Radiation is the least of Japan's concerns, says returning IDF officer
Dr. Ofir Cohen Marom, deputy to the chief medical officer of the IDF, says Israel can learn a lot from Japan about planning for potential disasters.
Dr. Ofir Cohen Marom, a gynecologist and a colonel in the Israel Defense Forces (he's deputy to the chief medical officer ), returned Tuesday morning from two weeks in Japan, where he headed the IDF medical team sent there after the March 11 earthquake and tsunami.
Col. Ofir Cohen Marom, you left Japan the day the nuclear disaster level rose to seven, the highest possible level. Did you sense panic among the Japanese?
Not really. For the locals, radiation is the least of their worries. Their living conditions at the moment are so miserable they are now worrying about where they will get bread and water beyond the next few hours. We just spent two weeks there, and now the infrastructure is already better, and there is a steady flow of food and water to keep them going, but many things are still lacking. They don't even talk about the radiation.
Were you concerned?
Before we left Israel, we were informed that the plans for our mission specifically stated that if the radiation level rises above the predetermined level, we were to evacuate immediately. Every member of the delegation had two personal radiation devices, and we also had with us a doctor who is an internationally renowned expert on radiation. In addition, we had a state-of-the-art device the team used to measure radiation levels in the air, water and on our patients.
How far were you from the reactors in Fukushima?
We maintained a minimum distance of around 150 km. The Americans defined 60 to 80 km. radius around the reactor beyond which there was a threat, and even that had extra margins for safety.
How was the location chosen for where you set up the clinic?
The Japanese did not want to accept assistance from any country, even though numerous countries offered their help. As part of the ancient tradition, they always manage with their own devices. Even the rescue dogs sent to them from New Zealand were first placed in 10-day quarantine. Luckily for us, the mayor of Kurihara volunteered in Israel years ago, and he is a good friend of our ambassador in Tokyo. This mayor decided to look after the fishing village of Minamisanriku, an hour's ride from Kurihara. The village was completely destroyed by the tsunami that struck after the earthquake and nearly half of its 10,000 residents died. The rest were left without shelter, and the mayor, together with the ambassador, pressed for the Israeli delegation to go there.
Your work was defined as "setting up a branch health clinic." What did you actually do there?
We set up a medical service that basically became the anchor for all the services in that area. After our arrival was approved, we realized that there was no need for trauma medicine but for medical treatment for the hundreds of thousands of people roaming around without a roof over their heads. They were brought to population centers, community centers and schools - several hundred to as many as 1,500 people at each venue, and there they were given food and water, but in the first weeks there were hardly any medical services. In some of the centers, there were no medical personnel at all; some had a single doctor with no equipment or medical support such as X-rays and other tools. They barely had a stethoscope. In our area, there were 9,000 survivors in dozens of centers.
How did you organize for the mission to Japan?
The requirement was that we should not be a burden to anyone there, because it was not possible to rely on the logistics. So we brought all of the food, water and gear with us; other things we arranged to acquire from other parts of Japan. The main thing was to arrive without needing assistance from the Japanese authorities.
The delegation had 55 members, 30 medical personnel including 14 doctors, seven nurses, and nine medical logistics people, X-ray technicians and lab personnel. We brought a doctor from each relevant field - general surgery, ophthalmology, otolaryngology, internal medicine, gynecology, pediatrics and geriatrics - and we built a medical center there that treated patients and also provided digital X-ray services and a state-of-the-art lab for doctors already there.
How did the work with the local medical services proceed?
Not all the Japanese liked the idea of our coming. The Japanese health system does not like people interfering, so we pretty much arrived against their will and at first they limited what we could do. As the commander of the delegation, my job was to organize collaboration and persuade them that we came to help them, and not to replace them. Day by day, the collaboration grew and deepened. After four days, they agreed to have us send teams beyond the population center where we were, to other centers, and even agreed to allow us to treat a few cases of people who could not leave their homes. We went to see pregnant women restricted to bed rest with a portable ultrasound to do examinations. Everything was done using vehicles we had organized and gasoline we purchased.
You returned to Israel after two weeks, but a lot of work remains to be done there.
We treated more than 200 patients there, but during our work there, we understood that beyond medical care, there is a need to rebuild infrastructure. The work there will not be finished in two months, and we went for a short time to provide basic needs in place of the local hospital, which was destroyed. Now they are better set up and over the last three days, we trained doctors to use all of the equipment we left and overlapped with them. Now the Japanese doctors are working there. Basically, we set up an anchor for the hospital until it is rebuilt.
What conclusions did you reach about dealing with future disasters here in Israel?
It's possible to learn a lot from Japan, primarily the need to do things according to plan. We have a tremendous capacity for flexibility - we do things from one day to the next on a level that advanced states are unable to do. But this is not an alternative to serious planning for potential disasters. A society that combines these two abilities will have the ultimate combination.