Friday, 24 August 2012

The Great East Japan Earthquake, Some thoughts from Red Cross

Based on 25 Years of Working with Disasters in the Red Cross/Red Crescent Movement

by Bjorn Eder   from The Journal of Humanitarian Studies Vol 1, March 2012,  Japanese Red Cross Institute for Humanitarian Studies.

On 11 March 2011 at 2.46 pm, the northeast of the island of Honshu was struck by a magnitude 9.0 earthquake with the epicentre 120 km off the coast. It was the fourth largest earthquake recorded in the world since 1900, and the strongest in Japanese history. Within an hour, a giant tsunami which reached up to 40 meters in the narrow bays and river valleys of this mountainous area, devastated communities along 700 km expanse of coastline. Iwate, Miyagi and Fukushima prefectures were most severely affected.

The President of IFRC and Japanese Red Cross together with Naoki Kokawa, visit the affected area soon after the tsunami struck.

More than 19,000 people died or are still missing and nearly 6,000 were injured. Of the fatalities, some 90 % were drowned in the cold water. More than 65% of those who died were over 60 years old. The tsunami also seriously damaged three nuclear reactors in Fukushima, where it caused an accident on a scale not experienced since the catastrophic accident at Chernobyl in 1986. It was the tsunami rather than the earthquake, which was responsible for virtually all the fatalities and, together with the nuclear accident, all the evacuees. More than 400,000 people were evacuated to temporary shelters, including those displaced from the 20 km zone around the damaged nuclear reactors at the Fukushima-Daiichi plant. Public and industrial infrastructure suffered massive destruction. The cold winter weather added to the difficult situation of those who were displaced. Local authorities and volunteers distributed large amounts of food, water and daily necessities, fuel, medical supplies, much of which were donated by those among the local population who had been less severely affected by the disaster and by people in other parts of Japan in a massive expression of solidarity. Commercial companies and officials from neighbouring municipalities and prefectures also rushed to provide support. Personnel from the Self Defence Forces, fire brigades, coast guards and police from the whole country were rapidly mobilised to assist, along with 500 nuclear disaster response teams. More than 2,000 medical teams went to the affected areas. From around the world, countries and organisations spontaneously offered search and rescue and relief assistance. The US and South Korean military also immediately responded by sending ships, planes and personnel. The costs of rebuilding after the destruction are estimated to be between 2.5% and 4% of the country’s economic output in 2010.

What did the Japanese Red Cross Society (JRCS) do?

When the earthquake happened, it rocked buildings much more severely than normal even in Tokyo, and the staff in JRCS national headquarters there immediately realised that this was exceptional and not just one of the earthquakes that occur almost daily in Japan. JRCS had well prepared plans to meet its obligations under the existing national disaster management plan and it implemented these very effectively. The Japanese Red Cross at once swung into action and within the first 24 hours, 46 medical teams had been deployed to the affected areas. A national fundraising campaign was launched to assist the municipalities to bring cash assistance to the affected population. In the days and months which followed, nearly 900 JRCS medical teams and more than 700 trained providers of psychosocial support were to treat nearly 90,000 shocked and vulnerable survivors of Japan’s largest recorded disaster. With hundreds of thousands of people initially crammed into evacuation centres, trained psychosocial nurses helped those hit by the disaster to come to terms with the emotional impact of losing their relatives, friends and neighbours, their homes and any certainty about the future. As the operation moved from relief into early recovery, people were able to settle in prefabricated homes or rented apartments. Most had few possessions, but with the aid of donations from across the world, JRCS provided 128,000 relocated families with a set of electrical appliances. Focusing especially on the most vulnerable, special beds and vehicles have been provided to elderly care homes. Nearly 170 schools have received various kinds of new equipment, including school buses and many vehicles have been donated for social services, along with items for school clinics and indoor play areas. As part of its longer term recovery plan, JRCS is reconstructing both permanent and temporary health facilities to replace devastated hospitals and clinics. The mostly prefabricated clinics which are currently in operation are stretched beyond their capacity and permanent hospitals will take several years to complete. In terms of its support to the survivors, JRCS is focused on meeting needs in areas such as psychosocial support for the largely elderly population in many of the temporary housing communities, preventing them from sinking into isolation, inactivity and despair.

