Wednesday, March 30, 2011

30/03 Democracy Is Messy

March 30, 2011
By NICHOLAS D. KRISTOF
CAIRO

Egypt is a mess.

Nearly two months after street protests inspired a democratic revolution, the transitional military-backed government has proposed — you guessed it — a law banning protests. That’s partly because everybody is protesting, even the police. The cops want more money, perhaps because their diminished authority means that they can now extract less in bribes.

With the police out of commission, the army uses thugs to intimidate its critics. And, when it really gets irritated, it arrests and tortures democracy activists. As I wrote in my previous column, it has even tried to humiliate female activists by subjecting them to forced “virginity exams.”

The Muslim Brotherhood, once banned, has been brought into the power structure. Instead of denouncing the system, it is becoming part of it — and some of its activists are rampaging around Cairo University.

27/03 Kaleidoscope of the Heart: Take a break from bad news

Kaleidoscope of the Heart: Take a break from bad news

Rika Kayama
Rika Kayama

At the Tokyo hospital I work at, many patients have come in with complaints after the earthquake. "I can't sleep because of the frightening aftershocks," they say, or "I can't ride in elevators," they say, because they are afraid the power will cut while they are inside.

However, I also hear complaints that are not directly related to the disaster, like, "For some reason I can't stop crying," "I get irritated without good reason," or "I keep standing up and sitting down and can't relax."

Even though they are not in the disaster areas, these people have been exposed to a long shower of images and words about the disaster, which has probably tired their minds and bodies.

I say to these people, "Let's try staying away from television and the Internet for a while and spending some time listening to the music you like, reading the comics you like, making cakes, or doing whatever you did in your free time before all of this."

One person argued against my recommendation: "But doctor, even if I temporarily spent some time relaxing like that, it doesn't change the fact that the earthquake happened. My mother's hometown was badly damaged. No matter how much I escape into fun things, when I am pulled back into reality nothing will have changed. Wouldn't I become even more depressed?"

Indeed, that is one view. However, I still think that escaping into recreation is good. With a disaster this large, obviously people within the disaster area have been hit hardest by far, but even those outside those areas have been emotionally hurt. It may take a long time to make a true recovery, and it is necessary to take small rests. Be it 30 minutes or an hour, get away from the reality in front of you and immerse yourself in the world of a video game or a TV series. Take your time drinking a cup of tea and say out loud, "Ahh, this is good." Even if it's only for that time, you can put a stop to feelings of uneasiness and hopelessness.

Resting oneself this way, even if it's an escape into a fantasy or virtual world, will give one strength to recover. If people spend 24 hours a day looking at nothing but sadness and struggle, it will wear down their emotional energy, and it could delay their recovery to their normal selves. I believe that having a brief time of fun, even if some might consider it self-deceit, will prepare one to face the future in a positive way.

The reality we are confronted with will not go away any time soon. Neither, perhaps, will the bad feelings that accompany it. Even so -- no, I should say "because" of that -- we should take a brief escape from reality. That is my recommendation. (By Rika Kayama, psychiatrist)

(Mainichi Japan) March 27, 2011

27/03 Kaleidoscope of the Heart: The line between patient and docto

Kaleidoscope of the Heart: The line between patient and doctor

I know a poet named Koji Tsukino. He presides over an expressionistic group where he reads aloud his own works in powerful performances. A requirement for being a member of that group, however, is having a physical or mental illness or disability that causes you to "struggle with life." Mr. Tsukino himself has struggled with and overcome alcoholism and neurosis.

Over the course of repeated visits to watch that group's performances, full as they are of both sorrow and joy, I have become hooked. I now associate with the members like we are friends. For instance, the other day I participated in an Internet radio program hosted by Mr. Tsukino.

However, until now, I tried to keep a personal distance between myself and those who might seek my professional advice. Even if I am not seeing them officially, I am a psychiatrist, and during training we have it hammered into us that if one casually associates with "patients," the relationship between doctor and patient will become warped. For example, if I were to go out for a meal with some of the members of Mr. Tsukino's group, and someone were to say that their personal doctor recommended such-and-such, and then ask what I think, I would have to decide whether to answer as a doctor or as a friend. In order to avoid such issues, I had decided that even outside of the hospital, I had better not get on too casual terms with potential patients.

Now, though, things are a little different. I feel that I've become better able to naturally respond to questions about treatment without worrying about whether to take the role of doctor or friend. If someone complained to me, "My doctor prescribes nothing but strong medicine," I think now I would be able to give a reply like, "Well, I think your doctor has their reasons for doing that. You know, things are hard for doctors, too. Why don't you try just frankly expressing your concerns to them?"

Meanwhile, during the Internet radio recording session with Mr. Tsukino, he told his stories of hardships in such a funny way that I couldn't help but laugh out loud. If I had kept a personal distance like until now, I might have worried that I had hurt his feelings by laughing, but instead I was able to feel that since we have gotten to know each other, it's OK to have laughed. And, if he had had his feelings hurt, I am sure that Mr. Tsukino would have been comfortable telling me so, and I would apologize in that case.

