The trickle of visitors to Okawa primary school began soon after dawn. Three men in dark overcoats, their shaved heads exposed to the freezing elements, stepped out of their black sedan and bowed before a makeshift shrine that has come to symbolise the most distressing episode of the Japan tsunami disaster.
Later, a woman arrived and lit sticks of incense, shielding them from the wind, then lingered in front of the tributes: paper cranes, plastic toys and dolls, a bell and bouquets of flowers. Beside them lay a stone carving of a mother cradling an infant bearing the words: "Protect the children."
The message carried extra poignancy for Miho Suzuki, whose two children were among the 74 pupils swept to their deaths last March, along with 10 staff. The body of her son, Kento, was discovered a week later, but after a year-long search, there is still no sign of her eight-year-old daughter, Hana.
"I can't say when or how this pain will end," said Suzuki, who makes daily pilgrimages to the school, its concrete shell one of the few structures left standing in Ishinomaki, where 3,097 people died and another 2,770 are still missing.
"We found our son, but we want Hana back, too. When they found my son's body I could at least rub his cold hands and wipe the mud from his face. Until Hana is back my family can't look forward. When she is with us again, perhaps that's when we can start to move on."
The force of the waves carried bodies for miles along the Tohoku coast or out into the open sea. The official death toll from the disaster stands at 15,854, but another 3,274 – almost three-quarters of them aged 60 or over – are unaccounted for.
The chances of recovering the corpses, now identifiable only by DNA samples, are receding by the day: search teams found at least 100 bodies a month soon after the disaster, but by the autumn, the number had dropped to a handful.
In the fishing town of Kesennuma, police and coastguard crews conduct regular offshore searches in the hope of finding bodies trapped in cars or beneath wreckage resting on the seabed.
On the morning the Guardian joined a search team aboard the patrol boat Sasakaze, divers braved icy water and low visibility but returned from the depths with nothing. Only two bodies have been recovered along the entire north-east coast since the start of the year, but coastguard officials insist that the search will go on.
"We know from experience how difficult it is to find people who have been swept out to sea," said Hirofumi Onodera, Kesennuma's coastguard captain, whose mother and eldest son are among the missing. "But we've never thought for a moment of giving up."
The lone figure of Wataru Sato stood at the water's edge, watching the divers surface briefly before they returned to the bottom of the harbour. Sato, a 68-year-old fisherman, spent weeks looking for his sister, Kiyako, after she was swept off a nearby bridge.
"I looked for her every day for 50 days, and then realised it was no use," said Sato, who lost 10 members of his extended family. "I'm only just beginning to accept that she may never be found."
The search for bodies continues against a dramatic change in the coastal landscape. Then-and-now photographs are testament to the speed with which the prefectures of Iwate, Miyagi and Fukushima have cleared their disfigured cities, towns and villages of debris and rubble.
Areas that were once a mass of shattered houses and mangled cars, and boats dragged in by the waves, are now flat, vacant spaces. Improvised memorials of stones, crockery and modest heirlooms are the only sign that these deserted tracts of land were once occupied by houses, shops and schools.
But the tidy piles of debris – an estimated 23m tonnes of it – also point to an inertia that hangs over the north-east coast. So far only 6% of the rubble has been taken away to be recycled, buried or incinerated, with other regions opposed to taking in material they fear could be radioactive. Debris from Fukushima prefecture is to be stored locally.
The environment minister, Goshi Hosono, admitted the current pace of disposal could derail plans to complete the job by March 2014: "I want to speed up this process because it is a huge barrier to reconstruction efforts," he said.
Local leaders, meanwhile, are still debating the wisdom of rebuilding in areas that history shows are susceptible to devastating tsunamis. So far not one of the municipalities affected by the disaster has submitted the necessary plans for reconstruction inland or on higher ground, blaming lack of resources and available land, and disagreement among residents.
According to one survey, only about half the 6.7tn yen (£52bn) of the reconstruction budget approved last year has been spent, including less than 3% of the cash set aside to repairs roads, levees and sewers.
Demand for building materials is rising, but there is little sign of the predicted post-tsunami construction boom, fuelled by government pledges of at least 19tn yen to "reshape" the battered coastline.
Japan's new reconstruction agency, which has been given the job of slicing through the red tape delaying the recovery, was launched only last month. Yuhei Sato, the governor of Fukushima prefecture, spoke for many when he said: "From the victims' perspective, I can't help but ask ... couldn't they have launched the agency sooner?"
No one, including the prime minister, Yoshihiko Noda, has articulated a coherent vision for the Tohoku region's recovery. Officials appear reluctant to countenance anything that involves combining neighbouring towns into new, bigger entities, a measure that would sound the death knell for smaller communities but which some experts believe is inevitable.
A solution to the rebuilding problem cannot come quickly enough for the 330,000 people living in temporary accommodation. Thousands of others have already left the region in search of jobs and a new start in cities such as Sendai and Tokyo.
The exodus is being led by young people, who are abandoning ageing towns and villages that were afflicted by economic decline and depopulation long before the disaster.
The immediate humanitarian crisis has given way to concerns about health problems associated with displacement and life in temporary accommodation – high blood pressure, pneumonia and heart disease – particularly among elderly people.
In the three worst-affected prefectures, the deaths of more than 1,300 people after 11 March have been attributed to the disaster. The total, according to a survey by the Kyodo news agency, includes an undisclosed number of suicides among residents of temporary housing units.
"We are paying more attention to mental health issues now that the emergency response phase has ended," said Toshitaka Irie, a Japanese Red Cross worker. "We are touring temporary housing complexes to try to get people to open up about their trauma. The problem is that in Japan, people tend to keep things to themselves."
Serious damage to the health infrastructure is hampering efforts to provide healthcare to survivors dotted around a wide area. Hospitals and clinics were among the buildings that were crushed or swept out to sea, while others lie abandoned inside the 12-mile evacuation zone around the Fukushima Daiichi nuclear power plant.
In Ishinomaki, however, there will be little discussion of the future until the wounds of the Okawa tragedy begin to heal. That is unlikely to happen soon. "Some parents want to keep part of the school as a monument to the disaster," said Naomi Hiratsuka, whose 12-year-old daughter, Koharu, was among the victims. "But I want it to be demolished. There is talk of replacing it with a park, but who would want their children to play in a place like this?"
In the distance, workers dredged a section of river as part of their search for the four missing children and one teacher.
"This search is just for show," said Hiratsuka, who obtained a digger's licence while she was searching for her daughter, whose remains were discovered last autumn, several miles from the spot where she died. "The authorities want to be seen to be doing something for the anniversary. I have been asking them to conduct an intensive search for month, yet it's taken them almost a year to do anything."
She said her daily search would continue: "I'll do everything I can to get them back to their families. You look around here and think that everything has changed, but nothing will change as long as they are still somewhere out there."
Some of the parents considered suing school officials for keeping the 108 children in their charge in the playground for 40 minutes before evacuating to a nearby bridge rather than up a steep hill located a short walk away.
Suzuki understands their anger, but for her any recriminations will have to come later.
"No matter how angry I get with the teachers, it won't bring back my children," she said. "What worries me most is that the authorities will call off the search because they're running out of money. But there are still places where we want them to look, even if there's only a small chance of finding anyone. I won't rest until every inch of ground has been covered."
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