Conferences and Lectures

JMA-PhRMA Joint Symposium 2015

Lecture 1

Disaster Management in Japan* 1

JMAJ 59(1): 27-30, 2016

Toshinori OGATA1

Developing Role-specific Disaster When a large-scale disaster occurs, an Emer-

Management Plans by a Three-tiered gency Response Team made up of director-
Administration Consisting of the general class members of related ministries and
National, Prefectural, and Municipal agencies is summoned to the Prime Minister’s
Office to begin talks within 30 minutes of the
Governments
occurrence of the disaster. Then an extraordinary
In the Japanese Disaster Management System, a cabinet meeting is held and the Extreme Disas-
Minister of State for Disaster Management is ter Management Headquarters is established.
appointed to the Cabinet, and the Disaster The Headquarters, headed by the Prime Minis-
Management Bureau plans the basic policy on ter as the Chief, makes the policies and provides
disaster management and plans and makes over- overall coordination regarding disaster emer-
all coordination on response to large-scale disas- gency measures. Accurate and prompt actions
ters. In normal times, Ministers of State, are expected to be taken in response to the
representatives of relevant organizations and instructions from the Chief.
experts form the Central Disaster Management
Council in the Cabinet Office to discuss impor- The Emergency Measures Activity Plan
tant matters such as the development of national Goes into Action Immediately without
disaster management plans and basic policies Waiting for Assistance Request
and to take charge of promoting comprehensive
disaster countermeasures by indicating a major Prompt and accurate emergency response is
policy. demanded in the event of a disaster, and to
Japan is governed by a three-tiered adminis- ensure its reliability, the government may estab-
tration: the national government, prefectures, lish the Onsite Headquarters for Disaster
and municipalities. The head of each level takes Management. For example, during the Hiroshima
full responsibility for that jurisdiction in a struc- landslides in August 2014, the Onsite Disaster
ture similar to that of a nation. Comprehensive Management Headquarters was set up and
disaster prevention plans are developed in accor- headed by a State Minister of Cabinet Office.
dance with the roles to be performed at each Likewise, Prefectural Disaster Management
stage. Headquarters and Municipal Disaster Manage­
In the event of a disaster, or where there is ment Headquarters are set up in affected areas
a risk of a disaster, the Cabinet Office, with the and these administrative units coordinate
cooperation of relevant ministries and agencies, operations.
takes the lead in countermeasures, correspond- Next I would like to introduce an overview
ing to each level of disaster with level 1 at nor- of the specific plan. Fig. 2 shows an outline of
mal times up to level 5 when a devastating current measures considered by the Central
disaster occurs (Fig. 1). Disaster Management Council in response to

*1 This article is a translation of the presentation published in the Report of the JMA-PhRMA Joint Symposium held in Tokyo, Japan, on No-
vember 18, 2015.
1 Deputy Director-General for Disaster Management Bureau, Cabinet Office, Tokyo, Japan.

JMAJ, July 2016 — Vol.59, No.1  27

Ogata T
【版面】W：156.633mm（片段　74.083mm）　H：220.133mm　【本文】★行　★ Q　★ H
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【統一事項】●図表とタイトルのアキ　2.25 ｍｍ

【版面】W：156.633mm（片段　74.083mm）　H：220.133mm　【本文】★行　★ Q　★ H
【図】●図番号・タイトル：11.3Q/14.1H　Helvetica LT Std　Bold　集合写真等のスナップ写真は 10Q/12.7H　●図説の幅　片段：固定　全段：図幅　●タイトル 1
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【統一事項】●図表とタイトルのアキ　2.25 ｍｍ

Fig.　2　

28  JMAJ, July 2016—Vol.59, No. 1

 DISASTER MANAGEMENT IN JAPAN
【版面】W：156.633mm（片段　74.083mm）　H：220.133mm　【本文】★行　★ Q　★ H
【図】●図番号・タイトル：11.3Q/14.1H　Helvetica LT Std　Bold　集合写真等のスナップ写真は 10Q/12.7H　●図説の幅　片段：固定　全段：図幅　●タイトル 1
行のとき左右センター　折り返しがあるとき：タイトルの先頭合わせ　図の下の文献：図の下、囲み罫内へ　9.2Q/10H　右揃え
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【統一事項】●図表とタイトルのアキ　2.25 ｍｍ

