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Prime Minister Kan visits
a supply storage site
Hundreds of thousands of people---550,000 by one count--- were displaced, including tens of thousands from the area around the Fukushima nuclear power plant. Many of these sought help in well-stocked evacuation shelters. A large number that had a house to return to---that was at least somewhat intact---decided to stick it out there.

There were 468,653 people staying in shelters on March 14, three days after the earthquake and tsunami. More than 130,000 people were still staying at evacuation centers as of late May 2011; 90,000 in mid-June. The numbers are hard to access as many evacuees have moved in with relatives and friends and some town records were destroyed.

As of March 2012, some 325,000 people made homeless by the disaster were living in temporary housing. At that time only one shelter remained: a building of former prefectural Kisai High School in Kazo, in Saitama Prefecture, 572 residents from Futaba, Fukushima Prefecture, were still living.

Some hotels also offered some help to victims of the earthquake. The 428-room Tokyo Bay Maklhama Hotel let people without access to water and electricity to come and uses its spa for around $6 so if nothing else they could take a bath. The Hilton Kyoto Bay offered rooms to victims for one fifth the normal price.

Surviving After the Earthquake and Tsunami of 2011

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Prime Minister Kan visits
a evacuation shelter
Reporting from Ayukawahama, Martin Fackler wrote in the New York Times, those stuck in their own homes fear they are at risk of falling through the cracks. Many have been left essentially marooned by the waves that knocked out roads, electricity and water...Seiko Taira and her family have settled into a grim routine since the tsunami struck: her sons forage for firewood; she and a daughter lug water from the marsh; and her grandson waits for their one meal a day, a package from the town office that usually contains a piece of bread each, a few cans of tuna and one cup of instant noodles. This day, her 4-year-old grandson found an unexpected treat: three containers of yogurt, a first since the waves struck. “Mommy, can I eat yogurt, too?” he pleaded. “If you eat it now, you might not have anything to eat tomorrow,” his mother answered.” [Source: Martin Fackler, New York Times, March 28, 2011]

“True to a Japanese ethos of “gaman,” or endurance, they are maintaining a cheerful stoicism that cloaks deep anxiety. “When I see the older folks, and how happy they are to get even one meal a day, I can’t complain,” said Ms. Taira, 54, who kept a determined smile on her face. “In this part of Japan, we are strong in enduring.” The hardships are particularly keen for those like Ms. Taira, who lived at the edge of Japan’s official poverty line to begin with, leaving her with no savings or reserves of food to fall back on when the waves struck. Even if she had money, many stores are empty, or washed away by the waves.”

“This has created scenes of deprivation that seem out of place in this affluent nation. “It is hard to believe this is Japan,” said Ms. Taira, who earned the equivalent of $1,500 per month as a part-time assistant at a home for the elderly before the waves came. “I never imagined we would come to this.” Some days, Ms. Taira and her younger daughter, Yumi, 17, comb the wreckage left by the tsunami for anything they can use, especially washed-up cans of food. Ms. Taira guiltily described how she claimed a large pot from the flotsam, which they now use to boil water. “Is taking a pot considered looting? We need it to survive,” she said worriedly. “It’s not looting, it’s recycling,” her eldest son, Hiroyuki Akimoto, 28, a fisherman, jokingly reassured her.

Ms. Taira said she remembered the waves that came on March 11 as black walls of water that quickly consumed this town of 1,400, one of Japan’s traditional whaling centers. Stranded at first at the town office, she finally reached her home a day later by hiking over a mountain. There, she found not only Yumi, who lived with her, but also both sons, her other daughter and her grandson, who happened to be nearby for work or shopping and were stranded when the waves destroyed the only road out.

Seeking Assistance After the Earthquake and Tsunami of 2011

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For the first week, they survived off the food in her kitchen, which was more ample than usual because she had happened to go grocery shopping the morning before the earthquake. But as the cupboards grew bare, she agonized over whether to ask the town office for help. As first, the family refused, saying that people in this region of northern Japan were proudly self-reliant. Then they heard on the radio about evacuation centers in other hard-hit towns, which were getting assistance. She said no officials had even checked on her neighborhood, which was safely perched up on a hillside near a Shinto shrine. [Source: Martin Fackler, New York Times, March 28, 2011]

“It began to rankle me that there were inequalities in assistance,” Ms. Taira said. “That is when I decided to go for help.” “If we suffer, we all want to suffer at the same level together,” added her elder daughter, Satomi Kanno, 33, who worked at the same facility with her mother. Officials responded with one food drop-off per day. When a recent one came, Ms. Kanno’s son, Riku, leaped into motion, roaring in glee and yelling, “I’m a dinosaur!” He grabbed the single piece of bread and quickly began devouring it.

Later, when Riku could not hear, Ms. Kanno confided quietly that the adults made sure he got more food than they did. But she wishes she could give him a candy bar or some juice---luxuries not in the daily deliveries. Then she called him over.”Riku understands he has to endure, like all of us,” she said, gently rubbing his hair. “Riku will endure,” the boy said, speaking of himself. “There’s nothing in the stores anymore, right, Mom?”

