Supporting Disaster Victims
This chapter opens by discussing what effects disaster victims suffer from in their lifestyles and psychology. Then it will summarize what support systems are available in supporting victims that suffered large damages in terms of legal systems, public support, and psychological caretaking. The chapter closes with discussions on life and psychological effects of those that suddenly 1 day turned into crime victims and various supports for them.
KeywordsDisaster relief Disaster victims Legal system Psychological recovery PTSD Reconstructing livelihood Victim support
17.1 Suffering Damages
A large number of lives have been lost with natural disasters in Japan. This section reviews problems about disaster victims.
17.1.1 Effects on Disaster Victims
When we are faced with natural disasters, the most important thing is to protect our own lives. We tend to apply the word “disaster victims” to mean those that suffered from a disaster but managed to survive it; however, we must not forget the many victims that lost their lives for the event. We would like to reconfirm that saving lives has the highest priority at the time of disaster.
Victims that survived a disaster, however, have a number of hardships waiting for them. Under the situation of being unsure of what effects the strong blast caused to their bodies, the lifelines stop immediately after the disaster, and they have to face a number of hardships under the lack of supplies and information. Kimura (2007) defined four phases of post-disaster situations that the victims have to go through.
The first 10 h is the “disorientation” where no one in the disaster-hit area is sure what is happening and not sure what action to take. Systematic disaster response by public organizations like local governments, the fire department, nor the police have not started, and the victims have to survive the disaster on their own. During this time immediately after a disaster, self-sustaining actions are most important. To minimize confusion in our lives and to keep our minds in peace, we shall plan beforehand what situations we will face during the disorientation period and plan preparations to overcome the difficulties.
After several hours are past since the point of disaster outbreak, the victims can grasp what happened to themselves and start mutual support actions like lifesaving, rescue, and safety confirmation activities. This is when the “Acceptance of New Reality,” totally different from ordinary societies, takes shape. With recent disasters, public organizations like self-defense force, police, and fire department start systematic disaster response in stages as early as possible; however, for wide-area disasters, such public responses take time.
Still within days after the breakout of a disaster, building and roads are still destroyed, and lifelines of gas, water, and electricity are still unavailable. In case of wide-area disasters, communication infrastructure takes long time to recover, information supplies are short, and many disaster victims are forced to live in evacuation shelters. People under these circumstances help each other to survive the inconvenient living conditions irrespective of their social status or jobs, and this time is called “disaster utopia.”
When the social infrastructures like lifelines are recovered and the societies gradually regain calmness, people start on the road to “Reentry to Everyday Life.” They have to overcome their griefs and hardships to reconstruct their lives although it may take very long times. Some of the disaster victims, however, find their directions and paths to recovery and reconstruction and quickly rebuild their lives. The power to recover relatively but smoothly from disasters is called “disaster resilience,” and it is catching attention these days. They depend on public support for their recovery and reconstruction. For faster recovery and reconstruction, the societies need enhanced individual resilience as well as resilience of the whole society.
17.1.2 Effects on the Psychology of Disaster Victims
Immediately after being hit by disasters, we sometime encounter effects to the body like, headache, stomach pain, loss of appetite, or worsening of chronic diseases. We may also face mind or psychological effects like anxiety, fear, irritation, or loss of interest. Adults may find effects on their habits like increased alcohol consumption or smoking and, in case of children, maybe degenerative behavior. These are normal reactions for people faced with abnormal conditions and are called “normal stress reactions.” We need to understand that anyone can experience normal stress reactions after receiving some shocks, and they are not behaviors to be alarmed about. Many people with normal stress reactions gradually return to their states before the shocks as time passes by.
Some people, however, if they suffer traumatic events like serious injury that almost took their lives, may continue to suffer from the stress reactions for long times, and their psychological pain may prevent them from returning to their social and occupational activities. These symptoms are called “post-traumatic stress disorder (PTSD ).” Typical symptoms of PTSD are sudden and repeated dreams or flashback of the traumatic event, being not able to have positive sensation of happiness or love, dissociative disorder for no reason, avoidance symptoms of the traumatic event, sleeping disorder, turning hostile, or arousal symptoms like excessive wariness or startle reaction. If the pain makes it difficult to lead regular daily lives, the advice for the victim is to consult with a doctor or counselor.
