Quake inflicts mental woundsNIIGATA--Communities already struggling with an aging and dwindling population have been hit hard by the Niigata Prefecture Chuetsu Earthquake that rocked the mountainous region Saturday.
Fourteen of the 31 people killed in the earthquake by Monday were thought to have died of shock, not physical injuries.
They died from heart attacks brought on by shock.
Despite plummeting temperatures, residents are choosing to put up with inconvenience and stay in evacuation areas, giving rise to mounting concerns for the health of evacuees, especially elderly evacuees.
The Japanese Red Cross Society has set up a first aid station on the grounds of Ojiya Primary School, dressing the wounds of the injured and administering intravenous drips to those in need. A handful of beds have been set up in a tent next to aluminum cases containing enough medicine to treat 200 people.
From Sunday afternoon to Monday evening the Red Cross treated about 200 residents at the first aid station.
Red Cross, local and central government medical crews of doctors, nurses and paramedics arrived in the region after the first wave of earthquakes hit.
The region was hit hard by natural disasters this summer, including torrential rains and typhoons. Local residents are under extreme stress following the earthquake.
Even residents whose houses survived the quake could be found sleeping in cars and evacuation sites, fearing returning home while aftershocks continue. The drop in temperature is making life harder for evacuees.
"It must be tough for elderly people to live in an environment with no privacy," said JRCS's Takaharu Horiguchi, 59, a doctor who had rushed to the region. "People have to sleep in cars or evacuation centers, causing them a lot of stress. Some elderly people are showing stress related symptoms, such as low temperature, low blood pressure and stroke."
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Different from Hanshin quake
Unlike the 1995 Great Hanshin Earthquake, where nearly 90 percent of victims were killed by collapsing buildings and fire, shock killed a number of people in the Chuetsu region.
In all seven devastated localities, including Ojiya, more than 20 percent of the population is aged 65 or over. In Yamakoshimura, a village isolated by the quakes, about 40 percent of the population is aged 65 or over. Eleven of the the 14 victims who died from shock were aged 60 or over.
A man who had received a dialysis treatment and then gone to evacuate by car collapsed as soon as he drank a cup of water.
Another man with a heart problem who, according to witnesses, looked exhausted each time he fled his house during the aftershocks, was found dead the next day.
"The condition of chronic disease sufferers may deteriorate after a shock like a big earthquake," said Kimitaka Tajimi, a professor of emergency and intensive care treatment at Akita University. "If patients have more active secretion of a hormone like adrenaline, they may well suffer an irregular pulse that could lead to sudden death."
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Mental health care needed
After emergency medical relief has been provided, locals will need support to overcome psychological trauma wrecked by the earthquake.
According to an organization that provided counseling services for about five years to survivors of the Great Hanshin Earthquake, many survivors suffered anxiety, irritability, sleep disorders and depression as well as communication problems. Some suffered alcoholism.
Elderly people face greater difficulty adjusting to a new environment, are more susceptible to psychological trauma and take longer to recover, according to the organization.
The organization said that the concerns of local residents need to be heeded before stress and fear snowball.
Following a request from Niigata Prefecture, the Health, Labor and Welfare Ministry on Monday evening dispatched an advance team of four doctors, including a specialist from the National Center of Neurology and Psychiatry, Japan, Kohnodai Hospital, who had provided mental health care to survivors of the Great Hanshin Earthquake.
Those hit by the most recent quake will also will need long-term medical support for both psychological and physical trauma.
Toshiharu Makishima of the Japanese Red Cross Medical Center advised that evacuees should talk openly about their anxieties.
"Residents should understand they may experience a variety of symptoms including insomnia, headache, stomachache, irritability and sudden shivering--as part of a natural reaction to fear of aftershocks and stress at evacuation sites, where there is little privacy," he said. "City officials may also need support as they are under heavy pressure from local residents."
Meanwhile, Shuji Shimazaki of Kyorin University said governments needed to prepare for treating more elderly people.
"Because of the aging population, it is important to set up systems to transport those suffering deteriorating health due to chronic disorders such as heart disease, kidney disease and high blood pressure, while also allocating types of patients to hospitals beforehand," he said. "As temperatures decline, evacuees need access to warmth and food. They also need to have regular health checks so that any complications from heart disease or high blood pressure can be detected early."
Yomiuri Shimbun, Fall 2004