The scale and severity of losses— human, economic, debris generated—were extraordinary, creating unprecedented challenges for emergency management, sheltering, housing, and recovery planning. Current loss estimates indicate 22,626 persons killed or missing nationwide (of which 15,534 are confirmed deaths), 107,000 buildings collapsed, and another 111,000 partially collapsed (National Police Agency, 2011). Table 1 indicates casualties for communities visited by the field team. The city of Ishinomaki alone had about the same number of casualties (including dead and missing) as Kobe had in the 1995 earthquake, but with a population one-tenth as large. Communities had high levels of tsunami awareness, pre-disaster mitigation (including structural works) and preparedness;