17.2 Systems for Victim Support
Disaster victims are subject to a number of effects on their lives, and their minds, however, still have to recover their lives before the event. Systems to support disaster victims in their efforts for recovery have gone through improvements throughout the history of disasters. This section summarizes systems for supporting disaster victims in Japan in three categories of law, public systems, and caring for the mind.
17.2.1 Legal Systems to Support Disaster Victims in Japan
When a natural disaster strikes, we lose a number of foundations for our lives and enter a state where our fundamental rights assured by the constitution are damaged. Rearrangement of legal systems, therefore, is on the way to support disaster victims.
Disaster Relief Act (1947) is the oldest of them all set in 1947 after the 1946 Nankai earthquake. Article 1 of the law states that “The purpose of this Law is to protect victims of disaster and maintain social order by causing the central government to provide needed relief services on an emergency basis in cooperation with local government and the Japan Red Cross, other entities, and the people of Japan.” That means for disaster victims with difficulties in maintaining their livings immediately after the breakout of a disaster, the central government provides emergency rescue and protection as necessary. The rescue involves setting evacuation shelters or temporary housing; emergency repair of houses; food preparation and supply of food and drinking water; providing school supplies, clothes, and beddings; medical and maternity services; search for corpses and their disposition; burying; and removal of obstacles like rocks and mud near housings. The Great East Japan earthquake revealed new problems of deemed temporary housing, wide-area evacuees, former residents in the difficult-to-return zone, and welfare evacuation shelters. Systems of rescue and protection responses immediately after a disaster need flexibility in their applications.
The 1995 Great Hanshin Awaji earthquake triggered the setting of Act Concerning Support for Reconstructing Livelihoods of Disaster Victims (1998). After its amendment in 2007, the purpose of act is to support the reconstruction of livelihoods of persons who have suffered substantial damage to the foundations of their livelihoods due to natural disasters, by providing measures to pay them support grants for reconstructing their livelihoods with the use of funds contributed by prefectures from the perspective of mutual support and thereby helping stabilizing livelihoods of residents and promoting the prompt recovery of affected areas. Households whose housing units have been totally destroyed or suffered large damage will receive support grants. The 1973 Act on Provision of Disaster Condolence Grant, set after the 1967 Niigata Uetsu flooding, states that it grants disaster condolence money to family members of the deceased or consolation money for serious disaster injuries. Victims that suffered damage to their housing units or property can receive loan necessary for rebuilding their livings as disaster support fund.
17.2.2 Public Systems to Support Disaster Victims in Japan
There are also a number of public systems to support disaster victims. Loan System for Life Welfare Fund loans necessary expenses for rebuilding livings for low-income households with difficulty in setting loans with banks or households with disabled or care receivers. There is also a system for single-parent households, i.e., single mother widows or single father widowers, welfare fund loans to support their independence, and special measures will be taken for disaster victims to delay their return of loans.
In terms of supporting child education, the kindergarten attendance promotion program reduces the entrance and attendance fee depending on the guardian’s income. There are also systems for free textbooks (school textbooks in Japan are usually purchased at fee) or discount or exempt tuition for children, students, or their guardians in elementary, middle, high school, or special needs schools. Most universities also offer tuition discount, emergency scholarship, or student loans.
In terms of jobs, there are systems for reimbursement of unpaid salary from bankrupt companies, unemployment benefits payment from employment insurance, free job training, and support system for living during training periods. Also, there are special reduction of local tax and national tax, discount or exemption from medical and nursing insurance fee, public fees, facility usage fees, nursing fees, and exemption from NHK reception fee for a certain period.
