The Japan Medical Association (JMA) trains and coordinates medical teams, known as Japan Medical Association Teams (JMATs), to respond in the event of a disaster or other large-scale medical emergency.Reference Ishii and Nagata ¹ In response to the Great East Japan Earthquake, the JMA, which comprises 160,000 members, deployed JMATs to the 4 prefectures with the most devastating conditions: Iwate, Miyagi, Fukushima, and Ibaraki.Reference Ishii and Nagata ¹

After the Great East Japan Earthquake in 2011, the JMA, as the professional society of Japanese physicians, recognized the importance of incorporating foreign medical teams (FMTs) into its large-scale disaster response efforts. ² The JMA has developed international medical teams of the JMA, or iJMAT, as a new framework to accept FMTs to provide medical care in the event of major disasters, particularly the predicted Tokyo metropolitan or South Sea Thrust mega-earthquakes. ³ The main aim of the iJMAT program is to secure the quality of care provided and certification of physicians’ qualifications to meet the needs of disaster-affected areas.

Over 30 nations offered medical assistance to the Japanese government following the Great East Japan Earthquake, and only 4 FMTs from Israel, Jordan, Thailand, and Philippines, could be accepted. The Ministry of Foreign Affairs, Japan, proposed “The scheme for medical assistance from abroad,” and the following 6 criteria had to be fulfilled before accepting assistance ² :

1. 1. FMTs should be self-contained (capable of providing the necessary drugs, medical equipment, food, water, fuel, etc, on their own).

2. 2. FMTs should send enough interpreters to meet the need.

3. 3. FMTs should also send Japanese physicians with experience in international cooperation.

4. 4. The duration should be 2 to 4 weeks (but case-by-case).

5. 5. A local disaster management headquarters should manage their activities.

6. 6. The government should cooperate on the smooth clearance of drugs and test equipment through customs.

To validate the concept of iJMAT, the JMA proposes that 2 major medical declarations/guidelines, the World Medical Association Declaration of Montevideo on Disaster Preparedness and Medical Response and the Sphere Project, should be followed. The World Medical Association Declaration of Montevideo, ⁴ adopted in October 2011, calls upon its members “to promote a standard competency set to ensure consistency among disaster training programs for physicians across all specialties.” Health care workers joining the iJMAT should have their own specialties and complete disaster medicine training in advance. The Sphere Project was initiated in 1997 by a group of nongovernmental organizations and the Red Cross and Red Crescent Movement to develop a set of universal, minimum standards in core areas of humanitarian responses, resulting in creation of the Sphere Handbook. ⁵

Based on lessons learned through successful deployment of JMATs and difficulties in accepting FMTs following the Great East Japan Earthquake, the concept of international medical teams in the JMAT was proposed by the JMA. The predicted Tokyo metropolitan mega-earthquake and South Sea Thrust mega-earthquake require advance planning in disaster medicine. If such events occur, FMTs are expected to participate in the disaster response as iJMATs.