Making Life under Evacuation Sanitary


Mitigating Health Dangers

The number of people in evacuation centers following the April 2016 Kumamoto earthquakes has fallen to around 50,000 (as of April 26) from a peak of roughly 180,000 people, and such basic amenities as running water and electricity are slowly being restored. The areas that suffered the worst damage, though, remain without a water supply, and many residents driven from their homes still have no choice but to sleep in their cars.

Living in such cramped conditions has resulted in 37 people suffering from economy class syndrome requiring hospitalization, according to an announcement by Kumamoto Prefecture. The evacuation center in the village of Minamiaso was also struck by an outbreak of the norovirus, and other evacuation centers have had to take measures to prevent the virus from spreading.

Collapsed homes in the town of Mashiki, Kumamoto Prefecture.

The gymnasium at Kinokura Elementary School in Mifune has been turned into an evacuation center.

In addition to cramped quarters, economy class syndrome is said to be caused by an insufficient intake of fluids. Many people have suffered from the syndrome even after the water supply has been restored, though, due to problems related to toilet facilities. Dr. Hasegawa Tarō, head of the Shōnan Urology and Internal Medicine Clinic who is volunteering at an evacuation center located at Hiroyasu Elementary School in Mashiki—a town devastated by two earthquakes measuring 7 on the shindo seismic intensity scale—explains:

Hasegawa Tarō at an evacuation center in Mashiki, Kumamoto Prefecture.

“Initially, odor was a big problem with the temporary toilet facilities because of inadequate cleaning, and people had to use the facilities in the dark due to power outages. It was also hard for elderly persons to use the Japanese-style squat toilets. Wishing to minimize their use of the facilities, many older people and women limited their intake of fluids, which had a negative impact on their health.”

Even when buckets of water were supplied for use in flush toilets, some waste ended up scattered around the toilets as a result of the uneven water pressure. Sanitary conditions deteriorated as a result and raised the dangers of norovirus and other types of infection. This pointed to a need to improve toilet facilities at evacuation centers as promptly as possible.

A volunteer nurse at Hiroyasu Elementary School suggested that the evacuation center use the same type of emergency toilet that was utilized after the 2011 Great East Japan Earthquake; the toilet hermetically seals waste using a special film, rather than utilizing water. After promptly submitting a request for assistance, the first such toilet arrived at the center on April 20—and another three arrived five days later. These emergency toilets have been primarily used by the elderly, persons with physical disabilities, children, and others unable to use the outdoor, temporary toilet facilities.

(Clockwise, from top left) A barricade was set up to prevent entry to the standard toilet at Hiroyasu Elementary School as it had become clogged, filling the evacuation center with a foul odor; a special coagulant is first applied before using the Wrappon toilet; after use, pressing the remote-control button ejects the sealed waste; Wrappon toilets also come with an optional cardboard unit, and plans call for it to be used at the evacuation center for women wishing to change clothes or nurse infants.

An Answer to Toilet Management Issues

The emergency toilets installed at Hiroyasu Elementary School are the Wrappon toilets produced by Nihon Safety Co. These products, initially designed for use at nursing homes, make it possible to automatically seal waste without having to handle it and then dispose of the sealed waste. As long as electrical power is available, the toilets can be used for many years, merely requiring the periodic refilling of the roll of 50 sheets used to seal waste.

Since the odor from waste does not spread, the Wrappon toilets can be installed indoors without causing sanitary problems. Hermetically sealing the waste or vomit of those suffering illness, moreover, can prevent secondary infection. The toilets have been used to respond to recent earthquakes in Japan, including the installation of 50 units after the Noto Earthquake, 100 after the Chūetsu Offshore Earthquake, and 150 after the 2011 Great East Japan Earthquake. For the Kumamoto earthquakes, the Nippon Foundation provided emergency assistance that will make it possible to install the record number of 500 Wrappon toilets at evacuation centers in the affected areas.

Wrappon toilets arrive at the Kumamoto Red Cross Hospital. The toilets were then sent to the evacuation centers with the highest hygienic needs.

“One elderly woman, who looked very distressed when I arrived, has now regained her smile thanks to the Wrappon toilets,” noted Hasegawa, “and her complexion has also improved. The toilets have also gone a long way toward lessening the bad smell in the center. Since the film and coagulant need to be replenished, we can’t have everyone using the toilet, but we’ve created a priority list and a set of rules, and we’re trying to gradually improve the quality of life for everyone at the evacuation center.”

Requests from Elderly Evacuees

In the town of Mifune, located south of Mashiki, around 130 people remain at the evacuation center set up at Kinokura Elementary School even after the water supply was restored. These evacuees include those whose homes were damaged or destroyed and elderly residents who live alone and are frightened due to aftershocks. The evacuees voiced a strong desire for the installation of Wrappon toilets even after the flush toilets came back into use. According to a local government official, “The flush toilets were located outside the school gymnasium, and many elderly people who used them at night stumbled and fell on the steps. Fortunately, no one was seriously injured, but due to lingering concerns about the safety of evacuees, a request was made for a toilet that could be used inside the evacuation center.”

An employee from Nihon Safety who came to install the toilet and explain how to use it was met by smiling faces, including one elderly woman who said, in her Kumamoto dialect, “This is great. It’s so easy to use!”

Evacuees at Kinokura Elementary School listen to an explanation of how to use the Wrappon toilet.

(Originally written in Japanese by Kawasaki Miho and published on April 27, 2016. Photos by Hashino Yukinori.)

earthquake disaster Kumamoto