被災地の医療 避難者の健康守る体制拡充を

The Yomiuri Shimbun March 01, 2014
Greater efforts needed to ensure health of 2011 disaster victims
被災地の医療　避難者の健康守る体制拡充を（3月1日付・読売社説）

Though three years will soon have passed since the March 2011 natural disasters and nuclear crisis, 267,000 people are still forced to live as evacuees.
　東日本大震災から３年を迎える今も、２６万７０００人が避難生活を強いられている。

The system to protect the health of disaster victims must be expanded and further improved.
　被災者の健康を守るための体制をさらに充実させるべきである。

About 100,000 of the victims live in small, prefab temporary housing. Forced to live away from their hometowns in isolated environments with no familiar faces, many evacuees tend to stay in their rooms all day long. There have been many cases in which they develop such lifestyle-related diseases as hypertension and diabetes and fall into a state of depression.
　被災者のうち、プレハブの手狭な仮設住宅に暮らす人は約１０万人に上る。住み慣れた土地を離れて孤立し、部屋に閉じこもる人は少なくない。高血圧、糖尿病といった生活習慣病や、うつ状態に陥るケースも目立つ。

With the loss of homes and jobs, some evacuees cannot see any hope of reconstructing their livelihood. This casts dark clouds over them both physically and mentally.
　自宅や職場を失い、生活再建を見通せないことが、被災者の心身に暗い影を落としている。

The situation is especially serious for residents who formerly lived along the coast of Fukushima Prefecture, as they cannot be sure of any prospect of returning home due to the continued effects of the disaster at Tokyo Electric Power Co.’s Fukushima No. 1 nuclear plant.
　東京電力福島第一原子力発電所の事故で、帰還のめどすら立たない福島県沿岸部の住民の場合は、特に深刻である。

Alleviating the psychological stress of victims is a major challenge.
　被災者の心理的ストレスを軽減することが大きな課題だ。

It is also important to deal with the continued increase in deaths caused by health deterioration due to such chronic illnesses as heart disease in the aftermath of the disaster.
　心臓病など、持病の悪化による震災関連死が増え続けている問題への対処も重要である。

Many medical institutions have yet to be rebuilt after being damaged by tsunami that followed the Great East Japan Earthquake. In some areas, railways have been left cut off. As a result, it is not easy for disaster victims to go to hospitals. Local governments are urged to make such arrangements as home-based medical services after obtaining assistance from the Health, Labor and Welfare Ministry and the prefectural governments concerned.
　津波で被災し、再建されていない医療機関は多い。鉄道が寸断されたままの地域もある。被災者にとって通院は容易ではない。地元自治体は、厚生労働省や県の支援を受け、訪問診療などの体制を整備してもらいたい。

In the case of temporary housing in Ishinomaki, Miyagi Prefecture, where about 4,000 evacuees live, doctors and nurses are sent from a temporary clinic built on the housing site to take care of the residents. There are also support staff for disaster survivors, who have work experience as health aides and make the rounds of housing units.
　約４０００人が暮らす宮城県石巻市の仮設住宅では、敷地内の仮設診療所から医師、看護師が訪問診療、看護に出向いている。「被災者支援員」と呼ばれるヘルパー経験者らも各戸を巡回する。

There are said to be cases in which such staffers have discovered residents’ health problems as they often talked to them, and ailing evacuees were able to receive medical treatment through their referrals.
　支援員が話し相手になり、入居者の体調の異変に気づいて治療に結びつけることもあるという。

Aid must be multilateral

Junichi Cho, director of the temporary clinic, said: “It is difficult to take care of the disaster victims with doctors and nurses alone. It is essential for various kinds of people in society to provide cooperation.”
　長純一所長は「医師や看護師だけで被災者をケアするのは難しい。様々な立場の人が協力することが大切だ」と強調する。

The population has been aging further in the disaster-stricken areas due to an outflow of young people.
　被災地では、若い世代の流出で高齢化が一段と進んだ。

Those involved in medical treatment and nursing care, as well as nonprofit organizations and volunteers, sustain home-based medical services for the elderly. Such a support system must be established nationwide amid the rapid aging of the population and is most urgently needed in disaster-affected areas.
　医療・介護関係者をはじめ、ＮＰＯ（非営利組織）やボランティアが連携し、在宅の高齢者を支える。その仕組み作りは、高齢化が進む日本全国で必要だが、とりわけ被災地では急務である。

Such areas were suffering a shortage of doctors even before the disaster occurred.
　被災地は元々、医師不足が深刻だった地域だ。

To help secure a sufficient number of doctors, the government has decided to permit the establishment of new medical departments at universities, which have not been allowed for a long time, only in the Tohoku region. This is expected to have some effect from a mid- to long-term perspective.
　政府は、医師の確保策として、長年認めていなかった医学部の新設を、東北地方に限って容認する方針を決めた。中長期的には、一定の効果は見込めるだろう。

In addition, assistance measures must be taken to promote the assignment of doctors and nurses to disaster-stricken and underpopulated areas plagued by a shortage of such personnel.
　これに加え、医師や看護師が、人材不足の被災地や過疎地に赴くための支援策も必要になる。

The most crucial task for the moment is to secure enough doctors. Medical societies and hospitals across the country must join hands to ensure the continued dispatch of doctors to the disaster-affected areas.
　最優先の課題は、当面の医師の確保である。医学会や全国の病院が協力し、被災地への医師の派遣を継続していくべきだ。

(From The Yomiuri Shimbun, March 1, 2014)
（2014年3月1日01時31分 読売新聞）