In the end, if there is a relationship of trust, then I don't think there is a reason to fuss over whether we are "doctor and patient" or "two friends." Still, it has taken me 25 years as a psychiatrist before coming to feel this way. Perhaps it is something that can only be understood after spending many years in this world. It makes me glad that I have continued this line of work. (By Rika Kayama, psychiatrist)

(Mainichi Japan) March 27, 2011

26/03 Kaleidoscope of the Heart: Everyone is capable of overcoming disasters

Kaleidoscope of the Heart: Everyone is capable of overcoming disasters

Rika Kayama
Rika Kayama

I wonder if you, who are reading my article, are safe and sound. I wonder if you are staying at a safe place. I'm sure some of you are at a loss what to do or are still in a panic after the deadly earthquake on March 11.

Some people must be suffering from health problems such as palpitations and dizziness after sleepless nights, while others may be crying in anxiety as they sleep at refugee shelters.

I have seen a lot of patients who seemed to be at the lowest point of their lives and were confused after getting involved in accidents and incidents. Some of them would pull at their hair saying, "It's all over," while others cried and screamed saying they did not want to live any longer.

However, all of these patients climbed out of despair and recovered even though it took them some time before they felt better.

I have witnessed a lot of miraculous recoveries in my consultation room. I believe anyone is capable of overcoming difficulties regardless of their age.

In times of difficulties, what should we try to bear in mind?

First, you should be patient and try to calm down by constantly reminding yourself that everything is going to be fine and that you need to slow down. Get as much rest as possible. Even if you cannot sleep, just recline in a chair and relax. If you have food, eat even if you have little appetite. It will also be helpful to talk to people around you. Don't hesitate to ask them for help whenever it's necessary.

And last, but not least, you must believe in yourself and those around you. You cannot abandon hope no matter what.

This kind of approach holds true for anyone from any country and region.

We have already overcome a lot of problems hand in hand. Anyone is capable of recovering from any problem. That is what humans and human society does.

Believe in yourself and help each and those around you. We should do the best we can one by one. We must find hope. (By Rika Kayama, psychiatrist)

(Mainichi Japan) March 26, 2011

25/03 Disaster victims need to be 'matched' with 2nd hometown as rebuilding will take time

Disaster victims need to be 'matched' with 2nd hometown as rebuilding will take time

People sit in a closed junior high school being used as a shelter following the March 11 Great East Japan Earthquake, in the Iwate Prefecture city of Kamaishi on March 17. (Mainichi )
People sit in a closed junior high school being used as a shelter following the March 11 Great East Japan Earthquake, in the Iwate Prefecture city of Kamaishi on March 17. (Mainichi )

A staff member from a nursing home in Saitama Prefecture was at a loss for words upon visiting Saitama Super Arena, a stadium where many evacuees from the disaster in northeastern Japan are taking shelter.

Elderly refugees and their families packed the facility, with those requiring nursing care getting their diapers changed in the hallway. Staff from the Saitama-based nursing home brought five of the elderly -- showing such symptoms as dehydration caused by fevers and decreased consciousness levels -- along with two family members back to their nursing home.

The following day, local government officials began transferring evacuees in need of medical treatment and other care to welfare facilities with availability. When evacuees first arrived in Saitama, however, the provision of "care" involved doctors, lawyers and administrative scriveners just listening to the problems and needs voiced by the displaced.

Learning of such distressing conditions, an operator of nursing homes and home-visit nursing care centers in Chiba Prefecture offered to take in evacuees via prefectural authorities. While a survey by the Chiba prefectural government found that facilities across Chiba are capable of accepting some 600 evacuees, such facilities have been unable to get in touch with communities affected by the disaster. Little progress has been made thus far by the Ministry of Health, Labor and Welfare to coordinate matches between disaster victims in need and those offering their assistance.

Many of those affected by the March 11 earthquake and tsunami are elderly. Although their lives were spared by the natural disaster itself, their health can easily deteriorate if shelters are unable to provide adequate food and water, endangering their lives once again if they lack the care they need. Many facilities across the country are offering their help, but that goodwill goes to waste if they cannot come in contact with the victims.

Kameda Medical Center in Kamogawa, Chiba Prefecture, is hosting all 184 of the elderly residents and staff from Onahama Tokiwaen, a nursing care facility located in the Fukushima Prefecture city of Iwaki, which was severely affected by the earthquake, tsunami and the subsequent nuclear power plant accident. Doctors and other staff from Onahama Tokiwaen are staying -- along with the facility's elderly residents -- at a Kampo no Yado resort inn near Kameda Medical Center, providing residents with daily care.

Volunteers prepare to give out food to people in a school gymnasium acting as a shelter for those whose homes were damaged by the March 11 earthquake and tsunami in Rikuzentakata, Iwate Prefecture, Japan, Sunday, March 20, 2011. (AP Photo/Matt Dunham )
Volunteers prepare to give out food to people in a school gymnasium acting as a shelter for those whose homes were damaged by the March 11 earthquake and tsunami in Rikuzentakata, Iwate Prefecture, Japan, Sunday, March 20, 2011. (AP Photo/Matt Dunham )

The Iwaki local government says it considers the inn a temporary enclave of the city and plans to foot the expenses of nursing care insurance the same way it did when residents were physically ill in Iwaki. Meanwhile, Kameda Medical Center has provided assistance not only in medical care, but also in maintaining contact with the Fukushima Prefecture and Iwaki City governments.

