Hostname: page-component-74656f9884-c52kr Total loading time: 0 Render date: 2026-11-06T14:23:12.463Z Has data issue: false hasContentIssue false
  • English
  • Français

Inclusive Mass Fatality Management and Planning in Cremation-Dominant Societies: Policy Challenges and Recommendations From Japan

Published online by Cambridge University Press:  06 November 2026

Hitomu Kotani Open the ORCID record for Hitomu Kotani [Opens in a new window] ,
Hirofumi Okai ,
Susumu Nejima ,
Maki Yamagata ,
Yuichi Sato  and
Naoki Maeno
Hitomu Kotani*
Affiliation:
Department of Civil and Environmental Engineering, School of Environment and Society, Institute of Science Tokyo , Tokyo, Japan
Hirofumi Okai
Affiliation:
Faculty of Sociology, Kyoto Sangyo University , Kyoto, Japan
Susumu Nejima
Affiliation:
Department of Regional Development Studies, Faculty of Global and Regional Studies, Toyo University , Tokyo, Japan
Maki Yamagata
Affiliation:
Rikkyo Institute for Social Design Studies, Rikkyo University , Tokyo, Japan
Yuichi Sato
Affiliation:
Japan Muslim Association, Tokyo, Japan
Naoki Maeno
Affiliation:
Japan Muslim Association, Tokyo, Japan
*
Corresponding author: Hitomu Kotani; Email: kotani.h.15c7@m.isct.ac.jp
Rights & Permissions [Opens in a new window]

Abstract

Even in societies where cremation is widespread in normal times, mass fatality management and planning that encompasses minorities who do not follow the custom of cremation are necessary. However, in Japan, the country with the highest cremation rate in the world (99.97% in 2023), little consideration is afforded to such minorities during disasters. We evaluated Japan’s past disaster responses and current disaster management plans, demonstrating that unidentified remains are highly likely to be cremated after a certain period, contrary to the will of the deceased or their families. Furthermore, we proposed actions and measures that the government, local authorities, and minorities could take to reduce this likelihood, such as securing refrigeration facilities, considering temporary burials, carrying identification cards stating one’s burial preference, and ensuring minorities’ participation in response and planning efforts. Since cremation is becoming increasingly widespread internationally, evaluations and proposals from Japan can contribute to inclusive mass fatality management and planning in other countries.

Keywords

mass fatality eventscremationburialminoritiesinclusion

Information

Type
Policy Analysis
Information
Disaster Medicine and Public Health Preparedness , Volume 20 , 2026 , e193
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Author(s), 2026. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc

Introduction

Mass fatality management during disasters requires ethical and sociocultural considerations. Improper handling of bodies deprives the deceased of their individuality and dignity, and hinders the psychological recovery and reconstruction of bereaved families.Reference Suwalowska, Amara and Roberts 1 , Reference G. Corpuz 2 Inclusion must address not only the needs of affected people in life (e.g., consideration for minorities in evacuation sheltersReference Kotani, Tamura and Li 3) but also those related to their deaths. Only then can truly inclusive disaster management and planning be realized.

In normal times, cremation is the predominant practice for final disposal of the deceased, particularly in East Asia. Japan has the highest cremation rate in the world (99.97% in 2023), and cremation is also widely practiced in Taiwan (96.76% in 2017), South Korea (92.87% in 2023), and Hong Kong (96.96% in 2022). 4 Consequently, cremation is also the dominant method for handling remains after disasters in these countries. In Japan, following the 1995 Kobe Earthquake, a large number of fatalities (approximately 4,600 confirmed deaths 3 days after the earthquakeReference Funaki, Kawata and Yamori 5) and damage to crematoriums meant that the rapid cremation of victims could not be handled solely within the disaster-stricken areas.Reference Funaki, Kawata and Yamori 5 Consequently, the Ministry of Health and Welfare (now the Ministry of Health, Labour and Welfare) urged each prefecture to formulate a wide-area cremation plan to promote efficient cremation by utilizing crematoriums outside the disaster-stricken areas to perform cremations on a wide-area basis.Reference Funaki, Kawata and Yamori 5 However, during the 2011 Tohoku Earthquake and Tsunami, a large number of deaths (approximately 8,000 confirmed deaths 10 days after the disaster 6) and damage to crematoriums occurred, just as it did in Kobe in 1995. Since the affected prefectures had not yet formulated wide-area cremation plans, all bodies could not be handled through cremation.Reference Umehara, Numada and Meguro 7 –Reference Duly, Kumagai and Perich 12 Consequently, temporary burials were conducted on an ad hoc basis for some bodies, including unidentified remains.Reference Umehara, Numada and Meguro 7 –Reference Duly, Kumagai and Perich 12 Early reburials (exhumations) also occurred sooner than planned due to requests from bereaved families or the identification of the buried bodies. These improvised temporary burials and reburials placed a significant mental and physical burden on workers and bereaved families, and are often described as tragic.Reference Umehara, Numada and Meguro 7 , Reference Yamada 9 –Reference Yamagata 11 Owing to these circumstances, wide-area cremation plans were formulated in all prefectures by 2023. 13 Thus, in general, Japan has been strengthening its policy of rapidly cremating bodies during disasters.

