From the eye of the Tiger: A Reflection of an American Nurse in Japan

The Story

I was boarding a plane with my backpack,  camera, and water bottle, preparing for a Southeast Asian trip to the Myanmar Delta, a devastated area from Cyclone Nargis.  The announcement came over the plane to turn off all electronics in preparation for departure to China in route to Myanmar.  As I was working to turn off my phone, I felt it ‘ding’ one more time, notifying me of new mail.  Of course I checked it, as it would be my last opportunity to access email for several weeks.  It was an email from the JMU Nursing Graduate program about the opportunity to attend a Workshop on Global Health and Disaster Nursing in Japan.  I immediately responded that I was interested, but would be away for several weeks with no access to email.  I only hoped that opportunity would still be available upon my return.  Fortunately, for me, it was.  After return from Myanmar and a competitive interviewing process later in 2013, I was chosen to represent JMU Nursing at the International Network of Universities Inaugural Global Health Workshop on Disaster Nursing in Hiroshima, Japan August 3-10^th, 2013.

Group Photo at the Farewell Party

 The Overview

We gathered together in the intensely hot, humid August of Hiroshima, from Spain, Sweden, South Korea, Japan, Australia, and the United States to learn about a nurse’s role in a disaster.  Each university represented prepared a 15-minute presentation on Disaster Management in their represented country, which was presented at the beginning of the workshop.  Throughout the course, we attended lectures on the Kasumi Campus of Hiroshima University (HU), from talented individuals around the scope of Disaster Management and nursing.  All the students, residing on the campus of  HU, were separated into three groups for completion of a mock-disaster surrounding or affecting Motomachi, a lower-income residential complex with nearly 6,000 residents, many of whom were Atomic Bomb survivors.  The three groups, Terrorism, Earthquake, and Pandemic, assessed the site for its preparedness in case of an emergency.  We assessed individual apartments, the surrounding area and neighborhoods, the Community Care and Volunteer Center, the residents with or without health needs, and the actual structure of the building.  Upon return to campus we were given our specific scenario with details related to our mock-disaster.  For the group on Terrorism, the group I was assigned, our scenario included an explosion in the nearby Public Transportation System with release of diphosgene gas, a choking agent.  Our mission was to complete an emergency plan for the site of Motomachi that included action plans for the time periods immediately after the attack, 24 hours after the attack, and one year after the attack using our assessment and from the perspective of a nurse. 

The Group on Terrorism

The Experience

Culturally, I wasn't shocked.  Perhaps that was the cultural shock.  Having a passion for traveling, I am accustomed to differences; therefore, it doesn't shock me to see a different language, cuisine, or even different customs.  Having recently been to Myanmar, I wasn't even shocked at the lack of English spoken.  While I wasn't shocked, it still proved to be difficult for communication with each other.  Disasters are truly an odd experience, and are perceived so differently across beliefs, countries, and languages.   As an American assigned to the Terrorism group, I unfortunately can relate to terrorist attacks and their frequency in America's social media; however, for some, this was an abstract concept because of their distance from similar events.  In my group, two of us were practicing Registered Nurses (RN).  As a RN, daily we deal with simple triage and small emergencies.  However, for the other four in our group that were not yet RNs, the concept of triage was still very unfamiliar to them.  These were the largest barriers for us as a group.  Those with strong English skills often dominated conversation, while the others struggled to understand.  Those with strong nursing skills or experience with disaster often understood a concept sooner than those without any experience.  What was really amazing, however, was that days before this we didn't know each other.  But only a few days into the workshop you could see the extension of compassion and empathy between students trying to help other students understand an abstract idea in another language.  Often it was through multiple languages.  I would communicate something in English between two people and that was then translated by myself and others into French or Spanish and then relayed beyond that to Korean or Japanese.  The challenges that presented themselves to us did not prevent us from our mission: to create a disaster plan in response to our mock-explosion.  Rather, it provided opportunity to experience another perspective; another way of learning.

