Maps were useless. The towns of Kobe had utterly changed.

The Great Hanshin-Awaji Earthquake struck in her first year of working as a public health nurse, an expert in regional health care, at a health care center in Higashi-nada Ward. Akashi City in Hyogo Prefecture, where Naomi Fukunaga lived, also experienced severe shaking. At that time, she felt a terrible thing had happened.

She could not go to her office in Higashi-naga Ward due to the suspension of train services. Thus, she worked at a health care center in Tarumi Ward for two days after the earthquake, and then drove to Higashi-nada Ward on January 19, the third day after the quake.

I saw that the towns of Kobe had utterly changed. Since the expressway had collapsed, it took eight to nine hours to get there, where it would normally take only one hour. I remember there was a tense atmosphere, with the roaring sounds of helicopters and sirens. When I arrived at the office, my bosses and seniors told me that they had cleaned the bodies and built coffins. It was an unforgettable experience for me to keep wrapping dry ice in paper for the coffins.

The health care center in the Higashi-nada Ward Office became a morgue for two days after the earthquake. Staff members took care of the bodies and built hundreds of coffins.

Since landmark buildings had collapsed and maps were useless, Ms. Fukunaga played a role in directing medical staff and medical teams organized by volunteer groups to the evacuation centers.


Making the rounds of evacuation centers and visiting individuals to confirm evacuees’ safety and health conditions

I was responsible for setting up a first-aid station at Hyogo Prefectural Mikage High School in Higashi-nada. I found that it was very hard work because pieces of glass were scattered on the floor of the health care room and it was covered with dust. Supported by people around me, I finally managed to open the station. After the medical teams arrived, many people started to visit the station for treatment.

About three weeks after the earthquake, she was busy visiting bedridden people, ailing people, and well as families with babies to confirm their safety. According to Ms. Fukunaga, some people had been crushed to death on the first floor by a collapsed house. After the end of January 1995, she had to deal with a flu epidemic. At the same time, some people developed cystitis because they had refrained from going to the bathroom due to the water shortage. Some people suffered from aspiration pneumonitis caused by bacteria that had grown in their mouth entering their lungs because they could not brush their teeth.

Since many people evacuated with only the clothes they were wearing, some of them were in trouble without drugs for chronic diseases or false teeth. Evacuees were also in need of nursing bottles, disposable diapers, and sanitary items. When relief supplies arrived, I made the rounds of the evacuation centers to distribute them to people in need.

I worked so feverishly that there was no time to be pessimistic.

Since the staff members of the health care center were also affected by the quake, they worked without enough sleep and food. Ms. Fukunaga slept on cardboard, wrapped in a blanket, at her office for about one week after the disaster.

I believe that I felt something in common with the people in the evacuation centers because of my experience of sleeping at the office. Even though I was exhausted both physically and mentally, I was, unexpectedly, filled with energy under the unusual circumstances. There was no time to be pessimistic.

Ms. Fukunaga then worked to ensure close communication with people at the evacuation centers who had assumed leadership at their centers, as well as maintaining the good health of evacuees in the “tent village.”

In the area I covered, some people lived in tents set up in a park, which was called a “tent village.” People could have a certain amount of privacy in a tent, while there were no partitions in the evacuation centers, such as gymnasiums. Since the outdoor environment was harsh, I frequently visited the tent village to check whether people were in good health, and if they had enough supplies.


I spontaneously stayed close to the affected people, listening carefully to them. When I heard that a mother had lost her child, I felt terribly sad. I tried to visit her everyday and talk to her as much as possible.

Photo: A public health nurse visits a temporary house.


Creating a new community necessary for temporary houses and reconstructed houses

At the end of January, a door-to-door checking project started, supported by volunteers from all over Japan. They visited 19,601 families over six days. After this period, Ms. Fukunaga, together with public health nurses from other local governments and other wards in Kobe City, kept providing health support to affected people, including those who had moved from evacuation centers to temporary houses.

