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At Japanese hospital, a post-quake nightmare AFTERMATH OF EARTHQUAKE IN JAPAN

KOBE, JAPAN — KOBE, Japan -- More than two days after the deadliest earthquake to hit Japan in almost half a century, the ambulances are still rushing the shattered human debris to Kobe's Shinko Hospital.

Amid a scene that is more devastating than any residents have seen since the Allied bombings of World War II, every hour a few more people are uncovered from the vast piles of rubble.

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The living are quickly brought to the hospital.

Shinko is Kobe's newest hospital. It opened last May. The 240-bed facility is equipped as well as, if not better than, any institution to handle disasters.

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There had been two fire drills since it opened, but no drills for earthquakes.

Unlike much of Japan, Kobe has in the past been spared the temblors that frequently jolt the rest of the country.

"This was not supposed to happen," says Motoko Takezawa, 32, the head nurse.

Considering the surrounding wreckage, it's a miracle the hospital is standing at all.

All around it, other structures, including hospitals and adjacent office buildings, have collapsed -- some into chaotic piles of splinters or bricks, others into more hideous configurations resembling sandwiches with innards of furniture, clothing, occasionally even people, caught between lawyers of steel and glass.

But inside, the modern six-story building is scarred. Floors, walls and ceilings are cracked, doors jammed ajar and windows broken.

Much of the hospital's sophisticated equipment, including the X-ray machine, is out of service. Painkillers and gauze, among other items, are in short supply.

With access to Kobe limited to helicopters and two gridlocked roads, no new shipments of supplies have arrived.

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The quake severed utility lines and damaged an emergency generator. Electricity and phone service were restored only late Tuesday, as long as 12 hours after the quake.

There is no water, and there may be none for a week.

Hiroka Katsuma says that has made it difficult to adequately wash between operations, increasing the probability of infection.

The hospital itself reflects a similar need for cleaning. There are .. splotches of dried blood on the stairs and corridors.

Another nearby hospital, Kanazawa, is in far worse condition -- its unattended entryway stained by broad smear of blood extending 15 feet to a stretcher leaning against a wall.

Ms. Takezawa looks young but she is exhausted. There are dark circles under her bloodshot eyes. Her pale skin is strained.

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Though she appears well composed, with her combed hair, spotless smock and dark blue sweater, the nurse apologizes for not having bathed in two days. Daily bathing is accorded ritual significance in Japan.

She speaks in a small room for nurses that reflects the havoc of the hospital. An X-ray viewing table lies on its side. Futons for the nurses to sleep on are scattered haphazardly.

Immediately outside a glass door, a dozen patients sit in a small waiting room filled with cigarette wrappers and soda cans and a broken pay phone, listening to the monotone of a television announcer reading the names of those killed in the quake.

When the temblor struck at 5:46 a.m., Ms. Takezawa was asleep in an employee dormitory connected to the hospital.

Awakened by intense shaking, she thought it was a bad dream at first. She was jarred into consciousness when several pieces of furniture and other possessions crashed onto her bed, pinning her down.

"The quake felt like it continued for 10 minutes, even though it really only continued for five," she remembers.

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Actually it was over in less than 40 seconds.

It was still dark outside. Worming her way out of bed, she grabbed a liter of milk from a small refrigerator and drank it all.

"I believed that I would never drink again," she says.

She squeezed through the wreckage of her room into the hallway, and then outside.

It was freezing but she could not find a coat in the chaos. So, still in pajamas, she and the other nurses began clearing out the dorm and then the hospital.

Because they did not know if Shinko would collapse or burst into flames like so much of the area, the first job was to get all the patients out of the hospital.

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About 150 patients were well enough to make it out of the building on their own. Another 100 considered too ill to walk were moved in their hospital beds, two nurses on either side, down as many as six flights of stairs.

"My hands became numb, I thought they would tear off," said Ms. Takezawa who, like most of the nurses, is a slight figure.

Within an hour, the hospital was empty. At the same time, though, there was pressure to reopen immediately.

New patients were coming to the hospital, many with broken bones, severe burns or bad bleeding. As many as 50 were dead on arrival, a stunning number for a hospital that rarely receives one fatality in a day.

Internal cracks and fissures inside the building looked menacing. The lack of electricity and water made matters worse, but the decision was made to reopen.

Similar decisions were being made throughout Kobe as roads and bridges, often with buckled or broken foundations, were allowed to carry traffic.

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So they moved all the old patients back in and started taking in new ones from the catastrophe.

"No one," says Ms. Takezawa, "knows how many people came in those early hours."

Dr. Katsuma says a month's worth of work was done in one day, with more than 500 people treated and several hundred admitted.

By late afternoon, Ms. Takezawa's only pause came when she drank some milk and ate some bread. Others in the hospital were maintaining a similar pace. In the evening she was able to rush back to her room and substitute work clothes for pajamas.

The initial chaos that came with the quake was replaced by late evening with a new fear: Dozens of fires had ignited throughout Kobe; from the upper windows of the hospital, they could be seen drawing close.

"The patients were scared," Ms. Takezawa says. "There are many factories nearby, and if they ignited the consequences would be horrible."

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It wasn't until yesterday morning that the worst of the blazes seemed under control, though significant fires continued throughout the day and the smell of ashes remained in the air.

Late Tuesday, the family of a longtime patient at Shinko dropped off a gift for the workers -- rice cakes and eggs. It was the first solid food of the day and the first hint of normality.

Ms. Takezawa wept.

Although the casualty figures for the quake continued to rise yesterday, the pace of new patients slowed. The number of patients dying in transit to the hospital dropped from 50 to 10 yesterday -- still distressingly large, yet seemingly better in the morbid mathematics of disaster.

The hospital seems to have become a beacon of safety even for those who have not been injured.

By late last night, a row of cars was parked on the street outside the front entrance. Blankets had been stretched across the car roofs and weighted down with slabs of broken concrete. Inside the cars, families slept, not stirring even as ambulances rushed by.

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More than 140 nurses work at Shinko hospital. All remain on round-the-clock shifts. As a concession to the slowing patient load, and the reality that the hospital remains limited in what it can do, last night they began rotating breaks of three hours to provide some sleep.

Offsetting any sense of relaxation is a disconcerting message from some experts in Japan that another, equally large quake may hit within the next 10 days.

"If I could," said Ms. Takezawa, "I would like to run away. I don't want to go back to the wreckage of my room. I want to move to a flat place where I wouldn't be frightened to sleep."


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