Japan one year on

The Fukushima Psychiatrist: 'It's Amazing How Traumatized They Are'

Since the Fukushima catastrophe almost one year ago, Jun Shigemura has been providing psychological care to workers from the stricken nuclear facility. In an interview with SPIEGEL ONLINE, he tells of the immense challenges facing TEPCO employees -- and why most of them have elected not to quit their jobs.

der Spiegel,

28 February, 2012

SPIEGEL ONLINE: Since May, you have been providing psychological assistance to workers in the stricken Fukushima nuclear power plant. How did you end up with such a job?

Shigemura: Actually it is a bit sad that I am in charge of the workers' mental health. But TEPCO had lots to take care of and didn't have enough capacity to provide mental health services. Before the quake, a part-time psychiatrist looked after the workers in Daiichi and Daini. But he is from Minamisoma and it takes him too long to get to work now because of the exclusion zone. A few nurses in the health center for the two plants read my publications and contacted me. Then TEPCO sent for me. I am there as a volunteer.

SPIEGEL ONLINE: You don't get paid for your work?

Shigemura: Not by TEPCO, but I wouldn't want that. It would hurt my position. I don't want to be involved in the profit-making nuclear industry, even more so because workers' wages have been cut by 20 percent. That's why I made a government project out of this. TEPCO has yet to find a psychiatrist who wants to take over the job. Most of them are probably worried about radiation and their image. Furthermore there are not enough psychiatrists in Japan. After the Kobe earthquake in 1995, more people began to understand how important psychological assistance is. But many still think that those who go to a psychiatrist must be crazy. I hope that things will improve further after this catastrophe.

SPIEGEL ONLINE: Aren't you worried about radioactivity yourself?

Shigemura: I am not afraid, but that doesn't mean I am not anxious. I haven't been in Fukushima Daiichi facility. The health center is at the Daini plant, about 10 kilometers away. Radioactivity levels are low there, but my wife isn't very happy about my new job. In the beginning she said: "Me or the nuclear plant." I have made several trips since then, so I hope my wife has accepted it to some extent.

SPIEGEL ONLINE: What have the workers gone through since the accident?

Shigemura: They thought that they would die when the reactors exploded in May. But they still had to continue their work, to save their country. Many come from the area around the plant, the tsunami washed away their homes, their families had to evacuate. The workers have lost their homes, their loved ones are far away and the public blames them, because they work for TEPCO. Many think that TEPCO is responsible for the catastrophe. The workers weren't seen as heroes as they were in Europe. One time, somebody donated fresh vegetables for the workers, because TEPCO at that point wasn't able to provide fresh food inside the evacuation zone. But the donation was made anonymously, because those who gave it didn't want to be caught helping TEPCO workers.

SPIEGEL ONLINE: How are the workers today?

Shigemura: It is amazing how traumatized they are. Two to three months after the quake, I carried out a survey among 1,800 TEPCO workers in Daiichi and Daini. When a catastrophe like the tsunami hits a community, about 1 to 5 percent of the general population suffers long-term traumatization. Among police, fire-fighters and other disaster workers, it is about 10 to 20 percent. Among TEPCO workers the percentage is much higher.

SPIEGEL ONLINE: What consequences does such a level of traumatization have?

Shigemura: I am currently treating a man in his early forties. He had a house on the coast close to Daiichi that was destroyed by the tsunami. That's when he lost his 7-year-old son. The man had to flee and he tried to rent an apartment somewhere else. But the landlord rejected him because he works for TEPCO. When he finally found a flat the neighbors posted a paper on his door: TEPCO workers get out. Because the man received quite a high dose of radiation, he had to change to another department. Now he's got a desk job that he doesn't enjoy and isn't trained for. He is afraid that he might get ill with cancer, he is in financial difficulties because his salary was cut and he lost his house. He also has problems with his family. His mother lost her husband to the tsunami and she feels guilty, because she couldn't save him and her grandson. She cries a lot. When my patient gets home after work, he doesn't feel comfortable there either.

SPIEGEL ONLINE: Why don't these people simply quit their jobs with TEPCO?

Shigemura: There are many reasons for this. Those I have spoken to are loyal to their company and want to save it. Others do it for money. About 3,000 workers go to Daiichi every day. The complicated jobs are done by employees of TEPCO and other firms like Hitachi and Mitsubishi. The simple jobs are done by people hired by sub-subcontractors. My team of seven psychiatrists prioritizes workers with higher levels of responsibility, which alone amounts to more than 1,000 people. Within that group, we treat special risk cases, meaning people who have lost their colleagues, their families or who are in financial difficulties. Of course I would like to see all the workers, but that would be impossible. We had to make compromises.

SPIEGEL ONLINE: What do you say to those who can't go on?

Shigemura: The most important message is that of appreciation and support for what they have accomplished. Very rarely do we advise them to take a rest. It is better for the workers if they can stay at work. Otherwise their colleagues would think they are weak and they would be stigmatized as mentally ill. Also it motivates them to belong to a group. Staying away from work is a last resort.

SPIEGEL ONLINE: How afraid is the population of radioactivity?

Shigemura: People are confused and suspicious of the authorities. In such an environment, rumors and misinformation spread quickly. In a crisis, communication needs to be quick, transparent and accurate. If you want to prevent panic, you should release as much information as possible so the people can understand and assess the danger. But the government doesn't know much about this kind of risk communication. They kept silent about a meltdown, and people became even more anxious.

SPIEGEL ONLINE: What psychological consequences has the catastrophe had in the affected regions?

Shigemura: It will be years before all the psychological consequences become apparent. I am sure the suicide rate will increase in the northeast. Even before the catastrophe there were many suicides there: the winters are long and cold, there isn't much work and people are known for their perseverance, meaning they often don't speak about their problems. On top of this you have the fear of radiation, which cuts some communities in Fukushima in half. In Tamura one part wants to leave, one part wants to stay. This can also mean a crisis for families and friends. Maybe the wife wants to leave and the husband wants to stay. Social relationships can break apart over this question.

SPIEGEL ONLINE: How can such conflicts be overcome?

Shigemura: I don't have an answer for that. Of course I can't say: "It is okay for you to return to your village." In every case, people should be offered a broad choice on where and how they want to live. And jobs need to be created to give them a new perspective. Unemployment is a big problem among refugees. It is difficult for them to find permanent work, because nobody knows when they will return -- after a year, after 10 years. Or never.

Interview conducted by Heike Sonnberger