The Mutual Growth of International and National Emergency Medical Teams (EMT): Synergetic Growth and Reinforcement Between Japan’s Disaster Relief Team and Disaster Medical Assistance Team

Yuichi Koido; Yoshiki Toyokuni; Madelina Ariani; Tatsuhiko Kubo; Tsutomu Iimura; Jiro Oba

doi:10.22146/ajdhm.v1i2.14390

Yuichi Koido Japan Institute for Health Security Japan DMAT Secretariat
Yoshiki Toyokuni Japan Institute for Health Security Japan DMAT Secretariat
Madelina Ariani Hiroshima University
Tatsuhiko Kubo Hiroshima University
Tsutomu Iimura Japan International Cooperation Agency, Japan Disaster Relief Secretariat
Jiro Oba Japan Institute for Health Security Japan DMAT Secretariat

DOI: https://doi.org/10.22146/ajdhm.v1i2.14390

Keywords: JDRT, DMAT, Disaster Medical Response, Emergency Medical Team

Abstract

Introduction: Japan, situated on the seismically active Pacific Ring of Fire, frequently experiences natural disasters. Consequently, Japan’s disaster medical response system has evolved significantly, leveraging both international and domestic experiences. This study reports the development of Japan’s disaster medical teams, emphasizing the synergistic relationship between international and domestic response efforts while highlighting key milestones in the system’s evolution. Methods: This study utilizes a case study approach to report the historical evolution of Japan’s disaster medical response system. Data were gathered through document reviews and a rapid review approach, which assessed major events and structural developments. Results: Japan’s early international disaster medical efforts began with its response to the Cambodian refugee crisis in the 1970s, leading to the establishment of JMTDR and later JDRT. Domestically, the Great Hanshin-Awaji Earthquake in 1995 catalysed the establishment of DMAT and Japan NDMS. The J-SPEED system, inspired by international deployments, further standardized WHO EMT for rapid and informative medical data collection. Conclusion: The evolution of Japan’s disaster medical teams highlights key milestones and the synergetic collaboration between JDRT and DMAT. Japan’s international and domestic disaster response systems have facilitated the advancement of disaster response capabilities, leading to more sophisticated response abilities.

References

Ushizawa H, Foxwell AR, Bice S, Matsui T, Ueki Y, Tosaka N, et al. Needs for disaster medicine: lessons from the field of the Great East Japan Earthquake. Western Pac Surveill Response J. 2013;4(1):51-55. doi:10.5365/WPSAR.2012.3.4.010.

Kondo Y, Ichikawa M, Kondo H, Koido Y, Otomo Y. Current disaster medicine in Japan and the change brought by information sharing. Journal of Disaster Research. 2019;14(2):292-302. doi:10.20965/jdr.2019.p0292.

Homma M. Development of the Japanese national disaster medical system and experiences during the Great East Japan earthquake. J Med Sci. 2015;18(58):53-61.

Cabinet Office G of J. Disaster Management in Japan.; 2015.

Cabinet Office G of J. Update Report: Damage Situation Related to the 2020 Noto Peninsula Earthquake.; 2020.

Cabinet Office G of J. Number of deaths and missing persons due to natural disasters in Japan. https://www.bousai.go.jp/kaigirep/hakusho/r05/honbun/3b_6s_02_00.html.

Ishiwatari M, Ranghieri F, Taniguchi K, Mimura S. Learning from mega disasters in Japan: sharing lessons with the world. Journal of Disaster Research. 2021;16(6):942-946. doi:10.20965/jdr.2021.p0942.

Sakamoto T, Inoue J, Shirokawa M, Ooyama F, Irahara T, Ihara N, et al. The JDR method, Our 20 years of experience and practice in developing human resources for disaster medicine. Prehosp Disaster Med. 2023;38(S1):32-33. doi:10.1017/s1049023x23001231.

Egawa S, Suda T, Jones-Konneh TEC, Murakami A, Sasaki H. Nation-wide implementation of disaster medical coordinators in Japan. Tohoku Journal of Experimental Medicine. 2017;243(1):1-9. doi:10.1620/tjem.243.1.

Anan H, Akasaka O, Kondo H, Nakayama S, Morino K, Homma M, et al. Experience from the Great East Japan earthquake response as the basis for revising the Japanese disaster medical assistance team (DMAT) training program. Disaster Med Public Health Prep. 2014;73(4):477-484. doi:10.1017/dmp.2014.113.

