What is most important in the face of adversity is to maintain a reason for living-no matter how trivial-and to develop good human relations.

After the Niigata Chuetsu Earthquake, a number of people who survived the initial jolt died from shock believed to have been caused by intense post-quake stress. Even now, further deaths among the elderly in the stricken area are expected.

In the 1995 Great Hanshin Earthquake, too, many people died after having suffered mental distress. I sincerely hope the lessons of the Hanshin earthquake will be put to good use in providing care for sufferers of the Niigata quake.

For some time after the earthquake, ``solitary deaths'' among elderly people living in temporary housing in the quake-stricken Kobe area attracted public attention. Although it has been nearly 10 years since the Hanshin earthquake, even now, many elderly residents living in homes built for survivors of the quake are dying ``solitary deaths.''

When I say ``solitary deaths,'' I refer to suicides and deaths from illnesses that involve various social factors. They include, for example, poor temporary housing environments, ``isolation'' from the local community, low income and chronic illnesses.

To recap, let me cite the following figures. Across Japan, the number of elderly people who live by themselves now tops 3 million, up by more than 1 million over 1995 when the Great Hanshin Earthquake struck.

Furthermore, the number of people, most of whom are elderly, receiving welfare throughout the nation has jumped by almost 500,000 in the last 10 years.

Naturally, the number of elderly people with disabilities and chronic illnesses that make it difficult for them to evacuate quickly when disasters strike has risen sharply. Actually, I estimate that as many as 30,000 elderly people will encounter ``solitary deaths'' or deaths under similar conditions each year in Japan.

I wish to refrain from arbitrarily summarizing the Niigata Chuetsu Earthquake as a whole. However, it is a fact that the stricken area is made up of depopulated communities with a high suicide rate and there is nothing that suggests elderly residents in this area are better off than the average Japanese of their age in terms of personal relations, income and health.

There are plans to build 3,000 temporary homes but people who move into them could also suffer quake-related deaths.

Looking back on the victims of the typhoons and floods that successively hit Japan this year, I cannot help but think that Japanese society was helpless in protecting the elderly from natural disasters-just as it was at the time of the Great Hanshin Earthquake.

People who lost their homes will be forced to live in unfamiliar environments from now on. In order to protect them from secondary and tertiary disasters, it is most important that the local community unite and develop good personal ties in everyday life. In this regard, the case of Yamakoshi village provides a good example of how neighbors can help each other.

Yamakoshi's entire community evacuated and moved together to seek shelter. It is important that society care for these people who have suffered material and psychological losses until the whole village can return together.

Elderly people who have suffered losses in natural disasters tend to lament that they have little time left to rebuild their homes and lifestyles. The stricken area has some of Japan's heaviest snowfall. What can we do to relieve the growing anxiety of the residents with the approach of a long winter?

If nothing is done to alleviate their sense of isolation, they could develop apathy and eventually come to lose their reason for living. When that happens, the danger of suicide and solitary deaths rises dramatically.

As I see the actual situation of people living in housing projects built after the Kobe earthquake, I believe what is most important in the face of adversity is to maintain a reason for living-no matter how trivial-and to develop good human relations. This is what the administration, local governments and other people involved in post-quake reconstruction must bear in mind.

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The author is director of Midori Hospital in Kobe. He contributed this comment to The Asahi Shimbun.(IHT/Asahi: December 8,2004)