Japan Psychosocial impacts of prolonged disaster displacement The combined impacts of a devastating earthquake and tsunami on 11 March 2011, followed by radiation leaks from the crippled Fukushima Daiichi nuclear power plant, displaced more than 470,000 people from their homes.147 Major recovery operations have made good progress in most of the affected municipalities, but some areas have lagged behind. Six years on, the disaster is far from over for around 124,000 people still living in displacement.148 The physical and mental health impacts of longlasting displacement have been widely observed among evacuees. They are strongly associated with the dislocation from close-knit communities and familiar surroundings, the loss of their homes and livelihoods and the separation of families caused by their displacement. People SPOT LIGHT evacuated from Fukushima because of nuclear radiation suffered from higher rates of posttraumatic stress disorder (PTSD) and depression for a longer period of time than those affected in other prefectures.149 Many evacuees were still suffering from sleeping disorders, anxiety, loneliness and depression five years later.150 In the other prefectures devastated by the earthquake and tsunami, the incidence of mental health problems also remains high. A recent survey of residents from Miyagi and Iwate found 14.3 per cent were still suffering psychological distress in 2015, an overall decline from 18.4 per cent in 2011 but still above the national average of 10 per cent. Among women still living in temporary housing complexes, the rates of PTSD and insomnia were significantly higher.151 Reclu- Along the Fukushima coast, enormous walls are being constructed to reduce the danger of tsunamis similar to that of 11 March 2011. Photo: IFRC/Masaya Noda, February 2016 ON THE GRID: Global internal displacement in 2016 43