Kondo H, Koido Y, Morino K, Homma M, Otomo Y, Yamamoto Y, et al. Establishing Disaster Medical Assistance Teams in Japan. Prehosp Disaster Med. 2009;6(24):556-564. doi: 10.1017/s1049023x00007512.

Wuthisuthimethawee P, Satthaphong S, Phongphuttha W, Sarathep P, Piyasuwankul T, Công SN, et al. How the ARCH Project could contribute to strengthening ASEAN regional capacities on disaster health management (DHM). Prehosp Disaster Med. 2022;37(1):S30-S43. doi:10.1017/S1049023X22000061.

Yanasan A, Pongpamon N, Pattanarattanamole R, Rojsaengroeng R, Natsukawa T, Katsube T, et al. ARCH Project and the global initiatives of disaster health management. Prehosp Disaster Med. 2022;37(1):S11-S15. doi:10.1017/S1049023X22000048.

World Health Organization. WHO guidance on research methods for health emergency and disaster risk management, revised 2022; 2022.

Cabinet Office Government of Japan. Disaster Management in Japan.

Cabinet Office Government of Japan. White Paper in Disaster Prevention.

Yoshiaki K. Heisei mega disasters: driving home the need for preparation. Nippon.com; 2019 Apr 9. [accessed 2024, Dec 3]. https://www.nippon.com/en/in-depth/d00477/heisei-megadisasters-driving-home-the-need-for-preparation.html.

Japanese International Cooperation Agency. 25 years since the Great Hanshin-Awaji earthquake: The birth of the DMAT and how disaster medical assistance know-how was handed down to it (part I). https://www.jica.go.jp/Resource/english/news/field/2019/20200117_01.html.

Japan Meteorology Agency. Report on The Hyogo-Ken Nanbu Earthquake 1995.; 1997.

Kitagawa Y, Hiraishi H. Overview of The 1995 Hyogo-ken Nanbu Earthquake andProposal for Earthquake Mitigation Measure. Journal of Japan Association for Earthquake Engineering. 2004;4(3).

Japanese International Cooperation Agency. 25 years since the Great Hanshin-Awaji Earthquake: disaster medical assistance know-how and knowledge are passed on from the DMAT to the JDR [Internet]. https://www.jica.go.jp/Resource/english/news/field/2019/20200117_02.html.

Yasuhiro Otomo. Comprehensive Research Report on The Approach to Wide-Area Emergency Medical Care During Disasters [Internet]. 2006.

Japan International Cooperation Agency. Collection of Contribution Commemorating The 40th Anniversary of The Establishment of JMTDR. 2024.

Koido Y, Kondo H, Wakai A, Ono T, Toyokuni Y. Introduction of Japan Disaster Medical Assistant Team as a National Emergency Medical Team. Prehosp Disaster Med. 2022;37(S2):s81-s81. doi:10.1017/s1049023x22001807.

Ishii M, Nagata T, Aoki K. Japan Medical Association’s actions in the Great Eastern Japan Earthquake. World Med Health Policy. 2011;3(4). doi:10.2202/1948-4682.1210.

Akitomi S, Koyama A, Kokogawa T, Maeda Y, Kimura R, Tamura K, et al. A study on disaster medical response during the great east Japan earthquake disaster based on the emergency support function – nine days at iwate prefecture from hyperacute to subacute phase. Journal of Disaster Research. 2020;15(1):41-52. doi:10.20965/jdr.2020.p0041.

Tatsuhiko Kubo, Hisayoshi Kondo, Yuichi Koido. The J-SPEED: a medical relief activities reporting system for emergency medical teams in Japan. Prehosp Disaster Med. 2017;32(S1):S228. doi:10.1017/s1049023x17005878.

Chandler DP. Seven Revolution in Cambodia, 1975-1979. The Tragedy of Cambodian History: Politics, War, and Revolution since 1945. Yale University Press; 1991.

Morgenbesser L. Cambodia’s Transition to Hegemonic Authoritarianism. Journal of Democracy. 2019;30(1):158-171. doi:10.1353/jod.2019.0012.

Jörg Menzel. Justice Delayed or Too Late for Justice? The Khmer Rouge Tribunal and The Cambodian “Genocide” 1975-1979. J Genocide Res. 2007;9(2):215-233. doi: 10.1080/14623520701368602.

Japan International Cooperation Agency. Disaster Relief and JICA Striving to Make a Difference; 2017.

Smilkstein G. Refugees in thailand and short-term medical aid. JAMA. 1981;245(10):1052-1054. doi:10.1001/jama.1981.03310350040020.

