Christmas Day saw dozens of masked men descend on Futaba, in the northeast of Japan’s main island of Honshu. They moved deliberately along deserted streets, clearing triffid-like undergrowth and preparing to demolish derelict buildings. Their arrival marked the beginning of an estimated four-year government-led project to clean up Futaba, which has succumbed to nature since its residents deserted almost seven years ago. Futaba is one of two towns (the other being neighbouring Okuma) on which sits the 350-hectare Fukushima Daiichi Nuclear Power Plant, which experienced multiple reactor meltdowns and explosions in March 2011, contaminating huge swathes of land and forcing the evacuation of 160,000 residents – all the result of the magnitude-nine undersea Tohoku earthquake and the devastating mega-tsunami that hit on March 11, claiming up to 21,000 lives. Despite 96 per cent of Futaba still being officially designated as uninhabitable due to high radiation levels, the government has set spring 2022 as the return date for its 6,000 or so residents. That the government has also built a 1,600-hectare facility to store up to 22 million cubic metres of nuclear waste in the town has led to doubts that many will return. “I find it difficult to believe anyone would want to go back,” says Ryuta Idogawa, 33, a former employee at Fukushima Daiichi operator Tokyo Electric Power Co (Tepco), and one of the so-called “Fukushima 50” – a hardcore of station workers who remained on-site after 750 others had been evacuated, battling to bring the melting reactors under control at great risk to their own safety. “They say time heals,” Idogawa adds, “but that depends how deep the wounds are.” On the other side of the world, members of a different and larger group of people than the Fukushima 50 are suffering health problems, ostensibly as a result of the disaster. For more than seven weeks following the catastrophe, the United States mounted a massive disaster relief mission, dubbed Operation Tomodachi (the Japanese word means “friend”). The initiative directly or indirectly involved 24,000 US service personnel, 189 aircraft and 24 naval ships, at a total cost US$90 million. While the mission was lauded a success by the US and Japanese governments, during Operation Tomodachi, thousands of US sailors were inadvertently exposed to a plume of radiation that passed over their ships, which were anchored off the Pacific coast of Japan. Since then, several hundred have developed life-changing illnesses, such as degenerative diseases, tumours and leukaemia, and defects have been detected in foetuses of some pregnant women. All are a result, they claim, of being irradiated by the plume. The sailors, however, knew nothing of their exposure and were literally marinated in the radiation According to one report, 24 sailors, who were in their late teens or 20s at the time, are living with a variety of cancers. At least six have died since 2011, while others suffer post-traumatic stress disorder (PTSD). “Unlike the nuclear plant workers, these sailors had no protective clothing, in fact some of them literally had no shirts on their backs because they had given all their clothing away to people they saved from the tsunami waves,” says Charles Bonner, a lawyer at one of three law offices representing 402 sailors who have filed a US$5 billion lawsuit against Tepco and General Electric Co, a suit that has been given the go-ahead to be heard in a US federal court. (Fukushima Daiichi’s Reactor No. 1 – the plant’s oldest reactor – was built by American manufacturer General Electric Co.) “And because they had given away all their bottled water to tsunami survivors, they were drinking desalinated water that also had been contaminated,” Bonner continues. “I do not doubt the psychological impact of the disasters on the plant workers, but at least they had masks and protective clothing, as required by law. The sailors, however, knew nothing of their exposure and were literally marinated in the radiation.” The legal teams of Bonner and the other two lawyers representing the US sailors – Paul Garner and former US senator John Edwards – declined this reporter’s requests for interviews with those they are representing, claiming that the experiences and the conditions the veterans are facing “are very emotional and difficult to discuss”. Some sailors have spoken of their ordeal, however, and in November, two gave accounts of their alleged afflictions to Courthouse News Service, a California-based media provider largely subscribed to by law firms in the US. Nathan Piekutowski was a marine aboard the USS Essex at the time of the relief mission. He was diagnosed with acute myeloid leukaemia less than two years later. “The type of leukaemia I had usually is something you get later in life,” Piekutowski, now 26, said. “Early onset can be caused from being around certain types of chemicals.” Another plaintiff, naval officer Angel Torres, one of 5,500 sailors and marines aboard nuclear-powered super-carrier USS Ronald Reagan, said he had suffered two hernias, loss of libido and PTSD since taking part in Operation Tomodachi. Torres had also exhibited symptoms of multiple sclerosis, though medical tests for that disease had come up negative. Torres described “an eerie feeling” that came over him when the Ronald Reagan passed through the radioactive plume, which appeared like “a gray smoke”. Once the sailors realised what it was, a sense of confusion and panic set in, he said. Back in Japan, Idogawa is no stranger to confusion and panic. Employed as an operator in the central control room at Fukushima Daiichi, which lost all power following the earthquake and the tsunami, he and his colleagues waged a knife-edge battle to bring the melting reactors under control. As they did so over the weeks that followed, fear and anxiety took their toll – a toll which Idogawa still lives with. I could hardly breathe. I thought, ‘Oh My God! I’m going to die’ The earliest signs of his ongoing battle with mental illness became apparent in the spring of 2011, Idogawa says, not long after his parents had been relocated