Three Years Since the Great East Japan Earthquake. Looking Back on the Past, and Thinking About
What We Will Leave Unto the Future
Medical Corporation Hara Clinic/MDMHCC
Yuichi Watanabe
1. Introduction
Before the disaster, I was a psychiatric social worker employed at a psychiatric clinic in Sendai.
It’s embarrassing, but I had no prior experience of disaster relief. I hope that you will understandand read this article with the understanding that it is not a report that can serve as a model.
The “blow” that stopped the flow of time came with the waves of the car radio with anindescribable warning sound. Subsequent violent shaking continued to violently bend the oldbuildings on both sides of the road. While everything in the world stopped moving, it seemed that
only the disaster was rampaging on its own.
“You can survive here.” For many years, it was said that Miyagi Prefecture had a high probabilityof a major disaster. Therefore, I think that there were not a few people living in this area who wereprepared to avoid a disaster. If a disaster is unavoidable, the process of ensuring safety is important.
It was this thought that first came to my mind out on the street on that cloudy day.
After a long period of shaking, I was afraid that the buildings on both sides would collapse andfall on the car I was in, but I couldn’t escape. A young woman who seemed to be a long-term care
professional was holding an old woman by her shoulders as she crouched on the roadside. I just
waited for the anger of the earthquake to subside.
2. Post-Disaster Support Activities: Considering Their Nature
The psychiatric clinic where I work is located more than 10 kilometers inland from the coastal
area of Sendai City, and the corporation also operated a Disability Welfare Service office. One of
the characteristics is that it has had strong ties with medical and welfare-related organizations andprofessional associations.
Therefore, with the recovery of communication means, we received safety confirmations andinquiries about necessary supplies from various places. Relying on the gasoline finally deliveredfrom an acquaintance living in Kanto, I attempted to grasp the situation in the coastal area while
confirming the safety of the people concerned. No matter where I visited, my words were taken awayby the enormous damage, and only a weak sigh remained.
What we were able to do at that time was (1) disseminate accurate local information and needs tothe outside, (2) distribute supplies delivered from all over the country, and (3) dispatch andcoordinate the necessary manpower. The disaster area was vast and the damage enormous. Many
people lost all their household goods, and no matter how much was delivered, it was but water onburnt stones, and I was left with a feeling of insufficiency.
When mental care teams arrived one after another from other prefectures, acceptance adjustments
began in each local government. How to arrange a “mental care team” that is said to have visited
more than 10 teams in one municipality when there are many. The public health nurses in charge ofeach responded with difficulty. I was impressed by the way he expressed his gratitude by responding
politely to supporters inside and outside the prefecture.
Evacuees often said their efforts to supporters from outside the prefecture who visited from afar.
However, some people said that they were tired of being called out many times a day. Many were
anxious and sad, but hid their emotions and focused on arranging food and daily necessities andcleaning up their homes. It is not difficult to imagine that the repeated calls under such circumstances
would have been far from what the residents actually needed at that time.
Therefore, we do not question local people about their mental health but instead build
relationships by helping with their needs, such as through the distribution of supplies and helping
them clean their homes. When the first summer after the disaster came, I talked to him while making
shaved ice on the bench. In addition, as a measure against flies in evacuation centers, “flypaper” wascollected from various places and distributed. When people moved to temporary housing, various
events, counseling sessions, and salons were held at meeting places. Such efforts according topeople’s living conditions and needs are still being continued at the Karakoro Station in Ishinomaki- 116 -

City, Miyagi Prefecture. The content of activities is gradually changing according to changes inliving conditions, but the basic attitude cultivated around this time remains the same.
3. What We Have Learned from the Activities of the MDMHCC: The Importance of Exploration
In November 2011, with the opening of the Operations Room of the MDMHCC, I received atransfer order for a limited period. I felt grateful and a sense of purpose at the opportunity to be
involved in support activities, while there were people around me who wanted to be involved insupport activities but could not because of their daily work.
In December 2011, the Stem Center was opened in Sendai City. First, I visited local governments
and related organizations in the coastal areas of the prefecture, and tried to build relationships withthe person in charge and collect information on each area.
