Japan is widely regarded as well-prepared for disasters, being used to frequent tsunamis, cyclones, earthquakes and volcanic activity, but a year after the calamitous events of 11 March 2011, the lessons from the multi-disaster still resonate.
"The learning from the Great East Japan Earthquake will be a vital contribution to preparing the world to meet the challenges of disaster risk in the urbanized, globalized world of the 21st century where a natural hazard can trigger a chain of catastrophic events," UN Special Representative for Disaster Risk Reduction, Margareta Wahlström, said.
On that day, a magnitude 9.0 earthquake struck 70km east off the coast of the Tohoku region in northeast Honshu, Japan's largest island, followed by tsunami waves up to 40m high. Soon after, explosions and radioactive leaks rocked the nearby Fukushima Daiichi and Fukushima Daini nuclear power plants, adding a new calamity for authorities to deal with while complicating the safety of aid workers on the ground.
"This disaster was totally beyond our imagination, beyond our preparedness," Satoshi Sugai, director of the earthquake recovery task force of the Japan Red Cross, told IRIN.
According to Japanese authorities, close to 16,000 people died and 6,000 people were injured, while more than half a million were made homeless.
The World Bank assessed damage at up to US$235 billion, with experts predicting it would take years for the region to recover.
But the magnitude and context of the disaster also presents a unique learning opportunity - not just for Japan, but for other countries around the world.
"[The years] 2010 and 2011 have been quite extraordinary from a disaster profile," Wahlström said. "A number of very rich, highly developed countries whose economies are totally interdependent with the world economy have been hit and they've been hit on a very grand scale, from New Zealand to Japan to Australia."
A notable aspect of the disaster was the role reversal in the provision of international assistance: normally a donor, Japan now found itself receiving aid.
According to the UN's Financial Tracking Service (FTS), Japan, the world's third-largest economy, received US$720 million in donations, the largest amount of any country for a natural disaster in 2011.
"[Some] 120 countries gave assistance in cash, in kind, and in service," Setsuko Kawahara, former director of humanitarian affairs at the Japanese Ministry of Foreign Affairs, said.
And for aid agencies operating inside the country, this meant a major rethink of how they do business.
"Japan Platform is designed to respond to emergency situations outside Japan. In 2006 we started to respond to disasters inside Japan, but we didn't have much experience with responding to domestic disasters," Noriyuki Shiina, secretary-general of Japan Platform, an NGO that helps provide aid through facilitating cooperation between NGOs, the business community, and the Japanese government.
"The first thing the government did right was to recognize the coordination challenge in the first place. They were very clear on what was needed, what wasn't needed, what could be accepted," said Oliver Lacey-Hall, head of the UN Office for the Coordination of Humanitarian Affairs (UN-OCHA) in the Asia Pacific.
"What came in from outside was designed to supplement, not replace national capacity, and ultimately that is what humanitarian assistance is supposed to do," he added.
At the same time, Japan Platform adapted its experiences to tackling domestic challenges.
"We could foresee that many NGOs would rush into the affected area," said Shiina. "We assumed that we could have lots of overlapping and unnecessary activities. So Japan Platform and another coordination body tried to be a focal point for international NGOs."
But adapting to being on the receiving end of aid was not always easy, the Red Cross's Sugai conceded.
"The basic responsibility of protecting lives of course lies on the shoulders of central government. But because this is too strong in the minds of local authorities, they sometimes don't know other players, like Care International or Save the Children. Local authorities didn't have any idea of how much capacity these NGOs, including the Red Cross, have," he said.
Despite Japan's expertise and resources, Sugai says the country would still benefit from taking full advantage of international support in the event of future disasters.
He gave the example of how the Japan Red Cross thought relief goods could be procured from within the country and consequently put out the message that donating relief goods would be a waste of energy and resources.
But logistical complications, including damage caused by the earthquake and tsunami, meant many relief items could not be procured or delivered without international assistance, he said.
Lacey-Hall believes the risk of future disasters of this magnitude means there is a need to move towards designing regulations to oversee large-scale international operations.
"A lot of what was achieved in Japan was because of individuals who understood how the international humanitarian system worked and what they could pull in rapidly. But institutional capacity could have been greater if there was a broader regulatory system. To codify this into national legislation would be an important step," he said.
Social and psychological impact
Still another key lesson learnt, especially for Asia's rapidly ageing population arose from the impact on Japan's elderly. Kawahara notes that 65 percent of identified victims were aged 60 or older.
"We should have a kind of system where we try to evacuate elderly people to higher ground. We should make a kind of map which indicates how many elderly people stay where and which ones should be prioritized to be evacuated," proposed Shiina.
"Even if they can survive and get temporary prefabricated housing, they may have to live alone. At the time of the Kobe earthquake in 1995, there were lots of suicides and isolated deaths of the elderly who were not being attended by anyone," said Sugai.
The government is trying to avoid this situation by putting a red light outside the prefabricated houses where an elderly person is living alone. If they need help they push a button and the red light will alert people.
While residents of prefabricated housing in Japan live in better conditions than displaced persons in Haiti, for example, the psychological impact of losing one's home and family still takes its toll.
"Humanitarian aid workers should receive some kind of training if you try to provide psychosocial care or support. Otherwise we could make the situation worse," observed Shiina. "Humanitarian aid workers also need help. Many aid workers also get depressed," he added.
Is prevention possible?
But perhaps the most critical lesson of all is how much can be done to protect communities from disasters on this scale in the future.
"People understand now that it is impossible to completely prevent disasters. If we didn't have proper building standards and regulations and measures for disaster response, the loss of life and loss to the economy would be enormous," Kawahara said.
"In one way this is not really an issue of natural hazards, it is an issue of how we plan these societies," Wahlström told IRIN.
"Do you agree to people living on the shoreline? Is the government ready to actually legislate that this is not reasonable, that it is high risk, that it is costly? If you are the government, you think you should service your population, but is it reasonable to service them wherever they live?" she asked.
Kawahara raised similar issues. "One idea is to change land use in city planning - there are some discussions in several towns and villages along the coast about a big blockade from the coast to the upper hill completely, but it is very difficult to have a consensus. And if you relocate, how do you assign the land to people?"
Wahlström hoped clear-eyed planning for disasters would be the lasting legacy of the 2011 Japan earthquake and tsunami.