Self-Defense Forces vehicles kick up clouds of dust as they make their way through narrow streets cleared through the piles of crushed houses, shops and fishing boats scattered like broken toys by the massive tsunami that killed thousands and flooded nearly half of this once beautiful city.

Ishinomaki is in ruins.

Despite all the aid and support pouring in every day to rebuild, the city’s inhabitants still suffer from a chronic shortage of housing and daily necessities, as well as sufficient manpower to clear out the rubble and restore the wrecked local infrastructure.

The death toll in Ishinomaki continues to rise as more bodies are discovered, while many more are missing and presumed dead. As of Wednesday, the city’s official death toll stood at 2,283, with 2,643 unaccounted for.

Roughly 18,000 people are still taking refuge in various shelters, and demand for temporary housing far exceeds the planned supply.

Ishinomaki Mayor Hiroshi Kameyama told reporters Wednesday that construction of 137 temporary houses began Monday, but 3,145 households have already applied to live in them. The city has asked the prefectural government to build another 10,000 housing units urgently, he said.

All people interviewed in the city Wednesday had suffered the death of a friend, or in some cases, family member. Lifelines haven’t been restored in many of the hardest-hit coastal areas, and many residents who haven’t made their way to temporary shelters live in damaged, half-flooded homes cut off from the influx of goods.

Ryoko Kurosu, a middle-aged hairdresser, is letting 20 other disaster victims stay in the second floor of her house — the first floor has been flooded — but said “everything was lacking,” including food and other necessary amenities.

“There is a discrepancy in the aid one can receive depending on where you live. Those like us who decide to stay in our homes haven’t been receiving enough goods,” she said.

Volunteer groups and charities are trying to fill in the void, like Chad Huddleston of Christian network Be One, who has been making the rounds in trucks and vans, dropping off goods in hard-hit coastal areas such as Watanoha, where Kurosu lives.

“We can probably get more food if we went to a temporary shelter, but I want to stay in my house. You’ve got to be able to protect yourself,” Kurosu said, lining up to receive goods distributed by Huddleston and other volunteers.

While the SDF has managed to scrape roads out of the piles of rubble scattered across the coast so vehicles can pass through, traffic lights in the hardest hit areas do not function and removal of debris is expected to take enormous time and manpower.

At temporary shelters such as Aoba Junior High School, nearly 800 disaster victims, including sisters Kayoko Kimura and Masako Oikawa — whose homes have been partially damaged — have evacuated along with their families, waiting for the daily meals served by the SDF and for the day they can move back home.

While Mayor Kameyama said they would like to propose that those taking refuge in schools evacuate to another destination before classes resume April 21, he also admitted it is difficult to persuade many of the evacuees to move farther away from their hometown when there is no end in sight for the evacuation.

And the stress of homelessness is taking its toll.

Shintaro Doyao, a worker at the facility dispatched from Tottori Prefecture, said residents in shelters are becoming increasingly anxious, and quarrels between dwellers are more and more frequent.

Rumors of looting and robbery also abound. Norihito Kurosu of Watanoha, who lost his home and his workplace to the tsunami, spoke of vending machines and television game shops being broken into during the days following the earthquake, while the lack of fuel is driving some to steal gasoline from abandoned vehicles.

“But the situation is improving, we have security personnel making the rounds now,” he said. The enormous tsunami that engulfed the city also severely damaged its medical facilities.

Ishinomaki Municipal Hospital, located near Ishinomaki Bay, has been shut down since tsunami destroyed its facilities, and many other clinics in the bay area have closed.

Takenobu Taima, a doctor working at Ishinomaki Red Cross Hospital in the relatively undamaged Hebita district, said doctors and staff have been working on site around the clock and medical personnel from across the nation have shown up to help.

Taima said many patients were hospitalized with pneumonia or hypothermia following the long hours they spent in flood waters.

As of Wednesday, 123 patients hospitalized since the quake had died.

Many of the doctors and employees at the hospital have also suffered from the disaster. Yoshihiro Aoki, a medical worker of the Red Cross hospital, said he has slept 11 days straight at the hospital since the tsunami flooded his house, and added his parents are living in a temporary shelter.

Aoki stressed that improving living conditions at the shelters is the biggest priority in preventing further patients from catching colds or other diseases.

“Sanitary management and the restoration of lifelines is most important — if this situation continues, the number of patients admitted will continue to grow,” he said.

But while the devastation has deeply scarred many victims, there were also signs that people are trying to fight amid the adversity and restore hope.

Nobukazu Endo, who tunes concert pianos and is well known in the local music scene, said that while the city tries to rebuild itself step by step, it is also important that its citizens, still shell-shocked, regain some composure with the help of music.

“I’m currently planning a large-scale, outdoor charity concert here in Ishinomaki, hopefully to be held this summer,” he said, adding it was a step to let the world know the city is setting off on the long road to recovery.

Endo, who lost many of his friends, including the owner of a live-music venue near Ishinomaki Bay that was wrecked by the tsunami, said he felt crippled when news of the scale of the devastation and other tragedies began pouring in.

“I seriously thought this was it for Ishinomaki, that we couldn’t make it,” he said.

“But I’d like the rest of the nation and the world to know that Ishinomaki is going to be OK, that we’ll survive,” he said.

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