TOKYO — Playtime at the Kashima day care center in Minamisoma, 150 miles north of Tokyo, begins with a radiation reading.

Teachers then wipe down the slide and jungle gym while 5-year-old children don their breathing masks and jackets.

They play for 30 minutes, staying away from the edges of the playground — the readings tend to be higher there, day care workers say.

The children cool off by drinking bottled water donated by U.S. military spouses, whose gifts are the legacy of a relief effort that once included 20,000 servicemembers.

The government tells people in this neighborhood, 20 miles from the Fukushima Dai-ichi Nuclear Power Plant, that the air is clean and the tap water is safe to drink. The government also told many of the people who live here that they did not need to evacuate their homes two years ago, even as the plant’s crippled reactors spewed massive amounts of radiation in the weeks following the March 11, 2011, disaster.

The national government eventually evacuated the towns within 12 miles of the nuclear plant, but it took months to do so.

“We can’t believe them,” Mikiko Yamaki, the day care center’s principal, said of her government’s health assurances. “The truth about the nuclear power accident hasn’t been told, so we are worried about the future.”

Yamaki’s distrust reflects the country’s post-disaster view of its elected leaders.

Only 15 percent of Japanese trust government spokesmen, down from 63 percent two years ago, according to an annual survey of 26 nations released in January by the Edelman public relations firm.

In Fukushima prefecture, the trust deficit mixes with health concerns and a feeling that normalcy for the displaced communities of the earthquake, tsunami and nuclear accident is still years away.

Distrust was spurred by government decisions that exposed many residents to far more radiation than they would have experienced, had communication been better.

On March 15, 2011, then-Prime Minister Naoto Kan appeared on television and told the world that the situation at the Fukushima power plant was under control.

“Those of us affected by the accident could not understand the meaning of that declaration at all,” said Hiroshi Suzuki, a former Fukushima University engineering professor who is now chair of a committee to reconstruct the prefecture.

That same day, residents in nearby Namie town could hear the explosions at reactors two and four. The mayor made his own decision to issue an evacuation order. The government would not declare the area an evacuation zone until April 22.

After hearing nothing from the federal government, Namie’s town mayor decided that the people would evacuate to the northwest. Had they been privy to the latest government information, they would have learned that they were following the path of the crippled plant’s radiation plume.

“Initially, Namie’s [people] went to a very dangerous area,” Suzuki said.

Radiation concerns

Assessing radiation health risk is tricky because there are different forms of it, and individual health factors come into play.

Much of the data needed to fully assess risk is unavailable, because the government was more concerned with reassuring the public than making data available in the disaster’s aftermath, said Tatsuhiko Kodama, professor and head of the University of Tokyo’s Radioisotope Center.

The biggest current issue now is cesium, which has a half-life of 30 years, Kodama said.

In late 2011, 30 percent of children studied in Fukushima prefecture had cesium in their bodies.

“It was a great shock, since it is something that does not exist in nature,” Kodama said.

Cesium remains in the body for a short time, and children generally get rid of it faster than adults. However, cesium exposure can lead to malignant tumors, according to the U.S. Environmental Protection Agency.

Japanese health and food safety workers made great strides following that discovery; by 2012, 99.8 percent of children were cesium-free. However, Kodama says that cesium concentrations among adults are now higher, because they are eating uninspected food from the region.

Residents can safely eat inspected food grown locally, since the testing standards are the world’s most stringent, Kodama said. However, the soil in Fukushima must continue to be decontaminated, he said.

Kodama tested the water at various points in settled parts of Fukushima prefecture, and said it continues to be safe to drink —as long as it is kept free of contaminated soil.

Another potential source of contamination is the Dai-ichi nuclear plant. Although it is in a state of cold shutdown, it continues to emit large quantities of radiation. The government estimates it will take 40 years or more for a full cleanup.

