Newest Quake Victim: Japan's Mental Health

KOBE, Japan -- In the crammed and chilly relief centers around this devastated city, cracks are beginning to show in the remarkable stoicism and endurance of the Japanese people.

Many of them, coughing and sniffling with cold or flu, which have begun to sweep through the centers, bitterly complain about official inaction and their own grim living conditions.

"We can't take a bath, the food is unsatisfactory, and there's no privacy," complained Yoshiaki Saito, 45, an evacuee stuffed into a small classroom with his family of five at the Uozaki Elementary School. "If this keeps up ... there is going to be an explosion."

As the aftermath of Japan's worst earthquake disaster in more than 70 years entered its second week, officials have managed to get through the initial trauma of mass death and injury, widespread shortages of medical staff and supplies and hospitals disabled by the quake damage.

But more ominous in the long term are the mounting mental health problems. Victims are beginning to show anger, depression and other signs of mental trauma common to disaster victims around the world.

After a week of unrelenting stress, Takashi Nakanishi, the official faced with the monstrous problem of restoring Kobe's water-supply system shattered by the earthquake, decided to end it.

He jumped from the fourth-floor window of his office building in an apparent suicide.

Compared with other countries, Japan is uniquely unprepared to deal with such problems, experts here say.

"In Japan, there is hardly any psychiatric training aimed at disaster victims," said Masaaki Noda, a psychiatrist at Kyoto Creative Arts College who worked with victims in calamities including the Hokkaido earthquake last year.

A report to the World Health Organization this week on the Kobe disaster identified only four people in Japan with the skills for trauma counseling -- all of them foreigners, said David Tharp, a mental-health consultant and medical journalist who has lived in Japan for 15 years and worked with Vietnam veterans and trauma victims.

Tharp said the importance the Japanese ascribe to social homogeneity has helped stunt the development of counseling services.

"It is an embarrassment or shame not to be perfect like everyone else," he said.