On the importance of imagining the unimaginable

The disaster in Tohoku went far beyond any of the pre-disaster expectations. It caused the greatest loss of human life in a single disaster in Japan since the Second World War and posed the nation with enormous challenges regarding the way earthquake and tsunami countermeasures have been developed so far. Disaster preparedness in Japan is very impressive and among the best in the world, but the 2011 earthquake and tsunami differed in size from the official pre-disaster hazard assumptions. The scope of the seismic movement, tsunami height and extent of the devastated area, all exceeded expected levels by far. The reason for this could be that the assumptions were intended to be used for technical purposes, where financial limitation is an important consideration. Risk estimations based on these expectations may even have engendered a false sense of security in coastal protection installations to an excessive degree. It is quite possible that the evacuation of residents was delayed by this. It is also likely that much of the confusion during the relief phase might have been avoided if the contingency planning for relief had been based on risk analysis considering scenarios of higher levels, which could have been used since the financial limitations would be much less important. Therefore there is a need to examine multiple damage scenarios, including worst-case disasters with complex impact, such as the largest imaginable earthquakes and tsunamis. This disaster happened during daytime, but if it had struck at a different time or season, or if the tsunami had affected a wider area, humanitarian consequences could have been vastly greater. The impact of the nuclear disaster was also limited compared to what it could have been by fortunate circumstances such as favourable wind directions. The coast hit by the earthquake and tsunami has the highest concentration of nuclear reactors in the world, all of which were affected by the disaster, but most backup emergency systems survived and these reactors successfully shut down.

Are there differences in impact of large disasters in high and low income countries?

In May 2011, JRCS and IFRC decided that the first six months of the operation should be evaluated in order to learn lessons and improve the mechanisms for managing large scale disaster response in high income countries. They jointly commissioned a small team of experts to carry out an independent evaluation, which was finalised in February 2012: “Preparing for and Responding to Large Scale Disasters in High Income Countries, Findings and Lessons Learned from the Japanese Red Cross Society’s Response to the Great East Japan Earthquake and Tsunami”. The reason for the focus on high income countries is that these generally share many characteristics: they have well-developed infrastructure and services, sophisticated and resource rich administration and industry, a large and fast-growing share of the population over 65 and a comprehensive welfare system. Most of them are also vulnerable to a variety of disasters and often their coping mechanisms are very different to those of low income countries. Additionally, national Red Cross and Red Crescent societies in these countries vary widely, reflecting the tradition and culture of which they are part. The evaluation compares the operation of JRCS in 2011 with the interventions after Hurricane Katrina which hit New Orleans and southern states of the USA, in 2005, the floods in Queensland, Australia, in 2011 and the earthquake in Christchurch, New Zealand of the same year. However, it would be unwise to draw too many general conclusions. Lessons can be learned, but each country must plan and respond to large scale disasters after analysing and considering its own unique context – and much applies equally to disaster response and preparedness in low income countries where people by necessity have to build resilience and cope with their available resources.

Emergency response, relief and shelter

The likelihood of another mega-disaster in Japan is very high and it is therefore obvious that JRCS should develop a comprehensive contingency plan for this, considering a number of issues. First, it needs to discuss and review the role and mandate of the Red Cross in the Government national disaster management plan. Then it needs to formulate a strategy to scale up and meet abnormally large needs in the case of mega disasters when several areas are seriously affected. This should cover issues such as the possible role of JRCS health institutions and Chapter offices as forward disaster management coordination centres in large scale disasters.