In the meantime, residents living 20 miles away are concerned that the contaminated water sitting in the plant’s basements will leech into the groundwater supply, as the buildings deteriorate. Workers at the site have still been unable to fully explore the basements, due to health concerns.

Increased risk

Some choose to remain in the towns and cities lying just outside the radius of Fukushima’s no-go zone because they do not want to abandon their community. Others lost everything they had in the tsunami or the nuclear accident, and have little choice.

Plenty more have left the area, though they hope to return one day as soil decontamination and reconstruction advance.

Keiko, who asked that her name be changed to protect her daughter’s medical privacy, now resides in Kawasaki, near Tokyo.

Keiko lived with her 13-month-old daughter about 30 miles from the reactor, in a place considered to be relatively safe. Shortly after the reactor accident, she called the city’s water department, which said the local water was safe to drink. The next day, the department announced that tests had shown elevated radiation levels.

Fearing for her daughter’s safety and mistrustful of further assurances by authorities, she fled to a friend’s house in Kanagawa prefecture, and later to a shelter in Kawasaki for next three months.

At the shelter, her daughter suffered from stress-related illnesses and unexplained fevers.

In October 2012, doctors found multiple cysts on her daughter’s thyroid.

Keiko was shocked — no one in her family has ever had a similar illness.

“I don’t want her to resent her illness … [I] hope she can live happily,” Keiko said.

Female infants who were closest to the Fukushima reactor accident are 70 percent more likely to develop thyroid cancer, according to a World Health Organization report released in February.

Exposed infants also face elevated risks for other types of cancer.

The report stated that risk drops with distance from the plant, and that researchers foresaw no observable increases in cancer risk for the rest of Japan.

In Fukushima prefecture, three children have confirmed thyroid cancer, and seven more cases are suspected, according to a recent local government study released in February.

Authorities could not conclusively determine whether those cases are radiation related, Kodama said.

Continuing with life

Hiromi Matsumoto shares all the concerns of her neighbors about food and water safety. She regularly has her 11-year-old daughter tested for thyroid irregularities.

Other than that, she does her best not to think about the risks too much.

“I’m afraid that I might have an emotional breakdown if I’m too concerned,” she said. “It probably won’t be good for my daughter.”

Matsumoto lives alongside dozens of other displaced families in Minamisoma. She is one of the 292,358 people living in government-funded housing as a result of the disaster, according to Ministry of Health, Labor and Welfare.

Of those, about 40 percent have spent the past two years in “temporary housing.” Some of the temporary homes are made of wood, but most are prefabricated homes of 538 square yards or less, depending on family size.

Like most others, Matsumoto would like to rebuild her house, which was destroyed by the tsunami. At the current pace of construction, she doesn’t expect to for several years.

In the meantime, she has tried to adjust. She has grown somewhat comfortable with her surroundings, even if her home is a bit cramped and drafty.

“Once you live in a place, it grows on you,” Matsumoto said.

Matsumoto said that organizations like Helping Hands for Tohoku, the unofficial military spouse’s group, have helped, in both their material and emotional support.

Helping Hands for Tohoku’s leader, Masako Sullivan, said the group sends about 1,400 liters of water to Fukushima monthly. The group works with 40 families in Fukushima, the Kashima day care center, and 70 families in the city of Ishinomaki, which was devastated by the tsunami.

Sullivan, a former Yokosuka Naval Base resident who has since moved with her husband to San Diego, has also coordinated exchanges between children in San Diego and Japan.

The group has also provided disaster survivors with a way to support each other.

Keiko, the mother in Kawasaki, sold necklaces on base, donating half of the money to volunteer efforts. When Hurricane Sandy struck the United States, she donated the proceeds to the victims there.

“I had been telling Masako-san that I want to do something … since they have helped me,” she said.

After two years of efforts, the people in Fukushima and all along Japan’s northeast remain mired in the tragedy, Sullivan noted. They suffer a great deal and health concerns are never far away, but they continue to endure.

“They are doing their very best to live positively every single day during this very difficult time,” Sullivan said.

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