Japan: Interview with Eric Ouannes, General Director, MSF Japan

"We tried to respond very rapidly. What we have looked at right from the beginning is a very small team trying to be flexible, mobile, modular."

Could you explain how MSF responded to the quake?

Well, rapidly. At least we tried to respond very rapidly. What we have looked at right from the beginning is a very small team trying to be flexible, mobile, modular. To be able to move from one place to another quite quickly and try to cover as much as distance as possible and visit as many evacuation centers as possible.

Can you tell us a bit about the national response to the earthquake and tsunamis?

It has been a massive response. Numbers are not very clear, but we speak about between 80,000 people and 250,000 people coming mainly from [Japan’s] Self Defense Forces, as well as other emergency medical mechanisms, and included in that [are] some other foreign aid groups or government aid groups.

What are the main issues in the places that we have seen in the area?

For the moment, in the 20 or 30 different evacuation centers we have visited, the main issues we're facing are chronic diseases among elderly people. Their treatment has been interrupted, so our doctors are looking at restarting the treatment to avoid that these elderly people fall into acute situations. Another issue is that communications have been very erratic over the last four days. It’s getting better but it's still quite difficult. Transportation is difficult. Roads were cut almost everywhere we went, as well as lack fuel for our cars.

For the people affected by the earthquake as well as the tsunamis, there are a number of issues: the cold—the weather is not really nice these days—as well as a lack of food, water. And the most urgent need is blankets to protect the most vulnerable sections of the population against the cold.

What kind of chronic diseases have we been seeing in the main?

The usual chronic diseases in an elderly population: hypertension, cardiac diseases, as well as diabetes. We are trying to restart the treatment, as I said earlier. We have also seen some cases of hypothermia on top of the other diseases I have spoken about, as well as dehydration. But again, it’s a limited number of cases with regards to the vast number of people who have been displaced or who have lost their homes.

Does MSF envisage a long-term involvement in this situation?

It’s too early to say. What we are looking at is contemplating expanding the team—the decision is not made yet—and to try and be more present in more locations, with near certitude that we have to go a little bit more north of the area where we are. We are now in the north of Miyagi prefecture and are trying to get to Iwate to see if similar needs exist, if there are similar gaps where MSF could have an added value. One thing that is clear is that the set up with these very flexible mobile teams is responding to the needs that we have identified at the beginning. We will continue with the same strategy, maybe expanding to more teams, covering more needs, but we are definitely not looking at a massive intervention with hundreds of international personnel coming from everywhere in the world. This is absolutely not what we are looking at the moment.

Why is that?

First, because there is a massive deployment of aid from the government and from foreign governments. It’s not a humanitarian crisis, at this stage. We cannot qualify this as a humanitarian crisis because most urgent needs are covered. A number of hospitals still function in the area, a referral system is still functioning, drugs are there, doctors are available in most of the hospitals.

Obviously, there are some gaps, but nothing abnormal in such a situation. And considering the scope of the disasters—and I say disasters, because there were several disasters—considering the scope of those disasters, there were gaps and we are here to try to fill those gaps.

What will MSF do in the event of a significant nuclear event or the situation in Fukushima getting worse than it already is?

We will evacuate our teams. That’s pretty simple. Today we are monitoring the situation on an hourly basis. We have radiometers [radiation detectors] with each of our personnel on the ground. We are cross checking the situation with various government and non-government agencies, and in many different locations in the world, not just Tokyo. And as soon as we reach a level that we consider an alarm for us, that could become unhealthy or dangerous for our teams, we will evacuate the team. We have the means to evacuate quite rapidly. Evacuation routes have been identified. So, yes, that’s what we will do.

What about treating illnesses caused by radiation? Is that something MSF can contemplate?

At this stage no. We are not experts on that. We are now trying to mobilize the entire network on the medical issue of nuclear radiation and trying to see. We have some people in our network of 25,000 or 30,000 people working in MSF who have worked in the past in this field of medicine, so we are trying now to collect this expertise to see if we could come with a particular response. This is more the duty of the Japanese government, and from what we hear or read in the news, they are already trying to prepare that.