the need to have a system to continue to observe the people from Namie.
Listening to survivors leads to “psychological care.”
Duty period: 2013/09/08 - 2013/09/21
Nurse: Akemi Morisawa, Japanese Red Cross Kochi Hospital
Ms. Morisawa says: “Listening to the evacuees in a sympathetic manner leads to trusting relationship and also psychological care for them. That is what I realized during my duty period.” The consultation results highlighted various health problems among the evacuees against the backdrop of the prolonged evacuation and their changed living environment. Therefore, Ms. Morisawa encouraged them to participate in the JRCS’s salon program which the JRCS started in the summer and is aimed at enhancing health and promoting their communication. The JRCS’s salon is providing various activities to relieve their lack of exercise and stress.
JRCS nurse renews her recognition on importance of a health consultation program.
Duty period: 2013/09/19 - 2013/10/01
Nurse: Miki Moritani, Japanese Red Cross Asahikawa Hospital
The JRCS health consultation results revealed that the public health nurses of Namie Town supporting the evacuees often traveled between Nihonmatsu City in the inland area where the temporary municipal town office of Namie and temporary housing are located and Iwaki City on the Pacific coastal area, and the long travel distance and hours were a heavy burden on the public health nurses.
Ms. Moritani says: “The evacuees are living dispersedly in Iwaki City. In such a case, there is a limit in support only from the local public health program. The JRCS health consultation program is important as a mid- and long-term support.”
JRCS Public Health Room for Namie opens.
Duty period: 2013/10/01 - 2013/10/25
Nurse: Satoko Nakajima, Japanese Red Cross Kyoto Daiichi Hospital
At the beginning of the second year of the program, the JRCS opened a “JRCS Public Health Room for Namie”, a new activity base office, on October 9, 2013. Consultations for reducing stress and health salon activities take place in this room.
Ms. Nakajima says: “I hope the JRCS Public Health Room will be a place where the evacuees can talk about anything comfortably or will be their community base to revive the bond among the people from Namie.”
Gap starts to be seen among the Namie people.
Duty period: 2013/10/01 - 2013/11/01
Nurse: Tomoe Sagami, Fukui Red Cross Hospital
It has been two years and seven months since the earthquake and the nuclear accident. There is a big difference in lives and the thoughts among the people from Namie. Some people had new houses and started new lives. On the other hand, there are quite a few people who are still forced to live in private housing rented by the Fukushima Prefectural Government. There are many people who feel isolated and anxious due to loss of their communities.
Ms. Sagami says: “The situations vary. That is why it is important to always stand by the people from Namie by thinking about more detailed support. I realized during my duty period that it is necessary to continue the health consultations.”
Health salon activities for future support.
Duty period: 2013/10/28 - 2013/11/22
Nurse: Kaede Yamane, Japanese Red Cross Okayama Hospital
More than half of the families Ms. Yamane visited were the ones that other nurses had visited previously. Many of the families appeared to have been looking forward to the JRCS’s revisit. They all talked about themselves cheerfully, but Ms. Yamane felt during the consultations that the evacuees were living with various fears.
The JRCS’s health salon activity was joined by only a small number of participants. However, as a result of inviting the evacuees to the activity at the door-to-door visits and communication events, more people now join the activities. Ms. Yamane says: “We want the Namie people to take the salon activities as opportunities to communicate with each other. At the same time, we hope the activities will help us provide more support for them.”
People of Namie welcome the first health consultation revisit in one year.
Duty period: 2013/11/05 - 2013/11/29
Nurse: Emiko Takayama, Japanese Red Cross Kama Hospital
Most of the families Ms. Takayama visited this time were the ones that other JRCS nurses visited previous time. Many of the people remembered their previous consultation very well and welcomed the second round of the consultation.
Ms. Takayama says: “It is important to continue to provide psychological care and advice about their health for the people from Namie. In terms of that, the activities by the JRCS Public Health Room for Namie are becoming more important. The program made me think about various things in a different way from the relief activities during the earthquake disaster. I will continue to convey the current situation of the people from Namie living in Iwaki.”