Ms. Kanno said the family was trying to build a reserve of food by setting aside a portion of what came every day, just in case the food shipments were cut off. “We are entirely dependent on the town now for our food,” Ms. Kanno said. She also confided her fears about her health. She suffers from Zollinger-Ellison syndrome, which involves a small tumor in her intestines, and has only four days worth of medicine left to treat it. Riku, who has a hole in his heart, was also scheduled for a regular checkup, and she is worried about the stress that the tsunami and refugee lifestyle have put on his heart.”If we only had 25 liters of gasoline,” she said, referring to the roughly seven gallons needed to drive to the university hospital where both are treated, in Sendai, the nearest large city.

When they are not foraging or washing, they spend much of the time waiting indoors, wrapped against the cold. But when asked, they are not really sure what they are waiting for things to improve, or for some signal, perhaps, that previous, more comfortable ways of living can be resumed. As snow fell outside, Ms. Taira looked forward to how her family would climb the mountains behind the town to pick wild vegetables later in the spring. “I haven’t had a vegetable since this happened,” she said, in a room cluttered with laundry hung to dry. “Older neighbors have been teaching us how to live off the land.”

Survivors Living in Damaged Houses

Tsuyoshi Takasawa and Hiroshi Miyahara wrote in the Yomiuri Shimbun, “Many people are continuing to live in homes severely damaged by tsunami in the March 11 disaster, despite the risk of collapse from aftershocks and in some cases a lack of water and electricity. Various reasons have kept people in their homes--some cite chronic health conditions while others say the evacuation centers where they took shelter have closed. Many people are living on the second floor of their home, as the first was flooded by tsunami.” [Source: Tsuyoshi Takasawa and Hiroshi Miyahara, Yomiuri Shimbun, May 23, 2011]

Transport company operator Isao Sato, 70, is living with his wife, Kazuko, 62, on the second floor of their house in the Minato district of Ishinomaki, Miyagi Prefecture. Many houses were damaged, some severely, by the tsunami in this seaside district. Isao and Kazuko removed the mud deposited by the tsunami, which submerged the first floor. However, the ceiling was severely damaged, its heat-insulating materials exposed. The couple did not go to a shelter because of Isao's chronic rheumatism. He gives himself an injection twice a week and warms his body by a stove even during daytime. "If I go to a shelter in my condition, we'll just inconvenience other people," Isao said. [Ibid]

His house was judged by the city government to be essentially "destroyed." It trembles and makes loud noises when aftershocks hit. The Satos sleep in their clothes every night. When they receive quake warnings on their cell phones, they evacuate to the second floor of a large commercial building about 300 meters from their house. "We haven't been able to sleep well because of anxiety," Sato said. [Ibid]

Norihiko Takahashi, 48, farmed wakame seaweed and scallops in Minami-Sanrikucho, Miyagi Prefecture. He left a shelter that closed May 4 and returned home with his wife and eldest daughter. At one point they stayed in a minshuku inn, but they could not secure a room just for their family. The Takahashis now live on mats laid on the second floor of their severely damaged house. They have no electricity or tap water, and are living on rationed bread, onigiri rice balls and drinking water obtained from a nearby distribution center. "We'll live here until we're chosen in the lottery for a temporary housing unit," Takahashi said. "I'll repair this house, even if it's just a little bit at a time." [Ibid]

Masao Mizuno, 61, runs a convenience store in Ishinomaki. He also began living on the second floor of his house in late April with his oldest daughter, 27. They have no tap water. They stayed at a relative's house for a while but felt "we shouldn't put them to any more trouble," Mizuno said. Mizuno suffers from chronic emphysema, and he coughed continually because of dust that had entered through cracks in his damaged house. About 10 days after he spoke with The Yomiuri Shimbun, Mizuno was chosen to move to a temporary housing unit. But he worried about his neighbors. "Many people are living on the second floors [of damaged houses]. I hope they can all move to temporary housing units," he said. [Ibid]

In Iwate Prefecture, 17,819 quake victims were receiving aid supplies while living in their own houses or other non-shelter locations as of May 17. There were 13,518 people living in shelters. The number of people not living in shelters included people staying at relatives' homes, and the prefectural government said it could not ascertain the details of their living conditions. In Miyagi Prefecture, where 30,647 people were living in shelters as of May 20, there was no data about quake victims living in their own houses. [Ibid]

Prof. Ruriko Suzuki of Iwate College of Nursing, a scholar of regional nursing, recently had public health nurses visit all households in Otsuchicho, Iwate Prefecture. "More and more people have moved back to their houses from shelters," she told the Yomiuri Shimbun. "It's difficult to maintain sanitary conditions in houses damaged by the disaster. There is the risk of food poisoning and tetanus. We ascertain the specifics of the situation and offer assistance," she said. Also, it is uncertain whether the houses are structurally sound. Municipal governments in disaster-hit areas have assigned classifications to houses and buildings, such as "destroyed" and "half-destroyed." [Ibid]

An official of the Miyagi prefectural government's construction and housing division told the Yomiuri Shimbun: "The labeling was for determining the need for public aid. It doesn't indicate the degree of resistance to aftershocks." Disaster management experts estimate that an overwhelming majority of the houses were damaged by tsunami rather than earthquakes, and the damage to some buildings is not visible from the outside. An official of the Miyagi prefectural government's disaster management headquarters said: "Municipal governments have recommended that people not return to houses that are in a dangerous condition. But we don't have enough manpower or time to clearly identify such houses."

