Primary Care in Crisis: The Missing Link in Disaster Medicine - Experience from the 2024 Noto Peninsula Earthquake and Floods

Summary: While Japan’s current disaster medical support system effectively addresses acute medical needs, sustainable primary care support requires enhancement. Following the Noto Peninsula Earthquake on January 1, 2024, the Japan Primary Care Association (JPCA) initiated specialized primary care support in Wajima City through December 2024. This report describes comprehensive primary care support activities in a region with over 50% of the elderly population that experienced flooding six months post-earthquake. Support was provided to an outreach-based primary care clinic where a local physician, an Ishikawa Medical Association’s Northern Noto Branch member, served as one of Wajima City’s medical coordinators. The clinic provides home medical care, nursing, and rehabilitation services, and operates an NGO offering a “third place” support program for adolescents. Between February 5 and July 1, 2024, eighteen physicians were dispatched. The team handled 1,487 outpatient visits and 725 home visits with local primary care physicians. This support enabled the local physician to attend 86 regional healthcare meetings, including the Wajima City Health and Medical Welfare Coordination Headquarters meetings. Additionally, 29 community activities were supported, including health promotion cafes and programs for high-risk pregnant women. Following severe flood damage in September, which caused one-meter flooding and the loss of outpatient functions, physician dispatch resumed. To enhance sustainability, visiting physicians covered weekend home visits, allowing local staff essential rest periods. The JPCA aimed to develop support focusing on local healthcare sustainability and human resources. Supporting this crucial medical institution, which functions as the local medical association’s disaster coordinator, contributes to maintaining the regional healthcare system’s mid- to long-term sustainability.