Ishinomaki Red Cross Hospital is a glowing example of how "disaster-resistant" buildings coped after the largest earthquake in Japan on March 3 last year. But their experience after the ensuing tsunami flooded the port area in north-eastern Miyagi prefecture also highlights the challenges the most earthquake-prone country faces -- and some difficult decisions that have to be made.

The waves destroyed or disabled all other hospitals in that zone. The Red Cross institution, however, was one of many across the nation which were built after the 1995 Kobe earthquake. Twenty per cent of natural disasters strike in Japan -- and it has learned from past tragedies.

In the 1923 earthquake in Kanto (Tokyo and the surrounding area), for example, the major cause of death was fire, as Masaru Sato, director of the Ministry of Foreign Affairs (Mofa) international press division points out. So concrete replaced wood in the reconstruction.

In the Kobe earthquake, most people died when buildings collapsed. So the Red Cross Hospital in Ishinomaki had the latest in "seismic isolation" technology.

Few died in collapsed buildings after the magnitude 9.0 earthquake last year -- but an estimated 95 per cent of more than 15,800 people drowned.

The tsunami affected 1.9 million phone lines, while operations at around 15,000 mobile phone base stations were suspended.

Masaaki Abe at the hospital's planning and coordination department recalls: "We were isolated. There was no support from anyone for the first three days."

After that, there was emergency radio connection with the local government. "There should be hotlines between critical facilities," he urges.