National | Regional Voices: Kyushu

Japan's nursing care facilities face challenge of safely evacuating during disasters

Nishinippon Shimbun

Torrential rains that caused widespread damage in the southern part of Kumamoto Prefecture in early July highlighted the need to prepare evacuation plans beforehand for nursing homes for older people during disasters.

At 11 a.m. on July 6, a care operator in Omuta in Fukuoka Prefecture, which is located near a river, decided in a staff meeting to start preparing for evacuations when the rain was still light.

When the city issued an alert, advising vulnerable people, including older people and those who need support, to prepare for evacuation, the staff moved aspirators, beds and a private power generator to the third floor and started evacuating residents around 3:30 p.m. The Meteorological Agency issued a Level 5 alert for heavy rain, its highest warning, about an hour later.

It took about two hours to evacuate about 80 residents, including those who are bed-ridden or who have dementia, from the first floor. By then, it was raining heavily outside, quickly raising the water level of a nearby river.

According to the land ministry, as many as 67,000 nursing homes for older people and hospitals across Japan for those who require special care are located near rivers at risk of causing flooding if they break their banks.

All of those facilities are obliged to prepare an emergency evacuation plan and conduct emergency drills. Before the flooding, the facility in Omuta had conducted emergency drills based on such an evacuation plan.

“The evacuation went smoothly as we were prepared for such emergencies,” said the facility’s director. However, as the rain flooded roads, workers who were not on shift that day could not assist with the evacuation.

“Even though we were prepared, I wonder if we could have proceeded smoothly if the rain lashed the area during the night shift when we were short on staff,“ the director added.

Such a scenario materialized in the Senjuen nursing home in the village of Kuma in Kumamoto Prefecture

According to witnesses, the Kuma River overflowed, flooding the facility at around 6 a.m. on July 4. With the help of neighbors, carers tried to transfer residents to higher floors. But in the midst of evacuation, floodwaters and mud broke windows and gushed into the building. It left 14 residents dead.

Senjuen is situated near a small river that branches off from the Kuma River. In the event of a flood, water levels were expected to rise up to 20 meters. The operator said that it had an emergency plan prepared for such an occasion and had conducted drills accordingly.

Unfortunately, fatalities in nursing facilities are not rare. Powerful typhoon Lionrock that struck the Tohoku region in late August 2016 left nine people dead in a care home in Iwate Prefecture. Heavy rain overnight from the typhoon caused a local river to burst its banks and flood the nursing home. The operator wasn’t aware of the meaning of the alert issued by local authorities that advised to start preparation for evacuation of the elderly.

The incident led to the revision of the Flood Control Act in June 2017. The revised law mandates emergency drills and preparation of an emergency plan.

However, in reality not many facilities have implemented such evacuation plans.

The government wants all nursing care homes to prepare evacuation plans by March 2022. But according to the Land, Infrastructure, Transport and Tourism Ministry, only 35.6 percent of facilities nationwide had such plans in place as of March 2019.

In the Kyushu region, the percentage was even lower at 24.2 percent, with the ratio in five of the seven prefectures lower than the nation’s average. It is believed that the lack of any penalty is the main reason for the low figures.

A land ministry official said that some operators of such facilities say they don’t know how to prepare an emergency plan.

Hirotada Hirose, a specialist in disaster risk studies and a professor emeritus at Tokyo Women’s Christian University, stresses that even though evacuation requires a lot of effort, many operators tend to think that their facility will not be affected.

“They should prepare for such emergencies instead of worrying about a swing and a miss. The operators also shouldn’t wait until the local government to issue evacuation advisories,” he says. “They need to make their own decisions based on local weather updates.”

This section features topics and issues from the Kyushu region covered by the Nishinippon Shimbun, the largest daily newspaper in Kyushu. The original article was published on July 8.

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