Since its formation in the wake of the 2004 Sumatra tsunami, American nonprofit organization All Hands has dispatched more than 6,000 volunteers to the scenes of more than a dozen disasters across the globe. While these teams are accustomed to encountering tough conditions — including torrential rain in Indonesia and the threat of cholera following last year's Haiti earthquake — what they encountered upon their arrival in Iwate Prefecture in April was an entirely different kind of problem.

"Although the tsunami had reduced whole areas of the coast to debris and the few houses still standing were full of mud, when we asked the owners if they needed help, they turned us down," recalls Neil Lawson, the NPO's work coordinator. "For almost a week we went door to door trying to assist people, but all of them declined."

The reactions of the residents surprised the volunteers. A month earlier, the mayors of Ofunato and Rikuzentakata, two of the Iwate towns most severely damaged, had given All Hands' Executive Director David Campbell and his fact-finding team a warm welcome. But it would prove more difficult to win over the trust of the survivors living in the heart of the destruction.