As we saw above, there are a number of various systems to support disaster victims; however, most people learn about them for the first time after they suffer from disasters, and there are even cases when the information about them do not reach the disaster victims. Sometimes new systems are set after occurrence of disasters. At the time of a disaster, specific and useful information supports the disaster victims, and administrative consulting is needed to quickly deliver such information to disaster victims so they can make use of the systems for rebuilding their lives.
17.2.3 Caring for the Minds in Disaster Victim Support
Disaster victims, immediately after the disaster, suffer normal stress reactions of feeling anxiety, having hard time sleeping, losing appetite, being irritated, and losing motivation to do anything. A way to support disaster victims immediately after the strike is psychological first aid (PFA) (National Child Traumatic Stress Network and National Center for PTSD: NCTSN/NCPTSD 2006). PFA is a method, based on researches so far on trauma recovery, which collected effective caretaking practices in reducing psychological pain for disaster victims with consideration to life stages and cultural factors. Application of PFA first secures safety for the disaster victims, watches them without pushing support services upon them, and provides practical specific supports and information to them.
After supporting the disaster victims with PFA, it is the turn for Skills for Psychological Recovery (SPR) (NCTSN/NCPTSD 2010). SPR is a training to lessen pain for the disaster victims and support them in gaining skills to cope with the number of difficulties they face like post-disaster stress. The purpose is for the disaster victim to gain self-confidence in recovery from the disaster. SPR emphasizes supporting forward moving actions through worksheet exercises to enhance the problem-solving skills.
PFA and SPR are not well shared among the people that actually carry out support activities in disaster-struck areas. PFA and SPR aim at supporting the disaster victims to stand on their own without putting pressure on them or pushing support service on them. Support without imposing it is the key, and we need to spread support activities that follow guidelines of support activities.
17.3 Being a Victim
17.3.1 Effects on Disaster Victims
Systems for supporting natural disaster victims and their psychology are immature; however, with the history of disasters, a number of support practices are shaping up. In comparison, systems for supporting victims of crimes and airplane and railway accidents still have shallow history. Crime victims, 1 day out of the blue, suffer death, injury, or property loss from crimes like manslaughter, violence, sex crime, child abuse, or drunk-driving. Victims of airplane or railway accidents suddenly encounter the accident and suffer death or bodily injury.
Victim Support Center of Tokyo (2007) reported on its study of family members of criminal victims that they are burdened with medical, transportation, and court expenses; lose sufficient time to perform housework, child care, or nursing; enter financial difficulty from retiring or taking leave of absence from work because of the incident; and forced to relocate to avoid curious eyes from the neighbors. Their daily lives suffer great influences from the crime. They also suffer large mental shocks that their family member was a crime victim, and sleeping disorder and loss of appetite persist over a long time. Many are forced to receive medical treatment for the stress symptoms, sufferings that are especially frequent with female family members. Family members of the victim not only have lost their irreplaceable family member, but they have their lifetime plans totally turned over from the bottom. Mental suffering is also extremely significant with their lives facing overall changes, and they are forced down to the bottom of grief and pain. They also often feel anxiety, burden, and pain with questioning from the police and prosecutor, testimonies in court, and discussions with the lawyer. In some cases, interviews from the mass media ignore privacy and sometimes cause confusion. The suffering is not just direct from the crime, but family members are drawn into a number of events to suffer secondary damages. The report pointed out that about 90% of family members of criminal victims answered they suffered secondary damages and that we need to have social understanding for criminal victims and their family members.
