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Japan beyond 3.11 Stories of Recovery

GREAT EAST JAPAN EARTHQUATE PROJECT NHK WORLD
Food Allergies and Disaster

This page is adapted from the original transcript of NHK’s TOMORROW, broadcast on January 26, 2015

Tomorrow Logo

After March 11 disaster

After March 11 disaster

Four years ago, the areas stricken by the Great East Japan Earthquake received many relief supplies. Foodstuffs were particularly welcomed by the hungry victims.

After March 11 disaster

After March 11 disaster

However, there were some recipients who felt very uneasy about those supplies of food.

Jason Hancock

“Immediately after the earthquake, these are the kind of relief supplies that were delivered. With no gas, electricity or water, those that came to the evacuation shelters cold and hungry were given these sweets, soups and breads. But there were some that were not able to partake -- those with food allergies.”
(Jason)

Wheat flour, eggs

Many of the relief supplies included breads that could be eaten as they were and cup noodles, which could be made simply by pouring on hot water. However, many food allergy sufferers cannot eat foodstuffs containing wheat flour or eggs.

After March 11 disaster

After March 11 Disaster

At the evacuation sites immediately after the disaster, everyone had their hands full with delivering supplies so there was little leeway to think about special items for those who were allergic to certain foods.

Family

In that environment, families with children allergic to certain foods were in trouble.

Yoshie Yokoyama

“If we were lucky and no symptoms appeared, they could continue eating, but if an extreme reaction like a state of shock occurred, it could have become a life-or-death situation.”
(Yoshie Yokoyama)

Food allergy

How did food allergy sufferers cope during the disaster period?

New approaches

And what new approaches have been developed since the disaster?

Jason

Jason reports on efforts to protect food allergy sufferers based on lessons learned from the 3.11 disaster.

Food Allergies and Disaster
Kesennuma

Kesennuma in Miyagi Prefecture.

Jason

Jason visits a family who suffered a great deal during the disaster because of a food allergy.

“Hello! Mrs. Yokoyama?”
(Jason)

Yoshie Yokoyama

This is Yoshie Yokoyama. Yoshie and her family are now living in a house built since the disaster. However, they had a hard time right after the earthquake.

After disaster

This video was taken at that time. The Yokoyamas’ house beside the river was wrecked by the tsunami, and they had no option but to stay at an evacuation site.

House remnants

“Here. This is the concrete foundation of our house...”
(Yoshie Yokoyama)


Luckily, all four members of the family evacuated safely.

Yokoyama family

But the thing that greatly worried the Yokoyamas was providing suitable food for their two daughters, who are both allergic to cereals, including wheat flour and certain types of rice. With rice in particular, there was a real danger of developing symptoms if they happened to eat the wrong types.

After March 11 disaster

After March 11 disaster

They could clearly decide not to take the breads amongst the relief supplies distributed at the site, but making a decision about rice was more difficult.

Jason and Yoshie Yokoyama

“How did you feel when you went to the evacuation site?”
(Jason)

“Well, what worried us most was what sort of rice that was being provided. However, because we were so hungry, we decided to go ahead and eat it anyway. If any problems occurred, they could stop eating it. In a way, they were risking their lives every day. If some extreme reaction like a state of shock occurred, it could be a matter of life-or-death, so that was really worrying.”
(Yoshie Yokoyama)


Fortunately, during the more than one month they stayed at the evacuation site, their daughters did not develop any severe allergic symptoms. However, it was a very stressful experience.

Kamaishi

A family in Kamaishi in Iwate Prefecture who also had to live at an evacuation site right after the earthquake included children who suffer from food allergies.

Toshiko Sawada

Toshiko Sawada escaped to this assembly hall with the four other members of her family. Her two sons who were then junior high school students were both allergic to eggs, fish, fruits and other foods.

Toshiko Sawada

The food prepared at the evacuation site was made using whatever ingredients were brought in, and there were very few ingredients her sons could eat.

“Basically, my sons could only eat the rice balls. That was fine, but while other children were having cup noodles and other things, they were eating only rice balls every day. That’s all we could give them.”
(Toshiko Sawada)

For the sake of their sons, the Sawadas left the evacuation site after less than a week. They spent their life in the upstairs of their house, which had narrowly escaped destruction by the tsunami.

Miyagi Children's Hospital

One doctor has raised the alarm regarding neglecting countermeasures to deal with food allergies in emergency disaster situations.

Dr Katsushi Miura

Katsushi Miura is a specialist in children’s allergies.Food allergies can occur unexpectedly.

“I heard that when some people were breaking eggs, children who were allergic to eggs developed swollen skin around their eyes or a rash simply by touching the eggs.”
(Katsushi Miura: M.D. & Ph.D. Specialist, Japanese Society of Allergology)


Food allergies can even result in those who have survived a disaster losing their lives.

