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  1. REHABILITATION OF PEOPLE
  1. KODOKUSHI -- SOLITARY DEATH

Kodokushi after the Great Hanshin Earthquake

Kodokushi is a solitary death where one dies completely alone without being taken care of or accompanied by anybody. One's body is often found several days after, in some cases even over a month after one's death. Newspapers reported on kodokushi in the temporary housing two years after the earthquake as follows:

"Found by a Volunteer Nurse. He had been visiting the hospital for visceral disease. He bought liquor rather than food. There were a bottle of sake and two copies of his CV at his bedside. In the refrigerator there was only an apple which was distributed by the community association. It could be classed as death from starvation. (Kobe Newspaper, January 29th, 1997, Port-Island temporary housing, Minatojima-Naka-Machi)" "The room was littered by empty bottles of sake and liquors. Half-eaten noodle and sushi-packs were found. (Mainichi Newspaper, March 13th, 1997, Iwaoka temporary housing, Nishi-ward)".

The number of kodokushi amounted to 253 according to Ueno Yasuhiro, an assistant professor (forensic medicine) at the Medical Department, Kobe University (March 9th, 1995, May 5th, 1999). The governments have not disclosed comprehensive data on kodokushi, and no data at all concerning post-disaster public housing. The only available data is one item from Prof.Ueno, and that from newspapers every time something appeared (238 cases) collected by the Hyogo Prefectural Council for the Promotion of Social Security (Shakaihosho-Suishin-Kyogikai).

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Two Characteristics of Kodokushi

There are two characteristics of kodokushi. The first is that middle-aged males formed the majority. The number of males who died a kodokushi was 2.3 times as many as that of females (165 males to 71 females), and as to the age group, those belonging to the 55-64 age bracket occupied 44%. In the case of females, those from the same age bracket occupied only 14%, while the highest percentage came from the 80-84 age bracket, occupying 18%. The female deaths show a natural increase as the age increases, but the deaths of male are disordinally concentrated on the middle-aged group (Figure).

The second is the alcohol-related problems. Prof. Ueno pointed out as to the cause of kodokushi in the males that liver disease amounted to 36%, heart disease to 35%, and cerebrovascular disease to 15%. Of the hepatism cases, 68.4% were considered to be alcohol-related. Also 44.7% of the hepatism-caused deaths or 60.7% of those who were known to have had a drinking habit, had a medical record of chronic excessive alcohol consumption or alcoholic addiction.

What Kodokushi Tells Us

(1) Forced Relocation to Far-off Unfamiliar Areas

Temporary housing was built in the remote areas and it took people a few hours to get there from the inner city areas. People were relocated and communities were fragmented. It is essential to maintain communities in times of disaster to reduce kodokushi.

(2) Communities Supported by Rapport Centers and Aged People

It was rapport centers, community associations and volunteers who played the most important roles in the recreation of communities. There were two prerequisites for a rapport center to function. The first one was a subsidy and the administrative bodies subsidized the running costs of one million yen per year per center. The second one was the self governing ability of the residents. Aged people were of a great help to community association activities because, though they might not be physically strong, they were economically stabilized with pensions, even if it was a small amount, and they had time to spare. In the cases where the middle aged residents took the initiative in the activities, the activities were limited to the evening and the rapport center could not be left open, since they were out working during the day.

(3) Alcohol-related Problems

Alcohol-related problems are one of the most difficult ones to tackle. It is essential to have support from specialists and self-help groups such as Alcoholics Anonymous, and the institutions where mid and long-term accommodation and workshop therapy are available.

(4) Kodokushi, Not a Specific Issue Related to Disasters

Kodokushi is not a specific issue in a time of disaster. The disaster only revealed the problem which may happen to anybody when loneliness coincides with poverty. What should fundamentally be taken are measures to relieve poverty.

(KADOYA Youkou)