Some 7,000 people remain evacuated following the earthquakes in Kumamoto, and with homes flattened and lifelines severed, the evacuation is likely to be a long one. How, then, may those taking shelter ensure that they stay healthy?
Some evacuees have been forced to stay in their cars, and Dr. Kazuhiko Hanzawa, a vascular surgeon at Niigata University, points out that staying in such cramped quarters without moving once every four to five hours can be dangerous.
No matter where you are, "the worst thing to do is to not move around," adds Tetsunori Kawase, the 54-year-old vice-director of the Hyogo Emergency Medical Center. "Blood flow in the legs can stagnate, which sometimes causes clots that can even be life-threatening."
"It's best to move around as much as possible," he adds by way of caution.
Staying in the same position for a long time can cause so-called "economy class syndrome," the formation of blood clots in veins deep in the legs. The clots can then travel to the lungs, where they can become lodged in blood vessels and cause a pulmonary embolism, which in turn poses potential dangers such as difficulty in breathing. To prevent this, it is important to move the leg muscles -- sometimes called "the second heart."
"Those who are able to walk should do so," advises Kawase. "Even just walking in place or bending and stretching one's knees can be effective."
Kawase also stresses the importance of getting important information to quake survivors. For example, the Ministry of Health, Labor and Welfare on April 15 advised medical institutions to provide care to those who do not have their insurance cards at the same cost as if they had brought the card, as long as they provide such information as their name and birthdate.
"Consideration should be taken so that such important information is available at evacuation shelters," he notes.
Meanwhile, Shinichi Oikawa, an associate professor at the Japanese Red Cross Junior College of Akita -- which began focusing on disaster prevention-related education following the 2011 Great East Japan Earthquake -- notes that "the emergency food supplies that tend to be sent to evacuation shelters are often nutritionally unbalanced, which can cause people to become ill and constipated."
He adds, "Shelter residents should make efforts to include things like vegetable juice in their diets, which can help replenish vitamins."
Because communicable diseases spread easily in the crowded environment of an evacuation shelter, it is also important for residents and visitors to be vigilant about washing their hands and gargling.