Monday, 11 March 2013

New psychological stresses emerge amongst survivors of Japan’s triple disaster

This large vessel remains grounded some 800 meters inland in the port of Kesenumma, while arguments continue as to what to do with it. MASAKI KAMEI/ IFRC

Two years after Japan’s triple – earthquake, tsunami and nuclear disaster, considerable progress has been made to help re-establish normal life for the thousands of families affected by the disaster.
The Japanese Red Cross has played a prominent role in recovery efforts, running a variety of social welfare programmes and construction projects. These include provision of a package of household electrical appliances to 135,000 displaced families to help equip their temporary homes. Significant investment has been made to rebuild damaged health infrastructure and temporary medical facilities.  Five hospitals and medical centers have now been constructed with Red Cross support and over 300 vehicles have been donated to support transportation needs in 200 social welfare institutions.  
But after two years, new psychological stresses are emerging amongst some of the 300,000 displaced survivors, particularly children and elderly people.
“What we are seeing is a scissor split, with most of the children getting better, but a small number of more serious cases emerging,” says child psychiatrist Dr Junko Yagi, who is based in one of the worst affected prefectures, Iwate. She estimates that while some 80 per cent of her caseload is improving, some 20 per cent are getting worse.
Stress of moving forward
“Some patients are only now starting to develop dissociation and depression symptoms. They seem to be actively moving forward with their lives but in reality, they are in a state of hyper-arousal. They are tired and exhausted.”
Dr Yagi is one of the key figures involved in setting up a centre for children’s mental health care in the Iwate Medical University in Morioka, which will be financially supported by the Japanese Red Cross.
Not just children
But children are not the only ones experiencing the psychological impact of prolonged displacement. While businesses and institutions are gradually being re-established, lack of consensus among the various stakeholders and difficulty in finding suitable land are making the reconstruction of permanent housing a slow process. Some people are giving up on it altogether and leaving for other parts of Japan where prospects may be better.
 “This year we’ve seen signs of depression emerging amongst a number of people living in temporary shelters,” said Takeshi Ino, director of the Red Cross Chapter in Miyagi. “This is because they see others around them starting new lives, finding jobs or moving on from their prefabricated homes. They feel trapped and uneasy about their own future.”
Much of the work of Red Cross staff and volunteers has been focused on providing a variety of services that are helping to meet the psychosocial needs of survivors in the worst affected prefectures of Miyagi, Iwate and Fukushima. These include social activities and physical exercise sessions for the elderly as well as recreational activities designed for children such as summer camps organised for thousands of school children from disaster stricken areas.
The elderly make up a large percentage of people living in prefabricated temporary housing. To prevent them from sinking into inactivity and isolation, the Japanese Red Cross is conducting a broad programme of activities including physical exercise, massage and health checks and events such as tea ceremonies to help build a sense of community.
Fukushima aftermath
The aftermath of the nuclear accident in Fukushima has also brought new issues to the fore.  Prompted by media reports, government officials have recently disclosed that decontamination has not been properly carried out in a number of places in the prefecture,
“This makes people both furious and sad, because we feel that our concerns are not being understood,” said Fukushima Red Cross Chapter Deputy Director General Takeyoshi Saito.
As part of its commitment to improve preparedness around nuclear disasters, the Red Cross plans to open a nuclear disaster information centre to gather together data and best practices. Red Cross nurses are also providing health monitoring and psychological support to the displaced survivors of some of the worst-affected areas, such as those from the town of Namie, which is one of the closest to the Fukushima Daiichi nuclear plant.  From next year the Red Cross will be involved in screening youngsters under 18 years of age for thyroid cancer.
Mixed picture
Taken as a whole, “the picture in the three worst-affected areas is a very mixed one, with a certain amount of real progress being made, but also a feeling that many people, especially the elderly and the young remain in a vulnerable state of mind, so we need to give them our continued support in a variety of ways,” says Japanese Red Cross and IFRC president, Tadateru Konoé.

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