“One-two-punch Exercise” for braving the chill.
Duty period: 2013/11/25 - 2013/12/20
Nurses: Sumi Onodera, Saitama Red Cross Hospital
Yoko Fujita, Japanese Red Cross Medical Center
On December 12, the JRCS Public Health Room for Namie provided a health salon activity for people from Namie. The participants did an exercise called “One-two-punch Exercise” which was created for the participants to move their body with a song “March of 365 Steps”, a famous Japanese song with lyrics including “one-two, one-two!”, and “one-two-punch”.
Ms. Fujita says: “I expect talks at activities like this to deepen conversations among the people.” Ms. Onodera says: “One of the participants asked if she can come to the salon activities with her friends who are Iwaki citizens. I hoped the salon activities will help to build a new relationship between the Namie and Iwaki people by inviting Iwaki citizens to the activities.”
Salon activities triggered communication between Namie and Iwaki people.
Duty period: 2014/01/06 - 2014/01/31
Nurse: Asami Toyoshima, Japanese Red Cross Musashino Hospital
The JRCS Public Health Room for Namie provides salon activities for people from Namie who rarely go out in order to provide opportunities for them to interact with one another. The salon activity for this year started with a class of “shakyo”, a style of Japanese calligraphy. The participants were told by an instructor to write their aspirations for the year in one word. They wrote their aspirations freely.
An exercise called “Yuru exercise” was also instructed. This exercise is designed so that even the elderly can do it easily. A handcraft class was also provided. The instructor was one of the staff members of the JRCS Public Health Room for Namie.
The salon activities were provided for the people from Namie, but are provided also for Iwaki citizens starting this year. The people from Namie invite their friends that live in Iwaki City, and the activities are now joined by more participants from Iwaki.
We want to support as many people as possible.
Duty period: 2014/01/06 - 2014/02/07
Nurse: Akiko Okata, Japanese Red Cross Suwa Hospital
Even if a door-to-door visit is not possible with some people from Namie, asking about their health/living conditions by telephone can lead to health assistance. Many evacuees still need psychological care. Ms. Okata’s impression from her duty period is that it is important to continue to build a trusting relationship with them by listening to them tenaciously in order to help as many people as possible in terms of their health.
During her duty period, she was told unexpectedly by one of the survivors, “The existence of the JRCS encourages me at the moment.” Ms. Okata renews her aspirations to help people from Namie, saying: “I was really glad when I was told so. That encouraged me to do much more for the people from Namie.”
Listening to people is also an important support.
Duty period: 2014/02/03 - 2014/02/28
Nurse: Chiharu Ikeuchi, Japanese Red Cross Nagoya Daini Hospital
As part of the health consultation program, JRCS nurses re-visit Namie people and listen to how they are doing now. During the second interview, many people talked about what they did not reveal in the previous health consultation interview. The trusting relationship built by the JRCS nurses and staff over time may help the people from Namie to talk about what they had not revealed to the nurses last time. The presence of the “JRCS Public Health Room for Namie” may also be getting recognized among the people from Namie.
Ms. Ikeuchi says: “I have learned that just listening to them can lead to some assistance. I have also realized the importance of the mid- and long-term support activities.”
Nurses’ listening to people from Namie has a significant meaning.
Duty period: 2014/02/10 - 2014/03/07
Nurse: Yuka Tsumori, Matsue Red Cross Hospital
Ms. Tsumori says: “The door-to-door visits allow us to learn firsthand how the people are living their lives and to give them advice both in terms of physical and psychological aspects. On the contrary, I found it a bit difficult when interviewing by telephone, because I had to decide whether they needed any support or not from the people’s voices and how they spoke.” During the health consultations, the people from Namie talked about various things. Some of them even revealed things to her that they could not talk to other people about.
