With the help of her son, 84-year-old Sai Ito survived the March 11 earthquake and tsunami that swamped their hometown of Otsuchi, Iwate Prefecture.
With the help of her son, 84-year-old Sai Ito survived the March 11 earthquake and tsunami that swamped their hometown of Otsuchi, Iwate Prefecture.
Amid the frigid temperature, the son, Akira, 60, and neighbors carried the elderly woman up a mountain, where she was air-lifted by helicopter the following afternoon to a nursing home.
Fully conscious but cold, Sai received intravenous drips and doses of insulin for her diabetes, but she had to go without the medication she used to take three times a day.
Sai kept eating and responding to her son even after she became unable to move. But she died 20 days after the disaster struck.
Her doctor listed the cause of death as disease.
Sai's case is one of the growing number of "invisible" deaths among evacuees who have died after developing illnesses or seeing their pre-existing conditions worsen following the quake.
But since they are not officially listed as disaster-related deaths, their surviving family members are ineligible for condolence money from the government.
As of April 18, only four evacuee deaths were certified as disaster-related in the stricken Tohoku region--three in Miyagi Prefecture and one in Fukushima Prefecture. They included one death in an aftershock.
Municipal officials are so preoccupied with searching for missing people and addressing problems at makeshift evacuation shelters that they have not had time to study whether deaths are disaster-related.
There are no uniform nationwide criteria for certifying disaster-related deaths. Local government officials who certify such deaths generally study the causal relationship between the death and the disaster and base their decisions on medical examination reports from doctors.
Akira, a fisherman, refuses to accept that his mother's death was caused by disease.
"She would not have died if there had been no tsunami," he said.
Currently, officials only certify deaths as disaster-related if the person was directly killed by the tsunami or a collapse of a building.
If the death of a breadwinner is certified as disaster-related, the bereaved family is entitled to 5 million yen ($60,262) in condolence money.
For the disaster-related deaths of others, 2.5 million yen is provided to the family.
Of 6,402 people in Hyogo Prefecture who died after the 1995 Great Hanshin Earthquake, 919, including those who committed suicide, were certified as disaster-related. Some of the deaths were certified several months after the temblor.
Officials warn that unless living and sanitation conditions soon improve in the often-unheated shelters in northeastern Japan, the number of invisible deaths could surpass the comparable figure for the 1995 disaster.
According to the National Police Agency, 137,696 people were staying in makeshift evacuation shelters as of April 18.
Construction of temporary housing has been significantly delayed, compared with the work done in the aftermath of the 1995 earthquake.
At an emergency shelter set up in a gymnasium of a junior high school in Kesennuma, Miyagi Prefecture, 10 evacuees in their 80s or older have died.
A hospital in Iwate Prefecture reported the deaths of 13 senior citizens after the tsunami inundated the building and cut off electricity. Some of the patients died of pneumonia.
Fifteen residents of a nursing home in Rikuzentakata, Iwate Prefecture, died at an evacuation shelter.
In Fukushima Prefecture, 18 people, many of them elderly, died during their travel to or after they arrived in shelters. They had been following the evacuation order for residents within a 20-kilometer radius of the crippled Fukushima No. 1 nuclear power plant.
As of April 19, the official death toll from the quake, tsunami and aftershocks was a postwar record 13,949, with 13,678 still missing.