Under current circumstances in which municipal governments in affected areas have yet to resume regular functions, relocating entire welfare facilities or evacuation shelters, with the host facility or hospital cooperating with local governments to set up a system for providing care, is an effective alternative. Why not consider having local governments far away from the disaster split the task of hosting entire communities from the disaster areas?

The aforementioned nursing home in Saitama took in elderly refugees from evacuation shelters without any personal identity verification. Moreover, the nursing home is currently footing the expenses of the families accompanying the elderly they accepted. The system must retroactively complement what is taking place, and the national government must provide its full support in realizing it.

Due to the sheer magnitude of the disaster, many victims are expected to be living in shelters for a long time to come. We must take part in relief efforts as if we are creating a second hometown for the victims.

(Mainichi Japan) March 25, 2011

24/03 Gov't should clearly explain health risks of radioactive contamination

Gov't should clearly explain health risks of radioactive contamination

In this photo released by Tokyo Electric Power Co. (TEPCO), gray smoke rises from Unit 3 of the tsunami-stricken Fukushima Dai-ichi nuclear power plant in Okumamachi, Fukushima Prefecture, Japan, Monday, March 21, 2011. Official says the TEPCO temporarily evacuated its workers from the site. At left is Unit 2 and at right is Unit 4. (AP Photo/Tokyo Electric Power Co. )
In this photo released by Tokyo Electric Power Co. (TEPCO), gray smoke rises from Unit 3 of the tsunami-stricken Fukushima Dai-ichi nuclear power plant in Okumamachi, Fukushima Prefecture, Japan, Monday, March 21, 2011. Official says the TEPCO temporarily evacuated its workers from the site. At left is Unit 2 and at right is Unit 4. (AP Photo/Tokyo Electric Power Co. )

The effects of radioactive contamination of food and drinking water are spreading as workers struggle to handle a nuclear power plant crisis in Fukushima Prefecture.

Following warnings in parts of Fukushima Prefecture, the Tokyo Metropolitan Government recommended that infants in Tokyo should not drink tap water. The government has halted shipments of unprocessed milk and some vegetables produced in Fukushima Prefecture, among other areas, and is asking people not to consume these products.

The government message that has accompanied such warnings is: "These products won't harm your health. But just in case, we don't want you to eat or drink them."

Just how should we receive this seemingly contradictory message? Food and water form the foundation of people's existence. Naturally, the government should boost the monitoring of products to accurately grasp the state of contamination, but that alone won't solve the problems that have emerged.

In areas damaged by the March 11 earthquake and tsunami, food and other materials are still in short supply. The government should consider the circumstances in these areas and improve its risk management and communication.

If there are going to be restrictions on the intake of water and some food products, then the government must prepare a system to deliver replacement products to disaster-hit areas. People have been left wondering what they should do if they can't obtain replacement products, and what risks infants and pregnant women face. The government must carefully address such concerns.

If officials want people to reach calm decisions -- not just about the safety of food and water but also about the radiation in the air -- then they must do more than occasionally dishing out figures and their interpretations of them.

How much radiation have the people living in affected areas been exposed to in total? When officials say there is no health risk if people are exposed to radiation for a long time, exactly how long is a "long time"? And what does the term "health effects" actually mean? If the government wants people to remain calm then it must answer such questions in clearer terms.

Officials should also clearly state whether radiation around the nuclear power plant is declining or not and how the situation is expected to develop. Information regarding the transition of radiation levels in Fukushima Prefecture would be helpful in determining the outlook for Tokyo, too.

Understandably, it is difficult to accurately measure the physical effects of exposure to low levels of radiation. Still, the threat of damage to DNA, resulting in cancer, is worrying. The human body is equipped to repair such damage, but when the level of damage is high, the long-term risks cannot be ignored.

After the Chernobyl nuclear power plant disaster, thyroid cancer emerged among children who continued to drink milk contaminated with radioactive iodine. Surely a priority for the Japanese government is to come up with ways to protect children, while explaining that the situation in Japan is different. If people over a certain age are not at risk, then the government should clearly say so.

In handling the situation, the government must ensure residents stay well even if radioactive contamination continues. It must not let people move about in confusion trying to get their hands on uncontaminated food and water.

(Mainichi Japan) March 24, 2011

23/03 High school baseball tournament a message of encouragement for Japan after quake

High school baseball tournament a message of encouragement for Japan after quake

The 83rd National High School Baseball Invitational Tournament opened as scheduled at Hanshin Koshien Stadium on March 23, less than two weeks after a massive earthquake and tsunami ravaged northeastern Japan.

The tournament is being held under the slogan "Ganbaro! Nippon" (Let's give it our best shot, Japan), and organizers want to make the event one that encourages people in areas hit by the March 11 disaster.

Opinions were split over whether the tournament should go ahead, but in the end it was opened with all qualifying schools participating -- including those in disaster zones. The Japan High School Baseball Federation and The Mainichi Newspapers Co., which sponsor the annual tournament, decided the players should not miss out on what could be a once-in-a-lifetime experience.

