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Nankai Trough earthquake, with an anticipated death toll of 323,000, is a disaster for which the country of Japan set the highest priority on building capacities. Tokushima prefecture aims to minimize preventable death among survivors and has strived to build a medical and health response system and strengthen outreach systems for vulnerable populations. To actualize these aims, Tokushima prioritized human resource development.
Tokushima has initiated periodic trainings based on the Sphere Standard, the internationally recognized minimum standards for humanitarian aid, since 2015. The trainings were conducted by certified trainers and trainees received an official certification recognized by the Sphere Project, Geneva. The training materials were localized and the trainings were contextualized to Japan as a developed and super-aged nation. The learning outcome was evaluated by a pre-post test.
Between April 2015 and November 2018 the two-day training was held seven times. There were two hundred twelve participants from various clusters such as health, education, logistics, nutrition and food, security, and protection. The results of the pre-post test were statistically significant (still in process) indicating the effectiveness of the training on knowledge. Training evaluations suggest nurturing ethical attitudes and skills utilizing the Sphere Handbook.
Despite under-recognizing the Sphere Standard in Japan, the Standard has been incorporated into the disaster risk reduction plan in Tokushima. For larger scale human resource development, training local representatives to be trainers would be the next step.
As Florence Nightingale stated, nursing plays a critical role in environmental management for people in sick, injured, and even good conditions. In current practice, affected people are forced to reside in the evacuation shelters for a prolonged period in Japan. Unfavorable living conditions lead to adverse physical and psychological outcomes including cardiovascular events, depression, and more. However, environment management cannot be achieved without involving the community.
To initiate community into shelter environment management a multi-cluster drill was coordinated by the Department of Psychiatric and Mental Health Nursing, University of Miyazaki, which appointed a director of Shelter Management for the annual nation-wide disaster drill hosted by the Cabinet Office of Japan.
With the Department of Health and Pharmaceuticals, Miyazaki Prefecture, the director invited local communities and held an exhibition type disaster drill on August 4, 2018.
36 organizations, including prefectural and municipal crisis management departments, health care organizations, a social welfare council, Red Cross, a telecommunication company, WASH cluster organizations, and the Japan Ground Self-Defense Force participated. The director requested to develop a plan filled with tactics and techniques protecting the health of people living in the shelter. Through meetings, the organizations recognized similarities and differences in roles, responsibilities, and capacities leading to an organized inter-cluster network. Participants created and prosecuted the plan independently and the director only orchestrated and negotiated with other supporting entities. The organizations exhibited and demonstrated how residents can protect their own physical and psychological health by setting up a proper shelter environment. Direct feedback from residents to organizations resulted in an expanded local network and the organizations improving their capacities.
Shelter environment cannot be managed by nursing solely but coordination by nurses may consolidate multi-cluster aid organizations so that shelter environment management would be done by residents and local organizations.
Providing culturally sensitive disaster nursing is essential to enhance survivors’ resilience, especially in Pacific Rim island countries, which are home to 80% of the disaster victims of the world. Until now, most studies have focused on immigrant culture or language, and few have explored the idea of disaster nursing adjusted to the affected area’s culture.
The study explores public health nurses’ (PHNs) tacit knowledge regarding culturally sensitive disaster nursing focusing on the Pacific Rim island countries. This first report is the result of the study that clarified how Japanese PHNs, as relief nurses, considered the local culture to provide care to survivors in Japan.
Study participants were nine PHNs from seven prefectures, who provided care to survivors of natural disasters that occurred in 2011–2017 in Japan. Semi-structured interviews were conducted with questions such as, “Which culture did you consider while providing care to survivors in each disaster phase?” Data were analyzed qualitatively and inductively and were sorted according to the four disaster phases. The study was approved by the ethical committee at the National Institution of Public Health.
In the acute phase, PHNs utilized close relationships between local residents and health care providers to collect information. They balanced local habits and the prevention of secondary health damage in the subacute phase; for example, balancing sanitation habits and prevention of contaminations. Additionally, they, as strangers to the community, played a role in alleviating tensions between residents under stress. During the recovery phase, they strengthened survivors’ attachment to the area.
PHNs dispatched from the outside of the affected areas must be culturally malleable to adjust their practice to the local context. Being strangers in an affected area can be advantageous if they utilize their position effectively.
United Nations peacekeeping personnel face numerous stressors due to their challenging deployments. Past studies have had inconsistent results regarding whether or not their deployment experience affects their mental health outcomes. Further studies are required to ascertain the associations between their outcomes and factors before, during and after their peacekeeping missions.
We sought to elucidate news article reporting of adverse public psychosocial behaviors, in particular, rumor-related coverage (eg, panic, demagoguery) and exclusive behavior coverage (negative behaviors, eg, discrimination, bullying) during the 2009 influenza A (H1N1) influenza pandemic in Japan.
We examined 154 Internet news-site articles reporting adverse public psychosocial responses in the first 60 days of the outbreak. Rumor-related coverage and exclusive behavior coverage were dichotomously coded as included or not. Moreover, we assessed whether or not health information (eg, coping methods, virus toxicity information) or emphasis on information quality (eg, importance of information, cautions about overreactions) were simultaneously reported.
Rumor-related coverage (n=120, 77.9%) was less likely to simultaneously report public health information (eg, toxicity information, health support information, and cautions about overreactions; P<.05). Conversely, exclusive behavior coverage (n=41, 26.6%) was more likely to report public health information (P<.05).
Rumor-related coverage was less likely to have accompanying public health information, whereas exclusive behavior coverage was more likely to include it. During public health crises, it is essential to understand that rumors and exclusive behaviors have adverse effects on the public and that accompanying public health information may help people take proactive coping actions. (Disaster Med Public Health Preparedness. 2015;9:459–463)
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