FUKUSHIMA Lives on the Line

225chap.IVPatient Relief Activity Records [Essays and Research Publications]FUKUSHIMA: Lives on the LineRyuki Kassai is professor and chair at the Department of Community and Family Medicine, Fukushima Medical University. He is a member of the BMJ editorial advisory board.BMJ Group blogs [http://blogs.bmj.com/]The First Anniversary of the Japanese TsunamiRyuki KassaiProfessor and Chair Department of Community and Family MedicineFukushima Medical University28 March 2012 by BMJ GroupAccording to the plan, we should be well along the path to rebirth, but in reality, foolishness has continued, and nihilism and despair have only spread.Hayao Miyazaki: Nausicaä of the Valley of the Wind (1994)(Translated from the Japanese by Matt Thorn)In the afternoon on March 11, 2012, I was standing on the tsunami-hit coast in Iwaki, Fukushima Prefecture, gazing alternately at the Pacific Ocean and the ruins of the town. The Pacific looked beautiful. On the opposite side, however, there spread a vast expanse of bare land, where, on the first anniversary of the disaster, several people came to pray for those who were killed by the Great East Japan Earthquake, and in particular the victims of the ferocious tsunami which hit there on March 11, 2011. It seemed to me that several of them were still looking for some shred of evidence that would make them believe their loved ones were not dead after all. One year on, how far — if at all — have we progressed towards full recovery? How much have we accomplished in terms of the reconstruction of our society?According to a national police agency tally as of March 21, 2012, in the three most affected prefectures in the Tohoku region: 4,671 people were killed in Iwate, 9,512 in Miyagi, and 1,605 in Fukushima. 1,237 people were missing in Iwate, 1,688 in Miyagi, and 214 in Fukushima. 20,185 houses were totally destroyed in Iwate, 84,749 in Miyagi, and 20,194 in Fukushima; and 4,562 houses were more than half destroyed in Iwate, 147,165 in Miyagi, and 65,733 in Fukushima. The reconstruction headquarters reported on the 26 January 2012 that there were still 341,411 people living in evacuation shelters, in the houses of relatives or friends, or in temporary accommodation far away from their home towns.Although Fukushima has fewer victims compared with Iwate and Miyagi, we probably have the largest number of evacuees, who now live in and outside the prefecture but who used to live along the coastal areas of Fukushima. A series of accidents at the Fukushima Daiichi nuclear power plant have rendered homeless the people from 7 towns and 2 cities. It seems too difficult for most people in Fukushima, as perhaps in the rest of Japan, to get a balanced understanding of the long term risk from low dose radiation. Even many doctors, nurses, and their families have left Fukushima, afraid of the possible fatal effects of radiation. Emotion beats scientific evidence.Let me share an episode that happened last summer to illustrate people's irresistible fear of the invisible threat. Obon is one of the Japanese folk customs to honour the departed spirits of one's ancestors, who are believed to revisit their home towns during Obon. It has both Buddhist and Shinto influences. Obon was originally celebrated on the fifteenth day of the seventh month of the lunar calendar, but in modern Japan it has been varied among the regions of Japan. It is now most commonly around August 15. During the Obon holiday, people return to their ancestral home towns and, together with family/and friends, hold reunions with their ancestors' spirits. At the end of Obon, we light Okuribi (send-off fire) on