“In fact, we did have two or three cases of anaphylactic shock. Allergy sufferers are in mortal danger and can even die in certain situations.”
(Dr. Katsushi Miura)


Critical allergy symptoms include anaphylactic shock, low blood pressure, consciousness disorder and respiratory arrest.

Figures for children with allergies

The total number of Japanese elementary, junior high and high school students who have food allergies is around 450,000. That’s about 4.5% of the nation’s children, and the number is increasing every year.

Tagajo

Tagajo City in Miyagi Prefecture.

Jason visits

Jason visits a family to find out what children with food allergies must pay attention to in their daily lives.

“Hello, good morning.”
(Jason)

The Shoji family

This is Akihiro Shoji and his family.

“Please tell me your names, everyone.”
(Jason)

“I’m Umi Shoji.”
(Umi Shoji: Age 6)

“Umi! Nice name!”
(Jason)

“This is Kanna”
(Akihiro Shoji: Umi’s father)

“Morning, Kanna. And you must be their parents? Thank you for inviting us today.”
(Jason)

Umi Shoji

Their son Umi was two years old when the disaster struck. He was allergic to about 30 different food items including eggs, dairy products, wheat flour and fish.

Supermarket

For Umi’s sake, the Shojis have to pay careful attention to their daily life. Jason joins them on a trip to the supermarket.

Eriko Shoji

“I’m buying some fish for Kanna, and meat for us and Umi.”
(Eriko Shoji)

Shopping

“Is this OK?”
(Jason)

“No problem.”
(Eriko Shoji)

Eriko and kids

Any unwrapped items must be put in a bag to avoid contamination from any allergenic substances that may have stuck to the basket.

Shopping

“If the things we are buying touch traces of dairy products or other items left in the basket, it could be dangerous for the children.”
(Eriko Shoji)

“What about items sold in a package?”
(Jason)

“We can buy them.”
(Eriko Shoji)


Anyone with a food allergy can develop symptoms simply by touching the items even if they do not eat them. For this reason, the possibilities for allergens sticking to anything else should be reduced as much as possible.

Shopping

Dangers also lie in this kind of place, a typical supermarket delicatessen section.

Croquettes

“These items don’t indicate anything about allergens, but I think they generally use risky items like eggs to bind the ingredients and the batter.”
(Eriko Shoji)

“That’s dangerous!”
(Jason)

“Yes, it is, so I won’t buy them at all.”
(Eriko Shoji)

Shopping

“Up to when he was about two years old, Umi showed an allergic reaction to steam from the cooking area which was right behind the sales counters.”
(Eriko Shoji)

“So it’s not just a matter of avoiding eating. He reacts even to steam?”
(Jason)


Steam floating from the cooking area of a supermarket can be enough to cause allergic symptoms.

The Shoji home

They can’t feel relaxed even at home.

Eriko Shoji

“The chicken wings that Umi likes….”
(Jason)

“He requested them today.”
(Eriko Shoji)

“You wash them one by one?”
(Jason)

“Yes, just to be on the safe side.”
(Eriko Shoji)

Washing chicken

Anything which goes into the mouth has to be carefully washed. What is more, the cooking utensils and dishes for Umi are kept separate from those for the other members of the family.

Eriko Shoji

“When he was much younger, he suffered from eczema and reacted to even a tiny quantity of allergenic substances, so we established a strict rule that we should keep things separate to avoid contact. He may be alright now, but it’s become a habit. He can only eat a few food items, so I compensate with my love instead.”
(Eriko Shoji)

Jason

“You compensate with love? I see.”
(Jason)

Chicken rice

The menu for this evening is chicken rice...

Fried chicken

...and fried chicken wings using rice flour instead of wheat flour.

Cooking

Any ingredients which can cause allergy symptoms have to be replaced with something else.

Akihiro Shoji

How did the Shojis cope during the 3.11 disaster?

“The adults could somehow secure enough food, but our son had a hard time.”
(Akihiro Shoji)

Eriko Shoji

“Just after the disaster, we had mostly things that he couldn’t eat. The only items he could eat were vegetables that didn’t contain any allergenic substances, rice and meat. That’s all. If we went to an evacuation site, there would be all kinds of people there, and if he touched food items or went near them, he might suffer an allergic reaction. So we resolved not to go to an evacuation site.”
(Eriko Shoji)

Umi and Eriko

At home, the supplies of electricity, water and gas had all been cut off. Even so, the Shojis thought it would be safer for Umi to stay there than at an evacuation site.

“What could we do about our children? We had no food. We couldn’t cook rice. We had no electricity. We couldn’t even heat up frozen rice. And our ramen noodles were useless because we couldn’t eat them.”
(Eriko Shoji)

“We found it very difficult to live. We had a house, but that was all we had.”
(Akihiro Shoji)

After March 11 disaster

Umi

For five days until the electricity supply was resumed, all Umi could eat was a small amount of dried sweet potatoes that they had stored at home.