from their Futaba home to a town just north of Tokyo. He recalls a sense of panic overwhelming him as he was boarding a train bound for the capital. The carriage walls seemed to close in around him and fellow passengers began to stare. “I was sweating, but I felt really cold, and my heart was racing, faster and faster,” Idogawa says. “I could hardly breathe. I thought, ‘Oh My God! I’m going to die.’” Mental afflictions are not unusual among Fukushima plant workers, experts say. According to one study, all 1,500 Tepco workers surveyed had experienced a variety of stress-causing ailments relating to their direct experiences of the disasters, losses of loved ones or the backlash from a disgruntled public, in particular residents who were evacuated. Around 30 per cent of workers at the plant subsequently displayed high post traumatic stress responses (PTSR), including flashbacks and avoidance of reminders of the terrifying events they experienced, according to lead researcher Jun Shigemura, an associate professor at Japan’s National Defense Medical University’s department of psychiatry. Shigemura and a team of other experts continued to survey workers in the years after the disasters and found the overall influence of disaster-related experiences on workers has decreased, but remains high. “For some workers, this is going to continue for a long time – probably years and decades,” says Shigemura, who specialises in the mental health of disaster workers. Following the Chernobyl nuclear accident of 1986, scientists assumed that cancers and other malignant disorders would be the biggest health risk, but long-term mental health issues turned out to be more prevalent, Shigemura says. “I think we can say with some confidence that the Fukushima workers, too, are at very high risk of developing long-term mental health issues,” he adds. A graduate of Toden Gakuen, Tepco’s now defunct training academy, Idogawa had lived and breathed the utility’s doctrine since he was 15 years old. That dogma centred as much around technical excellence as it did on corporate group identity and loyalty, and those who conformed to it were rewarded with the kind of salaries that placed them among the elite in their communities. On the day of the disasters, Idogawa was resting at his Futaba home, having worked a night shift the previous day. Even before the Earth’s violent convulsions had subsided, he was racing at his own volition towards the plant, arriving there just before the 15-metre tsunami engulfed the facility. As one of the plant’s key operators, his day-to-day duties included scrutinising instrumentation that monitored Reactor No 1. By the time he joined the on-duty team of operators, the tsunami had extinguished all available power sources, plunging the control room, which monitored Reactors No. 1 and 2, into darkness and disarray. With monitoring apparatus also dependent on power, there was no way of knowing if coolants were reaching the reactor cores. Believing this to be unlikely, Idogawa calculated that the reactors had probably started to melt as early as midnight. Portable monitoring devices showed radiation levels inside the control room were rapidly climbing. Over the next three days, he remained inside the control room, not knowing the fate of his loved ones, as he struggled to cope with meltdowns and reactor explosions. On March 14, Idogawa was ordered aboard a company bus bound for Fukushima Daini Nuclear Power Plant, which had faired better than its older neighbour and had been designated an off-duty recuperation and medical centre for Daiichi workers. During that 10km journey, his focus slowly shifted to the outside world, which had a distinctly fishbowl appearance through his full-face mask. At one point he looked out of the window and saw a man, wearing no protective clothing, walking his dog like it was just another ordinary day. “I wanted to shout out to him,” says Idogawa, “to get inside away from the high radiation.” The US Navy has stated that most of the plume of radioactivity did not deposit on its ships involved in the assistance mission off Japan in 2011, and that “the very low levels” of residual radiation that did “were mitigated and controlled”. It has said in a statement that there was “no indication” that any US personnel supporting Operation Tomodachi experienced radiation exposure “at levels associated with the occurrence of long-term health effects”. A study published by Britain’s Royal Society in late 2017 that revisits the issue of the health effects of radiation was equally dismissive. The report, which was conducted by experts from multiple research facilities worldwide, including the Centre for Radiation Protection Research at Stockholm University and Oxford University’s Oxford Martin School, concluded that the only health issues brought about by Fukushima to date resulted from “the effects of the evacuations, continued displacement [of evacuees] and fear of radiation”. However, there would be “no other discernible increase in ill-health attributable to radiation exposure […] in either emergency workers or members of the public”, although it was unclear if there would be a “detectable excess” in thyroid cancer cases in coming years. One of the authors of the report, Imperial College London cancer specialist Geraldine Thomas, says this was also true for the US sailors, whose exposure doses aboard the boats, which were officially reported to be anchored 100 miles (160km) northeast of the plant, would have been “insignificant”. “I don’t think there’s a case there at all from a scientific point of view,” says Thomas, who also oversees the Chernobyl Tissue Bank, which stores biomaterials from patients with thyroid lesions directly resulting from the Ukrainian disaster. “Any ill effects, such as cancers, for example, would not show so quickly. It would be much longer than just a few years.” The pseudonym “Fukushima 50” was coined by the overseas – not the Japanese – media, and the workers were internationally admired for their bravery, discipline and sense of duty. There were, in fact, significantly more than 50, and CNN regularly