17.3.2 Legal Systems for Supporting Criminal Victims in Japan
A legal system for supporting crime victims is the Benefit System for Crime Victims, set after the 1974 bombing of the Mitsubishi Building, Tokyo. The system intends to mitigate the financial damages with benefit payments from the central government to family members and victims who suffered death or serious injury by intended crimes like random attacking and have no hope for receiving any compensation. The system went into effect in 1981 and is said to be the first policy to support criminal victims. This system of mere financial support does not make much effect for a long time, and in the meantime, private activities to place first priority on human rights of the victims turned active. After the 1995 Tokyo subway sarin attack, National Police Agency established Office for Crime Victims in 1996. In 1998, a number of organizations that were active in providing criminal victim support over the nation formed National Network for Victim Support. As criminal victims voiced their call for comprehensive support, the central government, at last, started to take measures for protecting rights and benefits of criminal victims. The measure, Promotion of Policies for Crime Victims, involves recovery or mitigation of damages the crime victims or their family members suffered and support them so they can recover their calm lives. It also calls for the victims and family members’ proper participation into the criminal case processing. In year 2004, when the trial jury system started, Basic Act on Crime Victims was set. In 2008, Victim Participation System was introduced so criminal victims could take part in criminal trials. Further in March of 2011, the Cabinet Office of the Japanese government set basic plans for crime victims, and the legal system to value rights of criminal victims finally shaped up.
17.3.3 Public Systems for Criminal Victim Support in Japan
Promotion of policies for crime victims led to stationing supporting staff and hotlines for criminal victims in public prosecutor’s office over the nation. These measures allow the staff in responding to consultation requests from criminal victims, guiding and escorting them to courts, helping them with procedures for case records review, or having evidence returned, i.e., the support not only covers financial conditions but also psychological aspects and life recovery processes. Victim support centers are designated by Prefectural Public Safety Commissions as private organizations to support criminal victims. Japan Legal Support Center (JLSC) also provides support for criminal victims.
In addition to the above public organizations, criminal victims are starting movements to gather and form networks for mutual support among themselves as self-supporting organizations. More supporting organizations have formed, e.g., Child Guidance Offices for response to child abuse and Spousal Violence Counseling and Support Centers and Counseling Center for Women in response to domestic violence.
The movement is not limited to criminal victims, but programs for supporting traffic accident victims and victims of public transportation accidents like airplanes or railways are taking shapes. All these programs and systems have purposes of providing information or necessary support in active manners so the victims or their family members can gather and take steps toward recovery from their deep grieves or harsh experiences.
17.3.4 Psychological Care for Supporting Victims
Victims of crimes and accidents can experience normal stress disorder. Among those with traumatic experiences, some end up with PTSD with the stress reactions not disappearing even after long times after the events. Sexual crime victims tend to develop PTSD (Kessler et al. 1995).
WHO in 2011, published “Psychological First Aid: Guide for Field Worker.” This guideline explained what caregivers need to know in supporting victims, e.g., to respect the needs and intentions of the victim; to keep the response flexible to meet different needs of individual victims; to provide support to meet victim’s pace, not to insist on support the victim does not want, the importance of giving specific supports to meet the situation and needs of the victim in the early stage; and to make proper intervention if the victim cannot make decisions or is facing dangers that can threaten their lives. Supporters and doctors that were actually involved in victim support based the guideline on their empirical knowledge; however, scientific evidence of what support is effective is still insufficient. Scientific research and more knowledge are crucial for the future of victim support.
- Act Concerning Support for Reconstructing Livelihoods of Disaster Victims. (1998). http://www.japaneselawtranslation.go.jp/law/detail/?printID=&id=3026&re=01&vm=02. Accessed 21 June 2018.
- Cabinet Office of the Japanese Government, Outline of Programs for Victim Support. http://www.bousai.go.jp/taisaku/hisaisyagyousei/pdf/kakusyuseido_tsuujou.pdf. Accessed 30 June 2017.Google Scholar
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- NCTSN/NCPTSD. (2010). Skills for psychological recovery field operations guide. https://www.ptsd.va.gov/professional/manuals/manual-pdf/SPR_Manual.pdf. Accessed 21 June 2018.
- Victim Support Center of Tokyo. (2007). Kongo no Higaisha-shien wo kangaerutame no Chousa-houkokusho [2006 Investigation and Research in Victim Support Program, Report for Planning Victim Support in the Future – From results of questionnaire to family members of criminal victims] (in Japanese). http://www.shien.or.jp/report/pdf/shien_result20070719_full.pdf. Accessed 30 June 2017.
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