The importance of capacity to make its own independent field assessments and to exchange information with other actors is critical and cannot be underestimated, especially in situations where some local authorities are rendered dysfunctional by the impact of disaster, as was the case in Tohoku. The disaster response plans of the authorities were based on the likelihood of having to deal with the consequences of an earthquake but not tsunamis. The director of the Red Cross hospital in Ishinomaki told me that they only had a manual for an earthquake disaster and the JRCS medical teams kits were designed to treat injuries, including crush injuries, caused as a result of earthquake. The tsunami hardly caused any injuries since people were either killed or survived the devastating wave of ice cold water. The medical needs of those who had been evacuated were mostly related to chronic diseases and conditions following the strain of being housed in cramped and difficult evacuation canters. JRCS should work actively to develop a framework for cooperation with the appropriate government authorities at central and local levels, addressing both how to provide effective emergency relief and contribute to recovery of the affected population. It should do the same with NGOs and other relevant organisations to better share information understand each other’s plans and promote coordination of activities in the face of future disasters.

Nuclear accidents, Fukushima Daiichi and lessons for nuclear preparedness

The role and responsibility of JRCS in cases of large scale industrial accidents also needs to be made clear. The Movement should continue to partner with JRCS both in giving assistance to the affected population after the nuclear accident and in defining how to address the humanitarian consequences of such disaster events. It is important to formulate a specific strategy or guideline for the Movement which clarifies both the domestic and international roles of national societies and the potential roles of ICRC and IFRC when dealing with the humanitarian consequences of nuclear accidents. In my opinion, this should be done preferably with a broader perspective, including other industrial disasters which could be caused by chemical, biological or other accidents – or by acts of sabotage or terrorism. For example, the humanitarian needs were immense after the catastrophic leak of methyl isocyanate at the Union Carbide chemical factory in the Indian city of Bhopal in 1984. This is one of the world’s worst industrial disasters and it caused more than 550,000 injuries, of which almost 4,000 were severely and permanently disabling. As many as 25,000 deaths have been attributed to the disaster in recent estimates. In Japan, the release of methyl mercury in Minamata bay and Niigata are examples of tragic industrial disasters with thousands of victims, related to the slow release of chemicals. There are now extensive experiences of humanitarian interventions after the Chernobyl and Fukushima Daiichi nuclear disasters and the decision to develop such a framework was taken through a resolution at the General Assembly of the IFRC in Geneva 2011. The process is led by the IFRC secretariat with participation of JRCS and several other concerned national societies with the aim of presenting a set of guidelines within the next few years.

Assessment and Preparedness

After the disaster, it took 10 to 14 days to get a reasonably clear picture of the overall situation and the main needs. Even in the period up to June, some municipalities were struggling to indentify clearly the priority needs of their communities. The decentralised disaster management system in Japan compounded the situation. It is first and foremost the municipalities which are responsible for assessing and responding to disasters but in some municipalities many key officers died and the administrations became virtually non-functioning. The prefectures depended on information from the affected municipalities and this was difficult to obtain through normal channels. The rescue and emergency services assisted to fill the information gap, but getting a clear picture of the situation nationally and then defining priority needs took time. JRCS also depended upon information from the municipalities as a basis for making its response since it had no independent assessment mechanism. The spontaneous flow of uncoordinated relief added to the confusion

However, JRCS did have Chapters with close working relationships with their respective prefectures, which made access to information possible when it did become available. This information was conveyed to the national headquarters where a Task Force met daily under the leadership of the President. JRCS headquarters tried to gather the most reliable information available from external and internal sources. A group of experienced disaster managers from partner national societies was invited and visited the field during the first days after the disaster and brought a number of issues to the attention of JRCS. JRCS should train its domestic disaster response personnel to conduct assessments on the basis of IFRC developed methodologies in order to reach the most vulnerable. This requires well-trained assessment teams, ready to be deployed at short notice, who can help municipality authorities assess the needs of their communities. In large widespread disasters, this is only possible if there is a strong and well prepared volunteer base at municipal level with systematic training and organisation for disaster intervention and effective assessment. Therefore, JRCS needs to strengthen and diversify its trained volunteer base and have effective systems in place for their efficient mobilization and deployment. In Bangladesh, where frequent cyclones regularly devastate remote and inaccessible coastal communities, for the past forty years the Red Crescent has trained more than 35,000 local community volunteers over a 4,000 km coastline to make and report assessments of damage and needs in a consistent and systematic way. They also warn the population of the approaching disaster through low-tech means and are equipped for rescue and first aid. This system has been substantially supported by JRCS over the years and could provide valuable lessons also for Japan, where preparedness to a high degree relies on complex and vulnerable technologies which proved inadequate or inaccessible to the elderly at the time of the tsunami in much of the affected communities. It is critical to raise the disaster awareness of residents and those in charge of disaster management through disaster education and disaster drills and to review what type of information is essential at times of evacuation. In many countries where the Red Cross or Red Crescent has a strong and trusted community presence with social or health programs, volunteers play an important role in conveying information to residents who may be difficult to reach in other ways, such as elderly and disabled persons. Passing down disaster-related culture over generations based on disasters that have occurred across history is very important to improving people’s understanding. In addition to school education, effective information programs can be conducted by volunteers from the community if they are adequately trained and supported, and also included in Red Cross health and social establishment activities.

