The Great East Japan Earthquake, the largest earthquake in Japan (9.0) since recordings have been made, occurred on March 11, 2011, at 2:46 pm, local time. It was then followed approximately 25 minutes later by an enormous tsunami that caused catastrophic damage to coastal towns in the region.

At the Ishinomaki Municipal Hospital, 120 patients and 250 medical staff were isolated without power, water, or food. The first and second floors of the building were totally destroyed by the tsunami. On the second day, helicopters flew overhead, but no rescue teams arrived. On the third day, 1 surgeon and 1 officer swam across the debris-filled water from the hospital to contact rescue teams. The patients and workers were successfully rescued on March 14. The hospital was demolished 2 years later, and currently is scheduled to reopen at a relocated site in another 2 years.

Neither the municipal nor prefectural headquarters were aware of the hospital’s isolated status before the actual rescue team arrived, and many lessons were learned from this incident. Hospitals must continue to function during disasters and be considered one of the safest places where people can seek help. They should be designed and built to the highest standards and in the safest locations possible, and architects, engineers, and urban planners should involve hospital authorities in this process.

In addition, the management and staff of hospitals should be included in the planning and preparation for disaster situations. They also should collaborate with other civil agencies, communication services, and emergency rescue services to ensure a cohesive and timely response in disasters and emergencies. Considerable time should also be given to developing a reconstruction plan once the immediate situation is under control.

Ishinomaki Municipal Hospital half demolished 2 years and 3 months after the tsunami. The Japanese letters on top of the building stand for “(Ishino)-Maki Municipal Hospital. Photograph taken by Shinichi Egawa, author of this issue’s On the Cover.

In the Editorial, “Have We Forgotten About the Needs of Children?”, Deputy Editor, David Markenson asks if we have forgotten about the needs of children in our disaster planning.