Moving From a Car Into a Tent in Yamamotochio

Some evacuees at an evacuation center in Yamamotochio, Miyagi Province were put up in 33 white tents that were about 2.5 meters tall and had a floor space of 10 square meters and resembled camping tents. Many didn’t like them. They weren’t very warm and the 5:30am morning sunlight easily penetrated them, waking them up along with noise from nearby tents. Others said a least the tents gave them a modicum of privacy that was lacking on gymnasium evacuation centers. Many had been preciously living in their cars. [Source: Shunsuke Kita and Katsuro Oda, Yomiuri Shimbun, May 1, 2011]

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Describing on family that lived in a car Shunsuke Kita and Katsuro Oda wrote in the Yomiuri Shimbun, Aya Nagaki, her 12-year-old son and her parents went to an evacuation center after the March 11 tsunami flooded Nagaki's house...”but was shocked by the crowded conditions where they had to live close to complete strangers. She felt she had no choice but to live in her car with her family because it was difficult to move around the evacuation center because her 73-year-old father and 65-year-old mother have leg conditions that restrict their mobility. However, Nagaki only started the engine when absolutely necessary because gasoline was in such short supply after the disaster. On days when it snowed, she was too cold to fall asleep.” [Ibid]

Desperate to take a hot bath and find some respite from the harsh conditions, she stayed in a Japanese-style inn in Wataricho in the prefecture for three nights with her family at the end of March. It cost 85,000 yen for the four of them. "There's no way I can afford to keep staying here," Nagaki recalled thinking. She decided to live in a tent, which was provided by the town government, rather than stay in her car due to fear about so-called economy-class syndrome, a condition that can affect people who stay immobile in one position for long periods. [Ibid]

Although the tent provided more privacy than the evacuation center, being exposed to the elements presented new problems. Strong winds blew away the tent once, and water seeped up through the floor the day after a heavy rainfall. Fetching food and water from an evacuation center can be time-consuming, and it can be difficult to keep up with the latest information from the area.

The 33 tents cover the gateball ground at a general gymnasium in Onagawacho, Miyagi Prefecture, where about 770 people are taking shelter seven weeks after the March 11 disaster. The khaki tents were provided by Self-Defense Forces members who had seen the plight of disaster victims forced to live in cars because shelters were full.

Hiroshi Kashimura, 36, a company employee, serves as a "village head" who conveys information from town offices to evacuees in the tent village. Kashimura's house was damaged in the disaster, so he stayed in a car for about 10 days until he could shift into a tent with his family. His 8-year-old daughter goes to a primary school, and has become friends with other children in the tent village. People in the village sometimes share their food. Kashimura's wife, Satsuki, 36, said a bond had formed among the tent residents as they endured some dark times. "We came to share a sense of unity while we were huddling around open fires to keep warm, rather than staying in the freezing cars," she said. [Ibid]

Between 20 and 30 people are still staying in cars near the gymnasium. Some are waiting until a spot opens up in the evacuation center, having temporarily left the town. In Onagawacho, the first group of 57 households is scheduled to move into makeshift homes from May 1. Temporary housing for a second group will be built soon. However, with 1,909 evacuees in the town as of Thursday, demand for these homes far outstrips supply. [Ibid]

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U.S. Nay Water Barge

Problems For Evacuees

An Asahi Shimbun survey of evacuees found that 40 percent had lost their jobs or sources of income. Separate surveys showed higher levels of depression and insomnia among survivors. “It’s probably impossible to make life comfortable right now,” Yoshinori Sato, a worker at the city hall in tsunami-hit Ishinomaki, told the Washington Post . “Even I suffer from insomnia, though I didn’t lose as much as most people here. I have to take sleeping pills just to fall asleep. Even drinking sake doesn’t help.” [Source: Chico Harlan, Washington Post , March 11 2012]

By mid April schools that were putting up evacuees were starting to ask them to leave so they could start classes. Alternatives included school gymnasiums that has been swamped by the tsunami. Many evacuees were only able to bath once a week. "The hardest thing for me is that I can't bathe every day," a 17-year-old girl, nearly in tears, who was living in a shelter in Minami-Sanrikucho, Miyagi Prefecture, told the Yomiuri Shimbun. "Honestly, I don't even want to go out in public." Inside the shelter, the Self-Defense Forces has set up a bathing facility that men and women use in turns every other day. Most of Minami-Sanrikucho still has no access to tap water, and power has been restored only to about 40 percent of the town.

