Japanese Red Cross psychosocial workers have provided counselling support to more than 6,000 people in the Iwate, Miyagi and Fukushima prefectures since the March 11 earthquake and tsunami.

The head of the psychosocial program at Japanese Red Cross national headquarters in Tokyo, nurse Tomoko Higashi, said the impact of the disaster was affecting different people in different ways.

"The people in the north east in the Iwate and Miyagi prefectures lost loved ones, homes, their jobs," Ms Higashi said. "They are dealing with issues such as grief and loss, sadness, depression."

"The homes in the Fukushima prefecture were not as badly affected by the earthquake and tsunami. The people from that area are in evacuation centres because of the radiation from the Fukushima Daiichi nuclear power plant. They are angry. They don’t know when or if they will be able to return to their homes."

Ms Higashi said elderly people and children particularly were at risk.

"The risk for elderly people is not only psychological but also physical," she said.

"These areas had a high proportion of elderly people and many of them are now in evacuation centres. Their physical ability, their mobility, has dropped down quite a bit because they are not walking around as much. Some are starting to become immobile."

"In a number of cases, their physical ability has dropped down very dramatically. It is going to take a very big rehabilitation program to get them walking again. Once they are walking again their mental health will also improve."

"We tell parents that their children may go back to behaving like a baby and that this is a normal reaction for children after an emergency or disaster and that they (parents) should accept this behaviour."

Ms Higashi said it was vital, where possible, to keep communities intact.

"The lesson we’ve learned from previous disasters and the Kobe earthquake is that it is very important to maintain communities, to evacuate people together, to try and keep them together in the same evacuation centre or temporary housing village, and it’s important for these evacuation places to have a communal space where people can come together."

Looking ahead to recovery, Ms Higashi said: "Compared with last month, I can start to see that recovery is starting to happen, that many more prefabricated houses are being built and people are moving out of evacuation centres."

"But in relation to the emotions, the sorrow and sadness, this will never ever completely disappear. It is 16 years since the Kobe earthquake. But still on the anniversary of that disaster many people still cry, some collapse in tears. There is a lot of sadness still there. Over time, the sadness can and does lighten, the burden eases, but it never completely disappears."

Photo : Japanese Red Cross nurse Tomoko Higashi … "the disaster is affecting different people in different ways."