Ms. Tsumori looks back on her duty period, saying: “I suppose they talked about something sensitive because we are the Red Cross nurses. Through the health consultation program, I felt there is a significant meaning in our making door-to-door visits to the people evacuated from Namie or listening to their sufferings over the phone. The experience in the health consultation program made me realize again that mid- and long-term psychological care matters so much.”
Door-to-door visiting resumes for a second time.
Duty period: 2014/05/12 - 2014/06/06
Shohei Nishida, Oita Red Cross Hospital
Mr. Nishida provided health consultations for the families from Namie who received the consultation previously. As three years have passed since the earthquake and tsunami, he felt that the people who evacuated from Namie were gradually regaining their calm. Many people in younger generations built a new relationship in their new communities in Iwaki City. However, there are some elderly people who are not able to get familiar with their new environment and stay at home all the day. Such people are the exact population that the JRCS Public Health Room for Namie is targeting for its salon activities, but some elderly people have no transportation access to get there.
Mr. Nishida says: “It feels like some evacuees who are living far away from their families are isolating. I worry about them very much. The family existence is very important.”
I want to let other people know the hardship of being unable to return home suffered by the Namie people.
Duty period: 2014/06/09 - 2014/07/04
Nurse: Kazumi Kawano, Japanese Red Cross Fukuoka Hospital
Ms. Kawano says: “I met the people for the first time, but they talked to me without being distrustful of me. I realized this was because the JRCS has been involved in this health consultation program over a long period of time and the PR activities have been allowing the results of the program to be recognized little by little among the people from Namie.”
The visit program made her think again about the hardships of loss of homes and being unable to return to their own homes. Ms. Kawano says: “It may be difficult for people living in other areas to understand the suffering of the people affected by the earthquake and tsunami. Back in Fukuoka, I want to tell other people that the evacuation lives of the people from Namie are not over yet.”
We built a new house in Iwaki, but still want to return to our hometown.
Duty period: 2014/07/07 - 2014/08/08
Nurse: Tomomi Ogasawara, Hachinohe Red Cross Hospital
Many of the people from Namie purchased new houses in Iwaki City. However, Ms. Ogasawara heard many of them saying: “We keep thinking about the house we left in Namie and sometimes go back there to clean the house,” or “we want to return to Namie if it becomes possible.”
Ms. Ogasawara says: “We visit the homes of the people evacuated from Namie to Iwaki City to try to support them in terms of mental health as much as possible. However, there are other evacuees from Namie living outside of Iwaki City who are not provided with this kind of visit program and have difficulties in receiving support. I feel very sorry about that.”
Listening leads to psychological care.
Duty period: 2014/08/18 - 2014/09/11
Nurse: Ritsuko Takashiba, Japanese Red Cross Narita Hospital
At the end of a health consultation visit or a telephone consultation, Ms. Takashiba was told by some people from Namie: “Thank you for listening to my complaints.” “Talking a lot has refreshed me.” She says from this experience that she feels the JRCS activities contribute to psychological care for the people.
Some people told her that they abandoned returning to Namie Town for living there because they witnessed their wrecked homes when they temporarily went back to their houses for a temporary re-entry program.
Ms. Takashiba looks back on their complicated situations and says: “They usually look cheerful, but many of them told me that they sometimes cannot sleep at night when thinking about unforeseeable future.”
Life began to stabilize but people feel lonely.
Duty period: 2014/08/18 - 2014/11/14
Nurses: Tadashi Osawa, Japanese Red Cross Maebashi Hospital
Mayumi Mizobe, Japanese Red Cross Osaka Hospital
This is a second duty period of the health consultation program for Mr. Osawa. He looks back on his duty and says: “In my previous duty period, I strongly felt the anger that the evacuees had. However, in this period, I felt they are positive about their current situation and lives. Many of them found new jobs and their lives are getting stabilized.”
Ms. Mizobe says: “Their lives in Iwaki City are getting stabilized, but it is quite difficult for them to cope with their loneliness. To have someone to talk to is very important for them.”
“Listening” is still required.
