"Historically, the main concern of medical professionals was the symptom. The patient was a carrier of symptoms to which observation, medical reasoning, and techniques were applied. Therefore, the medical concern did not extend much farther than the biological body. Even when operating in a public health capacity, it was not seen as the responsibility of medical professionals to understand socio-cultural factors, even when they had an obvious influence on outcomes.
The Fukushima nuclear power plant accident of March 11, 2011 has challenged these assumptions."
So starts the preface of a new handbook for health professionals compiled following the Fukushima accident under the coordination of the IAEA and introduced at a conference for medical professionals in Singapore last week. The goal: to better prepare medical staff for the unexpected, including dealing with psychological symptoms of disasters.
"If we can assist medical personnel in communicating effectively with the affected population, the health outcomes will improve as well," said May Abdel-Wahab, Director of the Division of Human Health at the IAEA. "A tool like this handbook gives medical staff information to help people have better control over their lives and make appropriate informed decisions."
Over 100 medical professionals from nine countries participated at the 3rd Conference on Science, Technology, and Society (STS) Perspectives on Nuclear Science, Radiation, and Human Health: The View from Asia, organized jointly by the IAEA and the National University of Singapore.
A series of IAEA projects to help build capacity of medical professionals, physicists and other specialists in Asia and elsewhere to communicate about radiation-related health risks in a nuclear or radiological emergency has concluded with this week's conference. The initiative is focused on the need for clear and science-based communication about possible health effects of radiation during and after any such emergency.
Medical and social
Understanding the social dimensions of disasters is key to finding solutions, said Koichi Tanigawa, Vice President of Fukushima Medical University, who was involved in the preparation of the handbook. "The Fukushima accident taught us that what was required in medical response to a nuclear accident extends beyond ordinary medical expertise."
Anxieties regarding radiation can be exacerbated by lack of scientific understanding, which the medical community needs to be able to deal with. "Radiation specialists thought they would be able to persuade people" about the level and risk of radiation following the Fukushima accident, said Atsushi Kumagai, Associate Professor at the Education Centre for Disaster Medicine at Fukushima Medical University. "Instead, people went with their own hunch."
There is a need for medical professionals to acquire a broader understanding of the relationship between patient and society. This is particularly important in disaster situations, as knowledge of the social becomes increasingly important in establishing and maintaining a relationship between professionals and citizens, according to the handbook.
"Back in 2011, the biggest challenges were scarcity of information on radiation among the public, and lack of coordination among responding organizations," said Tanigawa, who led a radiation emergency medical team dispatched to Fukushima following the disaster. "A science technology society project may address the roles of individuals responding to these difficult situations."
Communicating about risks is a challenge for doctors and health managers, he said. "Health care professionals need to learn how to communicate with residents who have different perceptions about radiation, provide scientific information to the public as risk communicators, and facilitate their understanding of health risks, so that the residents can adapt their lives accordingly."
The handbook provides an overview of general radiation history and circumstances of release of radiological material in Japan. It addresses risk perception and advises on how best to deal with psychosomatic symptoms. Topics on preparing for and coping with disasters and risk communication are also included, along with legal and ethical considerations.
Although the context of the handbook is Japan following the Fukushima accident, medical professionals throughout the world may find it useful, Tanigawa said. "These outputs should be included in the core curricula of medical education not only in Japan, but also in other countries in order to better prepare for unexpected events such as a major nuclear or chemical accident or an outbreak of infectious diseases."
The handbook can also be useful to a wider audience such as journalists and the general public, Abdel-Wahab said. "The ability to help the affected population cope with disasters is not restricted to doctors alone."
The Fukushima accident taught us that what was required in medical response to a nuclear accident extends beyond ordinary medical expertise.