All: First, read this: Cnn Ireport of our latest trip to the Quake Zone: http://ireport.cnn.com/docs/DOC-595378 See this (only 50 of 400+ good photos are here, but they give an idea): http://my.slideroll.com/galleries/members/karukun/gallery/carlmasae-with-volmedics-in-quake-zone/?g=68afk3y9 Here is my add-on to this great report by Gerald Flint, Volmedics Founder—note, I want to get as much information out there first, so I will be providing bullets here; will try to rewrite this into more comprehensive/cohesive prose as we go forward: Participants: Gerald Scott Flint, Director of Volunteer Medics Worldwide. (My wife) Masae Sullivan, Hiroki Fukuyama, Doug Durghee, Interpreter/Translator, Danny Macleith, and myself, Carl Sullivan. Except for Gerald, the rest of us are interpreters/translators, members (several officers/former officers) of the Japanese Division of the American Translators Association and Japan Association of Translators. Several of us have a medical background, as well as military experience. Trip: 17-24 April, well over 1 month since the original earthquake took place on March 11, 2011 (I say “original” because they keep happening). Objectives: Basic mission was to conduct vision examinations and provide eyeglasses to as many persons as possible who had lost everything, including their “eyes” (glasses), in the tsunami (Gerald had already distributed over 1,000 pairs of glasses in previous missions to the Zone). Very many persons were experiencing vision problems—we worked to diagnose and assessed basic problems. We also planned to conduct a basic health check, including taking vitals (blood pressure, pulse), medical history, self report of illnesses/symptoms, self report of mental health-related items (depression, sleeplessness, etc.); we didn’t have capabilities to treat anything beyond basic first aid, so planned to report any serious finds to medical authorities/shelter directors and also to have patients make visits if capable (had wheels) on their own (with our follow up). We also planned to conduct clean up work, when it did not interfere with our medical mission, to survey the worst-hit areas to assess needs, and to conduct home visits where we suspected persons might not be getting reached at all. All of this including Gerald’s extremely significant work from before in getting fuel and food to the shelters, to assist in the evacuation of refugees from the area, etc., in the earlier days of the disaster. One other very critical goal was to provide a precise assessment of the situation on the ground to provide other good groups going forward—this is what I am hoping this does here. Locations: Staged by two vehicles, including my own POV, from Yokota Air Base in Tokyo, via Tohoku Expressway to Fukushima, then to sites in the quake zone. We visited several Shelters in Higashi Matsushima, Miyato, Shichigahama and Souma regions, and observed destruction in shoreline and mountainous regions all across those areas. We reached fairly close to the permissible southern limit at Minami Souma, but did not reach or penetrate it. Weather: Clear mostly, but some periods of rain. The weather is improving from my wife’s/Gerald’s earlier snow trips to the Zone, but it is still cold out there, and cold in many of the shelters. Cold weather preparation and self-sufficiency preparation is absolutely essential. We stayed in tents/in the open the first night (actually camped by mistake next to the morgue where the bodies being brought in from the field are washed down, so we had to move in the early am); from then on, we stayed in adjourning locations of the shelters—there were few other volunteers observed, and the shelter directors always seemed grateful to have us—we being in most cases the only ones visiting the shelters right now (some exceptions). This was especially true in Souma, where we quickly became a part of everyone’s family. A female supervisor at the Hamanasu Shelter in Souma asked me why we dared be with them with the radiation; I told her that we loved Japan and wanted to be with them and help them—we all cried hard. Shelter visits/status: Overall: Supplies are arriving, for the most part. Food and blankets are in good supply, although there are large disparities between shelters. Gasoline is now available—huge difference from earlier days. Stores are full, if you have the money and means to get to them. I didn’t see stealing as big of an issue as it was earlier. I saw medical supplies at one place that had been sitting there unused; patients/staff didn’t seem aware of how to make use of the materials—need a doc or nurse around to give them guidance. That given—here are the issues: basically, there is not much progress beyond the boxes sitting in the genkan at this stage, outside of what our volunteer group and very few others are accomplishing. Clothing—fundamentally, everyone has lost everything they own, including the clothes, glasses, wallets, etc. off of their bodies. Now, many have a few sets of clothes (the luckier ones have relatives who give to them), but quite a few only have two or three sets of clothing and underwear (lots of borrowing underwear). Overweight people have little or no clothing, because the focus of donations was on thin people. Very few shoes—many people still no have only slippers—critical need here all over the zone. Mentioned earlier—shoes are massively needed across the zone. One of biggest needs as of April 24. No funeral clothes available, even though many are attending funerals on a daily basis. Kids have no school uniforms—many high school kids are