Duty period: 2014/09/16 - 2014/10/10
Nurse: Mieko Tezuka, Nasu Red Cross Hospital
A husband and wife that Ms. Tezuka visited during her duty period managed their health conditions appropriately and lived their lives by enjoying their hobbies. They were cooperative with the JRCS health consultation program. Ms. Tezuka says that they were eagerly telling her about themselves and that was very impressive to her.
On the other hand, an evacuee who was worried about telephone frauds told Ms. Tezuka: “I can’t talk with you because I’m told not to talk with strangers.” However, the conversation over the phone continued for about 30 minutes more. Ms. Tezuka says: “This example shows ‘listening’ is still required by the people as part of the JRCS health consultation program.”
Giving advice for infectious disease control by utilizing qualifications as a certified nurse.
Duty period: 2014/11/17 - 2014/12/19
Nurse: Yuki Matsui, Kushiro Red Cross Hospital
Most of the evacuees who suffer from life-style related diseases such as diabetes and hypertension see a doctor regularly, and Ms. Matsui found no one who needed to be intensively followed or paid attention to.
In Iwaki City, the influenza was going around. Ms. Matsui, a certified nurse in infection control, says: “We see these infectious diseases being developed particularly in winter, and maybe I was able to work on the program by utilizing my qualifications as a certified nurse in the infection control area.” She prepared a leaflet to raise awareness about influenza and norovirus and hand it over to the people from Namie in order to encourage them to take precaution against those infectious diseases when she made door-to-door visits.
Survivors make efforts to live positively each day.
Duty period: 2015/01/05 - 2015/03/27
Nurse: Kazunori Keino, Japanese Red Cross Maebashi Hospital
This was the second duty period of the health consultation program for Mr. Keino. It seemed to Mr. Keino that the people’s lives became calm over time when compared to the previous period. During the door-to-door visits, he saw much fewer elderly people who looked depressed.
However, although the evacuees looked cheerful, their mental scars from the earthquake and tsunami were not healed. Mr. Keino says: “The people from Namie make various choices and decisions each day in order not to lose their current lives here in Iwaki with their family members. I suppose that they make efforts every day to try to make things better, step by step.”
Observing people by taking advantage of expertise.
Duty period: 2015/02/02 - 2015/02/27
Nurse: Manabu Kido, Yokohama City Minato Red Cross Hospital
Soon after the Great East Japan Earthquake and Tsunami, Mr. Kido visited evacuation centers in Rikuzentakada City, Iwate Prefecture and provided mobile psychological care for the affected people. Since he was inspired by the experience at that time, he studied psychiatric consultation-liaison nursing and was qualified as a liaison nurse.
Compared to the situation right after the earthquake and tsunami, he felt the people from Namie are currently living under more complicated circumstances than shortly after the earthquake. As part of the health consultation program, he visited a family with a person who had been hospitalized on and off since being evacuated to Iwaki City. Mr. Kido says: “My expertise as liaison nurse worked well for providing care for this person.”
Helping survivors to live positively.
Duty period: 2015/04/06 - 2015/04/24
Nurses: Makoto Hattori, Japanese Red Cross Narita Hospital
Kazumi Nishimura, Saitama Red Cross Hospital
The health consultation program entered the third year. When the nurses made a phone call to the people from Namie for a visit appointment, saying, “Hello, This is JRCS Public Health Room for Namie,” they quickly recognized the purpose of the phone call and this allowed the nurses to provide a smooth health consultation.
Mr. Hattori says: “In response to our questions at a door-to-door visit or over the phone, many evacuees told us, ‘I have no problem.’ or ‘I am fine.’ This suggests that they are trying to overcome their difficulties and live positively by having their new living basis here.”
Ms. Nishimura says: “I told each of them at the health consultation, ‘The JRCS and Japanese people never forget about you.’ Hopefully this message will encourage them to be positive or keep going.”
Helping people of Namie to be more positive with door-to-door visits.
