Comparison of Two Evacuation Shelter Operating Policies and the Role of Public Health Nurses after the Great East Japan Earthquake: A Qualitative Study.

This study describes shelter operations by public health nurses (PHNs) in Kesennuma City, located near the epicenter of the Great East Japan Earthquake, which occurred on March 11, 2011. The data were semi-structured interviews with 10 PHNs, 2 nutritionists, and 2 general administrators conducted from July 2013 to January 2014. All transcripts were analyzed using the constructivist grounded theory approach. We identified two operating methods for shelters: shelters stationed by PHNs in the Old City, and shelters patrolled by PHNs in the merged district. These methods were compared using four themes. In emergency situations, "operational periods," a predetermined short term for a leader to perform his/her duties responsibly, could be adopted for relatively small organizations on the frontline. PHNs must not only attempt to operate shelters on their own but also encourage residents to manage the shelters as well. Moreover, human resource allocation should be managed independently of personal factors, as strong relationships between shelter residents would sometimes disturb the flexibility of the response. Even when a situation requires PHNs to stay in shelters, frequent collecting of information and updating the plan according to response progress will help to maintain effective shelter operations.

Assessing the impact of household participation on satisfaction and safe design in humanitarian shelter projects.

Participation has long been considered important for post-disaster recovery. Establishing what constitutes participation in post-disaster shelter projects, however, has remained elusive, and the links between different types of participation and shelter programme outcomes are not well understood. Furthermore, recent case studies suggest that misguided participation strategies may be to blame for failures. This study analysed 19 shelter projects implemented in the Philippines following Typhoon Haiyan in November 2013 to identify the forms of participation employed. Using fuzzy-set qualitative comparative analysis, it assessed how household participation in the planning, design, and construction phases of shelter reconstruction led to outcomes of household satisfaction and safe shelter design. Participation was operationalised via eight central project tasks, revealing that the involvement of households in the early planning stages of projects and in construction activities were important for satisfaction and design outcomes, whereas engagement during the design phase of projects had little impact on the selected outcomes.

Difficulties of fathers whose families evacuated voluntarily after the Fukushima nuclear disaster.

The Fukushima nuclear disaster in 2011 resulted in radiation exposure, and many evacuees felt anxious of its health risks. However, little is known about the difficulties faced by fathers whose families evacuated voluntarily. Therefore, the aim of the present case study was to clarify the difficulties and concerns of fathers whose families evacuated voluntarily after the Fukushima nuclear disaster. Eleven fathers in Fukushima were interviewed between 14 December 2014 and 25 February 2015. Four themes emerged: (i) seeking a safe place away from radiation exposure; (ii) burdens of a double life; (iii) feelings of isolation and perceived deterioration of health; and (iv) deciding on whether to continue voluntary evacuation. Fathers were anxious about radiation exposure, similar to mothers, and faced work-family conflicts from the voluntary evacuation of their families, including financial, physical, and mental sacrifice. Half of the fathers did not express their difficulties to others. Our findings identified a new type of conflict between people of a community who did/did not choose voluntary evacuation. Occupational health nurses should understand fathers' feelings of isolation and monitor their health to prevent the development of stress-related diseases.

Knowledge of and Preparedness for Use of Environmental Assessments in Shelters During Disasters: Results of the 2013 State and Territorial Use of Shelter Assessments Survey.

OBJECTIVE: Environmental health assessments of disaster shelters are critical for monitoring the living conditions of the occupants. However, knowledge and levels of utilization of these assessments have never been estimated in the United States or its territories. We aimed to conduct a cross-sectional survey to ascertain knowledge and Utilization of environmental health disaster shelter assessments. METHODS: The State and Territorial Use of Shelter Assessments Survey (STUSA) of environmental health department directors (N=56) was carried out in 2013. RESULTS: Survey responses were received from 55 of 56 targeted jurisdictions. Of those respondents, 92% of state jurisdictions and 100% of territories reported having knowledge about shelter assessments. However, only 40% of states and 60% of territories reported receiving formal training, and 53% of states and 50% of territories reported having operational procedures for shelter assessments. High levels of knowledge and familiarity and low levels of training and processes for operationalizing assessments were assessed. CONCLUSIONS: Because environmental health assessments may provide useful information in disaster settings, we need to understand the barriers to their implementation. The results of these assessments may also help to validate their usefulness in protecting shelter occupants during disasters. (Disaster Med Public Health Preparedness. 2017;11:11-14).

Assessing the Congregate Disaster Shelter: Using Shelter Facility Assessment Data for Evaluating Potential Hazards to Occupants During Disasters.

Disaster shelter assessments are environmental health assessments conducted during disaster situations to evaluate the living environment of shelters for hygiene, sanitation, and safety conditions. We conducted a secondary data analysis of shelter assessment records available (n = 108) on ice storms, floods, and tornado events from 1 state jurisdiction. Descriptive statistics were used to analyze results of environmental health deficiencies found in the facilities. The greater numbers of environmental health deficiencies were associated with sanitation (26%), facility physical issues (19%), and food areas (17%). Most deficiencies were reported following ice storms, tornadoes, and flood events. This report describes the first analysis of environmental health deficiencies found in disaster shelters across a spectrum of disaster events. Although the number of records analyzed for this project was small and results may not be generalizable, this new insight into the living environment in shelter facilities offers the first analysis of deficiencies of the shelter operation and living environment that have great potential to affect the safety and health of shelter occupants.

Development and Verification of a Mobile Shelter Assessment System "Rapid Assessment System of Evacuation Center Condition Featuring Gonryo and Miyagi (RASECC-GM)" for Major Disasters.

