The plight of the elderly: Japan's forgotten victims of the tsunami

When the tsunami tore towards the home of Chiya Yamane, the 84-year-old woman was saved by strong arms and sturdy legs. But they were not her own. A fireman picked her up, put her on his back and raced up a hillside to the safety of higher ground. Without his intervention she is not sure she would have survived. "Arigatai," she says. "I feel blessed."

The plight of Mrs Yamane, a slight but lively woman now passing the days in an evacuation centre set up among the classrooms and corridors of a primary school in the coastal town of Miyako, is far from unique. Japan's elderly population has been confronted by extraordinary challenges by this disaster, not just from the earthquake and tsunami, but in the struggles that have followed. Often they live alone, and their welfare has been largely overlooked as the government struggles to respond to a natural disaster whose impact was not immediately appreciated.

The basic problem confronting the elderly was that they could not move quickly enough. Early-warning systems in place among the communities that line Japan's north-eastern coast provided a crucial 20- to 30-minute warning between the earthquake, which struck at 2.36pm a week ago last Friday, and the arrival of the huge wave it generated. Lots of those who drowned were simply not sufficiently nimble to get out of its way.

Tatsuyuki Kumamgaie reaches for a sheaf of papers. They contain the most up-to-date statistics on the dead and missing from the town of 70,000 people. He has not yet been able to analyse the data, but as he runs his finger down the column that lists the ages of the 231 people so far confirmed dead, it becomes clear that a striking number were old... 93, 94, 81, 80, 99.

"In rural areas, there are probably extended families. But in the city, grandparents are more likely to live by themselves," said Mr Kumamgaie, a government official overseeing the local relief operations. "When the tsunami came we had to go up the side of the mountain, but the elderly people could not run up there. The young people had gone out to work. Had they been there they could have helped."

Japan's people are famously long-lived. Longevity, combined with a low birth rate, has created a population profile in which more than 20 per cent of people are above 65. In more remote areas, including many of the communities struck by the tsunami, that figure rises to 35 per cent, pushed up by the migration of younger people to the cities in search of work.

Fifty miles south of Miyako, at the fishing town of Kesennuma, it isthe same story. When the tsunami warning came, many older people tried to escape by car but found themselves trapped in what became a lethal traffic jam. The only ones guaranteed to survive were those able to get themselves to the top of the hill that overlooks the narrow harbour, or to clamber up three flights of stairs within a solid, cement-built building.

"Many younger people have left here to go to Tokyo but there are still many elderly," says Kimio Onodera who works with the disabled. "When the tsunami hit, my parents were able to escape but not everyone could because they could not move quickly. I have heard many of those stories. There is a phrase which means 'the elderly helping the elderly'. That is how they died."

In the days after the tsunami, older people have struggled. Countless thousands have been left homeless and forced to sleep in the hastily established evacuation centres in schools and gymnasiums, eating whatever food is available and hoping they do not become ill. As temperatures plunge to around freezing at night, all they can do is to wrap themselves in blankets.

Usually they are anxious and often they are confused. With electricity and water supplies still cut off, the elderly often opt to stay in the shelters even if family members have moved back into their homes. "Three of my rooms cannot be used so I came here," says 74-year-old Chieko Yamanaka, staying at another shelter in Miyako where a communal kitchen is serving up steaming bowls of rice and traditional Japanese curry.

As with most Asian societies, deference and respect are traditionally extended towards elderly citizens in Japan. But in this disaster, they have on occasion been forgotten. In one notorious incident 128 sick and elderly people were left abandoned at a nursing home within the evacuation zone surrounding the stricken nuclear reactors.

They were discovered by members of the civil defence force in a hospital less than 10 miles from the Fukishima reactor. Reports said the majority of patients were comatose and that 14 subsequently died.

In Kesennuma, which was devastated by the wave, 11 old people were discovered dead in a retirement home. With no electricity and little gas for heating, it is believed the residents had died of hypothermia. The other 47 residents of the home had been killed when the tsunami struck. The home's owner said the residents still in the facility were alone and under "high stress".

Mrs Yamane was alone when the fireman came into her home and carried her to safety, as her wheelchair-bound husband had been at the care centre he attends every other day.

Had the tsunami struck on a different day, the outcome is painful to consider. As it is, things are bad enough. Mrs Yamane's home is badly damaged and she doesn't know when her husband will be able to return. Meanwhile, she is staying on at the shelter. "I don't know how long I will have to stay here," she added.

Tsunami miracles

* A four-month-old girl was found amid the rubble in the village of Ishinomaki three days after she was swept from her parents' arms. Wrapped in a pink woollen bear suit, she was was reunited virtually unharmed with her family.

* A 70-year-old woman was pulled from rubble in the devastated coastal town of Otsuchi more than 90 hours after the earthquake. Despite suffering from hypothermia, Sai Abe was otherwise unhurt.

* For Hiromitsu Shinkawa, 60, it was the roof of his ruined house that proved his lifeline. He was found floating on it 10 miles off the coast two days after the tsunami hit Minamisoma.

* A ship survived rollercoaster waves after it was ripped from its moorings in Miyagi and swept out to sea; all 81 passengers were airlifted to safety.

* A family returned to the rubble of their destroyed Arahama home to find their two dogs still alive.

* An Indonesian man, Zahrul Fuadi, 39, has survived two of the world's largest earthquakes since 1900. After fleeing from the 2004 Boxing Day tsunami, he moved to Sendai to study, where he also escaped unscathed.

* And a miracle that wasn't: a man was thought to have endured eight days amid the rubble in Kesennuma but he had in fact collapsed after popping back to his home from the shelter where he had been living.

Melody Miller