#IDM2016 celebrations: Midwives response and support during emergency
Midwifery Activities in Ibaraki Prefecture during the 2011 Great East Japan Earthquake
On March 11th 2011, magnitude-9.0 earthquake, which later called the Great East Japan Earthquake, struck Japan.
The massive earthquake and Tsunami, which was triggered by the quake, brought tremendous damages to Ibaraki Prefecture as well as other parts of Eastern Japan, causing so many deaths and injuries and destroying houses, streets and railroads. In the areas washed away by the tsunami, collapsed houses and cars and ships became a mass of rubble, and the area was extremely devastated.
Ibaraki two days after the earthquake, March 13, 2011
Furthermore, an accident occurred at the Fukushima Daiichi Nuclear Power Plant in neighboring Fukushima Prefecture on the following day, and made the situation worse, in that radioactive materials were released into the air.
The victims of this disaster had to evacuate quite far away from their homes temporarily, spending days in stressful evacuation sites, and struggling with disconnected communication lines and lifelines, gasoline shortages and severe weather. They were forced to live in very harsh conditions.
In the face of the unprecedented massive disaster, we, the Ibaraki Midwives’ Association, contacted our members to confirm their safety, distributed aid to victims, deliver water to birth centers, made arrangements to provide gasoline to emergency vehicles used for home births as a priority, and visited mothers and their children to check on them. In regards to confirming their safety, land-line phones and fax machines were no longer available, but we could connect with our members through texting on cell phones.
When member midwives visited mothers and their children to check on them, they noticed an increase in vaginal discharges and skin problems due to poor hygiene caused by protracted water outages. Also, an increasing number of mothers were becoming sick due to stress, and all the mothers were deeply concerned about the impact of the radiation contamination on their children. Some mothers even hesitated to breastfeed their children or get pregnant due to fear over radiation. All toddlers became emotionally unstable, and they held on tightly to their mothers and cried very hard every time they felt an aftershock. Under such circumstances, mothers were mostly seeking information and emotional support from visiting midwives.
When the situation settled down a little, the Ibaraki Midwives’ Association conducted a survey in collaboration with a university in Ibaraki Prefecture to find out what kinds of support midwives had provided during the early stages of the disaster relief.
In response, midwives working at hospitals answered that they had assisted patients evacuate to safer places, helped newborns evacuate by wrapping them in blankets and letting their mothers hold them, let mothers in the middle of child delivery lay down on mattresses placed in a safe area and supported them giving birth by calming them down and staying with them throughout the process, helped evacuate mothers who had just delivered babies by putting them on stretchers and carrying them down by hand on stairs, assisted mothers who was being infused with tocolysis for threatened premature labor by unplugging the Intravenous and switching to battery power, and secured emergency stockpiles, such as medicines, blankets, water, chairs, emergency supplies, etc. They were doing everything they could to assist mothers and babies, and even midwives who were off duty rushed to their hospitals and provided emergency care voluntarily without sleep and rest.
Midwives practicing locally and independently visited their patients, took care of the babies as they let the mothers prepare for evacuation in between aftershocks, and helped them evacuate to a safer place to secure the safety of the mothers and their children.
The survey results also showed that some midwives had volunteered to provide telephone consultation services, assist the elderly to get water, provided support for children at nursery schools, offered aid to foreign mothers and children and evacuees from other prefectures, and conducted a charity bazaar to raise funds for the victims and sent clothes to them. A midwife who is also a certified acupuncture practitioner said that she had given acupuncture to evacuees and hospital staff members working without sleep or rest.
Meanwhile, several midwives stated that they had offered to volunteer at evacuation sites to help mothers, children and women but they could not get permission to do so from those who were managing the sites. Some midwives said they had not known what they had to do to help those who were in need and how they could do it. These circumstances raised issues for the association to tackle with. We realized that we needed to build a structure in which midwives can provide quick support for pregnant women, mothers and children in an organized manner at a local level in the case of a disaster.
The role and support midwives
We promptly established a disaster countermeasure committee consisting of 12 members, and started formulating an emergency manual suitable to the situation in Ibaraki Prefecture by using the Great East Japan Earthquake Relief Fund of the Japanese Midwives Association. We also created an emergency contact network for our members to confirm their safety and acquire and provide information smoothly.
Since midwives could not provide much support at evacuation sites, we, the Ibaraki Midwives’ Association, submitted a formal request to the governor of Ibaraki Prefecture stating, “It is an urgent necessity to secure the safety of women including those who are pregnant and children and aid them, as they are the socially vulnerable. Thus, we request you to utilize midwives, who are capable of providing full support for child rearing and breastfeeding.”
However, since we did not hear any response from the governor months after the submission of our request, we resent the request to the prefectural official in charge of disaster relief directly. Finally, midwives were then able to register as volunteers.
From these experiences, we established a channel to respond to a request for emergency aid and dispatch our member midwives as volunteers to affected areas. First, the government of an affected municipality must contact the prefectural government to request support. Second, the prefectural government contacts the chairperson of the midwives association, and then, the chairperson sends volunteer midwives to the affected areas upon agreement with them.
We immediately called for volunteers and 23 willing midwives offered to help. So, we sent saddlecloths and the disaster relief manual to them, and asked them to prepare themselves in advance so that they can provide emergency aid smoothly.
Their activities required collaboration with government and other related organizations. Therefore, we visited eight prefectural government organizations, including departments of the prefectural government, police department and fire department, all the 44 municipal governments in the prefecture, three doctors associations and a nurses’ association to hand our emergency manual to them in person and ask for their cooperation.
At the same time, we supplied 11 birth centers in Ibaraki Prefecture with supplies, child birth support kits, helmets, hand-cranked portable radios, etc. We also designated September 9th as the day for an emergency drill and education and conducted an emergency drill.
“Every cloud has a silver lining”
As a mid- and long-term activity, the Ibaraki Midwives’ Association hosted an event called ‘get-together tea time’ six times a year in the affected area by utilizing the financial aid provided by the prefecture’s anti-suicide measure model project. Participants of this event can communicate with each other while having some tea, and we provided them with hand spa treatment, maternity yoga, baby massage and so forth. The goal of this event was to help the disaster victims get mentally healthier.
Few days after the earthquake, mothers gathered together and they felt happy to be in a safe environment with their children
In addition, we organized two events in Ibaraki Prefecture, which was put together by volunteer midwives and using support funding, as part of a reconstruction effort. With the theme of healing melody and talk, the events offered a concert and a speech. Both the get-together tea time and concert and speech events were very successful, and we would like to continue hosting these events in the future to remember the victims of this disaster.
This article was written by Kiyomi Ito, former President of Ibaraki Midwives Association in collaboration with other midwives