Japan Medical Association's View of Disaster Measures and Practice.

In Japan, community healthcare is provided under the public health insurance and the respective medical systems in accordance with local characteristics. However, when a major disaster happens, the community healthcare structure might be destroyed. One of the missions of the Japan Medical Association (JMA) is to restore healthcare in the afflicted areas under these circumstances by bringing together the forces of doctors and medical personnel across Japan. Currently, the number of elderly people, who are socially vulnerable, is increasing in Japan, making the continuity of healthcare support, not only during the actual disaster but also for some time after evacuation, a pressing issue. The predicted Tokyo Inland Earthquake or Nankai Trough Earthquake will strike major cities that especially face this aging issue, so a disaster preparedness plan must incorporate a long-term health support component. In addition to natural disasters, we cannot ignore the possibility of complex disasters generated as a result of chemical disasters or nuclear power plants. In the Great Hanshin-Awaji Earthquake, 83.3% of the deaths were caused by building collapse. In the Great East Japan Earthquake, 92.5% of the deaths were from drowning. A combination of the two disasters is anticipated to occur in the Nankai Trough Earthquake. A Tokyo Inland Earthquake would result in enormous numbers of evacuees and a state of severed logistics. The JMA is a professional organization consisting of member physicians in various medical specialties. It has a three-layered structure made up of prefectural and municipal medical associations, and covers the entire nation in a vertical direction through close collaboration at each prefectural and municipal level, and in a horizontal direction through information sharing such as by continuing medical education including disaster medicine. By making full use of these characteristics, we can respond flexibly with diverse teams such as lifesaving at an ultra-acute phase to long-term support, until medical institutions in the affected areas recover. There are many things we can do and the range of JMAT*2 activities can be very broad.