Although a certain amount of time had passed since the disaster, there were still some workplaces
where the feeling of fatigue remained strong. She put the burden on the person in charge first andforemost, and tried to be as humble as possible so that our involvement would not only be a further
burden if we made a mistake.
From April 2012, Regional Centers were opened in Kesennuma and Ishinomaki, and the project
was started for the entire prefecture. We were confused about the role of the organization that was
created more than a year after the disaster, as well as how other support groups and relatedorganizations would cooperate with this as-yet unfamiliar center.
Through many discussions with related organizations, I think that the role in each region has been
gradually clarified. And all that work was simply a series of “explorations.”
4. Looking Back on Our Activities Thus Far: What Have We Learned?
Three years have passed since the Great East Japan Disaster struck, and the affected areas andsupport activities have changed significantly. In addition, there were many phenomena and issues
that seemed peculiar to the disaster area, and it was often the first time that we were informed that
we were facing a disaster. Below, I will discuss some of these items.
(1) A Sense of Incompleteness
What things have come to people’s hearts because of this disaster? Isn’t it a feeling of
insufficiency as a whole? In mental health-related support, many supporters expressed thoughts
such as, “I couldn’t do anything in this short period of time” and “Did I really even help?”
Many supporters from other prefectures said that they couldn’t get into their original work evenafter returning to their hometown.
Even in the disaster area, there were many voices such as, “I was originally busy with workand could not get involved in support activities” and “I could not move because I did not havegasoline.” While these were legitimate reasons, for the people in question, it seems that suchfeelings cannot be wiped away.
Of course, the victims also have regrets that they were “unhelpful” and “wrong.” In this way,
I learned that people in various positions in the disaster area have different feelings of
insufficiency and guilt.
(2) Psychological Characteristics of Supporters
In this disaster, many supporters from other prefectures rushed to help. At times, the highenergy peculiar to supporters stimulated the local staff, who were exhausted. However, at othertimes, external supporters’ strong feelings regarding the disaster area caused friction with thelocal staff, which could be a major obstacle to support activities.
(3) The Burden on Local Coordinators, and Support for Supporters
It is the local support coordinator who bears a heavy burden because of the above-mentioned
friction. In addition to the burden of coordinating dispatch teams, it sometimes becomesburdensome to respond to requests from supporters. Kazuma Yonekura, who has been involvedin support activities in Fukushima Prefecture, describes the issue as follows. It can be said that
this is a common feeling among those involved in support coordination.
“I have heard the following from many supporters: ‘I want to do this job because I came toprovide disaster relief,’ ‘This case should be like this,’ and ‘I’ve done this in disaster relief
before.’ I could not help but feel that these people did not make all the required effort tounderstand the current situation in the disaster area and cooperate with me. Although such
behavior is not malicious, by comparing their experiences with our current efforts, they were
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not making any headway with regard to helping the currently disaster-stricken area.” (Kazuma
Yonekura, “Outreach activities to support disaster areas and team building required-From theefforts of the mental care center in the Soso district of Fukushima Prefecture,” PsychiatricMedicine, No. 72, 2013, Critics.)
In my experience as well, it took a lot of time to coordinate contact with external supporters,
and because of my unfamiliar role, responses were delayed, resulting in various inconveniences.
Fatigue increases with daily adjustments. Some people in the prefecture have also criticized thefact that there is no greeting from supporters outside the prefecture to the local area. When I
recalled the faces of those who lost their families, I felt indignant at the seeming selfishness ofthe supporters, but at that time she was devoted to doing what she needed to do. She no longer
had the capacity and time to argue.
(4) What We Can Learn from Lessons
Many people visited this disaster area because of prior experience of offering support after
the Great Hanshin-Awaji Disaster and the Niigata-Chuetsu Disaster. Valuable lessons based on
our experience of helping have given us a clear direction. The above-mentioned change ofdirection from “questions about mental health” in evacuation shelters and temporary housing
to “support based on the lives of disaster victims” is also advice from experienced people.