Furthermore, as experience from disasters in other countries shows, in times of emergency, many people who have not previously been connected to the Red Cross are eager to help, but need an organisational framework within which to effectively do so. In Japan, several hundred thousand people from all over the country went to Tohoku as volunteers on their own initiative. Consequently, robust systems have to be in place to handle a surge in the recruitment of new volunteers and their effective deployment in times of disaster, and models for how to do this can be found, for example, in the American Red Cross.

The importance of psychosocial support

In all disasters, many of the victims are seriously traumatised, especially among vulnerable groups such as children and the elderly. The need for instant psychological first aid is immense, as people are often in shock, having lost relatives, friends, neighbours, homes and the sense of control over their own lives. Normal reactions include feelings of grief, anger, frustration, fear and loss of trust. Following the initial shock, psychosocial support needs are obvious, as whole communities are uprooted and relocated into temporary camps. After the tsunami, the JRCS medical teams and dedicated teams provided psychosocial support as part of their emergency help, but many of those who are affected by this disaster will need such support for a very long time. Professional help to do this is not feasible or available even in many high income countries, but experience shows that trained community volunteers can be mobilised. Effective and functional models are available in many RC societies, in particular in Scandinavia, and IFRC has a reference centre for method development and sharing of such experiences hosted by the Danish RC. Beyond immediate psychological first aid, JRCS should therefore investigate how it could provide long-term, volunteer delivered psychosocial support to individuals and communities as part of its recovery programme. When the ‘Estonia’ ferry sank in the Baltic Sea in 1994, over 850 people drowned or died from hypothermia and psychosocial support was provided to family members and friends for several years by the Swedish Red Cross.

Some of the most important lessons learned after the tsunami off the coast of Sumatra in 2004 are the importance of coordinating and collaborating closely with other agencies who provide psychosocial support responses at a regional or national level and the desirability of conducting joint assessments. This minimizes the stress on individuals, families and communities every time a new agency arrives to ask questions on what has happened and what can be done. Sharing as much information as possible with other partners on findings from needs assessments and linking up with partners from other areas or sectors helps ensure a holistic response to the needs of the affected population. The primary partner to collaborate with should be the community in need of assistance. Representatives from the affected population and communities should be involved in all aspects and stages of any psychosocial intervention. Planning joint training in psychosocial support with other active stakeholders will enhance the reach of training and help ensure high quality psychosocial support. Coordinating the dissemination of information, or example on ‘normal reactions to abnormal events’ with other partners means that communities are not overwhelmed with different, perhaps contradictory or confusing, information from multiple sources. Successful coordination and collaboration among partners also improves advocacy for attention to mental health and psychosocial needs. Moreover, national societies should be prepared to both send and receive trained personnel to support their expatriate communities when large scale disasters strike, given the presence of many different nationalities in most countries.

