Step-by-step explanation:
On December 26 2004, waves triggered by a massive earthquake slammed into the coastlines of countries ringing the Indian Ocean. The death toll was enormous. Worldwide, it is estimated that about 230,000 people died that day. Aceh province, on the northern end of the Indonesian island of Sumatra, was hit hardest. There, more than 160,000 people – nearly 5% of the local population – were killed. In the worst hit areas, survivors lost their homes and livelihoods and saw their communities reduced to rubble.
Over the months that followed, governments, religious organisations, NGOs and individual people delivered substantial support for humanitarian assistance and rebuilding. Multi-year reconstruction projects began and Indonesia committed to building back better. Much of what has been learned from that disaster is relevant when considering how the world will recover from the coronavirus pandemic.
In the immediate aftermath of an event like the 2004 tsunami, the path forward is not clear. So how have those from affected regions fared since the day the waves crashed ashore? Over the last 16 years, we have followed people and their families who were living along the coasts of Aceh and Northern Sumatra, the two most northerly provinces in Sumatra, as part of the Study of the Tsunami Aftermath and Recovery (STAR).
Experiences of the disaster and its aftermath, and the meaning people take from them, have varied.
One young man we spoke to lost his wife, child, and 27 other family members in the disaster, but has since remarried. He says that the time since the tsunami has taught him that life sometimes brings happiness and sometimes not, but that affection is critically important.
Another young man who lost a wife and child has also remarried. But he told us that the time since the tsunami has not brought any positive changes in his life, though he is deeply committed to earning the money to support the education of the two young children he now has.
Our data covers the population before the disaster and measures exposure to the disaster in terms of impacts on both places and people. We have been able to measure the disaster’s various impacts on wellbeing and shed light on some of the key drivers for recovery.
Mortality and health
Death is the most extreme consequence of exposure to a disaster. Some deaths are immediate, but others may occur over the years as sustained exposure to stress takes its toll. Teasing out how disasters affect mortality risks is complicated, but can provide clues about what will happen when disasters strike in the future.
We have found that the groups least likely to survive the tsunami were older adults and young children. Among adults, women were less likely to survive than men.
Tracking mortality among survivors in the years after the tsunami provides direct evidence on people’s resilience. We see resilience as the ability to minimise the negative impacts of difficult situations and move forward effectively afterwards. The devastation caused by the tsunami has the potential to “scar” people, resulting in their premature death. But equally, the survivors may have protective traits that are associated with better health and longevity.
We examined mortality for survivors at five years and ten years after the tsunami. We found that among adults, both these factors are in play and that they operate differently for men and women.
Five years after the tsunami, there is clear evidence that for male survivors who were aged 50 and above when the disaster took place, those from heavily affected areas were more likely to still be alive than those from relatively unaffected areas. This shows that over this period, certain protective traits of survivors (perhaps general fitness) appear to exert a stronger effect on longevity than any “scarring” elements of the event.
But for women over 50, the reverse was true: we found that survivors from heavily damaged areas were at higher risk of dying over the next five years than women from unaffected areas.
These basic patterns were still apparent ten years after the disaster. But by this point, the evidence shows that in particular, post-traumatic stress for older men or the loss of a spouse for older women decreased the likelihood them still being alive. Although the two events are of course extremely different, these results should encourage us to reflect on what the long-term health effects of the COVID pandemic might be.