Jason in Sendai

The disaster victims who have a food allergy had to experience a much tougher time than we can imagine.

Jason and Kumi Mita

There was one woman who immediately made a move to help those with food allergies after the earthquake.

“Hello, Ms. Mita? I’m Jason. Nice to meet you.”
(Jason)

Kumi Mita

This is Kumi Mita.

Mita's products

Kumi runs a special shop dealing with foods suitable for food allergy sufferers in the city of Sendai. These items are all hand-made.

Jason at Mita's shop

“This is a layered sponge cake with white soy milk cream. And this is cheesecake style.”
(Kumi Mita)

Cakes

They look like ordinary cakes, but contain no dairy products at all. For sponges, soy milk is used instead of fresh cream and rice flour instead of wheat flour.

Pizza

“The pizza looks good!”
(Jason)

“It has a crust made from rice flour. And we use Vienna sausages that allergy sufferers can eat and glutinous millet instead of real cheese.”
(Kumi Mita)

Taiyaki

And there is even this kind of foodstuff.

“This is made using corn flour, tapioca and starch, with rice flour as a base, so that it’s soft even when cold. It works well.”
(Jason)

Naoki Mita

Kumi started the shop 30 years ago. The reason behind it was that her husband Naoki had a food allergy when he was a boy.

Families visiting the shop

As the couple managed the shop wanting to help families with the same problem as much as possible, many families with children suffering from food allergies started to visit them.

Kumi Mita

“Some parents suddenly discover their children are allergic to certain foods and shouldn’t be eating everything that they usually do. We wanted to support them somehow, so we started making lunch box items and things that are hard to make at home.”
(Kumi Mita)

Kumi's shop

Kumi’s husband died of an illness seven years ago, but she continued running the shop to support those with allergies.

After March 11 disaster

After disaster

She was working at the shop when the disaster occurred four years ago. She immediately thought about all the customers who relied on her shop.

Kumi Mita

“I was worried whether the allergy sufferers could escape from the tsunami. If they had, I was sure they didn’t have suitable food.I realized they needed what only we could provide.”
(Kumi Mita)

After March 11 disaster

Kumi's notice

The day after the earthquake, Kumi asked the City Hall to put up a notice saying that her shop would hand out foodstuffs for allergy sufferers free to anyone who came.

After March 11 disaster

People at the shop

Many people immediately came round to the shop. However, Kumi had another concern in mind.

After March 11 disaster

Outside the city

She assumed that allergy-sufferers living outside the city were unable to get hold of safe foodstuffs.

Ishinomaki

She headed to Ishinomaki City 50 kilometers away. About 20 customers living there were registered on her list.

Kumi Mita

“It was very hard to find those customers. We tried all kinds of means, walking from place to place in search of them without much success.”
(Kumi Mita)

“It was your mission to deliver them food?”
(Jason)

“Well, you know, I was sure they were in trouble.”
(Kumi Mita)

After March 11 disaster

Handing over foodstuffs

But that day Kumi could only hand over foodstuffs to three people. Most of her customers had evacuated and were living at evacuation sites, but she had no idea where.

Ishinomaki City Hall

She decided to ask for help from Ishinomaki City Hall.

Health Promotion Section

Health Promotion Section

She consulted with them on how the food items she had brought with her could be distributed to more allergy sufferers.

Kazue Ishikawa

Kazue Ishikawa, a nationally certified senior nutritionist, dealt with the matter. At the time she was busy with all kinds of tasks at the chaotic City Hall.

Kazue Ishikawa

“To be honest, I wasn’t thinking about allergy sufferers at all. I just didn’t have space to consider how many evacuees were allergy sufferers. We produced a name list of everyone who came to the evacuation sites, and asked them if they had any health problems. But I’m embarrassed to say that having an allergy was just beyond our imagination on the day of the disaster.”
(Kazue Ishikawa: Senior nutritionist)

After March 11 disaster

After disaster

Kazue immediately discussed the situation with the section operating the evacuation sites and they started thinking about what they could do.

“We produced a questionnaire with columns for names, birth dates, and many causes of allergies.”
(Kazue Ishikawa)

Questionnaires

These are the questionnaires Kazue and the team produced. They considered all foodstuffs causing allergies and asked in detail who needed what.

Filling out questionnaires

As a result, they were able to distribute the appropriate foodstuffs safely to more than 30 people, more than they had imagined.

Kazue Ishikawa

The lessons learned from that time are now incorporated in Ishinomaki City’s disaster prevention measures.

Kazue Ishikawa

“As for the future of the name lists created at evacuation sites, we believe that it would be better to include the matter of allergies right from the start. We nutritionists are considering ways to cooperate better with various other sections regarding the provision of supplements to those people in need.”
(Kazue Ishikawa)

Sendai

Ishinomaki is not the only city that has reconsidered means to respond to the needs of food allergies since the disaster. Sendai has also launched an initiative.