Levy BS. Special report: working in a camp for Cambodian refugees. New England Medical Journal. 1981;304(23):1440-1444. doi:10.1056/NEJM198106043042338.

Taithe B. The cradle of the new humanitarian system? International work and European volunteers at the Cambodian border camps, 1979-1993. Contemp Eur Hist. 2016;25(2):335-358. doi:10.1017/S0960777316000102.

Harvey JC. Medical relief work among Cambodian refugees in Thailand. Transaction of The American Clinical and Climatological Association. 1981;(92):28-38.

Yamamoto Y. International disaster medical care as a field of emergency medicine. Journal of Japan Surgical Society. 1994;19(1).

Okita Y, Sugita M, Katsube T, Minato Y. Capacity building of international search and rescue teams through the classification system: example from Japan disaster relief team and INSARAG external classification and reclassification. Journal of Japan Association for Earthquake Engineering. 2018;18(6). http://www.insarag.org/iec.

Nakayama S, Ukai T, Kozawa S, Kawase T, Ishihara S, Kai Kai S, et al. The 14th Asia pacific conference on disaster medicine in Kobe, Japan: a brief overview and a proposal. Prehosp Disaster Med. 2019;34(s1):s98-s98. doi:10.1017/s1049023x19002000.

De Grace M, Ericson E, Folz H, Greene W, Ho K, Pearce L. Proceeding for 5th Asia-Pacific conference on disaster medicine: creating an agenda for action. Pre Hospital and Disaster Medicine. 2001;16(1). doi: 10.1017/s1049023x00025498.

Ministry of Foreign Affairs of Japan. Japan Disaster Relief Rescue Team was Awarded IER “Heavy” Classification [Internet]. Tokyo: Ministry of Foreign Affairs of Japan; 2015, Mar 5. https://www.mofa.go.jp/press/release/press4e_000665.html.

Ministry of Foreign Affairs of Japan. Dispatch of Japan Disaster Relief Team [Internet]. Tokyo: Ministry of Foreign Affairs of Japan; 2025, Feb 10. https://www.mofa.go.jp/policy/emergency/assistance1.html.

Japan Association for Disaster Medicine. 学会概要 (Society Overview) [Internet]. Tokyo: Japan Association for Disaster Medicine; 2017. https://jadm.or.jp/contents/about/.

World Health Organization. Classification and Minimum Standards for Emergency Medical Teams. Geneva: World Health Organization; 2021, Jun 18. Available from https://www.who.int/publications/i/item/9789240029330.

Hamilton ARL, Södergård B, Liverani M. The role of emergency medical teams in disaster response: a summary of the literature. Natural Hazards. 2022;110(3):1417-1426. doi:10.1007/s11069-021-05031-x.

Benin-Goren O, Kubo T, Norton I. Emergency medical team working group for minimum data set. Pre Hospital and Disaster Medicine. 2017;32(S1):S96–S96. doi:10.1017/S1049023X17002473.

Kubo T, Yanasan A, Herbosa T, Buddh N, Fernando F, Kayano R. Health data collection before, during and after emergencies and disasters—the result of the Kobe expert meeting. Int J Environ Res Public Health. 2019;16(5). doi:10.3390/ijerph16050893.

Kubo T, Tomioka J, Kondo H, Koido Y. Experience of Activation of the J-SPEED (MDS) in Japan. Prehosp Disaster Med. 2019;34(1):130-131. doi:10.1017/s1049023x19002814x.

Norton I, Von Schreeb J, Aitken P, Herard P, Lajolo C. Classification and minimum standards for foreign medical teams in sudden onset disasters. Geneva: World Health Organization; 2013. Available from https://www.who.int/publications/i/item/classification-and-minimum-standards-for-foreign-medical-teams-in-sudden-onset-of-disasters.

Peiris S, Buenaventura J, Zagaria N. Is registration of foreign medical teams needed for disaster response? Findings from the response to Typhoon Haiyan. Western Pac Surveill Response J. 2015;6:29-33. doi:10.5365/WPSAR.2015.6.2.HYN_014.

Kubo T, Yanasan A, Herbosa T, Buddh N, Fernando F, Kayano R. Health data collection before, during and after emergencies and disasters—The result of the Kobe expert meeting. Int J Environ Res Public Health. 2019;16(5). doi:10.3390/ijerph16050893.

Nomura S, Kayano R, Egawa S, Harada N, Koido Y. Expected scopes of health emergency and disaster risk management (Health EDRM): Report on the expert workshop at the annual conference for the Japanese Association for Disaster Medicine 2020. Int J Environ Res Public Health. 2021;18(9). doi:10.3390/ijerph18094447.

