国連防災世界会議　相馬地方パブリックフォーラム 原発災害後の地域連携と復興への道のり: 相双地区の健康対策から 開会に際して: 越智小枝　相馬中央病院 WCDRR　Public Forum Community resilience and recovery after the nuclear disaster: A health protection in Fukushima Opening remark: Sae Ochi, MD, MPH, PhD Soma Central Hospital Good morning ladies and gentleman, welcome to the public forum on community resilience and recovery after the nuclear disaster. My name is Sae Ochi, director of Internal Medicine at Soma Central Hospital, and I am the organizer of this forum. It is my great honor to welcome you to today's event. Our mission is to present our experience in health protection after the nuclear accident in Fukushima and share an idea how to achieve community resilience.

大災害における負の連鎖 Vicious cycle of a disaster Vulnerable population 更なる弱者 Poor 貧困 Ageing 高齢者 Mentally ill　精神疾患 Losses　喪失 Assets　財産 Family 家族 Land　　土地 Collapse 崩壊 Family　家庭 Community コミュニティ Economy　経済 As all the attendance hear already know, huge disaster may cause a vicious cycle. Losses of lives and assets causes collapse of social system. This may also cause spin-off effect such as fear, stigma, demographic change and loss of livelihood, which will lead to deterioration in health. Worsened health will make vulnerable population more vulnerable to disaster. Worsened health　 健康被害 Physical 　身体的 Mental　　精神的 Economical　経済的 Spin-off effect　波及効果 Fear / Anxiety　恐れ・不安 Stigmatisation　風評被害 Ageing population　高齢化 Lack of confidence　自信喪失 Loss of livelihood　活力低下

原発事故の健康被害 Impact of nuclear accident on health ≠放射線被害 is not simply owing to that of radiation 避難区域設定による社会混乱 Social panic caused by the settlement of evacuation zone ２．患者の避難による健康被害→及川医師 Health deterioration among evacuated patients→Dr Oikawa 2okm: ‘no-entry zone’　立ち入り禁止区域 20-30km: 計画的避難区域→屋内退避指示　 ‘evacuation zone in case of emergency’; people were recommended to stay at home 30-50km: ‘planned evacuation zone’　避難準備区域 Today we are talking about nuclear disaster and health. But what we want to insist is that impact of nuclear accident on population health is not simply owing to that of radiation. For example, The settlement of evacuation zone caused huge social panic. Immediately after the nuclear accident, the government set 3types of evacuation zone and in this area, they recommended people to stay inside of house. This is scientifically reasonable, but what happened in the real world wa 科学的には「適切」、しかし実際に起きたことは… Scientifically ‘reasonable’, but in the real world.. 避難可能な人は全員避難 　All who could evacuate left the place 50㎞圏の流通が遮断 　No supply within 50km　

原発事故の健康被害 Impact of nuclear accident on health 3. 長期避難生活による健康被害→森田医師 Worsened chronic conditions due to long-term evacuation→Dr Morita 4. 放射線を避けるリスク Alternative health risks by avoiding radiation 放射線を避けるための行動 People trying to avoid radiation may.. 骨を強くするには Factors to prevent osteoporosis Food食べ物 Calcium　カルシウム Vitamin D　ビタミンD Vitamin K　ビタミンK Exercise　運動 Sunlight　日光 外へ出ないDo not go out 魚を食べないDo not eat fish 野菜を食べないDo not eat vegetables きのこを食べないDo not eat mushroom →全て健康リスクです。All may increase health risks

地域創生への正の連鎖へ Positive cycle to recreation Home land Recreation 地域創生 Disaster 災害 Government　政府 Prompt response　迅速な対応 Prevention 予防措置 Compensation　速やかな補償 Vulnerable population 更なる弱者 Losses　喪失 Collapse 崩壊 Researcher 研究者 Worsened health　 健康被害 Timely information 適時の情報提供 Monitoring モニタリング Visualisation 可視化 Education 　 教育 Spin-off effect　 波及効果 Companies & Hospitals 企業・病院 Detection & intervention 調査・介入 Occupational health　労災調査 Health checkup 健康診断

Multidisciplinary Co-operation in Soma Area 新地町　Shinchi 飯舘村　Iitate 相馬市　Soma 南相馬市 Minamisoma 20km 20km 30km 1F: Fukushima Daiichi Nuclear Powerplant 2F: Fukushima Daini Nuclear Powerplant

Multidisciplinary Co-operation in Soma Area 東京大学 University of Tokyo 相馬中央病院 Soma Central Hospital 慶応大学 Keio University 新地町　Shinchi 飯舘村　Iitate 石川建設工業 Ishikawa Construction Co. 相馬市　Soma 南相馬市立総合病院 Minamisoma City Genearal Hospital 南相馬市 Minamisoma 20km 20km 30km

Disaster as an opportunity to re-create community around health 労働環境 Occupational health Session 3-1 Shun Ishikawa 石川　俊 未来 Future 活力 Livelihood 健康 Health 革新 Innovation Cooperation 連携 復興 Renovation Education 教育 訪問診療 Medical outreach Session 3-2 Tomoyoshi Oikawa 及川友好 産業Industry 高齢化対策 Ageing society Session 3-5 Tomohiro Morita 森田知宏 放射線防護 Radiation protection Session 3-4 Masaharu Tsubokura 坪倉正治 空間疫学 Spatial epidemiology Session 3-3 Tomoyuki Furutani 古谷知之 住居 Residency