In the hours after the magnitude 9.0 earthquake and massive tsunami hit Japan in March, essential infrastructure and communication were cut off, leaving many of the disasters' survivors without access to phones, electricity or water.

And those who were on essential medications were on the cusp of losing their lifelines, too.

"The secondary disaster is just in its infancy—that is, how to supply and manage stable medical resources for patients with chronic diseases," Keio University School of Medicine cardiologists Yuichi Tamura and Keiichi Fukuda wrote in a letter in the May 14 issue of The Lancet.

As Katsutoshi Furukawa and Hiroyuki Arai, of Tohoku University in Sendai's Department of Geriatrics and Gerontology and Division of Brain Sciences, wrote in a letter in the same issue: "Many, even those who did not have a major acute injury or illness, could not source enough medicine for their chronic diseases, such as hypertension, diabetes, thrombosis, Parkinson's disease, etc."

Tamura and Fukuda were in charge of patients with pulmonary hypertension that required continuous infusions of the drug prostacyclin. But with so many key supply chain links severed—or at least uncertain—and when "telephone networks were unreliable even in the metropolitan areas," the situation looked dicey.

But, as Tamura and Fukuda wrote, "We were able to notify displaced patients via Twitter on where to acquire medications. These 'tweets' immediately spread through patients' networks, and consequently most could attend to their essential treatments." Twitter is widely used in Japan, with some 17.6 million users reported in the country in March.

Crowd-sourcing, social networks and tweeting information, especially in situations where verifiable reports are scant—such as in places or war, repression or emergency—can have its pitfalls, experts noted in a panel earlier this year in New York City.

And for life-threatening medical needs, trained personnel are usually necessary, too. As Tamura and Fukuda explained: "Our experience has shown that social networking services, run concurrently with physical support, were significant in triumphing over many difficulties in the recent catastrophe."

Japan's medical infrastructure, however, was not perfect to start with, as University of Iowa's Jay Starkey and Keio University's Shoichi Maeda, pointed out. "The weak primary-care system has left hospitals overwhelmed," they wrote in the same issue of The Lancet. As is increasingly becoming the case in other countries in the developed world, including the U.S., people in Japan are turning to specialists and hospitals—rather than general practitioners—for basic medical care.

But with the massive influx of patients after the earthquake and tsunami, Starkey and Maeda wrote, "hospitals were unable to tend to patients with non-urgent but important needs such as treatment of hypertension, diabetes, gastroenteritis and so forth. Japan needs to strengthen its primary care system."

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