The Study of the Tsunami Aftermath and Recovery (STAR):

Resilience and Recovery in Sumatra after the 2004 Indian Ocean Tsunami[1]

The 2004 Indian Ocean tsunami devastated thousands of communities in countries bordering the Indian Ocean. Destruction was greatest in the Indonesian provinces of Aceh and North Sumatra, where an estimated 170,000 people perished and the environment was damaged along hundreds of kilometers of coastline. The disaster generated an enormous flow of assistance to these provinces from the Indonesian government, NGOs, and donors. By 2007, efforts to build back the affected areas in Indonesia constituted the largest reconstruction project ever undertaken in a developing country.

The Study of the Tsunami Aftermath and Recovery (STAR) is a longitudinal survey of individuals, households, communities, and facilities in Aceh and North Sumatra, Indonesia. The study is designed to provide evidence on the immediate and longer-term consequences of the 2004 Sumatran-Andaman earthquake and tsunami and the recovery efforts initiated in its wake.

To shed light on how individuals, communities, and families were affected by and responded to the disaster, we established the STAR project. Beginning in 2005, STAR has followed a group of 32,000 people who were first interviewed in 2004 (pre-tsunami) in 487 communities, as part of population-representative household survey conducted by Statistics Indonesia. Post-tsunami interviews occurred annually for 5 years after the tsunami. Ultimately we ascertained survival status for 98% of the original pre-tsunami respondents and interviewed 96% of survivors in at least one post-tsunami survey. The data provide information on the short-term costs and longer-term recovery for people in very badly damaged communities as well as in comparison communities where the disaster had little or no direct impact. We highlight findings from our research based on data collected from 2004 through 2010. A 10-year follow-up survey is currently in the field.

Short-term Impacts:

The tsunami’s impact on mortality was immense. In some STAR communities more than 80% of people enumerated in the 2004 pre-tsunami survey were killed. Children, women, and older people were more likely to die than prime-age men, but our results indicate that household composition played a key role in survival. The number of 15-44 year old men living in the household is associated with lower tsunami mortality for same-age women, children, and for other men age 15-44. Going beyond composition to consider the types of kinship ties, our data provide evidence that survival chances are most tightly linked for husbands and wives, followed by mothers and their children. Taken in combination, our results suggest that when the tsunami came ashore, stronger members of the household tried to help weaker members, sometimes successfully and sometimes not.[i]

Among adult survivors, in heavily damaged communities, about one in four were caught up in or injured by the tsunami, and more than one-third witnessed family or friends struggle in the water.  Individuals from communities beyond the tsunami’s reach rarely experienced these traumatic events, but many did lose family members who lived in coastal locations at the time of the disaster. Damage to housing was also widespread, particularly in inundated communities, but in more protected locations as well, because the earthquake affected the region as a whole.  These results underscore the importance of STAR’s design, which targets individuals from communities across the entire west and part of the north coasts of Aceh and North Sumatra, rather than only those in the direct path of the waves.

Longer-term Impacts:

Mental Health:  In the period immediately after the disaster, symptoms of post-traumatic stress reactivity (PTSR) such as feelings of numbness or intrusive reminders of the event were highest among those who had been living, at the time of the tsunami, in heavily damaged communities, but were elevated among respondents from other communities as well. PTSR is also higher among those individuals who experienced traumatic events. But it is not only one’s own experiences that matter. Being from a community that was badly damaged also results in higher PTSR, net of individual experiences. Over time, symptoms diminished, but the pace of recovery was faster among those from heavily damaged communities. By 2007, average levels of post-traumatic stress reactivity did not differ by location of residence at the time of the tsunami. These results are unlikely to reflect receipt of mental health interventions, as only 7-10% of respondents report receipt of such services. One factor associated with faster recovery is education. Although educational levels were not associated with reduced vulnerability to PTSR in the immediate aftermath, individuals with more education did experience a more rapid reduction in symptom intensity over time.[ii],[iii],[iv],[v]

Family Formation and Fertility: The tsunami took a terrible toll on young lives, killing one third of children under age seven in heavily damaged communities. Our research shows that in the five years after the tsunami, a sustained increase in fertility occurred in communities affected by tsunami mortality, but not in other communities. The fertility response is explained by mothers who lost one or more children having additional children, but also by women who had not yet had any children at the time of the tsunami initiating childbearing in its aftermath. New families formed through marriage and childbearing at a faster pace in communities that experienced tsunami-related mortality than in other communities.[vi]

Children’s Human Capital:  Data collected in STAR are ideally suited to understand how children fared after the tsunami. A significant fraction of children lost one or both parents in the disaster. Among children between 9 and 17 years of age at the time of the tsunami, we compare changes over time for children who lost a mother, a father, or both parents to changes over time for children whose parents survived. Five years after the tsunami, the deleterious impacts of losing one or both parents in the tsunami are substantial for older boys (who leave school and enter the work force) and older girls (who marry), whereas the effects on younger children are far more muted.[vii] We also consider height of children, a marker of health and nutrition that is predictive of later life health and prosperity. Children who were in utero at the time of the tsunami and born 3 to 6 months after the tsunami are shorter, for their age, at eighteen months than earlier-born cohorts. This height deficit likely reflects the combined effects of maternal stress during pregnancy and reduced resources at that time. However, three years later, these children have caught up to or surpassed height-for-age of their older counterparts, suggesting that the post-tsunami reconstruction will have long-term impacts on health and well-being. The results are also important because they suggest recovery of height deficits in early childhood is possible.[viii]

