Japanese tsunami survivors mourning lost loved ones and struggling to replace shattered homes and workplaces also face daunting mental health concerns, experts warn.
Three weeks after a March 11 earthquake and tsunami left more than 27,500 people dead or missing, shock and awe at sheer destruction can give way to despondency and depression as the gravity of the survivors’ loss sets in.
“For a lot of people who up until this point have been able to ignore reality and what actually happened, as they get back on their feet they realize that, for instance, their house is gone, or their children are dead, and they’re being forced to confront these facts,” volunteer doctor Toru Hosada said.
“A lot of them are extremely uncertain as to what they can do,” he said during rounds at a shelter in the shattered port city of Yamada in Iwate Prefecture.
A tour of about 150km of the devastated coast of northern Japan showed brisk efforts to house, feed and bathe thousands of people made homeless by the tsunami — but worries that kokoro no care (mental health treatment) was coming too slowly.
“Many people cannot sleep well at night as they are afraid of earthquakes. They have lost many things so they are psychologically hurt,” doctor Keiichiro Kubota said at a makeshift clinic in Kesennuma.
The difficulty of comforting survivors is compounded by the more than 350 aftershocks recorded since March 11.
“I am sleeping with my regular clothes on. I am always feeling an earthquake. Even when a car passes by, I think it’s an earthquake,” said Toshie Fukuda, 64, a survivor in Rikuzentakata, one of the cities hit hardest by the tsunami.
At the main disaster evacuee center in Rikuzentakata, a junior high school, the psychological counseling center is a curtained-off 4m2 corner of a classroom.
“Do you suffer from headaches, stomach aches, diarrhea? Are you easily agitated and unable to sleep? Do you have no appetite, suffer nightmares about the disaster or lack your normal energy? Are you irritated by the smallest sound, unable to stop crying and unable to relax?” a clinic poster reads.
“These feelings are not at all unusual — they are the normal reaction of people who have received a severe shock,” the poster said. “Talk to a specialist to lighten your burden.”
In the school gymnasium downstairs from the clinic, where tsunami evacuees sleep and eat as they wait for new living arrangements, a young man suddenly vomits near the doorway.
“We are all stressed out here,” says fellow evacuee Yukio Kudo, a 55-year-old high school teacher who lost his wife and one of his three sons when the tsunami obliterated his town.
“Although I’m generally in good health, I’m pretty sure that I have post-traumatic stress disorder,” he said. “Sometimes I’m clear-headed and positive, but other times I’m seized by sadness — and denial that I am now a homeless widower who just had my teenaged son cremated.”
Kudo said he is cheered by the kindness of young volunteers who check on him daily, but adds: “When I knock on the door of the psychological counseling room, I never find anyone there.”
Cho Chow-mun of the Hong Kong aid organization Social Workers Without Borders says both trauma and shortages of trained psychological experts were common features of the earthquake in China’s Sichuan Province in 2008 and the Indian ocean tsunami in 2004.