At some of the larger evacuation centers many evacuees became frustrated with the constant menu of cold meals, with some suffering health problems due to the bland diet. According to the Yomiuri Shimbun, “A shortage of volunteers to prepare meals from relief supplies has meant that people staying in large shelters in the Tohoku region tend to have less chance of getting served a hot meal than evacuees staying in smaller evacuation centers. At a cultural center in Tagajo, Miyagi Prefecture, for example, about 430 evacuees had lived on a diet mainly consisting of rice balls and sweet buns during April. They were sometimes given fish-meat sausages and canned food.” [Source: Yomiuri Shimbun , May 9, 2011]

A shortage of automobiles was making it difficult for survivors and evacuees to get to work, visit health care facilities, stay in contact with loved ones and pursue other activities crucial to rebuilding their lives. The Yomiuri Shimbun reported: The tsunami destroyed or washed away a huge number of cars in the Tohoku region. Over 140,000 vehicles are believed to have been lost in Miyagi Prefecture alone. With railroads and other public transport systems not yet fully restored, automobiles are a necessity for people living in disaster areas. But with new and used cars in short supply, many people are forced to travel long distances on foot or by bicycle.” [Ibid]

“Yoshie Sato, 45, a part-time employee at a confectionery shop in Ishinomaki, Miyagi Prefecture, had two cars before the Great East Japan Earthquake. Both were destroyed by tsunami, as was her house, with one car washed away before her eyes as she fled the waters. Her husband Hiroyoshi, 44, had to spend 2-1/2 hours every day on a bicycle given to him by a relative just to commute between work and the evacuation center they moved to. Yoshie had to walk 40 minutes to get to the confectionery shop. She has a longstanding illness, and before the disaster she regularly saw a doctor at a hospital in Sendai. Although visiting doctors examined her at the evacuation center, Yoshie wanted to see her regular doctor---but this too would be virtually impossible without a car.” [Ibid]

Health Problems For Evacuees

Health problems suffered by evacuees included economy class syndrome, caused by sitting for long periods on the floor; pneumonia, caused by dust and chemicals stirred from dried sludge and the difficulty in maintaining oral hygiene. There has been a spike in pneumonia cases in disaster-struck areas. Some elderly suffered from aspiration pneumonia caused by their poor ability to swallow. At the Red Cross hospital in Ishinomaki about 150 people were admitted with pneumonia and 11 died in the six weeks after the quake’six the number from the previous year,

There was an alarming number of malnutrition cases caused by lack of electricity and water and poor nutrition of food distributed at the evacuation centers, which consisted mostly of rice and bread, sometimes with meat, fish and vegetable only available ne meal a day. Of course many of the victims were the elderly. People also suffered from bed sores and insomnia and harsh living conditions aggravated chronic ailments like high blood pressure. Lack of water kept people from brushing their teeth and caused oral bacteria to grow unchecked,

There was also a lack of health care facilities in the quake- and tsunami-hit areas. The Japanese government offer subsidies of about $3,500 a month to doctors to help reopen clinics.

Elderly After the Earthquake and Tsunami of 2011

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Evacuation Shelter
Mark Magnier wrote in Los Angeles Times: “Nowhere is Japan aging more visibly than in the rural, northern prefectures struck by the quake. This part of the country is characterized by towns and villages now the preserve of the elderly, many of their children gone to live and work in Tokyo and other big cities, leaving them without the family support that was an anchor of traditional Japanese society.” [Source: Mark Magnier, Los Angeles Times, March 22, 2011]

“Evidence of this senior tragedy could be seen in those who had retreated to the Miyako school... More than half appeared to be in the 60s-to-80s range. This is a generation that grew up in the devastation of postwar Japan, saw the country modernize into a place synonymous with high-tech comfort and now see their lives bookended by disaster. “I can't really compare this to World War II,” said Kiyoshi Kikuchi, 80. “Both are hard times, but I never saw my house so damaged like this during the war.” [Ibid]

“Many of the elderly leave shelters during the day to clean and search for precious items, returning to the evacuation centers at night. Most houses that are still standing have a pile of possessions out front, seen in Japan not as an invitation to steal but a pragmatic way to start digging out.” [Ibid]

“The loss of personal treasures is keenly felt. Miura Masao, 75, a painter and owner of the Art Space M gallery in Miyako, stood in a mess of ruined paintings of landscape scenes, though some hung just above the 5-foot-high water mark, high enough to survive unscathed. “Everyone in the family is fine, but perhaps most difficult for me is the loss of all the photos, mementos, memories,” he said. “Everything's ruined. And when I saw my studio, I was panicked. I still don't know how many paintings have been lost.”" [Ibid]

Neglect and Death Among Elderly After the Earthquake and Tsunami of 2011

Mark Magnier wrote in Los Angeles Times: “Japanese soldiers found 128 elderly people abandoned by medical staff at a hospital six miles from the stricken Fukushima nuclear plant. Most were comatose and 14 died shortly after. Eleven more reportedly froze to death at a retirement home in Kesennuma six days after several dozen of their fellow residents were killed by the tsunami. Morimitsu Inawashida, the facility's owner, characterized those who survived as "highly stressed." [Source: Mark Magnier, Los Angeles Times, March 22, 2011]

Yoshimitsu Inomata, head of Aozorakai Omachi Hospital 16 miles from the nuclear complex, told the national TV network that most of the staff had fled, there was no medicine or IV drips left, and little food remained. Many of the elderly patients are unable to digest emergency rations of canned bread, he said. And no one wanted to enter the radiation-affected zone to help. "It's a nightmare," Inomata said. "We don't even need people with special skills. Anyone who can get here and serve food or change a diaper would be great." The patients were later evacuated. [Ibid]

Post-Traumatic Stress Disorder

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Evacuation Shelter Shower
Reporting from Ishinomaki in July, John M. Glionna wrote Los Angeles Times, “Mental health officials are seeing post-traumatic stress and obsessive rituals of grief among survivors, such as the woman whose daughter drowned inside her school bus. The mother returns daily to the spot where the bus was found, searching for mementos.”

