[Role of pharmacists during serious natural disasters: report from Ishinomaki, the disaster-struck city].

On August 31, 2011, five months after the Great East Japan Earthquake, Miyagi prefecture reported 9357 dead and 2288 missing citizens, whereas Ishinomaki reported 4753 dead and 1302 missing citizens. A total of 12 pharmacists in Miyagi prefecture had lost their lives. Many medical institutions at the time were rendered out of service due to damage. Ishinomaki Red Cross had to serve as headquarters of disaster medicine management for the area. The government of Miyagi and Miyagi Pharmacist Association signed a contract regarding the provision of medical and/or other related tasks. Nevertheless, the contract was not fully applied given the impact of the tsunami, which caused chaos in telecommunication, traffic, and even the functions of the government. Given the nature of the disaster, medical teams equipped only with emergency equipment could not offer appropriate response to the needs of patients with chronicle diseases. "Personal medicine logbook" and pharmacists were keys to relief works during the disaster. Pharmacists played a critical role not only for self-medication by distributing over the counter (OTC) drugs, but also in hygiene management of the shelter. Apart from the establishment of an adoptive management system for large-scale natural disasters, a coordinated system for disaster medical assistance team (DMAT), Japanese Red Cross (JRC), Self-Defense Force (SDF), and other relief work organizations was imperative.