Illness in Tohoku

Illness that disaster victims in Tohoku are suffering is connected with society and economy. To recover from it, something spiritual is important

NOTHING was there. Fukanuma seaside in Sendai in Miyagi prefecture was destroyed by a devastating earthquake and tsunami on March 11th. The debris from the disaster is left on sea-swamped rice paddies. “I can’t believe it”, say security guards there. They were shocked out of their wits by the sights that changed completely. Dead bodies were found and a few people are still missing there. “It makes me cry”, the guards lament. They are not the only people who are suffering from pain. To recover from and prevent illness, what is needed for disaster victims?

After the disaster, including the nuclear accident at Fukushima Dai-ichi plant, there are many people in Tohoku, the devastated region in the north-east, who got sick. According to Mainichi Shimbun, a Japanese newspaper, more than three hundred people need mental care among disaster victims in the seaboard of Iwate prefecture. Tohoku University School of Medicine found that more than one hundred people got flu in evacuation centres in Miyagi in late March. It warns that the risk of the outbreak of infectious disease is growing.

The cause of infectious disease is an unhealthy sanitary environment of refugee centres. Some 54 thousand refugees live there together. At first water was in short supply thus they could not wash hands or gargle. Neither could they clean bathrooms and floors. Vaccines and medicines did not come either because of disturbed medical supply-chain. In Sendai, the flu had been widespread for a few months before the earthquake. So refugees are likely to catch infectious disease in such an environment.

To maintain clean refugee centres with sanitary conditions, alcohol is used instead of water. Medicine has been given by medical companies and medical universities. Tohoku University is working together with Miyagi to call for people to wash hands and gargle thoroughly in order to prevent the spread of infectious disease. Meanwhile, the prefecture formed a mental care team with doctors who have degrees in western medicine, nurses, clinical psychotherapists and mental health welfare professionals. Acupuncture is practiced too.

Despite those all-out efforts to improve health, they are not enough to solve the underlying cause of illness. As Fritjof Capra, a physicist and system theorist, says in his book The Turning Point, “Health is really a multidimensional phenomenon involving interdependent physical, psychological, and social aspects”. The appearance of illness is attributable to social and economic environment, which affect individual minds and bodies. Mrs Yukari Oba, a member of staff at social service department of Miyagi prefecture who is in charge of its mental care team, says, “To care minds of victims, it is very important to help them secure food, clothing and materials for housing, get back to their ordinary life and solve the problem of employment and other economic issues. In doing so, they can feel peace of mind and safety”. It is clear that unless those are achieved or solved, victims will continue to feel stress or anxious that affects their minds; hence never recover from illness.

There are three major causes of their stress and worries. The first is nuclear power plants in Tohoku. Miyagi and Aomori run Mekawa nuclear power station and Rokkasyo nuclear reprocessing plant respectively. The danger is that the former is located in an active fault zone. It threatened local people when a major earthquake happened in Miyagi in 2008. Although Japanese prime minister Naoto Kan decided to stop Hamaoka nuclear power plant, other plants will continue to operate. Meanwhile, after the nuclear accident in Fukushima, local farmers and tourist industries were hit hard by rumours. Japanese government temporarily banned exports of agricultural crops from places near the nuclear plant while neighbour countries stopped imports due to fears of radiation. For the same reason foreign tourists rapidly decreased.

The second is unemployment. Agriculture and fisheries are important industries in Tohoku. The region has 487 thousand farmers, consisting 5.21% of its population, which is the highest in Japan. But because of aging and depopulation, the primary industry is hollowing out. In 2007, while its agricultural and fisheries output was over 900 billion yen, that of manufacturing industry was more than 6.7 trillion yen. Then came the quake and tsunami. There are growing worries over job security. The Japan Research Institute, a think-tank, predicts between 140,000 and 200,000 people lost jobs and 10-20% of that comes from fisheries and agriculture. (On May 26th unemployment in the region exceeded 110 thousand.)

