『保健医療科学』第60巻 第6号, p.495-501 (2011年12月)
特集:東日本大震災(2) 震災を踏まえた健康安全・危機管理研究の再構築 <原著>
東日本大震災における DMAT 活動と今後の研究の方向性
小井土雄一 1,2),近藤久禎 1,2),市原正行 2),小早川義貴 1,2),辺見弘 3)
1)国立病院機構災害医療センター臨床研究部
2)厚生労働省医政局災害対策室 DMAT 事務局
3)日本 DMAT 検討委員会
抄録
東日本大震災を踏まえて,地域保健に関する研究は,有事の仕組みを整備することによって平時の機能を強化する方向の 研究,平時の仕組みを強化することによって有事に備える方向の研究,共通基盤としての人材育成に関する研究の三本柱で 推進していくことが重要である.国,自治体,研究機関が連携しつつ,現実の活動や枠組みの構築に資する研究を積極的に 行い,国や自治体の施策に生かしていくことが求められている.
キーワード: :東日本大震災,災害医療,DMAT,広域医療搬送
Abstract
Objective: We investigated Disaster Medical Assistance Team (DMAT) activity after the 2011 East Japan Earthquake and sought to indicate the present direction of DMAT research.
Method: 380 DMATs (comprising 1800 team members) from all over Japan were involved in the overall DMAT. Based on individual team reports, we checked assembling procedures, command and control, hospital support, disaster area transportation, wider-area transportation, and hospital evacuation. Then, we analyzed the causes and effects of various
problems.
Result: After the great 2011 earthquake, over 1800 members of the DMAT quickly gathered and worked together. DMAT commanders worked at three levels: national, prefectural and on-scene. The Emergency Medical Information System also functioned in the acute phase, and the DMAT worked as planned. There were few tsunami-related medical needs resulting from life-threatening trauma; however, DMAT support in severely damaged hospitals was effective enough. It is noteworthy to mention that wide-area medical transportation was practised for the fi rst time in Japan. While there were few medical needs in the acute phase, there were various medical needs, such as a hospital inpatient facility from day 3 to 7. The DMAT was able to flexibly adapt itself to meet such medical needs.
Conclusion: Considering the number of medical teams involved, it is true that acute disaster medical response has progressed since the 1995 Great Hanshin-Awaji Earthquake. This indicates the direction of research was not wrong. Various medical needs not observed in the Great Hanshin-Awaji Earthquake were identified in this earthquake, and some of them have not been studied until now. If the Tokai, Tonankai, and Nankai earthquakes were to occur simultaneously, it is thought that medical needs similar to that of the 2011 earthquake and tsunami would arise again. Therefore, more research regarding the problems found in the DMAT response to this earthquake is needed.
keywords: Great East Japan Earthquake, community health activities, partnership, leadership, human resource development