Tohoku High School in Miyagi Prefecture, which is taking part in the tournament, suffered heavy damage in the quake, with power and water cuts continuing at the dormitory in Sendai where many of the players live. Team members have been helping supply water to shelters and directing traffic.

Some players and school officials had suggested that now was not a time to be thinking about baseball, but since the decision to go ahead with the tournament was made, the players have shown determination.

"What we can do at Koshien is to run and play with all our might. We want to cheer up as many people as possible," one player commented.

Suijo High School in Ibaraki Prefecture, which is also participating in the tournament, suffered damage including cracks in the walls of the school, and the crisis at Tokyo Electric Power Co.'s Fukushima No. 1 Nuclear Power Plant hindered the baseball team's practice. Still, team members preparing to face Kosei Gakuin High School from Aomori Prefecture, which was also hit by the disaster, have vowed to play hard to encourage the people of both prefectures.

Players from areas that escaped damage are also eager to encourage disaster victims, saying that the greatest thing they can do now is to play their hardest. It seems that efforts to encourage people hit by the quake and tsunami through high school baseball are gaining momentum throughout the nation.

In the Great Hanshin Earthquake of 1995, many buildings around Koshien Stadium were badly damaged, but the tournament went ahead with the aim of contributing to disaster recovery. The current tournament will also pay respect to quake-struck areas: Teams will not march into the stadium or be cheered on with musical instruments, and part of the ticket sales will go toward areas affected by the quake and tsunami. Donations will also be sought at the stadium. In addition, since both the Tohoku and Kanto regions of Japan are facing power shortages, game starting times will be moved forward and the time between games will be narrowed in a bid to avoid night games.

Areas affected by the disaster are still struggling with relief operations and the handling of the crisis at the Fukushima No. 1 Nuclear Power Plant. Amid such circumstances, we want high school baseball players to acknowledge the joy of the game and play with all their heart, and we hope that the devotion shown by the players will become a source of encouragement for both those in disaster zones and other people across the country.

(Mainichi Japan) March 23, 2011

29/03 Data is the core of crisis management

Data is the core of crisis management

The central control room for the No. 1 and 2 reactors at Fukushima No. 1 Nuclear Power Plant, which was damaged in a massive earthquake on March 11, is pictured on March 23 in this photograph provided by the government's Nuclear and Industrial Safety Agency.
The central control room for the No. 1 and 2 reactors at Fukushima No. 1 Nuclear Power Plant, which was damaged in a massive earthquake on March 11, is pictured on March 23 in this photograph provided by the government's Nuclear and Industrial Safety Agency.

The fact that Tokyo Electric Power Co. (TEPCO) took more than nine hours before retracting a false report that an astronomically high concentration of radiation had been detected in water in a turbine building at its quake- and tsunami-hit nuclear power plant has raised questions about its crisis management ability.

What is happening to the reactor can be assumed by analyzing the types of radioactive substances the water contains. The data is crucial in ascertaining what action should be taken and predicting what will happen to the plant in the future.

Initially, TEPCO and the Nuclear and Industrial Safety Agency (NISA) announced figures showing that the water in the turbine building of the Fukushima No. 1 Nuclear Power Plant's No. 2 reactor contained a high concentration of iodine-134.

If the data was accurate, it would point to the possibility that the reactor had reached criticality in which nuclear fission is self-sustaining. If that happened, it would be far more difficult to place the reactor under control, raising fears that a massive amount of radiation will spread.

The data was corrected 9 1/2 hours after it was released. Nevertheless, this has not dispelled the public's sense of crisis, as the mistake has highlighted problems involving the accuracy of data analysis, assessment of analysis results and the way information is communicated.

The stricken nuclear power plant's earthquake-resistant
The stricken nuclear power plant's earthquake-resistant "emergency task room" built for handling emergencies. (Photo courtesy of TEPCO's Fukushima No. 1 Nuclear Power Plant website )

Inaccurate analysis of data could bring grave consequences. If serious problems involving the reactor worsened while TEPCO and the government regulator relied on wrong data, it could lead to an irreparable state of affairs. Such a situation must be avoided at all costs.

Obvious mistakes involving data can be corrected quickly if an evaluation system functions properly. Experts point out they could have easily found the data, which TEPCO and NISA had said suggested that the water contained iodine-134, was wrong if they had seen the figures. So one cannot help but wonder why TEPCO failed to promptly correct the data. Questions remains as to whether the power supplier has no system to accurately analyze data.

NISA's response has also raised questions about whether it assessed the data on its own. If it had failed to do so, that would mean that the organization has become dysfunctional.

If TEPCO and NISA had believed the data was correct, they should have pointed to the possibility that the reactor could reach criticality. If they had suspected that the data was incorrect, they should have promptly corrected the figures. The government's Nuclear Safety Agency of Japan (NSC) has also failed to sufficiently dispatch information on the crisis at the nuclear plant, which the public needs.

The way that TEPCO and the government regulator concerned analyze and evaluate data and release relevant information to the public -- which is the core of their crisis management -- needs to be improved promptly. In doing so, they should take care not to adversely affect the ongoing efforts to place the nuclear plant under control.