Jeannine Stein wrote in the Los Angeles Times, “Disaster survivors in Japan must not only deal with physical trauma from earthquakes and tsunamis, but with psychological distress that can strike immediately, soon after or long after the event.” "There will be people who will be able to move back to how things were, and there's going to be a subset of people who are going to have more mental health issues," Melissa Brymer, a clinical psychologist at UCLA, told the Times. [Source: Jeannine Stein, Los Angeles Times, March 11, 2011]

“Those more at risk for psychological problems, Brymer said, include people with a history of anxiety or depression, those who have been in a previous disaster, people who have suffered great physical trauma, and children who have been separated from their families.” [Ibid]

“Post-traumatic stress disorder -- an anxiety disorder occurring after a traumatic event -- can strike some immediately or long after a stressful episode. But those who are more resilient -- people with strong social support systems, good family and friend relationships or strong religious convictions, for example -- usually do OK. “The majority of people do get better, and there are effective ways to help them, Brymer says.” [Ibid]

“Psychological counseling is no doubt being offered to victims and medical and emergency staff in Japan, she adds. "We also know that how a community supports itself can also be a mediating factor in how people deal with a disaster." Self-reliant communities that support their neighbors and schools tend to cope better.”

“Anxiety can also be an issue for those on foreign shores waiting to hear from loved ones. Brymer recommends researching which forms of communication are working and which are not -- phones may not be working, but text messages might go through. “Just because technologies are not working and someone hasn't responded to you doesn't mean there's been a tragedy,” she says. “We know that after the Haiti earthquake it took some communities three or four days to reassure people that their loved ones were OK.”

Earthquake and Tsunami Mental Trauma

In late June 2011, Kyodo reported: “At least 14,111 survivors of the March 11 disaster have received mental care by psychiatrists in severely hit Iwate and Miyagi prefectures, local authorities said. Many have reported sleeplessness and anxiety as well as irritable moods after losing family members, houses or jobs in the wake of the killer earthquake and tsunami.” [Source: Kyodo, June 25, 2011]

Evan Osnos wrote in his The New Yorker blog: “Japan is racing to get mental-health workers in to see displaced and traumatized survivors. The prospect for post-traumatic problems is, of course, profound: the Times tells us today of a twelve-year-old boy who was swept by himself into the ocean for an hour before being recovered, naked and banged up; he remained in shock and unable to talk for days. Or, for that matter, the boy’s school principal, who said, “I want the surviving kids to shine---to continue their lives.” (The principal’s sister and brother have been missing since the tsunami, and her house is destroyed.)[Source: Evan Osnos, The New Yorker, March 23, 2011]

“Or consider the psychological effects on two thousand and five hundred “radiation refugees,” holed up in the Saitama Super Arena north of Tokyo, usually home to concerts and sports events. Among them is a sixty-three-year-old woman who survived the quake, survived the tsunami, only to look out her window and see the No. 1 nuclear reactor exploding and thought, “This is it.”

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Prime Minister Kan at a disaster shelter

Earthquake Mental Trauma and Children

Cristoph Mark wrote in the Daily Yomiuri, “As their Tokyo kindergarten rocked back and forth, two little girls, 4 and 5, stood up and started to dance and sing. It was only after the magnitude-9 temblor subsided that they began to cry. From the next morning, the 4-year-old's demeanor was overly cheerful. She started to prefer spending her time outside. Inside, she began to literally cling to her parents, needing to touch them constantly, even when it meant sacrificing her favorite activities...Many parents throughout the Tohoku and Kanto regions are witnessing unusual behavior in their own children since March 11; they surely recognize it as a reaction to extreme stress, but may not know what to do to help their kids get through this terrifying experience.” [Source: Cristoph Mark, Daily Yomiuri, March 27, 2011]

"Children are very sensitive and struggle to make sense of a frightening experience such as the earthquake, tsunami and after-effects," Linda Semlitz, clinical director at Tokyo English Life Line. Told the Daily Yomiuri. "Mental trauma is characterized by strong feelings, such as frightening thoughts and painful feelings. It can also produce extreme behavior. All of these reactions are normal reactions to a very abnormal series of events and are generally time-limited," she says, adding that reactions can sometimes appear long after the event.