As a part of a pursuit of peace that the International Network of Universities extends, we joined with the other workshops on Peace, Environmental Justice, and Global Citizenship at Peace Memorial Park.  This was in observation of the release of the first Atomic Bomb on Hiroshima, Japan on August 6, 1945.  We participated in events like the Peace Memorial Celebration where the Prime Minister of Japan spoke, as well as the Lantern Ceremony later that evening.  This senses overload experience allowed for reflection on the past, present, and future of nuclear warfare, war, peace, and the contributing role that our generation carries every day.  Personally, I reflected on how disaster and conflict doesn't just affect those immediately surrounding the event.  I reflected on the ways in which disaster affects long-term illness and healthcare, which can lead to political and economical conflict, which can then lead to social conflict.  It was very powerful to reflect on how one decision affects multiple facets of life and even across many decades of life.

Mr. Matsushima, myself, and Andrea Knopp, JMU Professor

 

We were able to hear from an Atomic Bomb Survivor, which as anyone can imagine, was overwhelming.  One of many memorable moments, was after our group photo with Mr. Matsushima.  He helped me up and then asked me, "Where are you from?"  There was this awkward silence around us as those awaited our responses to each other.  I timidly said, "America, near Washington, D.C.".  And his response still shocks me.  He said, "Really?  I love it there!"  If there was anything that shocked me more, it was this.  The abundant respect for people.  Not just people that make the right decisions or do only good in their life, but for people with painful pasts and histories of hurt.  Being the change doesn't just mean right now.  It means incorporating the change into your being; into who you are in life.  How can our world find peace if we cannot set aside our differences, extend the hand of compassion to others-regardless of whatever may divide us or make us different, and genuinely strive to make this a part of who we are as individuals?  I found Hiroshima to be rebuilt on this resilient atmosphere of moving forward, together.

Students from Hiroshima University in Japan, James Madison University in the United States, Flinders University in Australia, and Kyung Hee University in South Korea at Peace Memorial Park, the A-Dome.  The A-Dome was the only remaining building or structure after the nuclear bomb was dropped on August 6, 1945 at 0815.

Being the Change

So now what?  How did this once-in-a-life-time experience impact my life?  I'll be honest; It didn't.  It actually did far more than impact my life.  The experience in Hiroshima, Japan unexpectedly, yet profoundly, changed my life.    The topics we discussed, the activities we experienced together; they were difficult things to discuss.  It wasn't just an intellectual conversation we had.  We discussed disaster.  We discussed the events surrounding one of the deepest, darkest times a person can experience in life and how we can be the front line responders to those events, as a nurse.  What I realized is that we aren't just nurses.  We are healers.  We are intelligent.  We are educators.  We sacrifice for those that hurt.  We contribute to preparedness in disasters.  We contribute to recovery and resilience in disasters.  We are strong for those that are not. One of the fellow students always called me 'Tiger', based on the Chinese Calendar, of course.  She always said, "Tigers: they are strong, persistent.  They overcome."  It takes all kinds to be a nurse, but perseverance is required.  Nursing is not just something you do; it's something you choose to be.  I choose to be persistent through the challenging moments and the difficult hardships that come with life, like disasters, because I genuinely want the best for people.

I think the purpose of this workshop was to see that disasters will exist regardless of whether there is peace.  Earthquakes and Tsunamis, Germs and Bacteria; they will all exist, regardless.  We need to be ready and nurses are avenues to ensuring that communities are in fact ready.  All of us at the workshop, regardless of differences, were nurses.  We had that common bond and understanding that is so difficult to transcend to others that are not.  And because we accepted that challenge to nursing as a way of life, we have a responsibility to the communities in which we have returned.  We have a responsibility to carry the change that found us in Japan back to our schools, hospitals, and communities and to help continue to extend the arm of compassion.  We have a responsibility to take the knowledge learned to others so that when a disaster strikes we can all be ready and we can all advocate for each other.  I learned to embrace nursing as a way of life and not just a profession.  I learned to set aside my differences, alongside nurses from around the world, because of the common desire to simply make things better.