Jason and Yoshikawa

“I guess this is a storage container.”
(Jason)

“Yes, it’s a kind of disaster prevention warehouse.”
(Katsumoto Yoshikawa: Crisis Management Department, City of Sendai)

Allergen-free curry rice

“What’s this?”
(Jason)

“This is allergen-free curry rice.”
(Katsumoto Yoshikawa)

Food packets

“Allergen-free” means that the food does not contain any substance that could cause allergies. Most of the stockpiled food in Sendai has been changed to items suitable for anyone to eat safely during an emergency, whether they have a food allergy or not.

Food supplies

“This box contains rice porridge and this one retort-pouch foods which don’t require cooking. They are both allergen-free.

Katsumoto Yoshikawa

It’s very difficult to cater especially for allergy sufferers at the time of a disaster, so now 90% of all the foods in stock are allergen-free.”
(Katsumoto Yoshikawa)

Supplies

700,000 meals are now being stored at designated evacuation sites all over the city, with the idea that they will be sufficient until they are able to receive relief supplies.

Toshiko Sawada

Since the 3.11 disaster, mothers’ attitudes have also changed.

“This is an evacuation rucksack.”
(Toshiko Sawada)


The Sawadas, who left the evacuation site after less than one week, have reconsidered their home emergency stockpile.

Toshiko Sawada

“These are biscuits…and this is alpha rice. They’re all allergen-free, so my son can eat them.”
(Toshiko Sawada)


They decided to have enough food for a week at all times, so that her sons who are allergic to eggs, fish and fruits will have something safe to eat.

Toshiko Sawada

“You never know what will happen, and where to escape to depends on the time and the place. We’ve prepared supplies to ensure that the children will be alright for several days even if they have to escape on their own. It’s essential to be able to survive whatever happens.”
(Toshiko Sawada)

Kumi Mita

Kumi Mita, who runs the allergen-free food shop started making a move together with her regular customers after the disaster. They have started a new approach based on their shared experience of suffering.

Kaori Umehara

“What’s this card?”
(Jason)

“Looking back at the Great East Japan Earthquake, we realized several points: at the evacuation sites we had no way to inform people about our allergies; allergy sufferers and their families could have been more comfortable if they had been prepared in advance; and it would have been hard for the people around us to treat allergy symptoms. So we produced this set of cards in the belief that it would be useful if we could exchange such information and if we had something that could be understood at a glance.”
(Kaori Umehara: Customer of Kumi’s shop)

Allergy card

This portable card details the foodstuffs which the carrier is allergic to, likely symptoms, and a record of treatment received as an outpatient.

Allergy card

This means anyone can now tell that a young child has an allergy even if they cannot explain it in words themselves. Required treatment methods are also noted so that they can be provided if the symptoms suddenly develop.

Jason and Kumi

“People don’t know what to do even if they want to help. But all you have to do is show this. It’s a great idea!”
(Jason)

“We must do this. With this card, we’ll keep at it.”
(Kumi Mita)

Little by little, efforts to protect food allergy sufferers have begun. However, there is another important point that cannot be ignored.

Yoshie Yokoyama

A comment made by Yoshie Yokoyama, who stayed at an evacuation site, has stuck in Jason’s mind.

“At the evacuation site. I felt I couldn’t tell anyone that my daughters were allergy sufferers. On the contrary, I felt we shouldn’t because it might ruin the atmosphere at the evacuation site where we were all getting along well.”
(Yoshie Yokoyama)

“I am also allergic to certain things. But if I say that to people who don’t know much about allergies, they treat me in an awkward way, so I often hide it and don’t eat what’s given to me. I feel it would be more troublesome explaining. I don’t want others to misunderstand me, so I just keep quiet about it, and that’s honestly much easier.”
(Jason)

“I totally agree with you. If the symptoms got worse, then everyone would surely understand that it is a disease. We decided that it was better to keep quiet about it unless it became necessary to tell everyone. It might have been better if we had made an effort to speak out so that everyone knew, but in that situation, we didn’t have the energy or the enthusiasm to do it. That was the reality.”
(Yoshie Yokoyama)


A very important matter when it comes to making efforts to help food allergy sufferers...
...is that those surrounding them should understand their situation.

Jason summarises

“Unlike external injuries, food allergies cannot be seen, and are therefore less understood. But they are equally dangerous and delicate. But since the earthquake, local and national leaders are working together to change education and preparation for those with special dietary needs. With the help of local support groups and families of children with allergies, we can make a difference in making it easier for those with food allergies to live in today’s world. From what I’ve learned, the best thing we can do to help those with food allergies is to be understanding and sympathetic.”
(Jason)

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