However, in countries where cremation is dominant, the diversification of nationalities and religions has led to a recent increase in minorities that do not follow the custom of cremation, but rather that of burial. Examples include followers of Islam, Judaism, and Christianity. In Japan, the bubble economy of the 1980s led to an increase in the number of international Muslim workers from countries such as Pakistan, Bangladesh, and Iran, and their population has continued to grow (reported at approximately 110,000 in 2010Reference Tanada 14 and approximately 3 times that number, 294,000, in 2023Reference Tanada 15). Similarly, due to declining birth rates and labor shortages, Taiwan and South Korea are seeing an increase in the number of foreign nationals who practice burial. However, at least in Japan, minorities that practice burial are scarcely considered in disaster management and planning for handling remains. Forced cremation against their will violates their dignity and invites international criticism.Reference Marsoof 16

This paper evaluates past disaster response efforts and current disaster management plans in Japan, specifically highlighting the possibility that disaster victims may be cremated against their will or that of their bereaved families. Furthermore, this paper proposes measures and actions that relevant stakeholders—including the government, local authorities, and the individuals and communities of these minorities—should take. Although issuesReference Morgan, Sribanditmongkol and Perera 17 –Reference Ibrion, Parsizadeh and Naeini 21 and guidelines/manualsReference Cordner, Coninx and Kim 22 regarding the handling of remains during disasters have been discussed, most of them are intended for societies where burial is the predominant practice. Given that cremation rates are increasing worldwide, 4 Japan is considered a leading case internationally. It should be noted that although governmental policies have promoted the widespread adoption of cremation, cremation is not required by national law in Japan. Whether burial is prohibited is determined according to the ordinances of each local government. Our evaluations and recommendations can contribute to the realization of inclusive mass fatality management and planning in societies where cremation rates are expected to increase in the future.

Discussion

Evaluation of Past Mass Fatality Management and Current Planning

According to Japan’s past disaster response efforts and existing local disaster management plans, disaster victims are highly likely to be cremated against their wishes, that is, while their identities remain unknown. Regarding past cases, during the 2011 Tohoku Earthquake and Tsunami, unidentified bodies in Miyagi Prefecture were cremated by the prefectural government or by the distant Tokyo Metropolitan Government. 23 , 24 Regarding local disaster management plans, the wards of Tokyo outline the procedures for handling remains, but these flowcharts do not indicate any alternatives to cremation. Furthermore, it is explicitly stated that unidentified remains will be cremated after being stored by the wards for a certain period; for example, in Shinagawa Ward, it is noted as “approximately one week later.” 25 Within such a short timeframe during the initial chaotic period, identifying personal belongings or locating bereaved family members, including those living overseas, would be extremely difficult (i.e., early cremation could result in bodies remaining unidentified, as seen in Thailand during the 2004 Indian Ocean TsunamiReference Tsokos, Lessig and Grundmann 26). These past cases and existing plans imply that if persons who do not follow the custom of cremation become unidentified bodies, they will likely be cremated against their will in the early stages following a disaster.

Recommendations

To avoid unintended cremations in the immediate aftermath of a disaster, the government and local authorities should implement measures to preserve unidentified remains for as long as possible. For example, although logistical and power supply challenges must be addressed and the number of bodies is relevant,Reference Boret, Sasaki and Kimura 10 securing refrigerated storage facilities to slow the decomposition of remains is desirable. Extending the preservation period of remains facilitates the identification of personal belongings and location of bereaved families, including those living in distant locations or overseas, and may reduce the likelihood of cremations that go against the victims’ wishes or those of their bereaved. Moreover, temporary burial should be considered as one option. As noted in the Introduction, while temporary burial is often discussed as a tragic measure, it should not be implemented on an ad hoc basis. Rather, local disaster management plans and pre-disaster recovery plans should be prepared in advance, outlining the procedures, responsible entities, and land acquisition. Naturally, long-term plans following temporary burials, such as reburial plans and securing long-term burial sites, should also be discussed alongside these preparations. Formulating such plans, including securing land, may require the consent of residents and efforts to address public opposition to minorities. These social, cultural, and political contexts may pose major obstacles to securing burial lands. For example, in a municipality in Oita Prefecture, plans to acquire land for a Muslim burial ground were derailed due to opposition from residents.Reference Suzuki 27 Local communities (or the majority of society) will be faced with the question of how to address the deaths of minority groups, including in the context of disasters.

