The Ishikawa prefectural government confirmed that 15 people who survived the Noto Peninsula earthquake died in shelters or sleeping overnight in vehicles.

But the number of such “disaster-related deaths” may only be “the tip of the iceberg,” one expert says.

According to the prefectural government, the overall death toll in the Jan. 1 Noto Peninsula earthquake as of March 15 was 241, including 15 disaster-related deaths--six each in Suzu and Noto, and three in Wajima.

These and other quake-hit municipal governments have received applications and consultation requests about support for disaster-related deaths from bereaved families, indicating the toll is larger.

UNFAMILIAR ENVRONMENT CAUSES STRESS

The Jan. 1 earthquake damaged the home of Shinobu Ikebata, 47, a resident of Wajima, forcing seven family members to stay overnight in a car. They worried that an aftershock could collapse the home, and they were also concerned about contracting infectious diseases in a crowded evacuation center.

The following morning, Ikebata’s mother, Yukiko, 76, said, “My chest hurts.”

Since ambulances and other emergency vehicles could not arrive quickly, Ikebata took her to the hospital by car.

On a sofa in the waiting room, Ikebata kept calling out to her while rubbing her back.

Yukiko, who was sociable and well-liked by her neighbors, had high blood pressure. Her condition worsened, and she soon died of an aortic dissection.

Ikebata said, “I think the unfamiliar environment of staying in the car in the cold was too stressful for her.”

TEMPERATURE SHOCK

On the night of Jan. 9, Reiko Yachida, 64, was sleeping at an evacuation center in Suzu when she was suddenly awakened by another evacuee.

When she went to the entrance, she saw a man lying on the floor and receiving heart massage. It was husband, Hiroyuki, 65.

According to other evacuees, Hiroyuki was warming himself by the stove in the entrance hall that night and was the last one to leave the area. He turned off the stove before going to a temporary toilet outside the shelter.

He is believed to have suffered a myocardial infarction due to the shock from moving from the warmth of the room to the frigid cold outdoors.

About 30 minutes later, another evacuee found Hiroyuki lying outside. He was taken to a hospital, but he did not survive.

“I can’t believe that a life spared in the earthquake could be lost so easily,” Reiko said.

HARSH CONDITIONS

In general, municipal governments determine causal relationships between deaths and disasters and certify each case based on the disaster condolence payment system.

Wajima city said 26 bereaved families had applied for condolence money as of March 15.

In Noto, only one person has applied, but about 20 bereaved families have inquired about the payments.

Yoshihiro Okumura, 43, a professor at Kansai University who is an expert on disaster-related deaths, said the current figure of 15 in the Noto Peninsula earthquake is “just the tip of the iceberg.”

“It is possible that many more deaths have already occurred,” Okumura said, citing comparisons with the 2016 Kumamoto Earthquakes.

Two months after the series of quakes rattled the prefecture on Kyushu island, the Kumamoto prefectural government said 20 disaster-related deaths had occurred. The figure has now risen to 218.

Kumamoto Prefecture estimates that 177 of the disaster-related deaths, or 80 percent of the total, occurred within three months of the quakes.

Okumura said a combination of factors increases the risk of disaster-related deaths on the Noto Peninsula.

One factor is the lack of volunteers who can provide livelihood support, he said.

More than 9,000 people are still living in evacuation in Ishikawa Prefecture, but accessibility is poor on the peninsula, limiting the activities of volunteers.

In addition, water remains cut off to more than 13,000 households in five cities and towns, including Wajima.

The physically and mentally demanding environment for quake victims continues. And this situation is increasingly dangerous for people aged 65 or older, who make up more than half of the population in cities such as Suzu.

In the Kumamoto quakes, about 80 percent of the disaster-related deaths, or 169, were people in their 70s or older.

Many disaster victims in Ishikawa Prefecture have moved from evacuation centers and into temporary housing or returned to their homes.

But authorities should remain vigilant to prevent disaster-related deaths, Okumura said.

It is important to pay attention to the elderly, who have difficulty adjusting to changes, as well as those who have returned home, he said.

Monitoring should also be conducted for people forced to stay far from their hometowns, such as at their relatives’ homes or secondary evacuation centers, including inns and hotels, Okumura said.

(This article was written by Tetsuaki Otaki, Kantaro Katashima and Daishiro Inagaki.)