Depending on their age and how severely they were affected by the earthquake and tsunami, children could experience anything from regression to outbursts to thoughts of suicide. Akiko Ohnogi, a clinical psychologist who assisted in recovery efforts in Sri Lanka following the 2004 quake and tsunami, told the Daily Yomiuri, "Children should be provided with a lot of opportunity to play. Play is crucial to the healthy recovery of a child who has experienced trauma, as both the trauma experience and post-disaster play experience directly affect their brain structure. This holds for children of all ages, including infants and teenagers."

Long-Term Affects of the Earthquake and Tsunami Blamed for 451 Deaths

In November 2011, the Yomiuri Shimbun reported: “In prefectures affected by the Great East Japan Earthquake, including Iwate, Miyagi and Fukushima, 451 people have been recognized by local municipalities as having died due to physical deterioration triggered by the disaster as of the end of October, it has been learned. [Source: Yomiuri Shimbun, November 19, 2011]

As municipal governments have finished examining less than half of the 1,184 applications for such recognition, the number of deaths recognized as resulting from the March 11 disaster is expected to increase dramatically.

These cases are different from deaths in which people were killed directly by the earthquake and tsunami, such as in the collapse of buildings. The later deaths are defined as being indirectly caused by long-term fatigue and worsening of chronic diseases under the stress of living as evacuees. Once the death is recognized as having been triggered by the disaster, bereaved families can receive local government condolence money ranging from 2.5 million yen to 5 million yen.

According to the Yomiuri survey, in Miyagi Prefecture, 201 had been recognized so far from among 654 applications, while 197 had been recognized from among 443 in Fukushima Prefecture. In Iwate Prefecture, 52 of 63 were recognized. In Ishinomaki, Miyagi Prefecture, a city where the dead or missing exceed 3,900, the largest number of any municipality, 182 cases of later deaths were submitted to the city government for recognition as having been caused by the disaster. This was the greatest number of applications for one municipality. Most of them involved the deaths of people in their 70s or 80s.

According to the Ishinomaki city government, 125 cases were recognized as deaths resulting from the disaster because the victims swallowed a lot of seawater when the tsunami swept in or because they remained in cold water for a long time before being rescued. Nearly half died of pneumonia or hypothermia. In Shiogama in the prefecture, 10 applications were made. On Oct. 11, an examination panel of the city government recognized all 10 deaths as having been caused by the disaster. Of them, an 84-year-old man died one week after the day he had been scheduled to undergo a gastrostomy operation, which would have opened a hole in his stomach for nutritional support. He was found to have died because he could not have the operation, as many functions of his hospital were lost due to the disaster.Similarly, a 61-year-old man died in late March as he could not get regular dialysis.

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leader of Korea and Kan at a disaster shelter

Pets and Evacuees

A loose network of pet groups is working to provide many of the services for stranded and stressed animals that emergency services have been providing for people, including food, medicine and shelter. Some question why scarce resources should be devoted to saving animals when gas shortages are endemic and human beings have so many needs. Their response: The welfare of animals and people are often integrally linked. "Many people are very anxious, having lost their houses and most everything else," said Kazumasu Sasaki, a veterinarian who has been traveling to hard-hit communities around Sendai with donated pet food and animal medicine. "One way to take care of anxious people is to take care of their pets." [Source: Mark Magnier, Los Angeles Times, March 30, 2011]

The growing tension between pet owners and others in temporary shelters has forced some to keep surviving animals in their cars or tied up alone in the cold, Sasaki said, compounding the animals' stress. At Miyako's Yamaguchi Elementary School, a post-disaster shelter, Chizuru Nakaya, 19, and her family have retreated with their two hyperactive Yorkshire terriers to a narrow balcony, aware that their animals aren't appreciated by others.

Amid the devastation a few days after the tsunami, volunteer rescue worker Maki Oshiro found a small brown dog wandering in the debris fields in Natori. The number of abandoned or homeless pets hasn't been huge so far, reflecting the deadly force of the tsunami, though animal lovers said they may still find more in still-isolated areas.” A few days before Animal Friends Niigata helped rescue a corgi found on the roof of a house that had floated out to sea. "He bites, but I'm sure that is because he's stressed out to the eyeballs," Isabella Gallaon-Aoki said. "It's possible the owner might turn up---and we'll wait before placing him with another family---although I doubt it."

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China's Wen Jiabao and Kan at a disaster shelter

People Still in Evacuation Centers Five Months After Disaster

In July 2011, four months after earthquake and tsunami, 18,788 people were still living in 397 evacuation centers in Iwate, Miyagi and Fukushima prefectures, according to a Yomiuri Shimbun survey. Enough temporary housing units for all evacuees who want to move into such accommodations were available however many such units stood empty in suburban areas, as evacuees did not want to live in units located far from hospitals and schools. [Source: Yomiuri Shimbun, July 12, 2011]

Some evacuees endured hot summer days in the hot, humid facility, which had no air-conditioning.

Living conditions have improved. A shelter at Minato Primary School in Ishinomaki, Miyagi Prefecture, could only give evacuees things like sweets to eat immediately after the March 11 disaster. Now, however, it provides bread for breakfast, rice balls for lunch and bento boxed meals for dinner. When evacuees first began living in the shelter, they could not take a bath for a month. Now they can do so almost every day, supported by volunteers. Three washing machines have also been set up at the facility, allowing evacuees to wash their clothes frequently.

