For the past seven days, MSF has been providing medical consultations in evacuation centres in Minami Sanriku, where around 10,000 people are housed in 20 locations.

Dr Yoshitaka Nakagawa returned on Saturday night after spending a week in the northeast with teams sometimes hiking into remote communities heavily hit by the earthquake and tsunami. One patient he met was a 70 year old man who was suffering chronic renal failure and with his condition deteriorating because he was unable to reach a clinic with haemodialysis machines.

“Fortunately his family had been caring for him since the quake and doing everything within their power to help him by checking his weight, blood sugar levels and making sure his appetite and activities were maintained,” said Dr Nakagawa. He was able to prescribe his correct medication and provided an adapted treatment to stabilise him and another mobile MSF team will follow-up the case in coming days.

As well as the two MSF mobile teams working in Minami Sanriku, another team has been assessing communities between Kesennuma and up to Miyako on the northeast coastline. MSF is considering starting activities for elderly patients in Miyako and will now assess the situation in Rikuzentakada.

The situation in areas seen by MSF’s team in northern Miyagi prefecture is evolving quickly, as the massive national relief effort clears access to areas and large quantities of relief supplies continue to come in.

The main issues seen by the MSF doctors remain chronic diseases in what is largely an elderly population.

As members of MSF’s 12-person mobile team continue to provide medical consultations in evacuation centres in the affected area, MSF is listening and responding to the specific needs of evacuees, including requirements for supplies of personal hygiene items such as soap, toothbrushes, toothpaste and towels.

“Living conditions are still difficult,” said Emmanuel Goue, the emergency coordinator for the project. “There is overcrowding in some of the evacuation centres and after a week since the initial disaster people can be in need of personal hygiene items.

“In the coming days we are planning to distribute these items directly to evacuations centres for approximately 10,000 people in the Minami Sanriku region, on top of our medical activities.”

A psychologist also joined the team in the northeast on Saturday, to assess whether there is a need to increase our response and understand what resources exist on the ground.

“Elderly people are more vulnerable to this kind of situation. There is the intense trauma experienced following the earthquake and tsunami,” said MSF psychologist Ritsuko Nishimae. “However mid-term trauma also presents when elderly people are evacuated from their homes to a new location. Most people have the capacity to adapt to new living circumstances but for the elderly it’s far more difficult and they require more time.”

Before the earthquake last week, MSF in Japan had around 40 people working in the Tokyo office, and today has an additional five people in the capital working on the emergency and 12 people in the northeast.