As Japan begins the long process of cleaning up and rebuilding
after the March tsunami, the process of healing the internal
wounds is also just beginning.
The violent heaving and swaying seemed to go on forever.
Furniture crashed to the floor as cupboards ejected their
contents in a cacophony of shattering glass and splintering
wood. “It went on for so long,” Hitomi Asano
says of the earthquake. “I didn’t think it would
ever stop.”
Living in a country as seismically volatile as Japan, Asano
had experienced plenty of earthquakes, but nothing like the
one she felt at 02:46 on 11 March. Amid the wail of tsunami
sirens, Asano, 50, rushed to pick up her 10-year-old daughter
from her Ishinomaki primary school five minutes away.
Despite the warnings, Asano says she didn’t believe the sea would ever
reach her home more than 1 kilometre from the coast.
“We ran upstairs and ten seconds after we reached
the first floor, the tsunami flooded in,” she says,
sitting in the gymnasium of her daughter’s
school, one of scores of evacuation centres set up to house
survivors in the region. “The water reached up to the
ceiling of the ground floor. My car was destroyed.”
Ishinomaki was hit particularly hard. Once a vibrant coastal
city, backed by lush, green mountains, large swathes of it
have been flattened, evoking images of a decimated Hiroshima
in August 1945. More than 160,000 people used to live in
this Miyagi Prefecture settlement, many working in the fishing
industry and pulp mills. Almost 3,000 people have been confirmed
dead and a similar number remain missing.
That first freezing night on the first-floor balcony of
their damaged home was a lonely one for Asano and her daughter. “I
was listening to the radio as the aftershocks came one after
the other,” Asano says. “There
was no sound and there was no light. It was so dark. I just
didn’t know
what was happening.”
From physical to psychological
As in most calamities of this scale, the focus of the initial
humanitarian response was on providing physical relief. The
Japanese Red Cross Society (JRCS) immediately deployed medical
teams to stricken towns and sent blankets and other much-needed
supplies.
Understanding the importance of psychological care following
disasters, the JRCS also organized and dispatched teams of
psychosocial professionals to help those traumatized survivors.
The first workers arrived at the Ishinomaki Red Cross Hospital
three days after the earthquake. By the middle of May, there
were 289 psychosocial workers offering care and support in
the main affected areas. (In total, around 8,000 Red Cross
staff in Japan, including doctors and nurses, have received
psychosocial training.)
In late April, JRCS nurse Mayumi Oguri arrived at the evacuation
centre where Asano is living with another 300 local residents.
(There were 1,800 people living in the same space for the
first three weeks after the disaster.) Oguri is head of a
three-person psychosocial support team from Nagoya that relieved
another group of psychosocial support workers.
Sitting on the traditional Japanese straw tatami mat-lined
floor of the school gymnasium, she says her team assesses
the mental state of the people at the centre by walking around
and talking, listening and offering opportunities for more
private, emotional discussions. They also watch for tell-tale
signs of post-traumatic stress such as insomnia, flashbacks,
irritability and seclusion.
Children and the elderly, Oguri
says, are particularly vulnerable. “We’re
seeing a general trend at the moment of some kids mimicking
what happened in the tsunami and even pretending to bury
people,” the 41-year-old nurse
says. “It’s a part of dealing with the situation
and the play-acting isn’t such a worry. Parents have
to show that they will protect their children and offer them
peace of mind. The children should be able to cry if they
want to and not swallow their feelings.”
Trouble under the surface
While the world has marvelled at the resilience and stoicism
of the Japanese in the aftermath of the disaster, trouble
may be brewing underneath the seemingly stolid exterior of
some Japanese, particularly for men in a culture that extols
silent endurance.
“Men tend to feel responsible for protecting their
families, so they tend to overstretch themselves, and they
don’t have the chance to release their
stress,” Oguri says. “They never express their
feelings in public, so I try small talk with men. Then I
consider a private place where they can talk further and
express their feelings without being seen by others.”
But it appears that Japan as a society is growing more
aware of the dangers of keeping emotions bottled in. A notice
on the wall of the shelter from the prefectural government
advertises a counselling hotline for those suffering from
nightmares, bouts of anger or depression. Asano, the designated
leader of the shelter, says she is conscious of the importance
of facilitating communication between evacuees.
She explains how the cardboard ‘walls’ separating
evacuees’ personal
spaces in the gymnasium were planned to allow for both privacy
and interaction. “Between
families, there is always an elderly single person with lower
partitions, so they can easily talk with the people on either
side,” she says. “With
good communication, we feel less stress and are less worried.”
As
Asano talks, a group of children announce that it’s
time to fill up the portable toilets outside with fresh water.
Almost immediately, young and old alike shuffle outside,
form a human chain and begin passing buckets of water along
the line. Such practices, as well as mealtimes and organized
entertainment, say experts, help to reinforce the idea of
community.
A sense of routine
Psychologist Nana Wiedemann, head of IFRC’s Reference Centre for Psychosocial
Support in Copenhagen, Denmark, says that assigning roles to survivors adds a
sense of meaning to their situation, as does introducing some familiar elements
of everyday life.
“It would be very important to establish some kind
of routine,” she explains. “Of course, this is
not a normal situation, but things like cooking food, playing
with the children, taking care of the elderly and being a
part of defining what the group needs and how these needs
can be met are important.”
People typically wake up at the centre at around 05:30
each morning. Some head to work through the debris-strewn
streets, littered with upturned cars and boats, while others
return to their homes to salvage possessions or begin repairs.
The Japanese government aims to relocate all evacuees to
temporary housing by the end of August. Tokyo-based clinical
psychologist Andrew Grimes says this will be an important
step towards improving mental health. “Those living
in evacuation shelters have added stresses in that they lack
privacy,” he says. “So it may be harder to grieve
and share their feelings and comfort each other fully.”
The
JRCS says it will continue its psychosocial activities until
the end of June before deciding if its teams still need to
be deployed. Even after evacuees move into temporary housing,
Oguri says it’s vital that they continue to
be monitored and provided with follow-up health and mental
care.
Clinical psychologist Grimes agrees: “A rise in the
number of people in the disaster zone suffering from depression
and alcohol abuse may well be seen in time.”
As for
Asano, she doesn’t know yet if she’ll
return to live in her home as she worries about the future
threat of tsunami. For now, she remains focused on helping
others at the centre slowly piece together their lives. “Maybe
I work hard because I don’t want to remember that day
or have nightmares,” she says, before rushing off to
organize the evening’s entertainment.
By Nick Jones
Nick Jones is a freelance journalist based in Tokyo. |
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