The fatigue and stress of the workers who are tackling problems with the plant have apparently reached the limit of their endurance. It can be easily imagined that their working environment is extremely poor, and that there is a shortage of personnel. Both TEPCO and the government regulator are required to identify these problems and provide psychological and material support to the workers. Otherwise, other mistakes could be made in efforts to place the plant under control.

In this photo from a footage of a live camera released by Tokyo Electric Power Co. (TEPCO), black smoke billows from the crippled Fukushima Dai-ichi nuclear power plant in Okumamachi, northeastern Japan,Tuesday, March 22, 2011.
In this photo from a footage of a live camera released by Tokyo Electric Power Co. (TEPCO), black smoke billows from the crippled Fukushima Dai-ichi nuclear power plant in Okumamachi, northeastern Japan,Tuesday, March 22, 2011.

Top priority should now be placed on efforts to cool down the reactors. TEPCO and the government regulator should go ahead with the work while identifying priorities and protecting workers from radiation. Now is the time for all those concerned to devote themselves to achieve this common goal.

(Mainichi Japan) March 29, 2011

30/03 Japan must not overlook mental health of children in disaster zone

Japan must not overlook mental health of children in disaster zone

A sixth grader, Mirai Okuda, reacts following a graduation ceremony in the devastated city of Ishinomaki, Iwate prefecture, northeastern Japan, Thursday, March 24, 2011, after an powerful earthquake and resulting tsunami devastated the area about two weeks ago. (AP Photo/Vincent Yu)
A sixth grader, Mirai Okuda, reacts following a graduation ceremony in the devastated city of Ishinomaki, Iwate prefecture, northeastern Japan, Thursday, March 24, 2011, after an powerful earthquake and resulting tsunami devastated the area about two weeks ago. (AP Photo/Vincent Yu)

There are many elementary school children making the rounds of disaster evacuation shelters to look for their missing parents. Others are searching the rubble of collapsed buildings for mementos such as photos as well as their belongings. Some children were seen to smile during their school graduation ceremonies. People across the country are trying to cheer up these children in quake- and tsunami-hit areas.

More than 10,000 people have been confirmed dead and some 16,000 others remain missing following the March 11 Great East Japan Earthquake. Facing this unbelievable reality, anybody would want to encourage child survivors to help them conquer hardships already experienced and those sure to come.

However, children are already doing their best. Even though they do not understand what has happened to them as much as adults and cannot express their feelings, they can also suffer from disaster trauma and become overwhelmed with grief after losing their family members, their homes or both.

Rather than simply urging children to overcome the disaster, what is needed is to look for subtle changes in their emotions and provide appropriate psychological support.

Children who have experienced such a massive disaster tend to complain of insomnia and loss of appetite, act infantile, be frightened by loud sounds, easily lose their temper, have nightmares and refuse activities they enjoyed before the traumatic event.

If children begin to show these symptoms, adequate care should be provided to them, such as telling them, "You're all right," and avoiding letting them sleep alone, in order to reassure them.

Japanese performer chats with children evacuated from Fukushima Prefecture, northeastern Japan, where the troubled Fukushima Dai-ichi nuclear power plant is located, outside an evacuation center in Saitama, near Tokyo, Monday, March 28, 2011. (AP Photo/Lee Jin-man)
Japanese performer chats with children evacuated from Fukushima Prefecture, northeastern Japan, where the troubled Fukushima Dai-ichi nuclear power plant is located, outside an evacuation center in Saitama, near Tokyo, Monday, March 28, 2011. (AP Photo/Lee Jin-man)

Some children repeatedly talk about what they saw and experienced in the disaster, but adults around them should understand this as a sign that they are trying hard to accept the shocking reality and patiently listen to what they have to say.

Pep talks like, "Never say die" and "There are some other people who are in more difficult situations. Overcome this hardship," must be avoided. Adults may say these things to children to encourage them, but they can be counterproductive, driving a child into a psychological corner.

Some children are afflicted with survivor's guilt when the rest of their families lost their lives in the disaster. They should rather be convinced that they do not have to hide their tears or their feelings.

The Japanese Association of Clinical Psychology and the National Center of Neurology and Psychiatry (NCNP) have guidelines on their respective websites on dealing with children who have experienced a massive disaster.

Mental health experts are working in quake-hit areas, but they cannot look after all the children who need their care. Academic societies specializing in children's mental health are providing telephone and e-mail counseling, and such services should be fully utilized.

Children can initially endure the harsh living conditions at shelters because they maintain a sense of tension after the disaster. If their evacuation is prolonged, however, they may suffer from sudden depression or feel physically ill. Minor symptoms that children show immediately after a disaster can be dealt with if adequate care is provided. However, post-traumatic stress disorder should be suspected if children continue to show such symptoms for more than a month. In that case, expert treatment is required.

Even children who did not experience the quake could show symptoms such as insomnia if they repeatedly see shocking images of the disaster on TV. There are reportedly some cases where children who were not hit by the disaster complain they feel anxious and suddenly begin to cry in class. Close attention should be paid to subtle changes in children's words and deeds so as not to overlook any sign that they are developing psychological problems.

