Thirteen years have passed since the Great East Japan Earthquake devastated the northeastern region of Tohoku.

Even after the catastrophe, which resulted in more than 18,000 direct deaths and missing persons, massive natural disasters have continued pummeling the nation.

This year has been no exception. The Noto Peninsula earthquake occurred on New Year's Day, claiming precious lives.

From disaster preparedness to immediate response after a disaster strikes and to support for evacuees, numerous disaster-related challenges remain to be tackled. It is vital for the nation to continue the efforts to steadily resolve these challenges.

There are some encouraging examples of initiatives originating from disaster-affected communities that are gradually spreading. The city of Sendai in Miyagi Prefecture, where many local communities were ravaged by the towering tsunami triggered by the massive earthquake in 2011, has launched a program called "disaster case management."

In this program, public and private sector organizations eliminate vertical divisions to work together more effectively to provide increased individualized support to survivors tailored to their personal needs and concerns. The government's support measures for affected areas in the Noto Peninsula also highlighted promoting this approach.

Currently, it is notable that the disaster-stricken areas of Noto are suffering from severe shortages of medical and welfare services. On the other hand, however, it is heartening to see many vigorous private-sector activities to support the areas.

One major challenge confronting efforts to provide aid to disaster survivors in a way that leaves no one behind is mapping out an overarching plan for securing collaboration that transcends the boundaries between normal and emergency times and between the public and private sectors.

DISASTER AID TEAMS PLAY VITAL ROLES

On the second floor of the main building of the Wajima municipal government in Ishikawa Prefecture is the office of the local government’s “health, medical, and welfare coordination headquarters.” It is the base of operations for disaster aid teams from all over the country.

The disaster aid and relief units operating from the base include a Japanese Red Cross Society team, JMAT dispatched by the Japan Medical Association, DWAT, a group of nursing care experts, and DHEAT, which works to prevent health problems and deaths among disaster survivors and evacuees.

When I visited the headquarters at the end of last month, nearly two months after the disaster, aid and relief workers wearing patches and bibs showing various team acronyms were busily going in and out of the office.

AT stands for assistance team. The acronyms are made by combining AT with the other alphabets representing Japan (J), medical (M), disaster (D), welfare (W), or health (HE). They are dispatched in teams of about four from each field of expertise, collaborating with local staff to visit evacuation centers, welfare facilities and more.

DMAT (Disaster Medical Assistance Team), institutionalized in 2005, has been supporting the headquarters since immediately after the Jan. 1 quake disaster. Not limited to supporting medical institutions, DMATs have also handled tasks such as transferring hospitalized patients and residents from isolated settlements, with as many as 30 teams operating on busy days.

Overall coordination of their activities was also managed by six doctors from a Fukushima Prefecture DMAT in rotation.

Mitsuru Waragai, 45, a surgeon at Southern Tohoku General Hospital in the city of Koriyama, Fukushima Prefecture, was one of them.

Thirteen years ago, he was inundated with work dealing with evacuees from the nuclear disaster at the hospital. After undergoing a special training program, Waragai joined DMAT.

Since then, he has visited disaster areas almost every year. He was still working for the headquarters even after activities of DMATs from outside Ishikawa Prefecture ended.

Immediately after the calamity that struck the Tohoku region on March 11, 2011, a total of 383 DMAT teams deployed from outside the affected prefectures worked for about 10 days.

In the case of Ishikawa Prefecture, the number reached 1,139 teams over about 50 days following the earthquake, with activities extending to welfare fields such as assistance in elderly facilities.

The main factor behind the expanded DMAT activities this time is the dire straits of the regional medical and welfare systems, which had been suffering from a severe manpower shortage.

In the aftermath of the disaster, many nurses and welfare workers who were also victims have resigned. One tough challenge for the region is how to build a system to provide sufficient health care and welfare services after the operations of aid and relief teams end.

Another is how to reconsider the way support teams should engage in depopulating and aging communities. These are vital and formidable questions for all municipalities and the national government.

LEVERAGING THE PRIVATE SECTOR

The Noto Reconstruction Network (NRN) has been engaged in a wide variety of aid and relief activities from the day after the disaster. 

The NRN is a group of nonprofits and businesses that have been working to revitalize the Noto region based in the city of Nanao, the gateway to the Okunoto region in northern areas of the peninsula jutting out into the Sea of Japan.

The NRN is led by Nami Moriyama, president of Misogi-Gawa, a company created to invigorate local communities.

NRN has been working to link companies wanting to supply goods such as water, portable toilets and beds to evacuation centers that need them, provide freshly cooked rice in collaboration with local catering companies and junior chambers and conduct interviews with people at evacuation centers in support for the municipal governments.

People who engaged in aid and relief activities in the areas hit by the Great East Japan Earthquake support NRN.

The Tokyo-based nonprofit called ETIC has been cooperating with NRN by dispatching support staff based on its experience in corporate management and entrepreneurship support in the Tohoku region.

The strength of the private sector lies in its speed and deployment capacity, which is not found in the government. Similar initiatives are under way in many parts of the nation.

After the Great East Japan Earthquake, the newly established Reconstruction Agency has been working to connect the people's power to the disaster-affected areas.

It's time to leverage and upgrade the pools of experience and expertise that have been accumulated through these activities.

LEGISLATIVE INITIATIVES CRUCIAL

Disaster-affected areas require long-term support, from protecting lives and health, to recovery, and further to reconstruction.

At the same time, in the face of the possibility of another major disaster that could occur anytime, anywhere, it is essential to review and rethink the nation’s disaster response system fundamentally.

The Disaster Relief Law, created immediately after the end of World War II, puts the primary responsibility for post-disaster rescue and support on local governments.

However, in normal times, the main actors in welfare, food provision and logistics are private-sector entities. There is a compelling case for using the private sector's resources and capabilities more extensively for disaster response and relief.

Prompted by this imperative, a group was established four years ago by university and NPO personnel to propose a future disaster recovery system based on the March 11 experience. It advocates for legal amendments from this point of view.

The group calls for adding welfare services to the areas covered by the Disaster Relief Law.

The Disaster Countermeasure Basic Law has a provision to promote coordination and cooperation among the central and local governments and public organizations. The group proposes to add private-sector bodies to this framework to enhance their cooperative relationships before disasters strike.

The group’s principal mission is to build a society where individual dignity is protected and human rights are respected even in emergencies.

Current policy measures for supporting disaster victims and survivors are far from realizing this goal.

Disasters expose the vulnerabilities and the weaknesses of society.

It's the role of the national government and the Diet to back up efforts made by people working on the front lines of disaster aid and relief with legislative and budgetary measures, instead of just relying on their efforts.

--The Asahi Shimbun, March 11