Residents clean up their damaged houses in the earthquake rocked Mashiki in Kumamoto prefecture, Japan, April 17, 2016. (Xinhua/Ma Ping)

TOKYO, April 14 (Xinhua) -- Around 360 people observed a moment's silence at Kumamoto's prefectural office on Friday including Prime Minister Shinzo Abe, Kumamoto Governor Ikuo Kabashima and the friends and families of those who died in the earthquakes which struck the region exactly one year ago today.

As seems to be a running theme when it comes to massive natural disasters in Japan and perhaps due to a lack of localized and centralized disaster preparedness, one year after the earthquakes that left 225 people dead, 47,000 people are still displaced.

The first quake, a magnitude 6.5 temblor struck on on April 14 and a was followed by a magnitude 7.3 quake two days later that also affected neighboring prefectures in Japan's southwestern Kyushu region.

The first quake took people off guard and some of them escaping from damaged homes headed to evacuation points only to be hit by the second, more powerful quake.

For others, often elderly and living in traditional wooden Japanese houses so iconic of the outer skirts of the affected region, having ridden out the first quake in their homes and not wanting to leave in the first place, perished, as their already damaged houses were leveled by the intensity of the second quake or tragically obliterated by mudslides triggered from the surrounding hills.

The latest governments statics reveal that as many as 200,000 houses were damaged or destroyed in the quakes, forcing those who survived the double-temblors, to seek refuge in their own vehicles or in ill-equipped, over subscribed evacuation centers.

According to Japan's Meteorological Agency (JMA) in the past year there have been no less than 4,296 quakes in and around Japan's southwestern prefecture of Kumamoto with an intensity of one or greater, as of 7:00 p.m. on Thursday.

They include 2 tremors with an intensity of 7 and 2 jolts registering 6 plus; and 3 temblors with 6 minus, on Japan's seismic scale that peaks at 7.

Suffice to say, since the first two powerful quakes, it was reasonable for even a lay person to assume that there would be thousands of aftershocks and that some of those could be perilous.

Those staying in at-risk, old wooden houses, should have been fast-tracked into evacuation centers and those choosing to seek refuge in their own vehicles in the post-quake days also needed swift, life saving information.

Information that, as with the Great Tohoku Earthquake that violently shook the whole nation's eastern seaboard in March 2011 and in doing so triggering a colossal tsunami that ravaged Japan's northwest and battered a nuclear power complex leading to an as yet unresolved nuclear disaster, could have saved countless lives.

Without a doubt, deaths from an earthquake, be they from crush injuries, drowning in mudslides or being trapped in fires, are horrific beyond all imagination.

But many of the deaths in the days and weeks following the quakes were ascribed to what become known colloquially as "economy class syndrome."

This is a condition which can be triggered by spending long periods of time in a confined space where the body's movement and blood flow is restricted.

Following the powerful quakes and the lack of space in evacuation shelters, many people were forced to take refuge in their cars and other vehicles in car parks in Kumamoto and the surrounding areas.

But by living in such cramped conditions, deep vein thrombosis (DVT) can occur, often in a deep leg vein that runs through the muscles of the calf and the thigh, causing the swelling of the leg and sometimes leading to pulmonary embolism as a result of a blood clot breaking off into the bloodstream and blocking one of the blood vessels in the lungs.

When DVT and pulmonary embolism occur together the condition is known medically as venous thromboembolism or VTE.

Between 40 and 50 deaths were linked to "economy class syndrome" in Kumamoto, with questions still remaining as to why news about the potentially deadly condition wasn't made available by the government to those at risks earlier, before it became an epidemic, and why more spaces were not made available at emergency shelters.

This question is especially poignant following the outrage at the lack of facilities and squalid conditions at shelters opened after the Tohoku quake, tsunami and nuclear disasters in 2011.

It would seem that both the central and local government, as regards the 169 deaths have that have been attributed indirectly to the affects of the quakes, such as falling ill in evacuation shelters, or dying from economy class syndrome in vehicles, could be somewhat to blame.

"It became clear very early on that the evacuation shelters were becoming oversubscribed and some people, even the elderly and the disabled, were being turned away because apparently the shelters did not have the correct equipment to treat them," recalled Keiko Gono, an anthropologist and sessional lecturer in Tokyo.

"This is down to very poor crisis management and is a failing of the government. After the Tohoku quake and the debacle with evacuation shelters, you'd think the government would have developed nationwide protocols for particular areas to swiftly evacuate those from disaster-hit regions to safer areas," Gono told Xinhua.

She went on to explain that for some of the evacuees the conditions were so cramped and bordering on squalid that they opted to fatefully return home to their structurally unsound houses that would ultimately become their graves following the aftershocks that lay in wait.

Gono also said that those opting to live in their cars should have received vital medical information from local officials that could have saved dozens of lives from "economy class syndrome."

"It's like when you fly over long distance, the flight attendants advise you to get up and stretch two or three times throughout the flight to ensure good blood circulation. And a lot of passengers even know to wear their own medical compression sleeves on their legs," said Gono.

After the first few cases were admitted to hospital for DVT, there should've been a radio, TV and flyer campaign warning of the dangers to those living in cars and other vehicles," she added.

"It would've cost nothing and would've certainly saved lives. Why the government did not act quicker when it came to this is beyond me, it would've been such a simple move that could've saved lives. It's a huge failing of the government. Again," sighed Gono.