UNLABELLED: Introduction There were 5,385 deceased and 710 missing in the Ishinomaki medical zone following the Great East Japan Earthquake that occurred in Japan on March 11, 2011. The Ishinomaki Zone Joint Relief Team (IZJRT) was formed to unify the relief teams of all organizations joining in support of the Ishinomaki area. The IZJRT expanded relief activity as they continued to manually collect and analyze assessments of essential information for maintaining health in all 328 shelters using a paper-type survey. However, the IZJRT spent an enormous amount of time and effort entering and analyzing these data because the work was vastly complex. Therefore, an assessment system must be developed that can tabulate shelter assessment data correctly and efficiently. The objective of this report was to describe the development and verification of a system to rapidly assess evacuation centers in preparation for the next major disaster. Report Based on experiences with the complex work during the disaster, software called the "Rapid Assessment System of Evacuation Center Condition featuring Gonryo and Miyagi" (RASECC-GM) was developed to enter, tabulate, and manage the shelter assessment data. Further, a verification test was conducted during a large-scale Self-Defense Force (SDF) training exercise to confirm its feasibility, usability, and accuracy. The RASECC-GM comprises three screens: (1) the "Data Entry screen," allowing for quick entry on tablet devices of 19 assessment items, including shelter administrator, living and sanitary conditions, and a tally of the injured and sick; (2) the "Relief Team/Shelter Management screen," for registering information on relief teams and shelters; and (3) the "Data Tabulation screen," which allows tabulation of the data entered for each shelter, as well as viewing and sorting from a disaster headquarters' computer. During the verification test, data of mock shelters entered online were tabulated quickly and accurately on a mock disaster headquarters' computer. Likewise, data entered offline also were tabulated quickly on the mock disaster headquarters' computer when the tablet device was moved into an online environment. CONCLUSIONS: The RASECC-GM, a system for rapidly assessing the condition of evacuation centers, was developed. Tests verify that users of the system would be able to easily, quickly, and accurately assess vast quantities of data from multiple shelters in a major disaster and immediately manage the inputted data at the disaster headquarters. Ishii T , Nakayama M , Abe M , Takayama S , Kamei T , Abe Y , Yamadera J , Amito K , Morino K . Development and verification of a mobile shelter assessment system "Rapid Assessment System of Evacuation Center Condition featuring Gonryo and Miyagi (RASECC-GM)" for major disasters. Prehosp Disaster Med. 2016;31(5):539-546.

How differently we should prepare for the next disaster?

Following the Great East Japan earthquake (the Big Quake) that hit the northeastern parts of Japan on March 11, 2011, aid was dispatched from multiple levels of organizations including the Japanese Nurses Association (JNA). Evidence indicates that the JNA did not play an effective role in the aid efforts, since the professional organization had pulled out and stopped sending nursing personnel from the end of April 2011. In view of the way that things were handled in terms of aid efforts immediately, a year, or two years after the Big Quake occurred, the authors of this paper have identified issues related to nurse's role at the time of the disaster. By looking back at what happened, we have gained insights into how to prepare for future disasters.

The quality of life of flood survivors in Thailand, Nakhon Pathom Rajabhat University.

BACKGROUND: The flood crisis of 2011 was a disaster of the highest order in Thailand and Nakhon Pathom Province was among those hit. The purpose of this research was to explore quality of life of flood survivors in Thailand living in a flood shelter established by Nakhon Pathom Rajabhat University. METHODS: This study was a descriptive research. The research instrument was WHO quality of life-brief Thai questionnaire (WHOQOL-BREF-THAI). The data were collected by self administered questionnaires, or read to the subjects who cannot read, then evaluated the answers by themselves on November, 2011. Descriptive statistics, independent-sample t-test and one-way ANOVA were used in the data analysis. RESULTS: The study found that: (1) The quality of life score was found to be at a moderate level of 65.9% and a high of 34.1%. The social relationships domain of quality of life was at the highest level (47.6%). The poorest quality of life score was from the environmental domain (24.9%); (2) There was no significant difference between gender (t=0.004, p-value=0.997) or age (F=1.356, p-value=0.260), with quality of life. CONCLUSION: The quality of life evaluation of flood survivors should be further monitored after the recovery and a intervention programme should address their respective needs and covers all aged and genders.

Assessing functional needs sheltering in Pike County, Kentucky: using a community assessment for public health emergency response.

OBJECTIVE: During 2009-2011, Pike County, Kentucky, experienced a series of severe weather events that resulted in property damage, insufficient potable water, and need for temporary shelters. A Community Assessment for Public Health Emergency Response (CASPER) survey was implemented for future planning. CASPER assesses household health status, preparedness level, and anticipated demand for shelters. METHODS: We used a 2-stage cluster sampling design to randomly select 210 representative households for in-person interviews. We estimated the proportion of households with children aged 2 years or younger; adults aged 65 years or older; and residents with chronic health conditions, visual impairments, physical limitations, and supplemental oxygen requirements. RESULTS: Of all households surveyed, 8% included children aged 2 years or younger, and 27% included adults aged 65 years or older. The most common chronic health conditions were heart disease (51%), diabetes (28%), lung disease (23%), and asthma (21%). Visual impairments were reported in 29% of households, physical limitations in 24%, and supplemental oxygen use in 12%. CONCLUSIONS: Pike County residents should be encouraged to maintain an adequate supply of medications and copies of their prescriptions. Emergency response plans should include transportation for persons with physical limitations; and shelter plans should include sufficient medically trained staff and adequate supplies of infant formula, pharmaceuticals, and supplemental oxygen. (Disaster Med Public Health Preparedness. 2013;7:597-602).