Duty period: 2015/05/11 - 2015/06/05
Nurses: Hiroshi Naomoto, a chief nurse, Japanese Red Cross Osaka Hospital
Tomoko Katsura, Tokushima Red Cross Hospital
At the health consultations, the people of Namie looked back on themselves over the period since the onset of the earthquake and tsunami to their present situation and told Mr. Naomoto about their experiences, feelings and choices that they have made until now. He says: “The people from Namie were able to look at themselves objectively and affirm themselves by talking to me. I think it was good and listening to them may have helped them to be more positive.”
Ms. Katsura says: “They have to stay far away from their homes now. In Namie, they lived in a house with a large garden or vegetable fields and many of them were three-generation families. Younger generations left Fukushima and only elderly husband-wife families stay in Iwaki in many cases. The disaster changed their lives significantly. It is still a long way to go for recovery.”
JRCS nurses learn how people of Namie really feel through door-to-door visits.
Duty period: 2015/06/08 - 2015/07/03
Nurses: Yuka Sato, a head nurse, Japanese Red Cross Akita Hospital
Yoko Doi, Japanese Red Cross Sendai Hospital
Ms. Sato says: “The involvement in the health consultation program allowed me to know how the people of Namie really feel, which has not been reported by the media. The health consultations by JRCS nurses and public health nurses, who are professional personnel, help the people from Namie to pour out their feelings that they would otherwise keep to themselves. I think that can reduce their stress and prevent physical symptoms caused by mental sufferings from worsening.”
An evacuee told that she finally felt the current house which was purchased in Iwaki City was her “home.” A male evacuee who lost his mother-in-law by the tsunami said that he survived the tsunami and had been long blaming himself, but he was finally forgiving himself four years after the earthquake and tsunami. Ms. Doi emphasizes: “It takes a long time for them to relieve psychological distress caused by the earthquake and the nuclear accident. My involvement in the health consultation program made me recognize it once again.”
Importance of supporting and listening to the survivors.
Duty period: 2015/07/06 - 2015/08/07
Nurse: Tomoko Kono, a chief nurse, Japanese Red Cross Kyoto Daiichi Hospital
Ms. Kono is also an instructor for JRCS psychosocial care program and knows well the importance of listening to people. She tried to encourage the people from Namie who talked about their experience on the day of the disaster with tears in their eyes, saying, “There are a lot of people across Japan who care about you, the people of Namie.”
She looks back on the health consultation activities and says: “If I had not come to the affected area and listened to the evacuees, I could not have understood the reality that they are facing. Working on the program convinced me that one of the JRCS roles is to convey to the wider public what happened at the time of the earthquake and tsunami as well as the perspective of the evacuees from Namie.”
Talking has changed their lives.
Duty period: 2015/08/17 - 2015/09/18
Nurse: Hiroko Kurokawa, Japanese Red Cross Medical Center
Ms. Kurokawa talked to a mother-in-law and a daughter-in-law of a family, separately. The next day, the mother-in-law went out to buy vegetable seeds and went to a hospital by herself on foot, although she often stayed at home and did not look good until the interview day. Her life and behaviors changed.
Looking back on this story, Ms. Kurokawa says: “I believe we can help the people of Namie to make a step forward by standing with them and listening carefully to them.”
Door-to-door health consultation visits help the survivors to organize and clear their thoughts.
Duty period: 2015/10/05 - 2015/10/30
Nurses: Chieko Ikeda, Japanese Red Cross Nagasaki Genbaku Isahaya Hospital
Asami Yamada, Shimizu Red Cross Hospital
The JRCS health consultation program entered the fourth year in October 2015. Ms. Ikeda says: “I think that visits by JRCS nurses allow the evacuees to freely speak their minds. I felt just listening to their stories and feelings can help them to organize their feelings and thoughts.”
Ms. Yamada says: “Before I came here, I imagined they were having a normal and positive life because it has been already four years since the disaster occurred. However, as I carefully listened to them, I learned that there are many people who still have nightmares, blame themselves and have inner thoughts that they cannot tell even their family members.”
Cherish and nurture the protected lives.
