Background:
Several serious nuclear disasters were caused for the last 15 years, even in Japan, which are reviewed from the viewpoint of the role of surgeon. The role of surgeon is important during such mega-disasters. However, trauma surgeon seemed useless in this nuclear disaster. We analyzed the medical team’s roles including surgeon, mainly based on actual experiences.

Material and Methods:
Fukushima Daiichi Nuclear Plant explosions, which followed the Higashinihon earthquake, 2011 with more than 20,000 death or missing, was the same level of the Chernobyl incident. This was reviewed based on our experience in site, compared with other nuclear disasters: i.e., The JCO criticality incident, 1999( 3 were severely contaminated, 200,000 people were involved), the Mihama nuclear plant’s accident 2004 (ruptured secondary water cooling system, with 11 major burn), the Chernobyl incident, 1986 etc.

Result:
Many serious problems are revealed: 1)Inappropriate basic preparedness and education against the special disaster such as nuclear disaster, i.e.,: most members of Japan DMAT or disaster medical assistance team was laypersons, Insufficient transporting system to the weak/vulnerable people living in the contaminated district. Many aged inpatients seemed to be survived if appropriate triage and smooth transportation system with support of surgical teams was established.

Conclusion:
To cope with the mega and complex disaster, academic approach is also essential. It is insufficient to take makeshift measures or use cheap tricks. Moreover, feeling of security/safety of people or people’s reliability is important in the nuclear disaster to protect the society. Philosophy during mega-disaster should be reviewed.