As society ages, Japan faces challenge in helping vulnerable people in disasters [Mainichi Shimbun Editorial]

From The Mainichi

May 1 2024

JAPAN – How can we support the lives of elderly evacuees in disaster-affected areas? This is a challenge that Japan faces as a whole as its population ages.

Four months have passed since the Noto Peninsula Earthquake in central Japan. In the Okunoto region that was hit directly by the quake, close to half of the residents are seniors. Elderly care facilities that have supported the welfare of local residents also sustained major damage.

More than 90 such facilities in six municipalities in Ishikawa Prefecture including the town of Wajima were damaged in the quake. Following the disaster, 71 welfare evacuation centers in these municipalities were planning to operate, but only 10 were open a week after the disaster struck.

Many welfare evacuation facilities suffer damage

Welfare evacuation centers accommodate elderly, disabled and other people who need assistance. Local bodies form agreements with such facilities before disasters strike, but following the Jan. 1 temblor, many of them were not able to respond as they faced issues including water and power outages, and staff themselves being affected by the disaster.

The problem of the delayed opening of welfare evacuation centers was also pointed out following the 2016 Kumamoto earthquakes.

Elderly evacuees are prone to deteriorating health in shelters, and in some cases they can find it difficult to recover. It is essential to create an environment allowing them to stay healthy while providing care that supports their quality of life.

As a measure against future disasters, Japan needs to prepare a system to make sure welfare evacuation facilities can function as they should. For example, officials should assume that facilities in disaster-stricken areas could be uniformly affected, and prepare a system involving cooperation from other municipal governments. A network could be created to enable the acceptance of elderly individuals, dispatch of support staff, and provision of food and essential supplies.

Following the latest disaster, specialized groups of welfare professionals organized by each prefecture, known as disaster welfare assistance teams (DWAT), supported the elderly and others in disaster-stricken areas.

In the town of Noto, DWAT members played a central role in setting up welfare shelters in collaboration with the local government.

This initiative moved forward after members realized that elderly individuals with dementia were experiencing stress and health issues in regular evacuation centers. Approximately 30 seniors were accepted into in public facilities in the town, and a six-member team provided care for them. With the assistance of local caregivers and nurses knowledgeable about local conditions, they were reportedly able to provide comprehensive support.

The DWAT system was launched following the Great East Japan Earthquake and tsunami in March 2011, and some 1,300 team members were sent following the Noto quake — the largest-scale dispatch to date.

Local authorities alone cannot adequately support older individuals in shelters during disasters, especially in depopulated areas. Amid efforts to support disaster-struck municipalities, there is a need to strengthen deployment systems for specialists like DWAT members.

It is important to secure the necessary people and train coordinators who are aware of the needs of disaster victims and can connect them with support.

The Japanese government must strengthen measures to compile information on the whereabouts and conditions of people who are vulnerable to disasters so that the data can be shared by related organizations.

Collaboration with teams of doctors, nurses, public health workers and other professionals from various fields is also essential. If each team can leverage their strengths to identify needs, it will be possible to provide finely tailored support.

Care needed to prevent isolation

Some elderly people hit by the quake have difficulty living in evacuation centers due to illness or other reasons. In many cases, such people are forced to shelter in their own homes or even stay in their cars.

Following the Kumamoto quakes, 169 of the 218 victims whose deaths were certified as disaster-related were aged 70 or older, accounting for about 80% of the total. A survey on their living environments at the time of their death found that 10 had been in shelters, while 81 had been at home or elsewhere.

To prevent people sheltering at home from becoming isolated and being left out of support measures, there is a need to look out for them with home visits and other such measures.

If the local body hit by the disaster is unable to respond sufficiently, then it should prepare a system under which specialist teams can move about and provide support.

Many welfare facilities in Noto evacuated users over a wide area. To enable evacuees to be quickly accommodated when they return, introducing systems to support staff employment and continued operation should be considered

In the event of a Nankai Trough earthquake or an earthquake directly under the Tokyo metropolitan area, which could cause extensive damage, it is predicted that there would be large numbers individuals vulnerable to disasters. To protect as many lives as possible, measures that consider the aging of the population must be advanced through cooperation between the national and local governments.