The 1923 Great Tokyo Earthquake: An Overview of the Medical Response

Summary: This presentation provides an overview and context of the medical response to the Great Tokyo Earthquake (a.k.a., The Great Kantô Earthquake) and fire that destroyed much of Tokyo and Yokohama 101 years ago. At 11:58 am on September 1, 1923, a magnitude 7.9 quake 23km beneath Sagami Bay impacted Tokyo and the surrounding six prefectures. Although tsunamis hit coastal areas over 100km away, the main cause of mortality was fires in urban centers. These fires quickly spread throughout the wooden environment and eventually combined into firestorms. Of the estimated total 105,000 deaths, 92,000 are believed to be fire-related; over 85% of Tokyo’s 60,198 fatalities have been attributed to fire. The brunt of these was east of the Sumida River around modern-day Sumida Ward, where approximately 1/6 of the population died. At one site near the present-day Edo Tokyo Museum, a cyclone of flame engulfed several thousand evacuees gathered at an abandoned riverside military supply depot. Medical infrastructure was also heavily impacted by the loss of two thousand hospital beds and the main Japan Red Cross (JRC) warehouse. However, within one week, telegraphic communications were used to contact regional offices within the country, and in the Korean and Manchurian colonies. In addition, the US Ambassador requested aid from military units in the Philippines. Supplies and personnel soon arrived for temporary facilities; around fifty JRC centers were eventually established and continued operation into the following spring. This presentation outlines the early post-disaster medical and public health responses and explains how they have been evaluated over time. For example, while motorized ambulances represent innovations, dependency on foreign intervention has been criticized from a security standpoint. Meticulous data management practices of the JRC, municipal government, and the Metropolitan Police Department were also a feature and resulted in published detailed reports of the responses.