Lessons learned from the Japan earthquake and tsunami, 2011.

On March 11, 2011, an earthquake occurred off the coast of Honshu, Japan. The quake was followed by a powerful tsunami that caused extensive damage to the east coast of the Tohoku and Kanto regions. This disaster destroyed the medical system in place and thus drastically reduced the ability of the healthcare system to handle the large number of casualties. During the initial response to this disaster, we participated in several types of outreach medical relief teams dispatched to the affected area from the day of the earthquake onwards. The ratio of persons injured to persons missing or dead for the 2011 Japan disaster (0.31: 5,994 to 19,371) was much lower than for the Indian Ocean Tsunami of 2004 in Thailand (1.01; 8,457 to 8,393) and for the Great Hanshin-Awaji Earthquake of 1995 in Japan (6.80; 43,792 to 6,437). The different ratios for the different types of disasters indicate that medical relief efforts in response to natural disasters should be tailored to the type of disaster to optimize the effectiveness of the response and prevent further deaths. From a medical viewpoint, unnecessary deaths must be prevented following natural disasters. Doing so requires appropriate information transmission and an understanding of the mission's overall and specific objectives: 1) rapid search and rescue; 2) early care in the field, evacuation centers, and primary clinics; 3) definitive evaluation at disaster base hospitals; and 4) proper evacuation to unaffected areas. We propose a descriptive device that can guide headquarters in dealing with the commonalities of a disaster.