Salazar MA. Post Disaster Health Impact of Natural Hazard in The Philippines in 2013. Glob Health Action. 2016;9:31320. doi:10.3402/gha.v9.31320.

Chimed-Ochir O, Yumiya Y, Taji A, Kishita E, Kondo H, Wakai A, et al. Emergency medical teams’ responses during the West Japan heavy rain 2018: J-SPEED data analysis. Prehosp Disaster Med. 2022;37(2):205-211. doi:10.1017/S1049023X22000231.

Yumiya Y, Chimed-Ochir O, Kayano R, Hitomi Y, Akahoshi K, Kondo H, et al. Emergency medical team response during the Hokkaido Eastern Iburi earthquake 2018: J-SPEED data analysis. Prehosp Disaster Med. 2023;38(3):332-337. doi:10.1017/S1049023X23000432.

Yumiya Y, Chimed-Ochir O, Taji A, Kishita E, Akahoshi K, Kondo H, et al. Prevalence of mental health problems among patients treated by emergency medical teams: findings from J-SPEED data regarding the West Japan heavy rain 2018. Int J Environ Res Public Health. 2022;19(18). doi:10.3390/ijerph191811454.

Taji A, Yumiya Y, Chimed-Ochir O, Fukunaga A, Tsurugi Y, Kiwaki K, et al. Medical needs during the Kumamoto heavy rain 2020: analysis from emergency medical teams’ responses. BMC Emerg Med. 2024;24(1). doi:10.1186/s12873-024-01009-7.

Kubo T, Chimed-Ochir O, Cossa M, Ussene I, Toyokuni Y, Yumiya Y, et al. First activation of the WHO emergency medical team minimum data set in the 2019 response to Tropical Cyclone Idai in Mozambique. Prehosp Disaster Med. 2022;37(6):727-734. doi:10.1017/S1049023X22001406.

Kita T, Limpaporn S, Silapunt P, Koido Y, Toyokuni Y, Ikeda S. Impact of the ARCH Project on national capacity development on disaster health management among the ASEAN Member States and Japan. Prehosp Disaster Med. 2022;37(1):S44-S50. doi:10.1017/S1049023X22000073.

Wato Y. Japanese DMAT and Future National Disaster Medical System. The Journal of Japan Society for Clinical Anesthesia. 2014;34(5):692-696.

Ministry of Foreign Affairs Japan. Japan disaster relief teams deployed from 1987 to 2019 [Internet]. https://www.mofa.go.jp/files/000207528.pdf.

Fuse A, Yokota H. An analysis of Japan disaster medical assistance team (J-DMAT) deployments in comparison with those of J-DMAT’s counterpart in the United States (US-DMAT). Journal of Nippon Medical School. 2010;6(77). doi:https://doi.org/10.1272/jnms.77.318.

Wakai A, Toyokuni Y, Koido Y, Ono T, Kubo T. Development of Standard Operation Procedures for Receiving International Emergency Medical Teams. Cooperation between the United States National Medical System (NDMS) Disaster Medical Assistant team (DMAT) and Japan DMAT. Prehosp Disaster Med. 2023;38(S1):s33-s33. doi:10.1017/S1049023X23001243.

Kondo H, Koido Y, Kawashima Y, Kohayagawa Y, Misaki M, Takahashi A, et al. Consideration of medical and public health coordination - experience from the 2016 Kumamoto, Japan earthquake. Pre Hospital and Disaster Medicine. 2019;34(2):149-154. doi:10.1017/S1049023X19000177.

Chishima K, Akahoshi K, Toyokuni Y, Kondo H, Koido Y. Current Status of the Disaster Health, Medical, and Welfare Coordination in Japan. Pre Hospital and Disaster Medicine. 2023;38(S1):s124–s124. doi:10.1017/S1049023X2300328X.

Ishiwatari M. Institutional coordination of disaster management: engaging national and local governments in Japan. Nat Hazards Rev. 2021;22(1). doi:10.1061/(asce)nh.1527-6996.0000423.

World Health Organization. Health Emergency and Disaster Risk Management Framework; 2019.

Yasui K, Kimura Y, Kamiya K, Miyatani R, Tsuyama N, Sakai A, et al. Academic responses to Fukushima disaster: three new radiation disaster curricula. Asia Pac J Public Health. 2017;29(2_suppl):99S-109S. doi:10.1177/1010539516685400.