The Hanshin-Awaji Earthquake and Dental Care
Prehospital and Disaster Medicine
Abstracts: 11th World Congress, Osaka, Japan S39 patients who could be saved, regardless of whether the core medical institutes are located within or outside the destroyed area. It is very crucial to pick up such redtagged patients properly and to transport them to the other core medical institutes in intact areas beyond the boundary of local governments. The medical operations in a disaster are a part of the total disaster plan developed by each Prefectural government. After the Great
... the Great Hanshin-Awaji earthquake, about 500 hospitals were chosen as core medical institutes for disaster. Each core medical institute must satisfy several requirements: 1) capable to provide advanced medical services for the multiple severely injured patients; 2) capable to function as the headquarters equipped with a medical information system in disaster and emergency situations; 3) facilities to transport patients beyond the border of the local governments, such as dispatched doctors, emergency automobiles, heliport, etc.; and 4) enough personnel to dispatch selfcontained medical service teams. In order to utilize all medical institutions in the damaged area and make them fully functional in a disaster situation, several mutual-aid arrangements for health and medical assistance within a Prefecture or between neighboring Prefectures, or on a nation-wide scale have been established following the Great Hanshin-Awaji earthquake. Every effort has been made to make such mutualaid arrangements work properly through the use of drills and simulations. Every core hospital and other hospitals have come to prepare their own disaster manual. In this panel discussion, we will demonstrate the policies and the measures prepared in Osaka Prefecture. Kobe University School of Medicine is situated at the center of the disaster area where more than 5,500 peoples died in January 1995. Therefore, the affiliated University Hospital played a vital role for medical services for the victims from the beginning of the disaster. Also, the hospital received patients with a variety of stressrelated health problems after the Earthquake. At the same time, the Medical School organized systematic research on the various medical and health problems among victims. Research works carried out at the Kobe University School of Medicine on the Earthquake victims has ranged widely from forensic analysis of the dead, crush syndromes, effects of stress on cardiovascular and digestive systems, psychological problems, care systems for the victims, etc. The research project involved more than 100 doctors and researchers. This paper reviews a wide range of bio-psycho-social impacts of the disaster to the victims, and analyses the longitudinal changes in health problems. Special attention should be directed to the psychological and psychiatric aspects. Also, some medical problems still are continuing even four years after the Earthquake.