A mother and her children wait for food at a shelter after being evacuated from areas around the damaged Fukushima nuclear power plant Sunday, March 20, 2011 in Fukushima, Fukushima prefecture,
A mother and her children wait for food at a shelter after being evacuated from areas around the damaged Fukushima nuclear power plant Sunday, March 20, 2011 in Fukushima, Fukushima prefecture,

Efforts to provide mental care for children in quake- and tsunami-devastated areas have come to a crucial stage. The nation as a whole is urged to protect both the mental and physical health of children.

(Mainichi Japan) March 30, 2011

30/03 Trying to keep morale up

The Yomiuri Shimbun

The cold really seeps in at night, but workers in the 35-square-meter main office and hallways sleep packed together like sardines. Some line up a few chairs to spend the night on.

TEPCO employees who were at the power station when the earthquake hit on March 11 worked 23-hour shifts for the first few days, with time for only a one-hour nap each day.

With radiation levels outside as high as ever, the workers have put lead sheets on the floor of the earthquake-resistant building they are staying in, reducing radiation inside to between two microsieverts and three microsieverts per hour.

Very high levels of radiation have been measured in puddles of water in the turbine buildings.

"I can't emphasize enough how important it is for workers to avoid those puddles" while carrying out their duties, said Kazuma Yokota, an inspection chief at the Nuclear and Industrial Safety agency who stayed five days at the plant last week. Most workers are rotated out regularly in shifts, "but it's difficult for the management to leave," he said.

After a meeting at night, everyone gathers around for a group cheer. "Let's do our best!" they cry out with a synchronized clap, trying to boost morale.

"Considering the importance of the work they're doing, they aren't getting enough support," said Tokyo Women's Christian University Prof. Hirotada Hirose, a specialist in disaster and risk psychology. "This situation where they're not getting enough food or sleep will make them less efficient and increase the possibility of mistakes."

Hirose said working conditions could be improved by providing nutritional supplements and vitamins, plus making sure the workers have enough sleeping bags.

(Mar. 30, 2011)

30/03 Balancing act at reactors / Water vital for cooling, but drainage poses new set of problems

The Yomiuri Shimbun

Work to remove radiation-contaminated water from the turbine buildings of reactors at the Fukushima No. 1 nuclear power plant moved into full gear Tuesday, while efforts continued to cool the reactors with water.

Plant operator Tokyo Electric Power Co. earlier confirmed radioactive water that spilled out of the reactors had collected in underground trenches connected to them.

Workers were scrambling to prevent the contaminated water in the trenches from leaking into the sea. For instance, work was continuing around the clock to transfer water from the first basement floor of the No. 1 reactor's turbine building to a condenser.

The condensers at the Nos. 1 and 4 reactors still had room for more water as of Tuesday, but the condensers at the Nos. 2 and 3 reactors were already full to capacity.

At the No. 3 reactor, there were renewed efforts to transfer water in the condenser to a tank outside the building, and then to other tanks.

The top priority at the plant is to cool the reactors, but the dilemma facing workers is that the cooling process produces more contaminated water, which is time-consuming and troublesome to clear.

To minimize the amount of leaking water, water used to cool the reactors must also be kept as small as possible. But if too little cooling water is used, reactor temperatures will rise.

At the No. 2 reactor, water became contaminated with radioactive material during the cooling process, and is believed to have then leaked into the turbine building from the reactor containment vessel.

Late Sunday night, TEPCO reduced the amount of water being injected into the No. 2 reactor, from around 17 tons per hour to 7 tons per hour.

The temperature in the reactor pressure vessel, which had been about 125 C, increased to 148 C by 7 p.m. Monday and 152 C by 2 a.m. Tuesday.

Also at 2 a.m. Tuesday, at the No. 1 reactor, the temperature and pressure inside the pressure vessel were unstable. The amount of cooling water being injected has increased since Monday night in an attempt to suppress the rise in temperature that began Saturday.

As of 6 a.m. Tuesday, the temperature was stable at 323.3 C, slightly lower than it had been four hours earlier.

TEPCO is carefully monitoring conditions to assess whether the temperature had been brought under control.

At the No. 3 reactor, where the condenser is already full, the focus was on removing water from a makeup water tank--an outdoor tank for temporarily storing water from the reactor--and transferring it to empty water-storage tanks for storing water for pressure suppression chambers. These empty tanks, also located outdoors, are situated south of the No. 4 reactor.

Emptying the makeup tank will allow TEPCO to remove water from the condenser in the turbine building, and then transfer contaminated water from inside the building into the condenser.

Chief Cabinet Secretary Yukio Edano said a scenario where nuclear fuel is not being cooled by water has to be prevented by any means.

"A situation where fuel is burning without any water must be avoided. The cooling work should be prioritized," Edano said. He also stressed the importance of using as little water as possible.

(Mar. 30, 2011)

30/03 Japan, U.S. coordinate efforts on nuclear crisis

The Yomiuri Shimbun

The Japanese and U.S. governments have set up four task forces under a joint liaison and coordination council to deal with the accident at the Fukushima No. 1 nuclear power plant, sources said.

