UCLA pediatrician becomes a voice for children in Japan

UCLA Health article

No one knew what to do about the children.

  Dr. Kozue Shimabukuro did her best to treat these
  children with the limited medical supplies on hand.
  The older child appointed himself the team's helper
  and showed up everyday to make origami toys
  for the younger children. It wasn't until later that
  Shimabukuro began to suspect that he kept showing
  up because his parents never came home after the
  disaster. Photos provided by Shimabukuro.

Soon after Japan's 9.0 quake and towering tsunami, many evacuation centers housed small groups of orphaned children, recalled UCLA pediatric critical care doctor Kozue Shimabukuro, who canceled a visit to her family in Japan to join a roving government medical team in the first weeks after the quake. Amidst the chaos, with no parents or guardians, the children clung to each other, refusing to believe that their families were killed by the disaster and hoping their parents would soon appear. If they were hurt, whether from a scratch or a broken bone, they didn't know whom to ask for help.

"They just kept waiting and waiting and waiting for their moms to come and pick them up," said Shimabukuro, choking back tears as she struggled to tell a room full of listeners about her experience in the disaster zone. She returned from Japan to complete her fellowhip in pediatric critical care at UCLA, and gave her heartbreaking presentation at UCLA's Gonda Research Facility Tuesday, April 26, to give a voice to the tsunami orphans still in need of help.

"We told the children that somebody cares still, somebody remembers them, somebody is going to make sure their future is all right," said Shimabukuro. "Please don't let us be wrong."
"We need your help"

On March 11, the day the quake hit, Shimabukuro was on her way to LAX airport, about to begin a tropical vacation on Okinawa, the equatorial Japanese island where she grew up. Her plans included boat tours, bathing suits and cherry blossom festivals, but when she got to the airport, all flights were canceled.

"The tsunami hit Japan," an airline worker explained to her. "Tokyo is in blackout."

Shimabukuro dialed phone numbers again and again, finally getting through to a friend in Japan. "Get on the plane," the friend said. "We need your help."

She arranged an emergency flight and hours later was in the air. Then panic set in. Japan was famously well-prepared for quakes - what could have happened to plunge Tokyo into blackout, she wondered? At her presentation on Tuesday, she looked around the room at the familiar faces of her colleagues. "A couple of you probably got my frantic phone calls saying, 'I'm leaving for Japan soon. I'm freaked out. I don't want to go, but I have to.'"

Where are the children?

  Shimabukuro consulting with other doctors in
  the field.

Shimabukuro spent her first days in Japan sleeping on the floor of Tokyo's Narita airport until she got permission to join a disaster response team. Even then, it took a week for the government to let the team into the disaster areas. While they waited, limited helicopter transports carrying patients into hospitals were bringing in only adults, Shimabukuro said.

"Ten to 20 percent of the population were kids ... 10 to 20 percent of the transports should have been pediatric patients," she said. "We asked, 'Where are they?' ... The government's answer was, 'We don't know.'"

Meanwhile, other disaster response teams already in the field had no pediatricians, she said. "They told me, 'We pray that kids don't come to us ... because we won't know what to do,'" she said. "CPR, procedures, drug doses, everything is different with kids." Doctors who did encounter children told her they froze up.

Embarking into chaos

Finally, a week after the disaster, her pediatric team was allowed to set out. With resources stretched thin across the country, they had virtually no support, and drove through snowy, frozen mountain terrain from one evacuation center to another looking for patients. They had to scrounge food supplies and struggled to find passable roads, she said. Worse than the cold and the hunger was what Shimabukuro saw.

"It was hell," she said.

  Shimabukuro's team found toys strewn amidst
  the rubble.

Hospitals were in chaos, and doctors were working five-day shifts without sleep. Her team visited schools and shelters where people had hung fliers with pictures of lost friends, family and children, pleading for any information, even if their loved ones were found dead. The tsunami had strewn building debris with stuffed animals and children's school things.

They also found areas where clean-up teams had tagged houses as empty - the owners presumed dead - and had tried to clear away the remnants of lost lives. But over and over, Shimabukuro saw that the workers had intentionally left behind small piles of toys, children's drawings and photographs of happy families, just in case. "This one is a drawing from a kid to a daddy," she said, showing a picture. "They didn't have the heart to throw it away because they were hoping maybe the people in these houses are still alive."

At one school-turned-shelter, dozens of backpacks remained tucked in their cubbyholes. "When we got to this school, we knew we were in trouble. The kids hadn't come back to claim their stuff yet," she said. The team knew all those children were probably dead.

Because the disaster occurred in the middle of the afternoon when parents were at work and children were in school or walking home, families everywhere were separated, Shimabukuro said. When her team finally did find refugee centers with children, the children were inevitably alone. "No one knew whom they belonged to."
The team did their best, but makeshift hospitals in the shelters lacked medicine for children. She remembered with obvious distress how she couldn't treat a baby with a fever because there was no liquid Tylenol. She recalled the frustration of having nothing but the distraction of origami to give to a little girl who needed antibiotics because child-size doses were nowhere to be found.

Most of the children showed signs of depression or post-traumatic stress disorder, she said. Even those who were uninjured asked daily whether they were going to die, had trouble sleeping and avoided eye contact. Shimabukuro recalled children who sat alone, saying, "My mom is coming, my mom is coming."

"It's a dying story"

  Shimabukuro's team was crushed to find so many
  children's belongings unclaimed.

When Shimabukuro returned to the United States after three weeks in Japan, she was drained but determined to rally help for the people she left behind. The tsunami orphans still need help: pediatricians need medicine for children, Japan needs money to rebuild schools and educate new teachers, and much more, she said. But after completing one interview with a reporter, she was told the story might not run at all, because it was becoming old news.

"It's a dying story," the reporter had told her. Recalling the conversation, Shimbukuro said in a quavering voice, "If they could only see these kids' eyes when they cry every time an aftershock hits; when innocently they tell me that they are waiting for father to come back from the boat, he has just gone out fishing; if they could see those little boy's eyes saying 'School is starting soon, they promised me,' they would not have said this is a dying story."

You can read previous article on Dr. Shimabukuro here, here and here. Dr. Shimabukuro provided the following information and recommended donating to these charities for the biggest impact:

Japanese Society of Emergency Pediatrics Special Committee for the Japan Earthquake
Account name: The Bank of Tokyo-Mitsubishi UFJ, Ltd.
Swift Code: BOTKJPJT
Account Branch and Address:
Tsukiji Branch
1-10-6 Tsukiji Chuo-ku
Tokyo, Japan 104-0045
Phone: 81-33-541-2151
Beneficiary's Account Number: 025-0078003
Beneficiary's Name: Special Committee for the East Japan Earthquake, Japanese Society of Pediatrics.

American Academy of Pediatrics: Direct your donation to the Japanese Children's Disaster Relief Fund
Philanthropic contributions enable the American Academy of Pediatrics to do more for children and for those who care for them. Through its Friends of Children Fund, the Academy develops resources to support educational activities, research projects, and special programs that advance pediatrics: http://www.aap.org/donate/fcfdonate.htm. To make a designated gift to a specific AAP program or activity, please contact the Department of Development at (888) 700-5378 during business hours of 9-5 Central time or email [email protected].


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