Housing and Migration:  In the first four months after the tsunami, nearly two-thirds of individuals from severely damaged communities changed residences—a rate 10 times higher than that for individuals in areas of limited damage. About half of those who moved stayed at a camp or shelter at some point after the tsunami.[ix]Individuals whose homes were damaged in the tsunami were far more likely to move. Consistent with these results, the fraction of individuals who report living in a home owned by a family member falls dramatically between 2004 and 2005 for individuals living in heavily damaged areas at the time of the tsunami, but not at all for those living elsewhere at the time of the tsunami. Remarkably, by 2010, individuals are back in family-owned homes, at the same rate observed before the tsunami.[x]

Overall Findings:

The tsunami’s toll on the province of Aceh was enormous. Kinship networks were torn apart, those who survived lost homes and business assets, saltwater and silt inundation changed landscapes and soil composition, and physical infrastructure including roads, bridges, schools, and health facilities, was destroyed.  In the decade since the disaster, efforts to rebuild Aceh have absorbed the money and time of individuals from throughout the province, as well as from elsewhere in Indonesia and throughout the world. The results of these efforts are remarkable. Within five years, individuals were back in homes they owned, often on their original land, in communities with new schools and other infrastructure.  Ten years later, these communities have new residents as well as old, as a result of births and of in-migration. One’s overall impression of a province and a population that have recovered from a disaster of immense proportions is confirmed by data collected in STAR. Continued follow-ups of the respondents will provide a wealth of information about the longer-term impacts of the tsunami and the reconstruction program. The success of efforts to rebuild Aceh speak to the benefits of long-term and well-financed recovery efforts in the aftermath of disaster--- something all too easy to forget once the initial humanitarian crisis has been assuaged.

[1] STAR is a collaborative project of investigators at Duke University, SurveyMETER (Indonesia), the University of California, Los Angeles, the University of Pennsylvania, the University of Southern California, the World Bank and Statistics Indonesia. The project is directed by Elizabeth Frankenberg  and Duncan Thomas (Duke), with  Cecep Sumantri (SurveyMETER).  STAR is funded by grants from the National Institute for Child Health and Human Development (HD051970, HD052762) the National Institute on Aging (AG031266), the MacArthur Foundation (05-85158-000), the National Science Foundation (CMS-0527763), the Hewlett Foundation and the World Bank.

[i]Frankenberg, E., T. Gillespie, S. Preston, B. Sikoki, and D. Thomas. 2011. “Mortality, the Family, and the Indian Ocean Tsunami.” The Economic Journal.121 (August), F162-182.

[ii] Frankenberg, Elizabeth, Jed Friedman, Thomas Gillespie, Nicholas Ingwersen, Robert Pynoos, Iip Rifai, Bondan Sikoki, Cecep Sumantri, Wayan Suriastini, and Duncan Thomas.  2008.  “Mental Health in Sumatra after the Tsunami.” American Journal of Public Health.98(9): 1671-1677.

[iii]Frankenberg, E., B. Sikoki, C. Sumantri, W. Suriastini and D. Thomas. 2013. Education, Vulnerability, and Resilience after a Natural Disaster. Ecology and Society 18 (2): 16. [online] URL: http://www.ecologyandsociety.org/vol18/iss2/art16/

[iv]Frankenberg, E., J. Nobles, and C. Sumantri. 2012. “In the Wake of the Tsunami:  Destruction of Community Revisited.” Journal of Health and Social Behavior.December 2012 53(4): 498-514.

[v]Frankenberg, E., J. Friedman, and D. Thomas. 2014. “The Evolution of Mental Health after a Large-Scale Disaster.” Manuscript.

[vi]Nobles, J., E. Frankenberg, D. Thomas. 2014. “The Effect of Mortality on Fertility: Population Dynamics after a Natural Disaster.” Working Paper 20448.National Bureau of Economic Research.

[vii]Cas, A., E. Frankenberg, W. Suriastini, D. Thomas. 2014. “The Impact of Parental Death on Child Well-Being.” Demography. 51(2): 437-57.

[viii]Frankenberg, E., J. Friedman, N. Ingwersen, W. Suriastini, and D. Thomas. 2014. “The Impact of a natural disaster on child health.” Manuscript.

[ix] Gray, C., E. Frankenberg, C. Sumantri, D. Thomas. 2014. “Studying Displacement after a Disaster Using Large Scale Survey Methods: Sumatra after the 2004 Tsunami.” Annals of the Association of American Geographers. 104(3): 594-612.

[x]Frankenberg, E., C. Sumantri, and D. Thomas. 2013. “The Evolution of Well-Being in the Aftermath of a Disaster: Evidence from Aceh and North Sumatra. Prepared for the conference on “The Demography of Disasters: Implications for Future Policy on Development and Resilience.” Australian Demographic and Social Research Institute.