The move aims to use the strength of the Japan-U.S. alliance to coordinate joint efforts to deal with the ongoing crisis.

Ranking government officials, nuclear experts and military officials from both Japan and the United States, in addition to officials of Tokyo Electric Power Co. and other nuclear power plant companies, will take part in the task forces and the council.

The task forces have four respective aims--to shield nuclear substances to prevent their diffusion as soon as possible; dispose of the fuel rods to stabilize the situation at the plant over the medium term; decommission the nuclear reactors over the long term; and offer medical and livelihood assistance to residents near the plant.

The medical and livelihood support team soon will be established, following the three other task forces that already have come into existence. Goshi Hosono, assistant to Prime Minister Naoto Kan, is supervising and managing the work of the four task forces.

The joint liaison and coordination council has met daily since operations began on March 22. U.S. participants on the council include officials of the Energy Department, Nuclear Regulatory Commission, the military and U.S. Embassy in Tokyo.

(Mar. 30, 2011)

30/03 Plutonium detected in soil at N-plant

The Yomiuri Shimbun

Small amounts of three plutonium isotopes were detected in soil sampled at the Fukushima No. 1 nuclear power plant last week, but the levels do not pose a health risk, plant operator Tokyo Electric Power Co. has announced.

Plutonium-238, 239 and 240 were detected in soil samples taken at five locations inside the plant between the afternoon of March 21 and the morning of March 22 morning, TEPCO said Monday night.

"This is quite serious since it indicates fuel rods have melted to some degree," Chief Cabinet Secretary Yukio Edano said at a Tuesday morning press conference. Edano stressed the need to increase monitoring in the surrounding area.

Plutonium has been detected before after atmospheric nuclear weapons tests, but TEPCO said the plutonium measured this time was likely from the crippled reactors, judging from its characteristics. Only small amounts of substances used as nuclear fuel exist in nature.

The Japan Atomic Energy Agency conducted the analysis of the soil samples from March 23. It usually takes about a week to complete plutonium-detecting tests.

Levels of plutonium-238--a radioactive nuclide generated in nuclear reactors--in samples from a multipurpose field and a solid waste warehouse were 0.54 becquerels and 0.18 becquerels per kilogram of soil, respectively. The former amount is about 3.6 times the level normally detected domestically.

TEPCO Vice President Sakae Muto said in a press conference in Tokyo that plutonium-238 detected came from the recent crisis at the plant. Plutonium-238 made up a higher percentage of the samples than the other isotopes.

The plant's No. 3 reactor uses MOX fuel, a mix of uranium and plutonium. However, since plutonium is generated even when only regular uranium fuel is used, it is unknown which reactor was the source of the plutonium that was detected, Muto said.

Other radioactive substances that have been detected in and around the Fukushima No. 1 plant, such as iodine-131, are believed to have been generated in the reactors. TEPCO officials suspect plutonium was released together with these substances.

"I think the plutonium came from damaged nuclear fuel rods in the reactors, and escaped when water leaked out," said nuclear chemist Michiaki Furukawa, professor emeritus at Nagoya University.

"But it won't affect humans seriously since the amounts detected were very small. Also, since plutonium doesn't vaporize easily, it can't be carried far away by the wind," He said. "It's dangerous when it gets into the lungs but it hasn't been dispersed outside the plant."

TEPCO said it would continue taking soil samples to check for radioactive substances.

Plutonium is produced when uranium atoms are exposed to neutrons. It can be used as nuclear fuel similar to uranium. Plutonium's weight changes depending on the number of neutrons it has. There are several isotopes, including plutonium-238 and 239.

Plutonium, an alpha-ray emitter, has a very weak penetrating force. The risk of external exposure is therefore low. If plutonium is eaten, it is easily excreted, but if it is inhaled, it stays in the lungs and can cause cancer.

(Mar. 30, 2011)

30/03 Survivors fete miraculous return to life / Stories emerge of heroism, luck, quick thinking amid tsunami's furious onslaught

The Yomiuri Shimbun

Some people's miraculous return to life from the brink of death in the March 11 earthquake-tsunami disaster was a result of their desperate desire to emerge alive, combined with layers of lucky coincidence.

One person survived by holding onto wooden pillars as if surfing on the surging tide, while another managed to breathe in the narrow space between a building ceiling and rising floodwaters. All their narratives attest to the tsunami's real horror.

===

Car floats to 2nd-floor height

Yuko Ono, 39, of Yamadamachi, Iwate Prefecture, was driving a minivan when the tsunami hit the town. Her quick decision to drive her car into a narrow path saved the lives of three people.

Ono was on the way home with her son, Kento, 8, and his classmate sitting on the backseat, when she witnessed a tsunami breaking down the several-meter-high waterfront dike and heading toward them.

"I thought we'd be washed away," Ono recalled.

She put the car into reverse gear and entered a narrow path just wide enough for her car.

Water surged into the U-shaped area, which was enclosed by houses. Within seconds, the van floated to a height equivalent to the second floor of the adjacent buildings, just like an elevator.

The van was pushed up quickly and roughly, but walls of the surrounding houses prevented her car from tipping over.