Fig.　3　

large-scale earthquakes. It specifically suggests first aid, fire fighting, etc.; medical; supplies; and
that the possibility of a Nankai Trough Earth- fuel.
quake (with a magnitude of 8 or 9) and a Tokyo By incorporating lessons learned in the Great
Inland Earthquake within the next 30 years is East Japan Earthquake, its main feature is that
greater than 70%. The council is presently the Extreme Disaster Management Headquar-
reviewing the estimation of damage based on ters will grasp a whole picture of the damage
the Great East Japan Earthquake while promot- and action can be taken immediately without
ing countermeasures. waiting for receiving requests for assistance from
After reviewing the damage estimation, the affected areas. Wide-area support units such
it was assumed that a tsunami generated by as the police, firefighter and Self-Defense Forces
the Nankai Trough Earthquake and fires that are planned to be dispatched with a concentra-
broke out in the Tokyo Inland Earthquake would tion on key support accepting prefectures where
cause a high proportion of deaths. In particular, great damages are expected.
a tsunami from the Nankai Trough Earthquake For life saving, a timeline with target activi-
is expected to affect massive areas, causing enor- ties is set up for the five afore-mentioned catego-
mous damage. ries while keeping in mind the initial 72-hour
In March 2015, based on the estimation of maximum period for rescue, coordinating each
these damages, the specific Emergency Manage- activity according to the elapsed time from when
ment Plan for a Nankai Trough Earthquake was the disaster struck.
newly established (Fig. 3). This plan is made up Regarding medical care, JMATs (Japan Med-
of five categories in response to large-scale disas- ical Association Teams) and DMATs (Disaster
ters: emergency transportation routes; rescue, Medical Assistance Teams) are dispatched over

JMAJ, July 2016 — Vol.59, No.1  29

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a broad area during the initial 72 hours and the plan is to quickly build a backup system for
requested to provide assistance to the disaster treatment by transporting critical patients out of
base hospitals in the affected areas. In addition, the disaster areas from air transport centers.

Designated Remarks

Earthquake is announced. DMAT secretariat

offices are placed in the National Hospital Orga-
nization Disaster Medical Center (Tachikawa,
Tokyo) and the National Hospital Organization
Haruhiko HAKUNO2 Osaka National Hospital (Osaka), so that they
can respond to disasters across the country.
During the Great East Japan Earthquake of
March 2011, 383 teams were dispatched to the
The Ministry of Health, Labour and Welfare affected areas. Eighty eight teams were also active
(MHLW) has been advancing its policy of disaster at the time of the Hiroshima landslides in August
management in three pillars, focusing on how 2014 and heavy rain disasters of September 2015.
effectively and efficiently medical care can be The EMIS is an online system for the MHLW,
provided in the event of a disaster. These are: 1) governments and medical institutions in affected
setting up disaster base hospitals, 2) operating areas, and dispatched DMATs to share informa-
and training DMATs (Disaster Medical Assis- tion. In order to provide swift and efficient medi-
tance Teams), and 3) establishing an EMIS cal care during a disaster, it is necessary to collect
(Emergency Medical Information System). and share accurate information. The EMIS is the
As a rule, one or more disaster base hospitals central information system in the acute phase of
is set up in every secondary medical zone. These a disaster.
hospitals must withstand various disasters with While I have outlined the three pillars related
reinforced earthquake resistance and the like. to healthcare provision, the DMAT alone cannot
Currently there are 695 designated hospitals take on all the necessary medical care in the
across Japan that can act as bases to take in large affected areas. The JMAT, the medical team run
numbers of injured victims in addition to provid- by the Japan Medical Association provided sup-
ing medical care. port at the time of the Great East Japan Earth-
A DMAT is a medical team basically made quake for a very long time from the acute to
up of four members—a doctor, two nurses, and recovery phases. I would like to take this oppor-
one coordinator—with an emphasis on mobility. tunity to express my sincere gratitude to all the
To date, 9,328 members of 1,426 teams have been people involved.
trained. Their biggest feature is the speed at To provide appropriate medical care in the
which they can start activities in affected areas. event of a disaster, we need “all Japan” response
Similarly to the criteria of the government’s system that includes collaboration with various
Emergency Response Team for gathering in case sectors all over Japan. At the MHLW, we aim to
of natural disasters, the DMATs across Japan improve disaster preparedness functions at medi-
automatically go into standby in the event of an cal institutions and listen carefully to the voices
earthquake with a seismic intensity of upper 5 or of everyone, so that people are able to receive
higher in Metropolitan Tokyo or lower 6 or higher proper medical care during a disaster.
in other areas, a tsunami warning, or a Tokai

2
Emergency and Perinatal Medical Care Team Leader, Ministry of Health, Labour and Welfare, Tokyo, Japan (hakuno-haruhiko@mhlw.
go.jp).

30  JMAJ, July 2016—Vol.59, No. 1