Duty period: 2015/10/26 - 2015/11/27
Nurse: Akiko Nakamura, Japanese Red Cross Karatsu Hospital
A mother told Ms. Nakamura that she was determined to cherish her sons whose lives were protected right after the earthquake and at an evacuation center. Assistance from the JRCS and other organizations enabled her family to lead a life at an evacuation center. The mother also told that she will nurture her children, who will create the future, by always remembering her feeling of gratitude for protecting her sons.
Ms. Nakamura says: “During my duty period, I sometimes listened to the people’s hard experience and hardship, but I’m really glad to have heard the young mother’s determination for the future.”
JRCS program helped an evacuee to receive a regular advice for health by a public health nurse.
Duty period: 2015/11/24 - 2015/12/25
Nurse: Haruka Yamada, Japanese Red Cross Suwa Hospital
When Ms. Yamada visited a woman who had been receiving long-term medical treatment for a chronic disease, she learned that the results from her recent laboratory test were not so good, because she had developed an allergy from drug side effects and the drug administration was discontinued. The woman wanted to receive a dietary therapy and do exercises. Then Ms. Yamada contacted a public health nurse of Namie Town and this led to a regular advice on her diet and exercise.
Ms. Yamada looks back on this effort and result, saying: “I visited the people of Namie door to door and observed their physical conditions while talking to them. This enabled me to take appropriate action for this woman with a chronic illness.”
Persistent dreadful memory and hope for tomorrow.
Duty period: 2016/01/04 - 2016/01/29
Nurses: Keiko Takahashi, Nagaoka Red Cross Hospital
Miki Umemoto, Takatsuki Red Cross Hospital
A woman told Ms. Takahashi: “I witnessed the tsunami. Worse yet, two of her child’s friends were washed away by the tsunami. One is missing and the other child died. As March 11 is coming around, I am nervous and feel most nervous when I am home alone.” Ms. Takahashi says: “During the health consultations, I understood well that the feelings of the people from Namie are still far away from being calm.”
Ms. Umemoto cites a story told by a woman that she spent a lot of time to make a difficult decision on whether to live with her daughter or not after the earthquake. Ms. Umemoto says: “The earthquake and tsunami have been forced the people of Namie to make difficult decisions about whether they live with their families or live alone, depending on their situations. I want the public across the country to know about that.”
An evacuee finally responded with a smile as a nurse attentively listened to him.
Duty period: 2016/01/25 - 2016/02/26
Nurse: Sachiko Wada, Fukui Red Cross Hospital
Ms. Wada says: “A man I visited for health consultation did not respond to me first, appearing to be reluctant to accept my presence. However, I continued to talk to him until he finally responded. He began telling me that he was physically and mentally exhausted from frequently seeing a doctor at hospital and that his sleepless nights troubled him. He also said that he wanted to return to Namie, but thought it might be impossible.”
“He would not accept me first, but as I listened to him attentively, he began to open his mind and his dubious look finally changed to a smiling one. It was a wonderful encounter.”
Different feelings and thoughts among the evacuees five years after the earthquake and tsunami.
Duty period: 2016/02/22 - 2016/03/25
Nurse: Mizumi Matsumoto, Japanese Red Cross Kumamoto Hospital
Five years after the Great East Japan Earthquake and Tsunami, this was a second duty period for Ms. Matsumoto. Some of people from Namie purchased a house and completely settled in Iwaki City, because their houses in Namie Town are located in the area designated as a “difficult-to-return area”, although they want to return. On the other hand, there are some people who do not give up their hope to return to the town one day. During her duty period, Ms. Matsumoto learned that there are different feelings and thoughts among the evacuees.
When JRCS nurses visit the evacuees, each of them reveals their hard experience at the time of the earthquake and tsunami and what troubles them now and then says to the nurses, “Thank you for coming today and listening to me. I would be happy if you come again.” Ms. Matsumoto says: “I recognized again during this period the importance of listening to each evacuee and continued assistance.”