Ono's van drifted on the water like a boat for about 500 meters, getting stuck on a tree that stopped it from being washed away.

When the water receded, the vehicle "landed on" the debris without losing its balance. Many cars were washed away, lying around her van.

Ono and the two children smashed the car windows to escape, and dashed uphill. "We survived because of the surrounding walls," Ono said. "The wave hit the van not from the side but the front, and we didn't move. These factors might've kept my van from overturning.

"When I almost gave up [on our lives], my son cheerfully said, 'We'll survive.' That helped me gain some hope," Ono said.

===

Surfing on the flood

Fifty-six-year-old firefighter Junnosuke Oikawa and five or six of his colleagues were swallowed up by the tsunami floodwaters quickly roiling up to the ceiling of the second floor of their workplace in Minami-Sanrikucho, Miyagi Prefecture.

"I thought to myself, 'I can't make my wife a widow; I have to survive for my family,'" said Oikawa, recalling when the water nearly engulfed him.

He said the tsunami came at about 30 kph and pushed him about 500 meters. Then the backwash dragged him toward the sea for about two kilometers.

Oikawa heard roaring and rattling sounds, and saw cars and gas cylinders in the water. He grabbed a nearby pillar to raise himself up to get a breath of air.

Then the next wave hit him. Oikawa reacted by swiftly holding wooden posts in both hands and pulling them together to his chest, managing to ride out the wave in a way akin to surfing.

In his childhood, Oikawa said, he used to tie a plank to his waist to ride the waves for fun at the nearby beach.

"It was popular [among kids growing up] in a seaside town. If I hadn't known to do that, I would've been swallowed up by the water," Oikawa said.

He was rendered unconscious a bit, but was rescued in the town's Togura district, about five kilometers south from where the tsunami first hit him. "Tsunamis are a killer. I thought I died many times," Oikawa said.

===

Stuck between ceiling, water

When the massive earthquake struck the Unosumai district in Kamaishi, Iwate Prefecture, Norikichi Ichikawa, 41, and his mother were evacuating to the district's disaster management center, where 54 people died in the ensuing tsunami.

Water broke the windows and entered the building, soon roiling up to the ceiling. Ichikawa's body floated on the surface, with his left side touching the ceiling.

He almost was squashed by the rising water, but held his mother's hand tight.

"I couldn't breathe. I thought I'd die. But I thought I had to save my mother's life at the very least," Ichikawa recalled.

He gradually fell unconscious and thought, "This might be it." In the next breath, water receded to create a slight gap between the ceiling and water surface. He rose up to breathe as much as possible.

The water kept receding, but his mother died, and many bodies were lying around him.

Furniture blocked the center's entrance. For two nights until being rescued, Ichikawa and 25 other survivors remained in the building. Ichikawa said he swallowed too much muddy water and passed black urine for three or four days.

"I will live the rest of my life thinking of my mother, whose life was extinguished without mercy," Ichikawa said.

===

Using sunlight as a beacon

Fisherman Yoshinori Yamazaki, 62, was in Miyako, Iwate Prefecture when the tsunami struck, and was violently tossed about in the water. While submerged, he tried to calm down and opened his eyes looking for the sunlight, to indicate the direction of the water surface to try to reach for air.

Yamazaki struggled to break the surface but soon was dragged away by the water. He kept searching for the sunlight.

When the tsunami surged toward him, Yamazaki hopped on the bed of a light truck and held the vehicle's rollover bar. He and the truck immediately were swallowed by torrents of water, and the high-pressure flow pulled his hands away from the post.

The water current apparently was forming whirlpools, and it quickly and forcefully dragged Yamazaki down as he tried to emerge on the surface. He kept looking for the sunlight that would indicate the surface direction. "I remember I tried doing that three times," Yamazaki said.

But he then fell unconscious when his feet touched the ground as the water receded. He was rescued by local residents.

===

Wheelchair sits on table

On the first floor of Riverside Shunpo nursing home for the elderly in Kesennuma, Miyagi Prefecture, Norie Kanno, 86, was singing karaoke at an event at the facility when the tsunami hit the building.

Kanno, who was wheelchair-bound, and the others evacuated to the kitchen. In less than five minutes, the kitchen was filled with water, which rose higher than Kanno's head. "I thought I should focus on not swallowing water," said Kanno, who covered her mouth with a scarf and closed her eyes in the water.

Kanno nearly fell unconscious from a lack of oxygen. A few minutes later, another big wave hit the kitchen, making her body float. The next thing she knew, she and her wheelchair sat on the one-meter-tall table, on which she used to dine with her housemates. "I survived. It's a miracle," Kanno said.

With the help of nursing home staff, she evacuated to the building's rooftop.

Waiting for rescue, Kanno saw houses being pushed out to sea, driving her to tears.

About 50 people died at the nursing home.

Like Kanno, two other elderly people in wheelchairs survived by floating onto the table merely by chance. "I'd like to live a healthy life for my friends," Kanno said.

(Reported by Hiroshi Uesugi, Masanori Yamashita, Hironori Kanashima, Yosuke Honbu and Kenichiro Tashiro)

(Mar. 30, 2011)