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Toilet Problems in Evacuation Shelters in the Noto Peninsula Earthquake in Japan: Letter to Editor

Published online by Cambridge University Press:  21 May 2025

Kyo Takahashi*
Affiliation:
Institute of Integrated Research, Institute of Science Tokyo
*
Corresponding author: Kyo Takahashi; Email: tkyo-tky@umin.ac.jp
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Abstract

Information

Type
Letter to the Editor
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc

Dear Editor,

Michioki Endo et al. reported the challenges of providing continuous care during disasters through a case study of an older woman who developed aspiration pneumonia in an evacuation shelter for the Noto Peninsula earthquake in Japan.Reference Endo, Ozaki and Ikeguchi 1 The death toll from the Noto Peninsula earthquake, which occurred on New Year’s Day 2024, was reported to be 456 as of November 26, 2024, and more than half of them were related to health deterioration after the disaster. 2 Besides the disaster itself, changes in the environment, such as unusual life in evacuation shelters after the disaster, continued to threaten the health of the evacuees. In particular, the toilet problem in evacuation shelters for vulnerable population was serious.

According to a survey of the Noto Peninsula earthquake by the Japan Toilet Labo 3, it took more than 4 days after the disaster for temporary toilets to be installed in 9 of 10 evacuation shelters, and 85% of the temporary toilets were old-fashioned squat toilets with steps, making them difficult for children, older adults, and persons with disabilities with mobility problems to use. In addition, only 2 of the 12 evacuation shelters cleaned their toilets frequently.

Poorly managed toilets increase the risk of spreading infectious diseases.Reference Abney, Bright and McKinney 4 Furthermore, people’s reluctance to use poorly managed or inaccessible toilets leads to restrictions on fluid and food intake, which has a serious impact on their lives and health.Reference Gu, Zhou, Zheng and Huang 5 Japan produces high-quality toilets as a crystallization of advanced technology and hospitality; however, toilets in evacuation shelters during disasters remain a major challenge.

In the event of a disaster, local governments in charge of evacuation shelters will find it difficult to promptly install and manage safe and comfortable toilets due to the sudden increase in disaster-related work and a sudden drop in the number of active staff. It is necessary to stockpile the supplies required for installing safe and comfortable toilets in various locations throughout the community, to promptly send personnel capable of managing them from areas less affected by disasters, and to nationally standardize the entire process from installing to managing them.

Competing interests

KT is a member of the Japan Toilet Labo, a nonprofit organization, and has received honoraria for data analysis and other activities in toilet-related surveys.

References

Endo, M, Ozaki, A, Ikeguchi, R, et al. Challenges and implications of providing continuous care for the elderly in disaster situations: a case study from the Noto Peninsula earthquake. Disaster Med Public Health Prep. 2024;18:e307. doi: 10.1017/dmp.2024.161CrossRefGoogle ScholarPubMed
Cabinet Office Japan. Damage Situation Caused by the Noto Peninsula Earthquake. Published: November 26, 2024. Accessed December 17, 2024. https://www.bousai.go.jp/updates/r60101notojishin/r60101notojishin/index.htmlGoogle Scholar
Japan Toilet Labo. Survey on Damage to Evacuation Center Toilets During the Noto Peninsula Earthquake. Accessed December 17, 2024. https://www.toilet.or.jp/wp/wp-content/uploads/2024/06/noto_survey2024_0704.pdfGoogle Scholar
Abney, SE, Bright, KR, McKinney, J, et al. Toilet hygiene–review and research needs. J Appl Microbiol. 2021;131(6):27052714. doi: 10.1111/jam.15121CrossRefGoogle ScholarPubMed
Gu, Y, Zhou, W, Zheng, T, Huang, F. Health effects and externalities of the popularization of sanitary toilets: evidence from rural China. BMC Public Health. 2023;23(1):2225. doi: 10.1186/s12889-023-17192-4CrossRefGoogle ScholarPubMed