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Then there's fuel, which is in plentiful supply in southern Japan but all but impossible to procure easily in the north without special permits. To get even a 2.6 gal. (10 L) ration, cars in Tohoku often have to wait for half a day. When TIME wanted to accompany an NGO helicopter delivering aid to one stricken area, we were given permission on one condition: that TIME hire a car to drive the aid supplies to the airfield. The NGO's cars were out of gas and had no way to get the relief goods to the chopper. Such shortages have been repeated writ large, hampering even the efforts of major organizations like the International Federation of Red Cross and Red Crescent Societies, which was one of the first groups on the scene.

There have been some extenuating circumstances. The radiation leaking from the Fukushima plant has meant that aid vehicles have to take a wide berth around a region contaminated by higher-than-normal radiation levels. Nevertheless, there are other ways to Tohoku. Indeed, one of the first organizations to start relief convoys in the northeast was none other than the yakuza, Japan's famous gangsters. Unconstrained by reams of regulations, the underworld representatives, whose business tentacles extend to the trucking business, simply started delivering aid on their own, without government approval.

Citizen volunteers have been actively discouraged by the government from jumping into their cars and delivering aid themselves. That's because after the 1995 Kobe earthquake, roads into the area were jam-packed with well-meaning citizens whose endeavors hindered larger aid efforts. But there's a fine balance to be struck between not overwhelming damaged infrastructure and leaving it worryingly underutilized. And while U.S. military aid sorties conducted from American bases in Japan have been accepted by the Japanese government, other international organizations have been quietly told they're not needed — a stunning response given the magnitude of the disaster. "Everything has to go through government emergency centers," says one international NGO representative in Tokyo. "But they're very slow to respond and can't keep up with the flow of aid. They should let us get in there and start getting relief to people instead of worrying about paperwork."

Meanwhile, back at Saitama Super Arena, Kouhei Nagatsuka, 18, ponders the strange fact that he just graduated from high school without a proper ceremony in Futaba, the town next to where the Fukushima plant is located. On March 11, the earthquake destroyed his home — or so he has heard from a friend who went back to the ravaged town to take a look. Nagatsuka and his family were first herded into an emergency shelter for earthquake and tsunami victims. Then, just as they were contemplating trying to salvage what they could from their home, a Fukushima reactor began spewing radioactive material into the air. Four days ago, they arrived as nuclear-plant refugees to Saitama.

As Nagatsuka scrounged for warm clothes for his four siblings in a heap of donated goods, news that steam and smoke were again pouring from two of the plant's damaged reactors spread among the displaced Futaba residents. (By Tuesday evening, plant engineers said they had laid power cables to all six of the facility's nuclear reactors, though it's not clear whether the electricity can be turned on or whether pumps needed to cool down overheating reactors will work.) Already, reports of vegetables, water and milk tainted by small levels of radiation from the leaking nuclear plant have raised concerns about the accident's long-term effects — even if engineers are able to tame the reactors in the coming days and weeks. "I'm afraid I'll never be able to go back there," says Nagatsuka, who spent time volunteering when he was in high school. "I was supposed to start my adult life, but I guess I'll have to do that someplace else."