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Mar. 10, 2015 - Updated 04:16 UTC



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Rebuilding Shattered Lives

Yoshiko Nakata

Mar. 9, 2016

It's said that time is a great healer. But 5 years after the March 11 disaster, many people in northeastern Japan are struggling to rebuild their lives and heal their emotional wounds.

Kazuya Shizukuishi, 64, lives in a temporary shelter. He survived because he wasn't at home when the earthquake struck and the tsunami washed away his house. He lost the wife he adored, his two daughters and his father.

He was the only member of his family of five to survive.

"I’m all alone," Shizukuishi says. "I lived a full life until then, and all of a sudden I was left like this."

Shizukuishi lives in Ishinomaki, a city that was devastated by the earthquake and tsunami.

Many residents lost family members and their homes. Five years on, nearly 180,000 people still live in temporary housing.

Like Shizukuishi, some of them live alone. They are sometimes reluctant or unable to seek help, and in some cases end up dying alone. That's created a new set of problems.

After the disaster, Shizukuishi began trying to put the pieces of his life back together. But over time, he sank into loneliness and despair, increasingly unsure about how to proceed.

"Well, I try not to talk about the disaster," Shizukuishi says. "If I do, I end up crying."

From time to time a case worker visits him. Nobuyasu Takayanagi has been providing survivors with mental health care, and he asks Shizukuishi questions about how he spends his time.

Survivors sometimes have trouble expressing their feelings. So Takayanagi stays alert for unspoken clues, including subtle changes in lifestyle.

"Even if they don’t talk about their feelings or problems, the appearance of their living space can speak volumes," Takayanagi says. "That’s why I think it’s important to go and talk to them face to face."

Takayanagi works for a private mental health care drop-in center. It was established by local psychiatrists three months after the disaster, and it's subsidized by local governments.

About 20 professionals, including doctors, psychotherapists and caseworkers are on hand to offer assistance. Takayanagi says some survivors become lonelier and more desperate as time passes.

"People have been struggling hard for five years. But now they're worn out. Many are suffering emotionally even at this stage, because the recovery isn’t going as planned," Takayanagi says.

The center handles 10,000 counseling sessions a year.

"I have no courage, and I can’t move forward," one record of a counselling session reads. "I am a worthless human being."

"I feel so lonely and sad I want to die," reads another.

Takayanagi also says that some survivors who are moving from temporary shelters to public housing could end up feeling even more isolated.

"The change in living situation is making their lives more stressful," he says. "They're increasingly worried about how to integrate themselves into a new community."

Akifumi Oguro, 77, is one such survivor. His home was destroyed in the tsunami and his wife passed away the following year. The couple had no children.

Last August, Oguro moved to a new apartment complex. The walls are sturdy and provide plenty of privacy. But Oguro says he feels lonelier now.

"When I was in the temporary unit, I could hear the sounds of people nearby. They would make noise as they went past, and ask me how I was doing. Here, things are different," he says. "I’m sealed in, and it’s scary just being here. I wonder what would happen if I collapsed."

Oguro took to drinking to keep his sadness at bay. At Takayanagi's suggestion, he's keeping a written record of his alcohol intake in order to reduce the amount he drinks.

"Recently I've drawn lots of circles. That means I didn't drink. Back then there were only 'Xs.' That meant I was drinking every day. If I can keep this up, that will be really good."

In February, Oguro attended a monthly gathering with the encouragement of staff members at the mental-health center. It brought together 21 men who now live alone. Some lost their families in the disaster. Many, like Oguro, had shut themselves up at home.

They cooked a meal with staff and played games. As he spoke with others in similar situations, Oguro felt his mood lighten.

"I'm not much of a talker but when I come here I can chat, even if it's just about small things like how delicious the sweets were or how nice the tea tasted," he says. "I think it’s a good place, and I like coming here."

Shizukuishi says time alone won't ease his sense of loss. But he says he's found one important reason to keep going.

"As long as I live, I'll keep my family's memory alive, and tend to their grave," he says. "That's my mission, as a person who was left alive. I don't know how long I'll live, but I'll do it as long as I can."

The passage of time means nothing to survivors trying to come to terms with their ordeal. But a community of caring people could provide one important way to help them move forward.

"There's more to recovery than putting up buildings," Takayanagi says.

"I think it also means creating environments where people can regain the things they’ve lost, such as communicating with others, and the sense of belonging to a community."

Professor Hiroaki Tomita of Tohoku University, a psychiatrist who specializes in helping people affected by disasters, joined anchors Sho Beppu and Aki Shibuya in the studio.

Beppu: We tend to think that as time goes on that usually wounds are getting healed. But the cases that we've seen in this story is quite opposite -- the more that time passes, the more they get traumatized. Why is this?

Tomita: Well, there are experiences that cause intense stress, such as the loss of someone close to us, a life-threatening situation or losing a house or job. When we suddenly go through such things, we may not show sadness or a sense of loss right away. But they can become apparent after things have settled down.

Right after the disaster, people focused on rebuilding their lives. But as time passes, people have time to look back. For some people, that means painful memories coming back. And in this 5-year period, some people have lost family members who made it through the disaster together and shared those painful memories. That causes a deeper sense of loss. They feel they can no longer deal with the stress without such people. Or, some people feel increasingly frustrated as they face difficulty in rebuilding their lives. The feeling of grief can take longer to come to the surface.

Shibuya: So professor, you've been doing health surveys of people in Miyagi Prefecture since the disaster. What are the trends that you've been seeing?

Tomita: We've been continuously surveying 2,800 people. They all live in a coastal community where their houses were completely destroyed or severely damaged. In 2011, 32 percent experienced post-traumatic stress reaction, or PTSR. That includes flashbacks, avoiding things that can bring back memories of that day, sleep disorders and other physical symptoms. Since then, the percentage hasn't fallen much. One in 4 respondents still suffer from symptoms of PTSR. The same thing was seen in a survey on depression. More than 30 percent of people are still suffering, and the pace of recovery is very slow.

Beppu: So, facing this reality, what should be done?

Tomita: A separate survey covered 100,000 residents of Miyagi prefecture. We provided psychological support to more than 1,300 people with mental problems related to the disaster. In the process, we found out that many people suffering from depression or post-traumatic stress disorder haven't been able or willing to get help. That's because they don't see their symptoms as health problems. Instead, they blame themselves. What we need to do is to continue reaching out to people, especially those who may not be able to ask for help. Isolation and the lingering effects of the disaster on survivors' mental health mean we have to nurture links between individuals and the communities where they live.

Japan experienced another huge disaster in 1995 -- the Great Hanshin Earthquake. We learned that many survivors later died in isolated circumstances. Based on previous experience, we know that reaching out to people is very important. The lessons we've learned and the data we've collected are relevant anywhere in the world where disaster strikes.