Drawing on and Contributing to Global Capacity of the Red Cross/Red Crescent Movement

The increasing risk of more large scale disasters with growing urban and vulnerable populations and the added unpredictability arising from climate change, coupled with the existing threat from seismically active areas and disasters arising from industrial accidents makes for a greater need to draw on the collective capacity of the international Red Cross movement. In principle, all national societies are auxiliaries to their governments, but in reality these relations can be very different and their roles in disaster response vary widely depending on national circumstances and tradition. In some countries, like Japan, Bangladesh, Iran or the United States, they are an integrated part of national emergency plans. In others, like in many European countries, the national rescue services have the responsibility for emergency response and national societies have a relatively marginal role in national disasters. However, in most countries they are well recognised as auxiliary but independent organisations, based on principles of humanity, neutrality and impartiality, and they are widely known to provide assistance, without discrimination as to nationality, race, religious beliefs, class or political opinions, through voluntary action. Working in closer relationship with the disaster management authorities at all levels will enable effective and efficient liaison when large scale disasters strike and these bodies come under overwhelming pressure. To do this effectively, each national society needs high quality contingency planning for large scale disasters, including arrangements to access resources and assistance from within the Red Cross/Red Crescent Movement to respond to catastrophic events in their country. They need to adopt not only emergency relief but also recovery policies, taking account of their unique national contexts, the potential disaster risks and support and draw on the work being undertaken by IFRC in developing a common recovery policy. National societies must consider how to effectively facilitate access to available relevant experience and knowledge about international disaster management best practice and prepare to deploy their trained personnel in large scale disasters both nationally and internationally. This should be done in close coordination with the IFRC to ensure maximum impact. Based on my own experience of almost one year in Japan, I consider it important to place a representative of IFRC for coordination of experienced technical delegates with substantive consultative skills as needed and to ensure that they are well integrated into the host national society structure. Of course, international delegates need to respect and work with their national colleagues according to the host national society’s established standard operating procedures and culture and systematically share best practice. Red Cross and Red Crescent delegates and staff with such practical experience and expertise from international large scale disasters, familiar with Movement policies and standards, will be an invaluable resource if and when there is a disaster in their home country.

The Emergency Response Units should be more flexible and integrated into existing national society structures and systems so that they would also be suited for deployment with national societies in high income countries, complementing their existing capacity and become part of their contingency planning. One of the immediately identified urgent needs in the JRCS after the tsunami was for delegates experienced in communication with and reporting to international media and international donors. In general, national societies should make sure that they have sufficient capacity and competence to communicate critical disaster information in English as well as their own language to the public, media and their partners. This is an area where even a highly sophisticated and competent organisation like JRCS felt that it needed reinforcement during the emergency. Other expertise that may be needed from outside is in installing functional systems to restore family links, tracing services, how to use new technologies and how to manage social media.

Funding systems

JRCS did not appeal for international funding, but received massive support from other Red Crosses and Red Crescents after the tsunami, in total almost 1.2 billion USD from 92 other national societies and organisations – apart from the 3.7 billion USD donated to the Red Cross by the public in Japan. This was earmarked for cash distribution by municipality authorities to disaster-affected people and could not be used for funding any other activities, a mode which should be reviewed and perhaps changed to allow JRCS greater flexibility in the future Reinforcing the trust held in its integrity and capacity, JRCS provided good information and welcomed partners to visit and participate in the development of a recovery plan and budget that they would support. No agreed model for how to deal with the outpouring of unsolicited international funds existed, and it had to be developed during the course of the operation. The IFRC should therefore formulate an operational framework for national societies to use when accepting spontaneous donations from other national societies. This should regulate ways in which assistance could be channelled and specify the responsibilities of the operating national society in accounting for the use of these funds. The development of this operational framework must take account of existing policies and procedures. It must also determine how “no appeal” situations could be better handled in the future, based on the experience from Japan and similar disasters, such as Hurricane Katrina and the earthquake in Christchurch, New Zealand. This framework should also address the question of how the worldwide core institutional disaster response costs of the International Federation’s secretariat could be met through funding also from resources raised for such disasters. At present, this is entirely done through a percentage levied on multilateral funds contributed for disaster victims in low income countries. This seems both ethically questionable and in breach of the principle of collective responsibility.


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