On a recent rainy morning, three people sit chatting in the Wanokko House Support Center for disaster victims in Japan’s Otsuchi, Iwate Prefecture. There was Nisaburo Sasaki, a karaoke-loving, costume-jewelry-wearing retired steel worker; Shigeru Kanahama, a bonsai enthusiast; and staff member Akiko Sasaki, a middle-aged nurse.

The group likely wouldn’t have gathered before the tsunami swept away their town in March 2011. But now the two men, who live in temporary housing units nearby, meet at the center most days.

Over 300,000 people were temporarily or permanently displaced last spring after a magnitude 9.0 earthquake and tsunami struck the island nation. Japan’s elderly population was hard hit, and remains one of the most vulnerable groups among disaster victims. With limited mobility and shrinking support networks, many elderly Japanese find themselves isolated and alone seven months after the tsunami devastated their communities.

Equipped with exercise machines, baths, kitchens, and friendly staff, support centers like the one in Iwate Prefecture are part of plans by government agencies and aid organizations to stave off isolation and depression among the elderly.

“I don’t have any friends here, except this guy,” says Mr. Kanahama, giving his quiet companion a pat on the back.

In order to move disaster victims out of cramped communal shelters several months after the tsunami, municipal governments assigned temporary housing through a lottery system. Victims were moved and spread out across each municipality, losing ties to their neighborhoods along the way. A shortage of centrally-located flat land on which to build temporary housing units after the tsunami meant many elderly survivors not only found themselves living far from friends, but also from amenities like shops, clinics, and town halls.

“The older generation has been through a lot,” says Ruth Campbell, a visiting scholar at Tokyo University’s Institute of Gerontology. This includes war, poverty, and previous tsunamis. “A lot of them are very strong and resilient, but for some, the more losses they sustain, the more difficult it is for them to keep their wellbeing,” says Ms. Campbell, a retired geriatric social worker.

Community ties

For Nisaburo Sasaki, the support center is one of his few remaining ties to society. A widower of seven years, he lost one son in the tsunami and doesn’t see his other two children often. His former neighborhood friends are scattered across town. The nurse, Akiko Sasaki says he likes to drink. She’s found him passed out alone in his room on several occasions.

“I’m keeping an eye on him. I think he’d be at risk if it weren’t for this place,” she says.

It’s too early to assess how widespread the problems of depression and social isolation are, says John Campbell, also a researcher at the Institute of Gerontology. Prefectural officials haven’t compiled statistics on how many elderly are living alone in temporary housing or in their own partially damaged homes.

The government-funded Wano Support Center is one of about 12 support centers opened on temporary housing sites in Iwate, Miyagi, and Fukushima – ­the three prefectures hit hardest by the disaster – so far. But with 63 planned support centers still not completed by late September, many survivors over the age of 65 don’t have anywhere similar to go.

“This is the countryside and people tend to help each other out, but their communities have been destroyed,” says Takashi Yamamoto, director of the Peace Boat Volunteer Center in Ishinomaki city, located in Miyagi Prefecture.

Communities in small villages are less likely to receive public services such as support centers, he says. Peace Boat is one of the most active NGOs in Ishinomaki and recently began publishing a free paper to help build community ties among temporary housing residents.

Government officials and NGOs are well aware of the risks that isolation entails. Following a magnitude 6.8 earthquake in Kobe in 1995, a number of elderly survivors died alone in temporary housing units. Public, private, and nonprofit organizations say they are determined not to let that happen again.

What Japan is doing for it's older population

Japan has a universal long-term healthcare system, which means that even in remote areas elderly disaster victims are eligible for affordable day-care and health services. Some may even have more family support than before the tsunami because younger relatives are out of work and available to stay at home all day. But as months go by, many young people are forced to leave devastated coastal towns for economic reasons.

In September, a 65-year-old man committed suicide in a temporary housing unit in Ishinomaki, Miyagi, stoking fears that support projects may not be moving fast enough or reaching the residents of the nearly 50,000 temporary houses built so far. The man, who lived alone, was not found until relatives came for a visit about a week after he died, police said. Japan has the highest suicide rate in the world.

To reach those who can’t or don’t actively seek out support, the Japan National Council of Social Welfare is launching a 600-million-yen ($7.8 million) government-funded project. Support staff will go door to door at every temporary housing unit in the disaster area, and follow up with services, says Atsuo Shibuya, the organization’s policy planning director.

Ruth Campbell, who studied what happened to elderly in temporary housing after the Kobe earthquake, agrees that long-term programs are needed.

“In the beginning [in Kobe] there were lots of volunteers. The real risk came about a year later. People had so little contact with relatives. It had to do with family relationships breaking down,” she says.

Since then, awareness of the emotional needs of the elderly has grown greatly in Japan, she says. But to help prevent the same thing from happening in Tohoku, both public and private groups will need to stay focused on the issue for years to come.