People from Namie are getting settled in.
Duty period: 2016/06/06 - 2016/07/08
Nurse: Nanae Ishikawa, Shimizu Red Cross Hospital
The JRCS health consultation program for people from Namie Town is in its fourth year. When asked if they had a plan to go back to live in Namie Town, many evacuees answered that they already had new houses in Iwaki City and were getting settled in the city. That impressed Ms. Ishikawa.
In March of next year the evacuation order is expected to be lifted for some areas of Namie, but many evacuees said that it would be difficult for them to return to Namie. However, even though it is a small number, some evacuees hope to return, saying that they want to spend the rest of their lives there.
At salon activities organized by the JRCS Public Health Room for Namie, Ms. Ishikawa learned that mothers from Namie were worried about their kids because they say that their kids might be bullied at school if their hometown is revealed. When she visited the elderly evacuees, they told her that as they are old and much less energized, they have no energy to leave their current rental house and buy a new house. They also said to her that they have no energy for doing any activities.
Ms. Ishikawa looks back on her duty period and says: “During my activities, I really recognized the importance of focusing on preventing elderly people from receiving nursing care.”
Hoping to return to Namie and the difficult reality involved in it.
Duty period: 2016/07/04 - 2016/08/05
Nurse: Kumiko Shiga, Japanese Red Cross Mito Hospital
The JRCS health consultation program is now in the fourth round and Ms. Shiga expected that all of the people she was going to visit would also be receiving the consultation program for the fourth time. However, that was not necessarily the case. Quite a few evacuees moved to Iwaki City this year. One of them lived in another prefecture for four years after the earthquake and just recently moved to Iwaki.
Younger people can communicate with people in their community through their children, but elderly people have only a few opportunities to talk to their neighbors. Many of them just walk around their neighborhood and stay at home for the rest of a day.
During Ms. Shiga’s duty period, she visited two families per day almost every day for a health consultation. Since some evacuees talked for about two hours, she thought that two was a justified number to allow her to listen to them fully. Ms. Shiga was able to spend enough time listening not only to their hard experiences during the disaster but also casual topics like their hobbies. She says, “One of the evacuees was very pleased with my visit, saying, ‘I talked a lot today. I’m very happy,’ and I was very happy too.”
Final month of the fourth year of the program
Duty period: 2016/08/22 - 2016/09/16
Nurse: Megumi Takashima, Fukui Red Cross Hospital
September 2016 was the final month of the fourth year of the program. Many of the evacuees said that it would mean nothing to continue deploring their experience of the disaster and they had no option but to live their lives positively. In my impression, they were settled. However, there was an evacuee who had a new house in the city but was not communicating with neighbors, and began to complain upon our visit. Ms. Takashima’s team visited a couple whose views about returning to Namie Town were different between the husband and wife. She felt that there were still many problems left unresolved for returning to the town. Ms. Takashima says, “Now that many of the evacuees from Namie Town are settled, it may be possible for the JRCS to continue to visit some of the evacuees who need special assistance; such as people who are still suffering from the disaster, families with small children and the elderly who live alone.”
She also says, “When I worked at my hospital before being dispatched to this program, it was difficult for me to take time to talk to each of my patients partly because I could not devote enough time for that. However, this experience made me feel that I want to listen to each patient as carefully as possible back at my hospital.“
Home visits in the fifth year of the program
Duty period: 2016/10/24 - 2016/11/25
Nurse: Yuko Matsuki, Japanese Red Cross Matsuyama School of Nursing
The people of Namie Town were deprived of their daily lives and communities due to the radioactive contamination caused by the nuclear accident. More than five years have passed since the earthquake and tsunami. The decontamination work has progressed and the prospects for the evacuees' returning to Namie Town are finally in sight. However, they have a problem with their houses even if they could return to the town. Returning to the town involves not only the problem of the radioactive contamination but also the living environment. Without that in place, it is difficult for the evacuees to return to their town. Ms. Matsuki was touched by their dilemma.