There is a variety of reconstructing plans, including reconstruction of local industries and the use of energy, but many of them are defective. The government has passed a 4 trillion yen($50 billion) supplementary budget for clearing the debris and other urgent tasks. The ideas of special economic zones in the region and deregulation in various sectors are discussed, which are expected to bring private investment and young people into highly-protected areas such as agriculture. But Yasushi Harada, a senior economist at The Tokyo Foundation, a think-tank, points out that the recovery of private assets of fishermen and farmers should be more important than such things. In fact, many of reconstructing plans miss that point although they show some ways to create jobs for disaster-victims, including relocating collectively for job opportunities, creating new local industries and reforming education to change jobs, all of which indicate a breakaway from the primary industry. Mr Harada also says that financial investment is too much, showing that the government and the Ministry of Finance plan to raise tax.

The third cause of worry for disaster victims is related to the second: the Trans-Pacific Partnership (TPP). It aims to bring free-trade and competition to various areas from agriculture, forestry, fisheries to health by deregulation that allows private companies to enter those markets. But many people, including mayors, farmers, fishermen, doctors and experts, oppose TPP. One poll conducted by Japan Agricultural Newspaper shows 73% of 638 local mayors were against it while it was only Tokyo where the majority approved TPP; almost all of the mayors in Tohoku opposed it.

True, appropriate deregulation is needed. For example, Japanese forestry has been sluggish for a long time. To stop it, the government is so far surprisingly doing well to modernise the market. Japanese rice is highly protected, sending its price higher. A proposal for agricultural policy reform from The Tokyo Foundation says, "the right policy is that farmers receive direct payment from the government to maxmise external economy effects after entering into free-trade to increase profits as much as possible".

However, TPP has a negative aspect to national interest. Compared with other developed countries, Japan is dangerously low in the amount of grain production. Based on this, Hideyuki Sekioka, an expert on American-Japanese relations, maintains that Japanese paddy farmers should continue to be protected like those in countries such as Britain and France. Japanese private forests need urgent protection, too. While land is public property in other developed countries, it is not in Japan with private rights over land strongest in the world. Because of the decline in the forest industry in the last few decades, the management of private forest became sloppy. Now Chinese investors are showing their interest in them. Private forests in Tohoku are relatively managed well, but there are still ones whose ownership is unclear there.

What’s more, there is a fear that reconstructing is subject to the central and foreign governments. Local people should take a leading role in rebuilding their disaster-hit industries, but that is unlikely to happen. After all, TPP and the U.S.-Japan Regulatory Reform and Competition Policy Initiative are “two sides of the same coin”: they bring most benefits to American multinational companies at the expense of national interest. America pushes Japan to endorse TPP anyway. Ron Kirk, the head of Office of United States Trade Representative, urged the Japanese government to go ahead with TPP the other day. That may explain why regaining private property of local people in disaster-hit area is not included in many reconstructing plans.

Dr. Tetsuro Ishii claims in Mainichi Shimbun that TPP will do serious damage not only to local agriculture but also to medical system as a whole in the wake of disaster. With aging and depopulation, local hospitals in Tohoku are short of doctors, which was partly caused by deregulation in medical industry demanded by the past American initiative.

In the worst case scenario, TPP will destroy not only local communities but Japan as a whole. People in Tohoku have co-existed with Nature. For example, they traditionally make straw dolls to pray for good health. As Mr Sekioka fears, reform in agriculture threatens to break up agricultural cooperative as well as such traditional values. It will be a mistake to put more emphasis on free-market and competition than on the recognition of connectedness with Nature and co-operation.

History suggests that Tohoku should avoid trusting the central government too much. This region was once called Ezo with a bit of racism and caution. When the Meiji reformation was taking place, the region backed the old regime and fought to the end against the new government only to defeat and suffer unfair treatment. After the nuclear accident at Fukushima, there seems to be a growing sense of anger and disillusionment with the government among people in the region. For Tohoku, which has served to provide staples for the country, participation in TPP is like adding fuel to the fire. It should be careful with the central governement that has deceived many times in the past.

The best cure for illness of disaster-victims is to solve social and economic issues based on the sense of solidarity and mission that a growing number of local people have. These spirits will keep illness at bay. Mrs Oba thinks, "to bring out the individual healing power is important". Miyagi is due to finalise its reconstructing plan by September, but the governor of the cash-stripped prefecture, Yoshihiro Murai, is likely to proceed with free-market reform in the face of opposition from local fishermen. "There’s always pain when there’s revolution", he told to The Economist. A determined reformist he may be, but the governor is like a doctor who forgets that medicine is a benevolent art. â–