Ritsuko Ito, 63, used to manage a restaurant in Kamaishi before the earthquake. On July 1, she turned down the city government's offer of temporary housing in a suburban area of the city, saying she could not live so far away. Ito is planning to reopen her restaurant in a makeshift building in the center of the city in August, but she was not chosen in the lottery for temporary housing in the central area. If Ito accepted the city's offer, it would cost her about 300,000 yen per month to travel by taxi between her home and her restaurant.

Last Shelters of Evacuees Closed in December 2011

In late December 2011, the Yomiuri Shimbun reported: “The last two evacuation centers in Fukushima Prefecture were closed Wednesday, more than 9 ½ months after the March 11 disaster. All shelters set up in hard-hit Fukushima, Iwate and Miyagi prefectures--which held 448,000 evacuees at their peak--have now closed. [Source: Yomiuri Shimbun, December 29, 2011]

The evacuees have moved to temporary housing units, apartments rented for the evacuees or secondary shelters at hotels and other facilities. At the evacuation center set up in the Hibarigahara athletic stadium in Minami-Soma, 13 evacuees of nine households from the city and Namiemachi started packing up their belongings at about 9:30 a.m. Six individuals moved to temporary housing units in the city in the morning, and seven people of three households moved out in the afternoon.

In Aizu-Wakamatsu, a shelter set up in a civic sports center--where one evacuee lived--shut its doors. Although the shelters in Fukushima Prefecture have closed, 631 evacuees from Futabamachi in the prefecture are still living at an evacuation center at a high school in Kazo, Saitama Prefecture. The last evacuation centers in Iwate Prefecture closed in August, and the last one in Miyagi Prefecture closed in December.

Evacuees at the Last Evacuee Site

"I don't want to die here, but you never know," Tadashi Sato, 78, told the Yomiuri Shimbun with a sigh at the only remaining evacuation center for victims of the Great East Japan Earthquake and tsunami last year. He is one of about 300 people who evacuated from Futaba, Fukushima Prefecture, due to the crisis at the Fukushima No. 1 nuclear power plant, to the shelter at a school building in Kazo. The entire town of Futaba and the town office relocated to the former Saitama prefectural Kisai High School from its first evacuation site at the Saitama Super Arena at the end of March last year. [Source: Miho Ikeya, Yomiuri Shimbun, April 8, 2012]

Miho Ikeya wrote in the Yomiuri Shimbun, “About 1,400 of the town's residents once lived there as evacuees. Now, there are only 300, as those of the working generation gradually moved out to government-leased units in the neighborhood or relatives' homes. About a half of the remaining people are 65 or older.

The Futaba town government occupies the second floor of the five-story school building, which includes the town mayor's office. Other floors and a kendo training hall have been used as temporary residences. Most elderly people live on the first floor as many of them use walking sticks or wheelchairs.

Tatami mats have been laid out on the floors, with about 10 people living in each room. There are no partitions in some rooms to prevent the seniors from feeling isolated. However, standing up, it is easy to see what other people in the room are doing. A two-meter-high cardboard box in a corridor serves as a makeshift change area.

Sato has yet to return to his home since he evacuated shortly after the disaster without taking anything with him. He lived alone in his house. He said that while it is helpful to live in the evacuation center with people in the same situation, he misses his former community, where neighbors sometimes brought him cooked fish and other things.

Some people are unable to leave the evacuation center because they cannot find a job. Shoji Sugamoto, 56, is one of them. He helped with his parents' farming operation after he quit working at a local factory in his 40s. While living as an evacuee he said, "I cannot find a job because of my age." His house was destroyed by the tsunami and his mother remains missing.

On March 19, the Futaba town assembly passed a resolution calling for the return of the town office functions to somewhere in Fukushima Prefecture by the end of June. However, Futaba Mayor Katsutaka Idogawa has avoided specifying the place and date of relocation. Even if the town office functions can be moved back to Fukushima Prefecture, it is unclear whether the 300 people living in the evacuation center will be able to move together. "It might be difficult to return to Futaba but I hope the town's name survives," Sugamoto said.

Evacuees Hard to Track Down

In December 2011, the Yomiuri Shimbun reported: Regulations intended to protect personal privacy have hampered relief efforts for people affected by the March 2011 earthquake and tsunami, with aid supplies still not reaching many people living in facilities being rented by local governments.With local governments often denying requests for access to residents' personal information, aid groups have found it difficult to get help to disaster victims, including disabled people. This rigid administrative attitude has been criticized, with one expert calling for local governments to be more flexible. [Source: Yomiuri Shimbun, December 29, 2011]

Early last month, Takato Chiba, 73, of Ofunato, Iwate Prefecture, received a box of detergent from an aid organization. "I'm relieved [aid] has finally arrived," he said with a smile. Chiba's house was destroyed by the March 11 tsunami. After failing twice to win a spot in temporary housing compounds, he settled with his 72-year-old wife on the second floor of an apartment building in July. The Iwate prefectural government has rented the couple's apartment and other existing facilities for people who lost homes in the disaster. The detergent was the first aid Chiba had received since he moved to the apartment. "We don't get any information about local events or reconstruction plans," he said. "We don't know anyone here, so it's a bit lonely."