In addition to the government and local authorities, individual members and communities of minorities must also prepare and respond. For example, the Japan Islamic Cultural Center (Otsuka Mosque) in Tokyo issues Muslim ID cards that identify the holder as a Muslim. The cards state the holder’s objection to cremation and preference for burial, as well as instructions to contact Otsuka Mosque when the holder dies.Reference Okai 28 In normal times, unidentified bodies have sometimes been cremated only to be later identified as Muslims.Reference Yamagishi and Iizuka 29 , Reference Sakurai 30 The cards are issued to avoid recurrence of such a possibility. Carrying such a card can delay the cremation process and help identify the appropriate recipient of the remains, thereby reducing the likelihood of cremation even in disaster situations. Furthermore, minority communities should be involved in establishing procedures for the transport and burial of remains, as well as determining the entities responsible for implementing them. Although few burial cemeteries exist in Japan,Reference Suzuki 31 these communities usually conduct their funerals and collaborate with funeral directors who possess the knowledge and skills to transport and bury bodies.Reference Okai 28 The knowledge, skills, and networks of these communities should be utilized in disaster response and planning. The involvement of diverse stakeholders in response efforts and plan formulationReference Kotani, Okai and Tamura 32 , Reference Kotani, Okai and Tamura 33 is also necessary for inclusive mass fatality management and planning.

Furthermore, although not a measure aimed at reducing the aforementioned unintended cremations, one supplementary measure involves religious communities and medical organizations issuing statements during emergencies that “cremation is unavoidable.” Such statements may help bereaved families come to terms with the situation, even if the remains are cremated against the victim’s wishes, and could contribute to their psychological recovery and reconstruction.

Conclusions

Even in societies where cremation is the dominant practice in normal times, mass fatality management and planning must be inclusive of minorities for whom cremation is not customary (e.g., Muslim, Jewish, and Christian). While Japan has the highest cremation rate in the world, minorities are rarely considered. This paper indicated that, based on the past disaster responses and current disaster management plans, cremation is highly likely to be carried out against the wishes of the deceased or their families. To reduce this likelihood, this paper proposed several actions and measures that governments, local authorities, and individuals and communities of such minorities should take, while addressing social, cultural, and political issues. Inclusive disaster management and planning are required not only for the survival and recovery of affected people but also for the handling of death. To achieve this, the insights from this paper can be employed not only in Japan but also in other parts of the world, particularly East Asia, where cremation rates are increasing to ensure the dignity of all the deceased and their bereaved families.

Acknowledgments

The authors used DeepL Translator, DeepL Write, and ChatGPT-5.5 to improve readability and language in the writing process. After using these tools, the authors reviewed and edited the content as needed and took full responsibility for it. We would also like to thank Editage (www.editage.jp) for English language editing.

Author contribution

Hitomu Kotani: Conceptualization, investigation, writing—original draft, project administration, funding acquisition.

Hirofumi Okai: Conceptualization, investigation, funding acquisition, writing—review and editing.

Susumu Nejima: Conceptualization, investigation, writing—review and editing.

Maki Yamagata: Investigation, writing—review and editing.

Yuichi Sato: Investigation, writing—review and editing.

Naoki Maeno: Investigation, writing—review and editing.

Funding statement

This work was supported by the Japan Society for the Promotion of Science (KAKENHI Grant Nos. 23K22881, 23K01733, 24K03406, and 25K21916).

Competing interests

None.

