Bureaucracy often prevents government assistance from reaching the people in needJapan is thought to be one of the most generous countries in the world in terms of handing out foreign aid, but when it comes to helping those in need at home, many believe it could do more.
An ageing population and a lack of job security is putting pressure on Japan to broaden its welfare.
Criticism has been mounting over the government's treatment of the poor.
The experience of Fumie Matse, who has tried for two years to sign up for state welfare but has been unsuccessful, is emblematic of a problem that Japan has yet to fix.
Savings devoured
The 71-year-old, whose eyesight is failing, says medical bills have devoured her savings.
Fumie lives simply, in a tiny two-room apartment, in a rundown public housing
But she is barely surviving on her $500 monthly pension.
She says when she went to the welfare office, the officials there were rude and dismissive to her.
Fumie said: "The most shocking thing was that he told me, 'just because you are disabled does not mean you can get income support easily'.
"They sent me away, three times by phone and twice from the counter. They didn't even want to listen to me."
Welfare in Japan is so hard to get that some people literally die trying.
One elderly man, also living in Kitakyushu, starved to death after his benefits were cut off. His mummified body was not discovered until months later.
What stunned the Japanese people though was not just the man's death, but the heart-wrenching diary he left behind.
"2am. My stomach is empty," he wrote six weeks after his benefits were
cut.
"I want to fill my belly with rice balls."
"3am. This human being hasn't eaten in 10 days, but is still alive."
Budget constraints
Kayoko Takagi, a lawyer who helps the needy fight the bureaucracy, said that welfare offices often refuse to even hand out applications.
"The primary reason is to keep the budget down. A lot of people are not
"3am. This human being hasn't eaten in 10 days, but is still alive"
Deceased Japanese elderly
Although a wealthy nation, Japan has very strict rules for welfare recipients, often requiring them to exhaust all their resources and rely on help from relatives before receiving government assistance.
Most of Japan's poor are elderly. The country's ageing population and the demise of "cradle-to-grave" jobs is increasing the number of people applying for welfare.
But Fumie says that is no excuse for turning away the truly needy.
"I think politicians should cut their income before they talk about cutting welfare or increasing taxes to pay for the welfare budget," she said.
But those who are too ashamed or too polite to demand their due, will continue to suffer, and sometimes starve, in silence.