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Back 20 April 2016

#IDM2016 Celebrations: Experiences of Midwives in emergency situations

 

Fukushima: Two years after the earthquake and Tsunami emergency

Experience and Role of Midwives

 

Brief Overview of Fukushima Prefecture and the Situation after the Disaster

The prefecture of Fukushima is located in north east of Japan.  It is the third largest prefecture in the country in area, and has a population of two million.  It consists of three regions: Hamadori, which has a mild climate and little snow in winter time and is known for fishery as the main business of the area, Nakadori, which has a bullet train line and highways and is known as a “fruit kingdom” since its famous for farming of fruits, such as peaches, cherries, grapes, pears, apples and persimmons, and Aizu, which is well-known as a rice cropping region. 

On March 11th, 2011 at 2:46 p.m., a magnitude 9.0-earthquake occurred off the Pacific Coast of Tohoku, triggering a massive tsunami that struck the entire area of Hamadori.  The disaster also caused the accident at the Fukushima Daiichi Nuclear Plant of Tokyo Electric Power Company on the following day of March 12th, affecting all the residents and businesses in the prefecture with radiation emitted from the plant. 

 Disaster near the elementary school                                                                                                     This photo was taken near where the elementary school used to be

In Fukushima Prefecture, the death toll and the number of missing reached 4,202, and 300,000 houses and building were destroyed.  Even today, two years and three months after the disaster, about 156,000 people are still living in places far from their homes and hometowns as refugees, and all the residents in the prefecture are suffering from the effects of radiation. 

Fukushima Midwives Association’s support during the emergency  

Immediately after the disaster had struck Fukushima, midwives practicing in local areas began visiting nearby evacuation sites and providing supports for mothers and their children.  Since gasoline was no longer available, bicycling and walking were the only means of transportation.  The lifelines including electricity, gas and water, were cut off. 

On the day after the disaster, we received a request for hot water to make infant formula from a mother.  However, we could not even boil water or deliver hot water to her.  Some mothers needed baby food since their little children could not eat the food supplied to the evacuation sites, such as cooked rice and rice balls.  This made us realize the essentialness of breastfeeding very strongly.  If mothers could breastfeed, they would not have to worry about not having infant formula or hot water and could still provide their children with adequate nutrients while baby food is not available.  Above all, breastfeeding would give comfort to both the mother and the child.  We believe that providing support to enable as many mothers as possible to breastfeed is a major issue to be resolved in the future.

Meanwhile, we hardly ever saw any mothers with young children at the evacuation sites when we visited there to offer support.  While we made visits to mothers with young children to check on them and provide necessary assistance later, we learned that the mothers and families with young children avoided staying in an evacuation site, and instead, they were staying with a relative or a friend, moving from place to another.  Therefore, they had no access to appropriate information and support.  We realized the necessity of safeguarding pregnant women, mothers and children in a place where they can feel safe in case of any emergency.

After the disaster everything gone                                                                                                       The aftermath of the disaster, everything was washed away

Fukushima prefectural government was very quick to move pregnant women and mothers with young children to secondary evacuation sites, such as hotels.  However, when we visited these pregnant women and mothers with young children, we saw many of their family members staying in the small hotel rooms with them.   It was not a place where a pregnant woman and a mother with a young child could stay comfortably. 

After witnessing this situation, we opened a puerperal-care facility called “Aizu Josanshi no Ie Ohisama (Midwives’ House the Sun in Aizu),” to provide pregnant women and women who had just delivered with a place where they could stay more comfortably in even the slightest terms and where the radiation level is less even if there was only a small difference.  At the same time, we used three birth centers in Fukushima Prefecture and started offering 24-hour puerperal care by midwives.  At the time, 69 pairs of mothers and children used these centers in 718 days in total.  Through these activities, we noticed the necessity of an evacuation facility with welfare services for pregnant women and mothers with young children.

Meanwhile, we were surprised to discover that a large number of mothers and young children had been staying in their homes for months due to the fear of radiation impact.  We, therefore, started a periodic get-together for mothers with young children hosted by midwives in the city of Minamisoma in September 2011 in order for mothers and young children to go out of their houses feeling safe and be able to communicate with other mothers raising young children.  Currently, this event is held across Fukushima Prefecture, and so far, 203 get-together events have been held and 2,443 pairs of mothers and children have participated in total.

Mothers who participated in the get-together said that they were able to feel refreshed by going outside, that it was fun to talk with other mothers, that they could confirm growth of their children and felt reassured after spending time with other children, and that they felt relieved to know that there were many mothers and babies still in the city.

Moreover, the government of Fukushima Prefecture started offering telephone consultations and a test for radioactive concentration of breast milk in June 2012, to respond to questions and concerns from mothers regarding radiation impact on breastfeeding.  Mothers were worried if it was safe to breastfeed their children, if they should start giving formula instead of breast milk or what they should eat themselves to breastfeed their children safely.  Fukushima Midwives Association was put in charge of providing telephone consultations and conducting the test for radioactive concentration of breast milk.  We have received 1,044 telephone inquiries, and of all, 467 mothers were actually tested for radioactive concentration of their breast milk.  The results showed that no radiation was detected in any of these mothers’ breast milk.

 Two Years after the Disaster: the Situation in Fukushima Today and Roles of Midwives

Today, the air radiation level is being monitored at more than 700 places in Fukushima Prefecture and the results were disclosed by newspapers and television shows every day.  The air radiation level of Fukushima City, where I live and which is about 65 kilometers from the nuclear plant, was 0.36μSv/h yesterday.  Currently in Fukushima Prefecture, various decontamination efforts and measures against radiation exposure are being carried out to reduce the radiation level in the air.  A thyroid test is offered to all the residents under the age of 18, a test for internal radiation dose using a glass dosimeter and whole body counter is available, and all the food served for lunch at schools, kindergartens, and nursery schools is tested for radiation.  All the food sold in stores is also tested for radiation before placed on a store shelf, and people bring the food, such as rice, vegetables and fruits, that they grow at home to a nearby testing facility before consuming them.  But, these measures still cannot eliminate the concerns of pregnant women and mothers raising children.

However, pregnant women and mothers and families raising children in Fukushima Prefecture seem to regain their calm respectively.  Meanwhile, some mothers started expressing their concerns and stress that they had been keeping inside.  The other day, I met a mother who told me crying that she became scared of meeting and talking with people after spending such a long period of time as an evacuee.  I could only give her a hug and listen to her gently. 

Fears, concerns and stresses that respective mothers have are unique and different.  We are committed to providing continuous assistance that meets the needs of mothers and their children, such as telephone consultations, visiting, aid for breastfeeding, get-togethers for mothers with young children, and puerperal care, while listening to their requests and in collaboration with midwives across the prefecture, to support them in raising their children and feeling as safe as possible in Fukushima Prefecture.

This article was written by Tokiko Ishida, Chairperson of Fukushima Midwives Association

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