showing up in any uniform thing they can scrounge from the donation pile—junior high uniforms, etc. Medical supplies are often meager. Physician visits are random, and not organized in any particular manner. For example, at Souma Hamanasu, a courageous doctor from Ishikawa Prefecture showed up early on, and provided weekly visits on his own, while at Miyato there hasn’t been a physician visit since March 17. Simple over the counter drugs are often not available. On a number of occasions, our team observed critical blood pressure and mental health issues that were either unknown or not being cared for. Seldom are there primary medications; let alone things like antibiotics, etc. Center conditions vary widely—some centers are clean, tidy, orderly, well fed, and heated, while others are dirty, unsanitary, cold, overcrowded, under-lighted, and depressing. There seems to be little central organization of all of this. JSDF are located (camped) at many centers, but with exception of Shichigama area, don’t seem to be participating in the centers directly. I don’t blame them—think that their mission is focused on body search and recovery now, as well as cleanup, which I saw them very involved with. At Shichigahama, there are medical teams from Miyazaki and Shimane providing care—very organized; even a dentist visits every other day, and mental health counseling based out of Tohoku University are being provided, which is unheard of in other areas of the Zone. Why is everything moving so slowly? Why are there so very few volunteers (aside from several Japanese groups we encountered who are moving the dirt at residences)? Radiation and quake fear is one factor (by the way, my vehicle tested lower in radiation reading after coming back from a few days in the Minami Soma/Soma area than it did when it left on its maiden voyage there; we did get shook up a few times, however). Inability to rough it is another—those with a 4 star hotel mentality will probably not make it. Waiting for officials to welcome them in may be a third factor—you will be waiting a long time by my guess. A fourth reason may be the huge disparity in what gets reported, either officially or in the media, and reality. Fifth—few people are unable to offer a specific, focused, desperately-needed care specialty like Gerald does with the glasses—right now, no one can “see,” literally, because they have lost their glasses in the tsunami (“megane ga nagasareta” time and time again); we are giving them their eyes back, and are heroes in the process. Anyone who can offer such focused, needed item will be even huger out there. Although the simple things like cleaning homes, etc. are also in desperate need and vastly overmanned (but plan to be self-sufficient). Also, the Japanese people are their stoic, tough samurai selves—dealing with day to day in an amazingly good-natured manner in many cases. People who aren’t as conversant with Japan misinterpret this as the Japanese handling things better than they actually are—this is the “tatemae” self (outward showing), as opposed to the “honne” (inner feelings) they have, which are often far more desperate, but hidden. I think there has been an over-tendency to gloss over the extent of problems, due to this issue. Short: The roads to the zone are in good shape; the dangers are present and should be respected, but should not deter aid. The shelter directors can be identified, and have phone numbers. The needs can be isolated and identified. Aid could be as simple as preparing yourself well, isolating the needs, getting in your car, driving to the zone and executing it—yet it is not happening. Lack of mental health care may be starting to be a focal point—we met two groups in the field that were focused on this (one seemed to be more focused on making sure that people didn’t do the wrong thing—rather tough assignment when nothing is happening in the first place). However, there is none out there. Japan is abysmal for this even in Tokyo, let alone the Quake Zone. I think that any solid counseling professional who understands a bit of Japanese culture, can hike himself in with an interpreter and stay for awhile, building trust, is worth his/her weight in gold. I met one patient on thyroid medication—critical shortage because the plant that produces 98% of such medication domestically used in Japan was destroyed by the quake. The patient was down to his last pill when a doctor prescribed another set—he had 18 days left as of today. Many other unrecognized shelters and persons braving it alone (somewhere else I mentioned the big problem at Minami Souma; this seems to be all over)—big need to identify and care for these. No music for kids or adults---need now for cd players, music, etc. (although they have to have earphones). More books/magazines also needed. Being together is a big plus, where it happens and where people are not otherwise discriminated against for “being from Minami Souma,” etc. The community feeling is making for rather fun, “campfire times,” in many cases, at least at this point. How this lasts is a question. The biggest heroes in the Zone are the informal heads of the shelters—they are saving hundreds of people by amazing bravery and sacrifice. Suzuki san at Higashi Matsushima incurred extensive damage to his home and issues with family, but is running around 20 hours a day taking care of almost a thousand people at multiple shelters. Mikiko san is a 29 year old mom and city worker there is under Suzuki san taking care of all the issues at Ono. Watanabe san is a samurai at Soma—had a show down with