They had to leave Namie Town where they had lived for a long time and start new lives in unfamiliar places. They needed to get along with their new neighbors by following the local customs and also needed their livelihoods. They were confused with the different life customs from theirs, but Ms. Matsuki observed the evacuees from Namie Town making efforts to regain their daily routines. Some evacuees cried when talking about their experiences during her home visits. The home visits taught her that there are still some people who need psychological assistance even more than five years after the disaster. Ms. Matsuki says that it is important to assess the evacuees’ health conditions and their current situation in rebuilding lives by sharing information with people involved in the recovery to help the evacuees to regain their daily lives and live healthy and independent lives as soon as possible.
The road to returning to Namie Town
Duty period: 2016/11/21 - 2016/12/22
Nurse: Kiyomi Fukuda, a deputy director of nursing, Fukui Red Cross Hospital
Ms. Fukuda visited a couple who started living together again for the first time in five years after living separately due to the evacuation. They found that they sometimes disagreed with each other and argued because they had established separate lifestyles during the five years. However, at the end of the interview with Ms. Fukuda, the wife said something positive: "I want to get used to this life." Ms. Fukuda felt the wife was making efforts to solve their problems.
On March 11, 2017, six years after the Great East Japan Earthquake and Tsunami, the evacuation order issued to Namie Town is expected to be lifted. This will allow the evacuees to return to some areas of Namie Town where the living environment has been prepared. It will take time until the administrative services can be provided in the same level as before the earthquake. It will also take time before the residents re-establish their lifestyles after the evacuation order is lifted. Therefore, the actual return to live again in Namie Town is going to take time. There are still other challenges for the return. Ms. Fukuda felt that it is going to be important for the public authorities, the Namie Municipal Government and the people of Namie Town to cooperate and collaborate for the recovery of the town.
There are also nuclear power plants in the prefecture from which Ms. Fukuda came to work on this program. As she listened to them talking about their sufferings of not being able to return to their town, she thought deeply about nuclear power plants.
In every home visit, the evacuees expressed their sympathy to Ms. Fukuda, saying: “It’s hard that you came a long way to Iwaki from Fukui.” Some evacuees said: “Come again and listen to me. I’m expecting you to visit me.” She thought that the evacuees said this because the JRCS has been providing this program service for a long period of time. She says that she will convey to others what she has taken away from this program experience and the current situation of Namie Town and Iwaki City.
The final visits of the program
Duty period: 2017/01/10 - 2017/02/03
Nurse: Nanako Yoshida, Takatsuki Red Cross Hospital
Since it has been a long time since the Great East Japan Earthquake and Tsunami, most of the evacuees seemed to be determined to live in their new locations and it looked like they were living their lives in a stable way with new human relationships and new local customs. Many of the evacuees said: “We are sort of settled into our new location.” However, this suggested that they cannot return to their familiar land and there is no option but for them to accept this unchangeable reality. I strongly felt that they are trying to keep positive in living their current lives. At the end of March 2017, the evacuation order is expected to be lifted in some areas of Namie Town. The evacuees from the areas said: “There is a difference between hoping to return to the town and being able to live back in the town under stable conditions. We may be able to live in the town materially but we will be unable to have a secure and stable life there. It is important to return to the town with former neighbors.”
During the home and telephone visits, the evacuees talked about their horrible experiences. I always came back to the original purpose of this program, which is to listen to the evacuees. During the visits, I kept in mind that this program would be more meaningful, if they could sense that I was “listening” to them during the interviews and that would help them to release their feelings as much as possible.
The JRCS Public Health Room for Namie has held salon programs for mothers and young children from Namie Town. The mothers had been affected by the nuclear accident and relocated many times due to evacuation. They gave birth to their babies and raised their young children in unfamiliar places. These mothers have overcome these hardships. They came to the public health room to talk about their concerns in raising their children.
Ms. Yoshida says: “There is still a long way to go until they have a full recovery. Therefore, I want to remember the problems that are becoming obsolete and convey the problems to other people.”