Japan: health after the earthquake

Abstract

The magnitude 9·0 earthquake that hit the northeast coast of Honshu at 2·46 pm on March 11 has shocked TV viewers worldwide. The unstoppable force of the tsunami that followed was a hitherto rarely seen spectacle—and tragedy. Estimates suggest that as many as 10 000 people may have died. Half a million people have been made homeless and the country has been plunged into a state of emergency. The Japanese Government has responded calmly and carefully to the catastrophe. But the very real danger of radiation exposure now represents a sinister further complication facing Japan's political leaders. Although the earthquake caused huge structural damage, fires now seem largely under control and most hospitals are fully operational. Over 1 million households are still without electricity or running water, but those numbers are falling fast. The government acted quickly by establishing an emergency management committee, led by the Prime Minister. A disaster medical assistance team activated 120 field units, with a further 119 on standby. Food, water, blankets, and portable latrines have been widely distributed to those affected. The international response has also been impressive, with at least ten countries sending additional rescue teams. The disaster is bad enough. But the multiple explosions at the Fukushima Daiichi Nuclear Power Station have caused temporary increases in radiation outside the affected reactor units. WHO immediately sought help from its Radiation Emergency Medical Preparedness and Assistance Network—40 specialist institutions expert in radiation emergency medicine. WHO's task in this situation is to assess the public health risk and provide technical guidance and assistance. It has done so, reporting that although the public health risk is small, conditions could change. What happens over the next few days depends on whether further radiation is released, as well as the weather. In the coming weeks, Japan will inevitably enter a period of profound mourning and reflection. WHO might consider convening experts to review the consequences for human safety of nuclear energy, and the wider lessons to be learned from recent earthquakes. The mounting anxiety about events in Japan demands a calm but considered international, as well as national, response.