Japan: MSF Supports Construction and Rehabilitation of Temporary Clinics

Japan 2011 © Yozo Kawabe/MSF

MSF staff supervise a team of local evacuees constructing a temporary shelter outside an overcrowded evacuation center near Minami Sanriku in May.

Doctors Without Borders/ Médecins Sans Frontières (MSF) has begun to support the construction of two temporary clinics in the northeast of Japan, where the Tohoku earthquake and tsunami completely destroyed existing primary healthcare facilities.

MSF has been in the northeast area since the March 11 disaster. While the government’s recovery efforts continue, it will be several years before permanent medical facilities are rebuilt. The temporary clinics are expected to be used for three to five years, or until permanent facilities are ready.

Japan 2011 © Giulio Di Sturco/VII mentor

A national MSF staff member assists an elderly patient in a mobile clinic in Minami Sanriku.

In Minami Sanriku, Miyagi prefecture, MSF will assist with the design, construction, and equipment of a primary-level clinic that will serve the local population of 23,000. In the town of Taro in Iwate prefecture, north of Minami Sanriku, MSF will assist in the refurbishment and equipping of a similar clinic located in a hotel.

Kunio Yamazumi, an architect working with MSF, has visited the proposed sites and will support and supervise the construction process.

“We have submitted our plans for the facilities in Taro and Minami Sanriku and are working closely with local medical authorities to ensure the two clinics meet the needs of the local population,” Yamazumi said.

In Minami Sanriku, the proposed clinic would offer outpatient facilities, as well as dental, pediatric, and ear, nose and throat services. The clinic in Taro would offer general outpatient services and basic examination facilities.

MSF also delivered two 30-seat buses to authorities in Minami Sanriku to help transport patients from evacuation centers and temporary housing to medical facilities. In the town of Taro, MSF delivered a vehicle specifically designed to transport disabled patients.

Raising Awareness

Staff psychologists continue to engage in a range of outreach activities in the tsunami-affected region, including distributing leaflets and providing information via a community radio station set up by evacuees.

Key topics discussed include identifying mental health issues, information for parents, stress management, and where to seek psychosocial support.

MSF has also accompanied public health nurses to visit temporary houses and provide direct training while visiting patients. Staff have contacted a local nursery school about providing teachers and parents with training and information about mental health.

“Unlike physical medical problems, mental health is harder to observe and quantify, and can therefore be underestimated,” said Suzanne Petrie, an MSF psychologist who has worked with traumatized populations in Pakistan and Jordan. “An entire community infrastructure has been destroyed, so normal social support structures and activities are largely nonexistent.”

Social Support

Since an MSF "café" staffed by a team of MSF psychologists was established on April 27 near Bayside Arena in Minami Sanriku, 2,220 people have used the space, with more than 300 receiving some type of psychological intervention.

The café space provides an area where people can get refreshments and talk in an informal setting with mental health staff who can then identify particularly vulnerable cases requiring further support and offer one-to-one counseling.  

“Disasters like a tsunami alter people’s understanding about a lot of things—about what is safe, their hopes for their future, their relationships, and their community,” said Petrie. “For most people, these reactions will naturally reduce with time, but a minority may require professional mental health help. This is when the reactions are particularly severe, persist and they are significantly impacting on the person’s ability to cope.”

Petrie says providing information about normal reactions during this stage of the recovery process, developing awareness about ways of coping, and having services available for individual and group support are important investments in the future well-being of the community. She says the area’s doctors, nurses, teachers, and community workers must be trained to help the people cope with the aftermath of the disaster.

MSF has worked in Japan since 2004.