A memorial ceremony was held Monday to mark nine years since the powerful 2016 earthquakes in Kumamoto Prefecture that killed 278 people.

The first earthquake struck on the night of April 14, 2016, followed by an even stronger main shock in the early hours of April 16. Both quakes registered 7, the highest level on Japan’s seismic scale.

In the town of Mashiki, where 45 people died, one survivor continues to share her experience and lessons from the ordeal.