References

Suwalowska, H, Amara, F, Roberts, N, et al. Ethical and sociocultural challenges in managing dead bodies during epidemics and natural disasters. BMJ Glob Heal. 2021;6(11):e006345. https://doi.org/10.1136/bmjgh-2021-006345CrossRefGoogle ScholarPubMed
G. Corpuz, JC. Commemoration of the dead in the time of COVID-19. Disaster Med Public Health Prep. 2022;16(5):1706–1707. https://doi.org/10.1017/dmp.2021.52CrossRefGoogle ScholarPubMed
Kotani, H, Tamura, M, Li, J, et al. Potential of mosques to serve as evacuation shelters for foreign Muslims during disasters: a case study in Gunma, Japan. Nat Hazards. 2021;109(2):1407–1423. https://doi.org/10.1007/s11069-021-04883-7CrossRefGoogle Scholar
The Cremation Society of Great Britain. Cremation Statistics. Accessed April 2026. https://www.cremation.org.uk/statisticsGoogle Scholar
Funaki, N, Kawata, Y, Yamori, K, et al. A study about mortuary care and cremation of deceased people after large-scale disasters. J Japan Soc Nat Disaster Sci. 2006;24(4):447–471. https://www.jsnds.org/ssk/ssk_24_4_447.pdf (in Japanese)Google Scholar
Fire and Disaster Management Agency. The 2011 Tohoku Earthquake and Tsunami (Report No. 68) [Heisei 23 nen (2011 nen) touhoku chihou taiheiyouoki jishin (dai 68 hou)]. https://www.fdma.go.jp/disaster/higashinihon/higaihou-past-jishin/2011/ (in Japanese)Google Scholar
Umehara, A, Numada, M, Meguro, K. Analysis of dead body processing during the 2011 Great East Japan Earthquake. Seisan Kenkyu. 2014;66(4):393–396. https://doi.org/10.11188/seisankenkyu.66.393 (in Japanese)Google Scholar
Okamoto, R, Iwamoto, S, Nishida, M, et al. Emergency operations and feelings as described by municipal employees six months after the Great East Japan Earthquake: body recovery and management work. Japanese J Public Heal Nurs. 2016;5(1):47–56. https://doi.org/10.15078/jjphn.5.1_47 (in Japanese)Google Scholar
Yamada, S. Funerals of the Great East Japan Earthquake disaster victims in Kesen-numa City. Bullten Natl Museum Japanese Hist. 2019;214:303–316. https://doi.org/10.15024/0000002457 (in Japanese)Google Scholar
Boret, SP, Sasaki, H, Kimura, T. Responding to mass fatalities on 3.11: preliminary lessons from an interdisciplinary perspective [3.11 deno tairyoshi heno taiou: gakusaitekina shiten karano yobitekina kyokun]. Tohoku J Relig Stud. 2023;(Special Issue):31–45. https://doi.org/10.50974/00136789 (in Japanese)Google Scholar
Yamagata, M. Analysis and consideration of inhibiting and promoting factors regarding temporary burial of large numbers of bodies in large-scale disasters: based on interviews with people involved in temporary burial after the Great East Japan Earthquake. J Soc Saf Sci. 2024;44:69–78. https://doi.org/10.11314/jisss.44.69 (in Japanese)Google Scholar
Duly, S, Kumagai, A, Perich, P. Adapting international forensic protocols to local needs: an interdisciplinary assessment of the 2011 Great East Japan Earthquake and Tsunami. Hum Remain Violence. 2025;11(1):63–87. https://doi.org/10.7227/HRV.11.1.4CrossRefGoogle Scholar
The Sankei Shimbun. Cremation of major disaster victims: use of facilities in neighboring municipalities—wide-area plans in all prefectures [Daisaigai giseisha no kaso, shuhen jichitai no shisetsu riyou zen todoufuken de kouiki keikaku]. Published August 26, 2023. Accessed April 1, 2026. https://www.sankei.com/article/20230826-5L5OUXPIYVON5BA2NWCDMCWOMY/ (in Japanese)Google Scholar
Tanada, H. Mosques in Japan [Nippon no mosuku]. Yamakawa Shuppansha; 2015. ISBN:978-4634474741 (in Japanese)Google Scholar
Tanada, H. Estimate of Muslim population in Japan, 2024. Res Pap Muslims Japan. 2024:1–27. https://www.imemgs.com/muslim-research/806/ (in Japanese)Google Scholar
Marsoof, A. The disposal of COVID-19 dead bodies: impact of Sri Lanka’s response on fundamental rights. J Hum Rights Pract. 2022;13(3):669–689. https://doi.org/10.1093/jhuman/huab030CrossRefGoogle ScholarPubMed
