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The great Hanshin-Awaji (Kobe) eartquake January 17, 1995 – KAMEDO-report 66

The Kamedo-reports are published by the Swedish Disaster Medicine Study Organisation (Kamedo), at the National Board of Health and Welfare. Observers study the medical, psychological, organisational and social aspects of disasters. The results, with a focus on experiences gained, are presented in the reports.

This report is entirely in Swedish. Only summary in English.

Summary

On 17 January 1995 at 5:46 a.m. the region of Kobe-Osaka, which is one of the most densely populated areas in Japan, was devastated by a strong earthquake of 7.2 on the Richter scale. It was called "The Great Hanshin-Awaji Earthquake" and brought about unprecedented damage. Its epicentre was at the Awaji island close to Kobe. It was caused by an active fault running along Kobe's urban area, which led to the destruction of practically the entire area.
The number of fatalities surpassed 5,000. Nearly 35,000 people were injured. More than 100,000 buildings were destroyed by the quake and the fires in its aftermath. These figures include 38,321 completely collapsed, 48,546 partially collapsed, 14,081 partially damaged and 5,864 burned down houses. More than 300,000 people were displaced out of their homes. Long portions of the Hansin Expressway, which links Kobe and Osaka interconnecting much of the region surrounding Osaka Bay, collapsed. There were severe damages to life-lines utilities giving suspension of water supply, electricity, gas and telephone.
On the day of the earthquake, 136 fires broke out from the debris of collapsed houses and old wooden houses. Due to lack of water and the interruption of the transportation access the fire service was not effective in putting out the fires. The fires spread over large areas. Fires continued to break out. After a week 414 and after a month 531 fires had been reported.
The government applied the disaster relief law. Rescue activities were implemented in 10 cities and 10 towns in Hyogo prefecture and 5 cities in Osaka prefecture. As much as 29,000 personnel from Self Defence Forces took part in the activities. Fire Defence Agency dispatched 83 rescue teams, 110 fire brigades and 65 other teams. 27,000 policemen were mobilized.
Most of the hospitals in Kobe could not provide qualified medical care due to lack of water and electricity. As the telephone communication did not function there was no co-ordination of the resources.
In adjacent cities the staff of hospitals stood ready to take care of injured people from Kobe but only a few patients arrived. The majority of the roads from Kobe were damaged or blocked by vehicles which also made ambulance-transportation difficult.

Some conclusions can be drawn:

When preparing for an earthquake the effect of the quake differs much during the day and night.
If the earthquake had occurred a few hours later the number of fatalities had been much higher. Hundreds of thousands of people had then been travelling with trains, busses and cars.
With other and better principles for construction of houses, bridges and highways the damages can be reduced and the number of fatalities lowered. A better tolerance against horizontal forces is needed. Buildings constructed according to a new recommendation of 1981 proved to withstand the earthquake of Kobe much better.
People, still alive but trapped in the debris, run a risk of being choked by inhalation of heavy dust during the first 20-30 minutes after an earthquake. Examples of other life-threatening conditions are crush and squeeze injuries and their complications. The situation might be complicated by fires giving bums and intoxication from carbon monoxide inhalation. Immediate resources are needed to rescue people caught in the debris. The probability for survival is diminishing very fast. "The golden 24 hours" is often mentioned. After five days no one is likely to be found alive.
The possibility to use motor vehicles may be very restricted during the first days and weeks after a quake. In Kobe motor traffic was impossible in large areas. The expressway and the railways were severely damaged and the roads were blocked by destroyed houses. The roads outside Kobe were blocked by jammed motor vehicles trying to get into Kobe or to leave Kobe. Immediate and powerful operations to restore the communication network are needed to bring help to the disaster area and to transport injured people to hospitals in adjacent non destroyed towns.
The ambulance service can not meet the demand after an earthquake. Often its staff is also hit by the disaster. In Kobe, members of the staff who were not on duty had difficulties to return to their jobs and were then also used for fire fighting and rescuing people out of buildings. The streets were destroyed and blocked and hindered the ambulances from transporting patients.
The function of hospitals might be very limited after quake. In Kobe the hospitals could not offer necessary qualified treatment and "high tech" service without water, electricity and gas. The absolute need of normal water supply of modern hospitals was apparent. A serious problem was also the destroyed telecommunication system. There was hardly any contact between the hospitals in the region.
A few days after a disaster infection diseases from the upper airways lungs and gastro-intestinal canal may appear. The victims of Kobe staying close together in the shelters facilitated infections to be spread. Several thousand people caught a cold or pneumonia and problems from the gastro-intestinal canal were common.
Even the "normal" medical requirements grow after a disaster. Already during normal conditions a large part of the population has medical problems. After a disastrous earthquake this population can not get their medical treatment any longer. The people are now also exposed to severe physical and emotional stress. The need of medical help will grow to huge levels. A disaster of a kind like in Kobe will not only put a heavy load on the surgical capacity but also on most medical disciplines.

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