Some people had to move to unfamiliar places, because temporary houses and reconstructed houses were provided by lot. Even though their living environments had improved, they may well have experienced emotional difficulties, living in a place they were not familiar with.

Ms. Fukunaga and other public health nurses kept conducting health surveys by visiting temporary houses one by one. While taking care of people whose health conditions had worsened and people with depression on an individual basis, they served as a bridge between people with health problems, such as mental difficulties and alcoholism, and psychiatrists or psychiatric medical facilities.

Meantime, new communities were built in new places. Meeting places were set up one after another, and earthquake recovery meetings were frequently held. This enabled public health nurses to provide health consultation in various places. We also rang door bells to ask the residents how they were doing. These small but important activities helped us to build relationships with the people in the area.

Staying familiar with local information on a routine basis

After medical facilities in the area resumed their operations, the first-aid station in Higashi-nada Ward was withdrawn at the end of March 1995. Ms. Fukunaga made the rounds more often to gather detailed information and provide it to the local people. What does Ms. Fukunaga, as a public health nurse, keep in mind in the event of a disaster?

I try to keep very familiar with neighborhood news, such as news about local hospitals and nursing care services, on a daily basis. Now that Kobe City has prepared a manual on health care operations in the event of disasters, systems in each region are gradually being developed. There is, however, an increasing number of younger staff members who never experienced the Great Hanshin-Awaji Earthquake, even in Kobe City Office. I hope that the manual will provide a good opportunity for such members to think more about the actions they should take in the event of a disaster.

Affected people feel encouraged when they are close to familiar people.


Photo: Ms. Fukunaga visits a temporary house in Rikuzen-takata City to conduct a health survey.

When the Great East Japan Earthquake struck in 2011, Ms. Fukunaga visited Rikuzen-takata City. With the experience gained from the Great Hanshin-Awaji Earthquake, affected people in the Tohoku region were moved to temporary houses on a community basis, taking regional society into consideration.

In early July 2011, I mainly visited evacuation centers for five days. I saw many people who had lost their family members, as well as those who had lost the basis of their livelihoods. There was no direct support I could provide, but I believed that I could be of help by carefully listening to them and empathizing with their feelings.

The people living in the temporary houses I visited were from almost the same area. Someone said to me, “When I am in trouble, I ask XX living in Y zone for help.” I felt relieved to see the affected people living close to people they knew.

Maintaining support systems on a daily basis in the event of disasters

What does Ms. Fukunaga think regarding how to take action in the event of a major disaster, as a public health nurse who experienced the Great Hanshin-Awaji Earthquake?

No one knows when such a major disaster will strike. I always keep in mind how my division takes action in the event of a disaster. To take prompt actions, cooperation with our family members is essential. I believe that members of the division, myself included, need to discuss what measures we should take in the event of a disaster with our family members on a daily basis.

When the Great Hanshin-Awaji Earthquake struck, many medical specialists, including doctors, nurses, pharmacists, physical therapists, and psychiatric staff members, immediately visited affected areas to help us. Our role at that time was to ensure their smooth operations. When people asked us what they should do, we were actually overwhelmed. Through this experience, I realized it is important to develop systems in which supporters can take actions on their own. For example, a health care nurse can start operations with some information and a map.

Public health nurses play an important role in providing health support both physically and mentally

As the recovery of the affected areas progresses, it is said that the gap between people who can return to their original lives and those who cannot widens. I strongly believe that more people in affected areas will be saved mentally and economically if public health nurses better understand their health conditions, as well as their individual feelings, and serve as a bridge between such people and relevant governmental organizations to find the best solutions.

What we, as public health nurses, can provide is physical and mental assistance. We can pass on the information and requests we receive to necessary service providers and related organizations in an official capacity. I believe that building close relationships with people in the community on a daily basis, not only in the case of disasters, is the most important action we can take. If a major disaster should happen in other areas in the future, I will visit there to offer assistance. Lastly, I would like to extend my sincere appreciation to members of local governments and volunteers who were here for us.

(Photographed by Natsumi Morimoto, interviewed and written by Aya Yamamori)