MSF-USA: Japan: MSF Supports Construction and Rehabilitation of Temporary Clinics

June 13, 2011
Japan: MSF Supports Construction and Rehabilitation of Temporary Clinics

Doctors Without Borders/ Médecins Sans Frontières (MSF) has begun to support the construction of two temporary clinics in the northeast of Japan, where the Tohoku earthquake and tsunami completely destroyed existing primary healthcare facilities.

MSF has been in the northeast area since the March 11 disaster. While the government’s recovery efforts continue, it will be several years before permanent medical facilities are rebuilt. The temporary clinics are expected to be used for three to five years, or until permanent facilities are ready.

In Minami Sanriku, Miyagi prefecture, MSF will assist with the design, construction, and equipment of a primary-level clinic that will serve the local population of 23,000. In the town of Taro in Iwate prefecture, north of Minami Sanriku, MSF will assist in the refurbishment and equipping of a similar clinic located in a hotel.

Kunio Yamazumi, an architect working with MSF, has visited the proposed sites and will support and supervise the construction process.

“We have submitted our plans for the facilities in Taro and Minami Sanriku and are working closely with local medical authorities to ensure the two clinics meet the needs of the local population,” Yamazumi said.

In Minami Sanriku, the proposed clinic would offer outpatient facilities, as well as dental, pediatric, and ear, nose and throat services. The clinic in Taro would offer general outpatient services and basic examination facilities.

MSF also delivered two 30-seat buses to authorities in Minami Sanriku to help transport patients from evacuation centers and temporary housing to medical facilities. In the town of Taro, MSF delivered a vehicle specifically designed to transport disabled patients.

Staff psychologists continue to engage in a range of outreach activities in the tsunami-affected region, including distributing leaflets and providing information via a community radio station set up by evacuees.

Key topics discussed include identifying mental health issues, information for parents, stress management, and where to seek psychosocial support.

MSF has also accompanied public health nurses to visit temporary houses and provide direct training while visiting patients. Staff have contacted a local nursery school about providing teachers and parents with training and information about mental health.

“Unlike physical medical problems, mental health is harder to observe and quantify, and can therefore be underestimated,” said Suzanne Petrie, an MSF psychologist who has worked with traumatized populations in Pakistan and Jordan. “An entire community infrastructure has been destroyed, so normal social support structures and activities are largely nonexistent.”

Social Support

Since an MSF "café" staffed by a team of MSF psychologists was established on April 27 near Bayside Arena in Minami Sanriku, 2,220 people have used the space, with more than 300 receiving some type of psychological intervention.

The café space provides an area where people can get refreshments and talk in an informal setting with mental health staff who can then identify particularly vulnerable cases requiring further support and offer one-to-one counseling.

“Disasters like a tsunami alter people’s understanding about a lot of things—about what is safe, their hopes for their future, their relationships, and their community,” said Petrie. “For most people, these reactions will naturally reduce with time, but a minority may require professional mental health help. This is when the reactions are particularly severe, persist and they are significantly impacting on the person’s ability to cope.”

Petrie says providing information about normal reactions during this stage of the recovery process, developing awareness about ways of coping, and having services available for individual and group support are important investments in the future well-being of the community. She says the area’s doctors, nurses, teachers, and community workers must be trained to help the people cope with the aftermath of the disaster.

Tohoku activities and donations

By the end of May, MSF medical teams had conducted a total of 4,356 consultations with patients in Minami Sanriku and Taro. In both places, the main issue addressed was hypertension, followed by upper respiratory tract infection. MSF medical support activities continue, but are expected to be phased out by the end of June.
MSF is in the process of supporting local authorities in the construction of two temporary medical clinics, one in Minami Sanriku and one in Taro.
Since the MSF café staffed by a team of MSF psychologists was established on April 27 near Bayside Arena in Minami Sanriku, 2,220 people have used the space, with more than 300 receiving some type of psychological intervention.
MSF psychologists continue to conduct awareness-raising activities in both Minami Sanriku and Taro. MSF staff have also been conducting outreach support to evacuees in Tomarisaki-sou, Seikan-sou and an evacuation center at Hotel Kanyo, and accompanied public health nurses to visit temporary houses and provide direct training while visiting patients. Contact has been made with a local nursery school, where discussions have taken place about providing school teachers and parents with some training and information about mental health.
MSF supported the construction of a semi-permanent building, built by a team of 25 evacuees at their request, outside an evacuation centre in Baba-Nakayama near Minami Sanriku. The facility has reduced overcrowding in the other center and provided a private space for approximately 30 women and children.
Soon after the earthquake and tsunami, MSF distributed 4,030 blankets, 6,500 liters (1,717 gallons) of water, one generator for a temporary shelter in Baba-Nakayama and 10,000 hygiene kits comprised of soap, toothbrushes, toothpaste, and towels to survivors of the disasters. Non-food item kits containing batteries, candles, matches, and towels were distributed to 4,000 people. MSF also donated $160,000 worth of drugs, consumables, and medical equipment.
MSF donated two buses to local health services in Minami Sanriku to enable patients to travel between evacuation centers, their homes, and medical facilities. In addition, MSF donated a vehicle especially designed for wheelchair passengers.
MSF has improved the electrical system of the hotel housing some of the evacuees and the temporary clinic in Taro.