To the Editor:

Minamisoma Municipal General Hospital is located along the coast of Fukushima Prefecture, 23 km from the Fukushima Daiichi Nuclear Power Plant. We monitored air radiation levels, the number of cases managed by anesthesiologists, and reconstruction efforts for the period 2010–2014 (1 year pre-disaster, 4 years post-disaster). Immediately after the catastrophic breakdown of the Fukushima Daiichi Nuclear Power Plant, air radiation levels were 20.00 µSv/h immediately outside the hospital and 2.50 µSv/h indoors. The hospital had no anesthesiologists at the time of the earthquake, although the number of cases managed by anesthesiologists at the present time is now back to previous levels (Electronic Supplementary Material Table 1). There remains a lack of hospital beds and staff, but efforts are being made to reduce the lengths of stay of patients admitted to the hospital. The hospital and its staff face numerous problems: direct earthquake damage; effects of long-term radiation exposure; economic damage; misinformation; ethical issues; social changes; financial difficulties; changes in public health policies; mental health issues; general illness; legal problems [1]. These problems particularly affect the elderly and children. Air radiation levels have decreased through decontamination efforts, but the local population is declining. Social changes include a decrease in the number of children and able workers [2]. We are concerned about the effects of radiation on the children of hospital employees which has the potential to affect staffing levels and lead to fewer hospital beds. If the present trend continues, we will be unable to increase the number of hospital anesthesiologists and hence the number of surgeries performed. The average age of our anesthesiologists is 58.5 years at this time and is progressively increasing. We are very concerned about this situation, which amounts to a medical crisis.