Yume Net Ofunato is one of the nonprofit organizations that visit people like Chiba. In addition to distributing relief supplies, the group has helped by preparing meals since the March disaster. The NPO said it had heard that aid supplies were not reaching many disaster victims who do not live in the temporary housing compounds built after the disaster, but the organization did not know where these people were living. Yume Net Ofunato has dispatched about 10 workers to go door to door since early November to search for people living in housing rented by local governments. About 700 households are reportedly living in such arrangements in Ofunato, but the NPO has only located 20.

Iwate Prefecture's ordinance on the protection of personal information has been a bottleneck for aid groups. Based on the Personal Information Protection Law, local governments have created regulations to safeguard personal information such as names and addresses. The prefecture's Reconstruction Bureau, which is in charge of finding housing for disaster victims, said it cannot give out personal information because it would be a violation of the ordinance.

This ordinance has also undermined a system launched by the central government to provide counseling to disaster victims. As of late November, the Japan National Council of Social Welfare had hired 534 counselors to visit disaster areas in Iwate, Miyagi and Fukushima prefectures. However, the council has been unable to access personal information managed by local governments.

The Iwate Prefectural Council of Social Welfare said its staff has visited almost all the households living in temporary housing compounds built after the disaster. However, the council has located only about 40 percent of the about 5,000 households living in facilities rented by local governments. And just 341 such households, less than 10 percent of the total, had been visited by counselors as of late October.

Some municipalities, however, have chosen to take action. In November Minami-Sanrikucho, Miyagi Prefecture, asked residents living in temporary housing facilities for permission to provide aid groups with their addresses. An official of the town's health and welfare section said: "Dealing with personal information is a sensitive issue. We know about the difficulties volunteers are facing and we'd like to respond quickly, but it's not that simple."

Shigeo Tatsuki, a Doshisha University professor and specialist in disaster prevention, said, "Local governments' ordinances on the protection of personal information usually have exceptions that allow information to be released when it is deemed in the public interest." "Local governments should use these exceptions flexibly to share more information with aid groups," he added.

43,000 Moved from Tsunami-Hit Prefectures

In January 2012, the Yomiuri Shimbun reported: More than 43,000 residents moved out of three Tohoku region prefectures severely hit by the Great East Japan Earthquake from March to November, with Fukushima Prefecture suffering the biggest exodus. The number of people leaving the three prefectures was more than four times higher than the about 10,000 who left during the same period in 2010. [Source: Yomiuri Shimbun, January 12, 2011]

Of them, more than 30,000 people moved out of Fukushima Prefecture, where the crisis at the Fukushima nuclear power plant took place. Officials have suggested that many residents in coastal areas that suffered tsunami damage have moved to inland areas. The population outflow was calculated based on population estimates announced monthly by each prefecture. The figure represents the total number of residents who left the prefectures minus those who moved in.

About 4,000 people shifted out of Iwate Prefecture during the March-November period, about the same as the figure for the same period in 2010. However, the about 8,200 departures from Miyagi Prefecture was 13.5 times the number from 2010, and the 31,400 residents who moved from Fukushima Prefecture represented a 5.6-fold jump from 2010. Officials believe the actual figure could be even higher because some people might have moved to other prefectures without changing their resident registrations.

According to a Yomiuri Shimbun survey, carried out prior to the one-year anniversary of March 2011 earthquake and tsunami, 57 percent of those survey in Fukushima Prefecture said they wanted to return to their hometowns. This contrasts with the 87 percent who felt this way in the one-month survey, 71 percent after three months and 65 percent after six months. [Source: Yomiuri Shimbun, March 12, 2012]

Evacuees in Iwate and Miyagi prefectures were more eager to return home and expressed more confidence in restoration work, according to the survey. In Iwate and Miyagi prefectures, 43 percent of people responded, "We want to return to the areas where we used to live before the disaster." Although the number of people who responded this way fell from 65 percent after one month to 47 percent at three months and 42 percent at six months, the decline has stopped.

Concerning when they would be able to return to their hometown, 43 percent responded, "When people in our neighborhood have begun to return and the living environment, including shops and hospitals, is in place." Twenty-three percent responded "when radiation levels become zero," while 17 percent said "when the central and local governments say it is safe to do so." A 67-year-old man who evacuated from Iitate to a temporary housing unit in Date said: "I want to return to the comfortable surroundings of my hometown, but I wonder whether I can live there even if I did return. I doubt whether young people will return."

Image Sources: Wiki commons, Kantei, Office of Japanese Prime Minister

Text Sources: New York Times, Washington Post, Los Angeles Times, Times of London, Yomiuri Shimbun, Daily Yomiuri, Japan Times, Mainichi Shimbun, The Guardian, National Geographic, The New Yorker, Time, Newsweek, Reuters, AP, Lonely Planet Guides, Compton’s Encyclopedia and various books and other publications.

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© 2008 Jeffrey Hays

Last updated April 2012

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