Eric Ouannes, MSF
MSF general director Eric Ouannes in Tokyo talks about MSF’s response to the disasters in Japan.

Can you explain how MSF responded to the disasters in Japan? Well, rapidly. At least we tried to respond very rapidly. What we have looked at right from the beginning is a very small team trying to be flexible, mobile, modular. To be able to move from one place to another quite quickly and try to cover as much as distance as possible and visit as many evacuation centres as possible. Can you tell us a bit about the national response to the earthquake and tsunamis? It has been a massive response. Numbers are not very clear, but we speak about between 80,000 and 250,000 people coming mainly from [Japan’s] Self Defense Forces, as well as other emergency medical mechanisms, and included in that are some other foreign aid groups or government aid groups. What are the main issues MSF staff have seen? For the moment, in the 20 or 30 different evacuation centres we have visited, the main health issues we are seeing are chronic diseases among elderly people. Their treatment has been interrupted, so our doctors are looking at restarting the treatment to keep these people from falling into an acute health situation. Another issue is that communications has been very erratic over the last four days. It’s getting better but it's still quite difficult. Transportation is difficult. Roads were cut almost everywhere we went, and there has been lack of fuel for our cars. For people affected by the earthquake as well as the tsunamis, there are a number of issues: the cold – the weather is not really nice these days – as well as a lack of food and water. The most urgent need is blankets to protect the most vulnerable people against the cold. What kind of chronic diseases are staff seeing? The usual chronic diseases in an elderly population: hypertension and cardiac diseases, as well as diabetes. We are trying to restart their treatment, as I said earlier. We have also seen some cases of hypothermia on top of the other diseases I have spoken about, as well as dehydration. But again, it’s a limited number of cases with regards the vast number of people who have been displaced or who have lost their homes. Does MSF envisage a long-term involvement in this situation? It’s too early to say. What we are looking at is contemplating expanding the team – the decision is not made yet – and to try and be more present in more locations, with the likelihood that we will have to go a further north from the area where we are. We are now in the north of Miyagi prefecture and are trying to get to Iwate to see if similar needs exist, if there are similar gaps where MSF could have an added value. One thing that is clear is that the set up – with these very flexible mobile teams – is responding to the needs that we identified at the beginning. We will continue with the same strategy, maybe expanding to more teams, covering more needs, but we are definitely not looking at a massive intervention with hundreds of international personnel coming from around the world. This is absolutely not what we are looking at at the moment. Why is that? First, because there is a massive deployment of aid from the government and from foreign governments. It’s not a humanitarian crisis, at this stage. We cannot qualify this as a humanitarian crisis because most urgent needs are covered. A number of hospitals still function in the area, a referral system is still functioning, drugs are there, doctors are available in most of the hospitals. Obviously, there are some gaps, but nothing abnormal in such a situation. And considering the scope of the disasters – and I say disasters, because there were several disasters – there were gaps and we are here to try to fill those gaps. What will MSF do in the event of a significant nuclear event or the situation in Fukushima getting worse than it already is? We will evacuate our teams. That’s pretty simple. Today we are monitoring the situation on an hourly basis. We have radiometers [radiation detectors] with each of our personnel on the ground. We are cross checking the situation with various government and nongovernment agencies, and in many different locations in the world, not just Tokyo. And as soon as we reach a level that we consider an alarm for us, that could become unhealthy or dangerous for our teams, we will evacuate the team. We have the means to evacuate quite rapidly. Evacuation routes have been identified. So, yes, that’s what we will do. What about treating illnesses caused by radiation? Is that something MSF can contemplate? At this stage no. We are not experts on that. We are now trying to mobilize the entire MSF network on the medical issue of nuclear radiation and trying to see what we might be able to do. We have some people in our network of 25,000 or 30,000 people working in MSF who have worked in the past in this field of medicine, so we are trying now to collect this expertise to see if we could come with a particular response. This is more the duty of the Japanese government, and from what we hear or read in the news, they are already trying to prepare for that. This interview has been edited.