In addition, the Miyagi Heart Care Center regularly receives information from people at theHeart Care Centers in Hyogo and Niigata prefectures. Experience-based advice on what issues
to consider and what measures to take in the future is very encouraging for us.
Experience in the disaster area will be a valuable lesson for the next disaster. To what degree
can we apply the lessons learned from the Great East Japan Disaster in the future? This is an
issue that we should tackle from now on.
(5) The Importance of Laying the Groundwork for Support
What I have always been keenly aware of over the past three years is the foundation of support,that is, the importance of relationship formation. I would like to reiterate that no matter how
advanced the skills and knowledge are, they will never be demonstrated without good
relationships with local personnel.
And I would like to add that in order to build good relationships, a humble attitude that
respects the needs and pace of the disaster area as much as possible is a prerequisite.
5. What We Can Think of Now: Support from HereIn Miyagi Prefecture, incineration of all the rubble resulting from the Great East Japan Disasterhas been completed, and a “fire-filling ceremony” was held for the temporary incinerator in Ishinomaki City, which had been in operation until the end of the prefecture. As the years went by, thelandscape changed little by little, and the traffic of trucks to remove debris eventually shifted to theconstruction of roads and reconstruction public housing that also served as seawalls.
The cover page of the local newspaper on New Year’s Day contained the results of a questionnaire
survey administered to the principals of elementary and junior high schools in the coastal area of
Miyagi Prefecture. It mentioned “70% of the impact of the disaster on children” and “prominenthousehold suffering.” Many children have problems that are thought to be the effects of the Great
East Japan Disaster, and more than 80% of principals consider the situation to be serious. Specificdetails include problems of household finances and a place to study at home. It was reported that therate of mental stress caused by problems in the family was high.
At first glance, reconstruction is steadily progressing, but this does not reflect the conflicts amongpeople in the background. People could feel isolated because of having rebuilt their homes at a fasterpace than the surroundings, becoming estranged from familiar neighbors, and the ceasing of visitsfrom supporters. People could feel lonely or frustrated because of the depopulation of temporary
housing as they move to public housing for reconstruction. Even now, when three years have passed,
many people speak with tears when looking back on those days.
Many who have lost irreplaceable things are hiding their true emotions. With regard to supporters,
another sense of insufficiency that they could not finish remains. Even now, three years on, the entire
affected area continues to suffer from the complex pain caused by the disaster.

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Finally, I would like to introduce a new sort of initiative.
The Disability Welfare Service Office, “Koubou Chikyumura” in Yamamoto Town, located on
the border with Fukushima Prefecture, was severely damaged by the earthquake. Subsequently, we
have accepted many supporters from all over the country, and through the network created there, we
are actively developing new independent products and expanding sales nationwide.
In November 2012, a trailer house establishment, “Cafe Chikyumura” was opened on thepremises of Kobo Chikyumura. In addition to temporary housing residents from the neighborhood,people who once visited as supporters from other prefectures occasionally come here, and stories of
the time of the earthquake and those of the future of Yamamoto Town are blooming.
About a year after the earthquake, one of the staff retired with the aim of revitalizing thestrawberry industry, which is a specialty of the town and was devastated by the earthquake. Currently,
we are providing materials for strawberry jam, which is an independent product of Kobo
Chikyumura, and we are continuing to struggle in new fields every day with a view to accepting
people with disabilities.
The establishments that have been rebuilt with support from all over the country are developing
unprecedented initiatives instead of “returning,” and they are playing a part in the reconstruction of
the town together with the local people. The pain caused by the earthquake remains in people’s hearts.
However, despite our pain, we will continue to watch over the future of Yamamoto Town, which isadvancing on a new path, with “Team Yamamoto,” an initiative of Kobo Chikyumura, which istrying to take a chance to move forward.
Three years since that day, that is my only wish, from a disaster area that has only just begun to
walk the long road of reconstruction.
(Quarterly Welfare Labor No. 142 published on March 25, 2014)
Yuichi Watanabe
Psychiatric social worker/social worker. He works at Hara Clinic, a medical corporation. Engaged insupport activities after the Great East Japan Earthquake, he was transferred to the Miyagi Heart Care
Center Planning Division in November 2011.

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