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Juntendo Medical Corporation Juntendo Hospital Executive Director

Yoshimi Shirahama

Learning from experience: flood prevention measures for medical institutions

By taking measures based on the assumption that flooding will occur.

minimize damage

It has been pointed out that the risk of flood damage is increasing year by year due to the effects of climate change. Juntendo Medical Corporation, which operates medical treatment beds (115 beds) and nursing care health facilities (70 beds) in Saga Prefecture, was hit by floods caused by heavy rains in 2019 and 2021, and suffered a large amount of damage. Ta. We ask Yoshimi Shirahama, the executive director, about the flood countermeasures they are taking based on the lessons and experience gained from the two floods.

Flood damage prevention measures for medical institutions learned from experience Minimize damage by taking measures assuming flooding will occur

Recognizing that this is a flood-prone area,
Securing a lifeline in case of flood damage

When our corporation moved to its current location in 1999, which is surrounded by the Rokkaku River (a first-class river) on three sides, we were aware that this location was a flood-prone area, so we constructed the building on land that was raised by embankments. Did. Furthermore, in order to prevent ``disaster-related deaths,'' we aim to have a complete facility for evacuation, and in addition to stockpiling emergency food, we also have a water purification system that provides a stable supply of water, and a system that can last for at least five days even if the gas supply stops. We have also worked on lifeline measures such as installing a large capacity gas tank and installing a private power generator on the roof.

However, in the 2019 flood, the building was flooded with water approximately 25cm above the floor level, forcing them to be stranded for three days. Medical equipment that could be moved in advance, such as ultrasound diagnostic imaging equipment, was moved to a safe location and survived, but large medical equipment and rehabilitation equipment, such as X-ray X-ray equipment, breast X-ray imaging equipment (mammography), and CT equipment, were submerged in water. I lost everything (Photo 1). Fortunately, there were no human casualties. I believe this was extremely important in order to quickly resume medical treatment.

In the 2019 flood disaster, we resumed medical treatment 13 days after the disaster. The reason why we were able to reopen in such a short time despite suffering such severe damage was that the electronic medical record server and computer terminals that had been installed on the third floor in case of a flood were not damaged and medical records remained. Examples include being able to use some of the medical equipment and securing their own lifelines.

<photo1>

The rehabilitation room was also damaged in the 2019 flood. Much of the rehabilitation equipment was unusable.

In 2021, an unexpected situation occurred,
Suffered from above-floor flooding for the second time.

Based on the lessons learned from 2019, we installed new water stop plates at 20 locations such as entrances, exits, and internal doors, but unfortunately they were of no use during the 2021 flood. The above-floor flooding in 2019 was caused by torrential rain that fell in a short period of time in the early morning hours, as well as oil leaking from a nearby factory and the drainage of contaminated water being stopped to prevent further damage. After the disaster, the factory announced preventive measures, and we installed a 70cm water stop plate, anticipating that even if it rained a considerable amount, if drainage could be treated normally, the level of water would only reach 50cm above the floor. .

However, the way the rain fell in 2021 was different from 2019, and heavy rain that reached the level of a heavy rain/flood warning continued to fall for 4 days. Drainage treatment could not keep up, resulting in damage of 1 m above the floor level (Photo 2). Then, just like in 2019, we lost all of our large medical equipment, rehabilitation equipment, etc., and again suffered losses in the billions. What our organization learned from the two flood disasters was that, even if you predict water levels and rainfall and take measures, unexpected things can happen, so flooding is inevitable.

So we changed our thinking and decided to take measures based on the premise of flooding. At the same time as moving large medical equipment to the second floor, we reviewed the lineup of large medical equipment, leaving only the necessary equipment. The MRI system we introduced after the 2019 disaster became unusable due to the 2021 flood, so we took this opportunity to discontinue it. In addition, we decided not to reinstall the mammogram X-ray machine due to the low number of users.

In addition, in light of the fact that during the 2021 flood, the items placed on the desk on the first floor were flooded, we have installed a shelf on the top of the wall in the room so that important items can be quickly moved to a safe place. was built. In order to minimize damage to property, it is important to keep important paper documents and other items tidy and tidy so that they can be taken out at any time, and we made sure to do this thoroughly.

<Photo 2>

In 2021, flooding reached a maximum level of 1m above the floor and 2m40cm above the road.

Regarding the means of securing personnel in advance
It is also necessary to consult with the government

Evacuation drills were an effective countermeasure. Since 2017, our corporation has held evacuation drills based on flood disasters once a year. In the process of considering evacuation drills, we discovered that wheelchairs are more efficient than beds for transporting disabled elderly people. At the site, where transport in a wheelchair had been thoroughly practiced through training, we were able to evacuate without major confusion thanks to the patient's cooperation. However, when heavy rain and flood warnings are issued, we increase the number of night shift staff (10 in normal times) by three people, but evacuation at night takes time. On the other hand, I believe that ensuring safe evacuation is more important than speed. For this reason, it is important to repeat drills so that staff and patients become accustomed to evacuation.

Another area where measures were insufficient was ensuring the safety of staff. During the 2019 flood disaster, many employees came to work with water up to their chests and waists. However, since there was a risk of a water accident, I regret that I should have issued an order to stop working all at once. Subsequently, we established standards and a communication system for issuing work stoppage orders.

Furthermore, during the 2019 flood, we were stranded for three days and had no way to replace staff. When we consulted with the town hall, they agreed to use the town's boat to transport the staff, and in the event of a flood in 2021, the boat would arrive first thing in the morning. It is also necessary to consult with the government regarding methods of securing personnel.

Having been affected by the disaster twice, the staff members feel a sense of crisis that ``flood damage may occur again this year.'' In order to minimize the damage caused by disasters, I believe that it is most important to be prepared on a daily basis so that we can respond to flood disasters at any time, and to maintain a constant awareness of disasters throughout the hospital.