the city leaders who were struggling, and now works day and night to support his flock at the Soma Arena shelter instead of recovering his ruined home. His passion for helping us and giving us ideas of where to support were crucial and inspiring. Iwai san is a 23 year old volunteer at Miyato—taking care of everything for 240 homebound survivors and another 300 survivors in 3 shelters that are accessible only part of the time due to high tides. There are others. These are the ones who will bring Japan back, and who most deserve medals from the Emperor, in my opinion (although there are all kinds of heroes, and a fair share of villains). We also visited mass graves being constructed at Oshio—indescribable emotions there. Shallow graves being constructed very counter to Japanese culture, due to necessity. My heart went out the JSDF and others working there. Bodies in first two rows were placed in plastic bags first; then wooden boxes were constructed and remaining rows were filled with these. Many hundreds of people have been/will be placed here. Names and city locations being noted on wooden placards. Suzuki san from the center broke down—couldn’t bear to look at the names of the people from his town on the placards. When they heard that I was from America, the comment was made at Souma by three families I was sitting with about “where were the Americans when we needed them?” There seemed to be recognition that the U.S. was there and poised to help, but then didn’t come through—and perplexity about why. People seemed to sense that the U.S. cared for them, and that it wasn’t their decision to hold back. Higashi Matsushima Ono Shelter 240-300 persons (increased by 60 after schools opened and other shelters were closed) Suzuki san is contact; Mikiko san is significant person there (most city leadership is killed, so people are stepping up as leaders in most cases I observed). Suzuki san is contact for other shelters in area. Crowded; marginal health conditions; relatively serious mental health issues here—(in earlier mission had two potential suicidal patients for whom we obtained some help earlier). Cold in shelter. Person stepped on nail—we assisted in getting him to tetanus shot; if we hadn’t been there—no care/followup would have happened. No medical care on site—few medications available. Sadder feeling amongst those here, I felt. Red Cross nurse was coming out the door on day one—the only Red Cross presence that I observed anywhere. Earthquake happened when I was there—5-6 children around me burst into tears in fear. Morgue is located here. NyuYogu shower facility here—big plus at this facility, and very enjoyed. Food/supplies decent. I didn’t ask about clothing here. On last day, we met members of the Japan 300 Mental Health NGO there—doing great things for the shelter residents. Higashi Matsushima Community Center Shelter Large numbers/very crowded—people sleeping in hallways, etc. 5-6 member JSDF medical team was there (only time I saw them on this trip)—looked like good care to critical patients. We conducted eye clinic—went well. Seemed warm in shelter; relatively good impression of conditions that day. Akai Nishi Center Small shelter—quite crowded; very close knit—genki group. Very appreciative of the clinic we conducted. We weren’t at this shelter, or at the Community Center Shelter, to really get a full assessment. Akai Center Beautiful facility—by far the best shelter we visited; those in this shelter seemed to be of higher social class. Clinic conducted earlier, so we visited for follow-up. Once had oysters, crab, etc. delivered here, according to my wife from past trip. Warm; friendly staff. Oshio Center [from earlier report by my wife] One lady, who had been main figure in helping residents here, had many things stolen. Miyato (Eastern peninsula jutting out from Higashi Matsushima—perhaps the first place to take the tsunami) 3 shelters (300 people) and another 240 people in homes. Dark, crowded and cold shelters. The tide comes up close to the door of the shelter at high tide, closing everyone off. Everyone is related here—like a family atmosphere. Spirits are relatively good, despite the physical problems. Worried about how they will make it during the months/years ahead. Medications are sitting in boxes, but no one there to tell folks how to take them or what to take. Lack of shoes was mentioned here—many want to go running or walking, but can’t right now; their lifestyles are upset (also true in places like Soma Hamanasu with high fisherman population, who are all “doers” and exercisers). Although the center reports that a physician comes every Thursday, the dozens of people I interviewed said that they hadn’t been seen since about March 17 (although some were commuting by car to a local hospital). Young girl Iwai and courageous staff are carrying the ball for the community here. We examined and provided eyewear to many dozens of the folks here, who traveled hours prior to the appointment to stand in line to be able to see/read again. Shichigahama By far the best shelters/care in the region. 