called them “heroes”; Britain’s Guardian newspaper opined that the world “can only look on in admiration”. In Hong Kong, a group of posters on the popular HKGolden online forum rewrote and dedicated Cantonese and Japanese lyrics for a Cantopop song to the workers, calling it Martyr of Fukushima – Tribute to the Fukushima 50 . As one of them, Idogawa worked shifts for months, battling reactor meltdowns and recuperating at the Fukushima Daini plant or, like other workers, at new homes outside a 20km exclusion zone. Idogawa’s new lodgings were 90km away, in Koriyama City. With nothing to do but await his next shift, his mind wandered to, among other things, the man walking his dog, and the tens of thousands of residents like him who had been forced to flee their homes as invisible radioactive substances fell on their land. He began to suffer stomach cramps and chronic insomnia and depression, and turned to the only thing he could think of that would help him sleep and wash away the unwelcome images in his head: alcohol. “I felt bad for those people, like it was my fault,” he says. “As a member of Tepco, I thought I was to blame.” Though their frequency has decreased, Idogawa continues to suffer panic attacks. One cause of this condition, he believes, is the sense of guilt: that he was powerless to prevent the devastating nuclear accident that occurred during his shift. “At the beginning, I wasn’t even aware of my condition, or I felt somehow separate from it,” he says. “Looking back, maybe I was hiding it, or hiding from it.” For their bravery and civic duty, the Fukushima 50 have been rewarded with something close to ostracism Self-criticism has been major contributor to mental illnesses among plant workers, according to Takeshi Tanigawa, a professor of public health at Jutendo University’s graduate school of medicine, who has been involved in mental health surveys of workers. So, too, has the continuing criticism by residents, a reflection, says Tanigawa, of a tendency in Japan to closely associate employees with the company they work for. “Whereas in a Western context military personnel and disaster workers are considered heroes, in Japan, even if nuclear plant workers put their lives on the line to save others, that’s seen as a matter of course,” Shigemura says. “There’s no show of appreciation: only criticism.” A 2013 editorial in the Guardian made a similar point, stating, “In any other country, the workers who tried to prevent the plant from going into total meltdown would have been heroes […] For their bravery and civic duty, the Fukushima 50 have been rewarded with something close to ostracism.” “We found that those who have experienced such criticism and discrimination have a high degree of psychological distress, or PTSR – more than two times higher than controls,” Tanigawa says, adding that with 80 per cent of workers being local hires, the criticism sometimes came from friends and relatives, making it even more difficult to take. Alcohol abuse, increased smoking and obesity are prevalent among workers surveyed, he says. Idogawa’s radiation exposure levels were in excess of acceptable levels by the time he quit Tepco in January 2012. His resignation was out of protest for the utility’s poor treatment of workers – who were mostly local hires and therefore victims, too – and the government’s announcement the previous month that the plant had been brought “under control”, which was at odds with what he saw. Despite his disgruntlement, Idogawa is hopeful that his former employer will implement measures to monitor and treat mental health issues that he believes continue to persist among workers. When asked to comment on post-accident care of its workers for this article, Tepco said it was unable to provide details due to privacy issues. It did, however, continue to hand out “health check” questionnaires to all personnel, the Tepco spokesperson said. Shigemura, whose surveys and subsequent treatment of plant workers was brought to an abrupt halt by Tepco in 2015, believes continued “surveillance” of workers is imperative, not least because of the very real possibility of the “delayed onset” of mental illnesses, which have frequently occurred among “survivors” following other historical disasters and conflicts, including some Vietnam war veterans, who only developed such illnesses more than 20 years on, triggered, says Shigemura, by the start of the Gulf war. Meanwhile, on the other side of the Pacific, lawyer Bonner says that while his team represents more than 400 sailors, there were a further 69,600 American citizens – military and civilian – potentially affected by the radiation, and who have yet to join the class lawsuit. He also expresses indignation at the Royal Society study and the viewpoint of cancer expert Thomas, insisting that the health of the young US service men and women aboard the ships was endangered and in many cases compromised by Operation Tomodachi. “[The sailors] were certified by the Navy as healthy and fit, so why are they getting cancer and other illnesses?” he asks. “That can only be because they were exposed to radiation. It can’t just be a coincidence.” Thomas’ response is that cancers, “regrettably”, like other life-threatening illnesses, are not uncommon in society, and research attempting to tie them irrefutably to the relatively low levels of radiation the sailors would have been exposed to has been inconclusive. Indeed, according to US federal data, new cancer cases total 455 per 100,000 men and women in the US each year. And while Thomas is doubtful of direct health effects for the sailors, she says psychological disorders, especially among plant workers and first responders, are almost inevitable. “The situation was stressful and quite possibly the mental health problems are due to reacting particularly badly to thoughts relating to radiation.” The plant workers, who were exposed to much higher radiation than the sailors but show no direct health problems, Thomas adds, could be particularly susceptible. Rob Gilhooly is author of a book about the Fukushima nuclear accident titled Yoshida’s Dilemma.