PROBLEM: The Ishinomaki Red Cross Hospital is the only designated disaster hospital in the Ishinomaki Medical Zone, Japan that was undamaged from the Great East Japan Earthquake in March 2011. The tsunami completely destroyed a large part of the Ishinomaki Medical Zone.

CONTEXT: The Ishinomaki Red Cross Hospital was designed with the capability to respond to disasters. An instruction manual for responding to disasters had been developed and was exercised through drills.

ACTION: In accordance with the manual, the hospital disaster task force was established. The Ishinomaki Zone Joint Relief Team coordinated medical support from organizations such as physicians associations, dental associations, self-defence forces medical teams, pharmacists associations, the Japanese Red Cross and relief teams from hospitals all over the country. In three days, the joint relief team directly visited all emergency shelters to make an initial assessment and to collect information about the number and state of health of evacuees, provision of food and drinking water and the availability of electricity, water and sewerage.

OUTCOME: Initial assessment revealed that 35 emergency shelters lacked a sufficient food supply and that 100 shelters had unsanitary conditions. The joint relief team provided the Miyagi Prefecture government and the Ishinomaki municipal government with information about emergency shelters that did not have sufficient food supply. As of 30 September, the activities of the joint relief team were completed, and there was no outbreak of communicable diseases in the Ishinomaki Medical Zone. A total of 328 shelters with 46 480 evacuees were managed by the Ishinomaki Zone Joint Relief Team.

DISCUSSION: Advanced preparation to quickly establish an initial response system, expertise, and decision-making ability and the ability to get things done are required for disaster response management.

As a characteristic of traditional medicine, the direction of development of acupuncture and moxibustion would be headed towards localization. Whereas Western medicine has been developed along the road of globalization, traditional medicine has developed along the path of localization.
So what are the characteristics of Japanese acupuncture and moxibustion, which have been developed locally in Japan?Very delicate procedures for acupuncture and moxibustion, a variety of equipment, diagnosis that emphasizes heart pulse, and combination and compromise of various treatment methods are all such characteristics. These characteristics have been strongly influenced by Japanese culture, spirit, feelings, and mentality.
It has been reported that acupuncture and moxibustion, as traditional medicine, were cultivated in close association with the people of each era. Since they are medical treatments that connote tradition, acupuncture and moxibustion should be able to meet the needs of people in any era. We need to reconfirm this and survey the future of acupuncture and moxibustion.

A questionnaring was conducted on farmers in Akita Prefecture who went in for sports in the intervals of farming. Notably one group of farmers who answered that they took regular exercise showed the following results:
1. The self-consciousness of being healthy and having good physical fitness is by far more intense in this group than in the groups of farmers who took irregular or occasional excercises.
2. The chief reasons why they continued to practice sports were:
a. that they had developed closer friendship among them through sporting activities.
b. that they obtained a good understanding and cooperation from the rest of the family members.
c. that they had leisure time.
3. To find time for sports they saved, above all else, their farming hours, indoor leisure time and homekeeping hours.
4. General endurance, agility and balance were the top three qualities of physical fitness that the greatest number of the farmers referred to as essential to modern farming. Further inquiry will be required into sports which might help to develop these qualities.