115 temporary shelters will be ready there soon (others are being told to wait up to 2 years for them)—drawing to be held for them. This area does not need further supplies of anything. Very well organized because their city leadership is intact. One problem is privacy—lots of complaints about this following 1 month; to ease this issue, Gumma Onsen is shuttling families every day on 3-4 day trips to Onsen in Gumma. Souma Arena Shelter I personally spent more time here—these folks are my family now. Moderate levels of supplies; few medications on hand. Volunteer masseuse makes life easier for many. They went crazy with our clinic—examined/delivered lots of eyewear, courtesy of Dr. Eyes (thank you!!!). Fewer clothes here-same shoe issue. One man was very depressed—had a broken leg and other problems; I spent a lot of time with him, somehow he was a different man at the end. Watanabe san runs this shelter—came with his bottle of sake along with many shelter folks to share stories after hours. We spent much of one day helping to clean Watanabe san’s house out, together with a great Japanese NGO group from various places. Warm, nicer shelter by comparison, with running water. Still, many issues and latent problems. Souma Hamanasu Shelter Large shelter (one of 8 now running in Souma); big eye clinic we ran there. Great group. Many medical problems require treatment here; mostly elderly (20 percent younger people). Staff were exuberant that we were there—just showed up on the fly. Everyone in Souma can’t believe that we could brave it to be with them---they sense that they are the “modern day burakumin,” with everyone being afraid of the radiation. Anyone who goes there will be greatly loved and appreciated. I met a former worker of the Daiichi plant, who said that he had tested for high radiation levels due to his prior work there, and was very concerned, because he had no idea if he was in danger or not, or what kind of danger he was in. He was keeping this quiet By the way, right this moment, I called Terajima san at the Hamanasu shelter, to see how he was doing and what they needed. He said “well, we need everything.” I asked where to start—“maybe shoes?” He replied “yes, no one has shoes.” I said that I would try to get some shoes moving his way. I assured him that I would try to call every few days to check their status. Minami Souma/Kashima, etc. No shelters here--“most are evacuating.” However, as has been the case since March 11, what you hear is not necessarily the truth—as a result of going house to house and providing care to families, we found that many folks who have gone to shelters in Fukushima city and other places are encountering discrimination when they announce they are from “radiation-infested” Minami Souma (in one case we encountered, a person bounced around to five different shelters), so that they are then deciding to return to their homes and tough it out alone. Also, others are returning (along the still-allowed northern border) so that their kids can go to school; as a result, there is a flow back into the area. I have no idea how these people are going to be supported or cared for in any manner. All persons in the Souma area are relatively or very fearful for the future, and the effects of radiation. Extent of disaster observed—status: Higashi-Matsushima area—Broad destruction. More homes tend to be partly remaining here, so many shelter dwellers are returning to search their homes for their items. Areas closer to the ocean were just being searched by JSDF as we visited there this past week—troops very busy there (amazing after a month post-disaster; this thing is so huge). We were the first persons in one area we passed through, so got out and conducted a short search—saw two bodies in the river. If this had been our main mission and we had lent time thereto, we would have found many bodies in cars amidst homes in a neighborhood there, I am sure. Miyato (peninsula)—Everything gone, so no one is going back to their homes. Tide is very high there now, so access to shelters is possible only at certain times. Sendai Airport area—More homes were just swept away—lots of cars still in the fields. More areas are being searched for bodies than what has been reported earlier, although there are still broad sections not searched. Airport has been rebuilt—beautiful thing to see, in the midst of everything else. Shichigahama—I personally only saw it at night, but it was grizzly. The line between complete destruction and untouched homes is pronounced there. Sendai city—quite a bit of destruction in spots, and large parts of the city untouched. Talking to a Seven Eleven worker about what was going on a few minutes away from his place of employment, it was like he had no clue—the line between those who are touched and untouched is amazing. Souma/Kashima—Either garbage, or it was all taken away. Shelter dwellers are not going back to their homes. Extensive body searches now underway by JSDF troops. High number/ratio of cars with X’s marked being picked up by JSDF indicated large deaths in vehicles there. I mentioned how we were loved—we were truly beloved in many places, especially in Souma. This week will live in my heart as no other time in my life. If I didn’t have orders to Afghanistan (military reservist) soon, I would want to move out there and stay until it was all done. Not one person was bitter—everyone accepts the situation with a chuckle, and determination. The very best of Japan is exhibited in the survivors—maybe they will be the seeds of Japan’s renewal. Am tired—will close now. Apologies for the disjointed nature of this report—trying to get info broadly and accurately out asap—if you are capable, don’t wait for the invites or conjure up the excuses—(be like Gerald and) go get em!!!!! CNN ireport of our trip: http://ireport.cnn.com/docs/DOC-595378 Masae’s quake video: http://www.youtube.com/watch?v=AgiW2z_X-Kc 2nd report of Volmedics Quake Relief: ""JAPAN SHAKES" A Disaster Mission Story” http://ireport.cnn.com/docs/DOC-591037 Volmedics website: 　http://www.volunteermedics.org/