Morgan, OW, Sribanditmongkol, P, Perera, C, et al. Mass fatality management following the South Asian Tsunami Disaster: case studies in Thailand, Indonesia, and Sri Lanka. PLoS Med. 2006;3(6):e195. https://doi.org/10.1371/journal.pmed.0030195CrossRefGoogle ScholarPubMed
Scanlon, J, McMahon, T, Van Haastert, C. Handling mass death by integrating the management of disasters and pandemics: lessons from the Indian Ocean Tsunami, the Spanish Flu and other incidents. J Contingencies Cris Manag. 2007;15(2):80–94. https://doi.org/10.1111/j.1468-5973.2007.00511.xCrossRefGoogle Scholar
Phillips, B, Neal, D, Wikle, T, et al. Mass fatality management after the Indian Ocean tsunami. Disaster Prev Manag An Int J. 2008;17(5):681–697. https://doi.org/10.1108/09653560810918685CrossRefGoogle Scholar
McEntire, D, Sadiq, A-A, Gupta, K. Unidentified bodies and mass-fatality management in Haiti: a case study of the January 2010 Earthquake with a cross-cultural comparison. Int J Mass Emergencies Disasters. 2012;30(3):301–327. https://doi.org/10.1177/028072701203000303CrossRefGoogle Scholar
Ibrion, M, Parsizadeh, F, Naeini, MP, et al. Handling of dead people after two large earthquake disasters in Iran: Tabas 1978 and Bam 2003—survivors’ perspectives, beliefs, funerary rituals, resilience and risk. Int J Disaster Risk Reduct. 2015;11:60–77. https://doi.org/10.1016/j.ijdrr.2014.11.006CrossRefGoogle Scholar
Cordner, SM, Coninx, R, Kim, HJ, et al. Management of Dead Bodies After Disasters: A Field Manual for First Responders. 2nd ed. 2016. Accessed April 2026. https://icrcndresourcecentre.org/wp-content/uploads/2019/06/0880_002_Management-of-dead-bodies_WEB_2-1.pdfGoogle Scholar
Miyagi Prefecture. The 2011 Tohoku Earthquake and Tsunami: A Record of Activities by the Miyagi Prefecture Department of Environment and Community Affairs. Accessed April 2026. https://www.pref.miyagi.jp/site/ej-earthquake/kansei-shinsaikiroku.html (in Japanese)Google Scholar
Miyagi Prefecture. The 2011 Tohoku Earthquake and Tsunami: A Record And Analysis of Disaster Response in Miyagi Prefecture During the First Year. Accessed April 2026. https://www.pref.miyagi.jp/site/kt-kiroku/kt-kensyou3.html (in Japanese)Google Scholar
Shinagawa Ward. Shinagawa Ward Local Disaster Prevention Plan [Revised in Fiscal Year 2025]. Accessed April 2026. https://www.city.shinagawa.tokyo.jp/PC/bosai/bosai2/bousaikeikaku/hpg000001888.html (in Japanese)Google Scholar
Tsokos, M, Lessig, R, Grundmann, C, et al. Experiences in tsunami victim identification. Int J Legal Med. 2006;120(3):185–187. https://doi.org/10.1007/s00414-005-0031-4CrossRefGoogle ScholarPubMed
Suzuki, K. Expanded Edition: Reportage on Burial in Japan [Zohoban rupo Nippon no doso]. Shukyomondai; 2025. ISBN:978-4863061910 (in Japanese)Google Scholar
Okai, H. Coping with aging and death Japanese Islamic organizations’ responses to the death and burial of Muslims. Annu Rev Migr Stud. 2023;29:43–56. https://doi.org/10.60271/jamsarms.29.0_43 (in Japanese)Google Scholar
Yamagishi, T, Iizuka, M. 100 Q&A to Help You Understand the Islamic World [Isuramu sekai ga yokuwakaru Q&A 100]. Akishobo; 1998. ISBN:978-4750598109 (in Japanese)Google Scholar
Sakurai, K. Muslim Society in Japan [Nippon no musurimu shakai]. Chikumashobo; 2003. ISBN:978-4480061201 (in Japanese)Google Scholar
Suzuki, K. Reportageon Burial in Japan [Rupo Nippon no doso]. Syuukyoumondai; 2023. ISBN:978-4-910357-13-3 (in Japanese)Google Scholar
Kotani, H, Okai, H, Tamura, M. Mosque as a vaccination site for ethnic minority in Kanagawa, Japan: leaving no one behind amid the COVID-19 pandemic. Disaster Med Public Health Prep. 2022;16(6):2683–2685. https://doi.org/10.1017/dmp.2022.78CrossRefGoogle ScholarPubMed
Kotani, H, Okai, H, Tamura, M. Activities and roles of mosques in Japan after the recent major earthquakes: a comprehensive study. Prog Disaster Sci. 2023;20:100297. https://doi.org/10.1016/j.pdisas.2023.100297CrossRefGoogle Scholar