Second regional TRIAMS workshop Bangkok, 21–23 March 2007

Tsunami Recovery Impact Assessment and Monitoring System This publication has been prepared by the United Nations Development Programme, the World Health Organization and the International Federation of Red Cross and Red Crescent Societies. It is published by the World Health Organization on behalf of all three partners. All the maps in this document have been produced by Public Health Mapping and GIS (Communicable Diseases) and Health Actions in Crisis (Recovery Department) of the World Health Organization.

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Swedish International Development Cooperation Agency

The second regional TRIAMS workshop was made possible through the support of the Swedish International Development Cooperation Agency (SIDA) and the American Red Cross.

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Tsunami Recovery Impact Assessment and Monitoring System WHO Library Cataloguing-in-Publication Data Tsunami recovery impact assessment and monitoring system: second regional TRIAMS workshop , Bangkok, 21–23 March 2007 . 1.Natural disasters. 2.Relief work. 3.Indonesia. 4.Maldives. 5.Sri Lanka. 6.Thailand. I.World Health Organization . II.United Nations Development Programme. III.International Federation of Red Cross and Red Crescent Societies. ISBN 978 92 4 159639 8 NLM classification: WA 295 1

Abbreviations

ADPC Asian Disaster Preparedness Center AIDMI All India Disaster Mitigation Institute BMI Body Mass Index BPDE Electronics Data Processing Body (Indonesia) BPS Bureau of Public Statistics (Indonesia) BRR Aceh and Nias Rehabilitation and Reconstruction Agency (Indonesia) DAD Development Assistance Database DCS Department of Census and Statistics (Sri Lanka) DHS Demographic and Health Survey DDPM Department of Disaster Prevention and Mitigation (Thailand) ECHO European Commission Humanitarian Aid Department EMIS Education Management Information System (Maldives) GIS Geographic Information Systems HIES Household Income and Expenditure Survey HR Human resources IAS Information Analysis Section IDP internally displaced person International Federation International Federation of Red Cross and Red Crescent Societies MDG Millennium Development Goal MICS Multiple Indicator Cluster Survey NDMC National Disaster Management Centre (Maldives) NER National Enrolment Ratio NGO non-governmental organization NSO National Statistical Office (Thailand) OSE United Nations Office of the Special Envoy for Tsunami Recovery RADA Reconstruction and Development Agency (Sri Lanka) RAN Recovery Aceh-Nias Database RHS Reproductive Health Survey SIDA Swedish International Development Cooperation Agency TEC Tsunami Evaluation Coalition TIAS Tsunami Impact Assessment Survey TRIAMS Tsunami Impact Assessment and Monitoring System UN United Nations UNDP United Nations Development Programme UNDP-BCPR UNDP Bureau for Crisis Prevention and Recovery UNICEF United Nations Children’s Fund UNORC United Nations Recovery Coordinator for Aceh and Nias VRS Vital Registration System WHO World Health Organization WHODAS World Health Organization Disability Assessment Schedule 2

Table of contents

Executive summary ______4 Section I: Setting the scene ______6 Introduction ______6 Objectives and expectations of the workshop ______9 Section II: Monitoring the progress of tsunami recovery: Country experiences ______10 Status of TRIAMS implementation ______10 Indonesia ______10 Maldives ______11 Sri Lanka ______12 Thailand ______13 Summary ______13 Progress of recovery efforts by country ______14 Indonesia ______14 Maldives ______20 Sri Lanka ______36 Documenting achievements at the country level using the TRIAMS framework and selected indicators ______47 The impact of the disaster in terms of lives lost: the case of the most-affected districts in Aceh province ______47 The overall impact of recovery activities on health status and quality of life in tsunami-affected communities ______52 Section III: Review of TRIAMS indicators ______55 Adoption and utilization of the TRIAMS indicators, by area of recovery ______55 Vital needs ______55 Basic social services ______56 Infrastructure ______57 Livelihoods ______58 Revision of the core TRIAMS indicators ______60 Vital needs ______60 Basic social services ______61 Infrastructure ______62 Livelihoods ______63 3

Section IV: Incorporating disaster risk reduction into recovery ______66 What is disaster risk reduction? ______67 The challenges of disaster risk reduction in practice ______68 Disaster risk reduction efforts in the context of the tsunami: country presentations ______69 Indonesia: Developing policies and guidelines to reduce risk ______69 A “safer islands” approach in the Maldives ______71 Integrating disaster risk reduction in recovery: capturing post-tsunami experiences in Sri Lanka ______72 Risk reduction indicators in the context of TRIAMS ______73 Key messages and recommendations ______76 Country recommendations for incorporating disaster risk reduction ______77

Section V: Country action plans ______78 Indonesia ______78 Maldives ______80 Sri Lanka ______82 Thailand ______84 Section VI: Co nclusions and next steps ______86 Main challenges for the next phase of the TRIAMS initiative ______86 Next steps ______88 Facilitating organizations ______88 Implementing agencies ______88 Partners, donors and other stakeholders ______88 Annex I: Outcomes statement ______91 Annex II: Agenda ______93 Annex III: Participants ______96 4

Executive summary

The second regional workshop on the Tsunami Recovery Impact Assessment and Monitoring System (TRIAMS), held in Bangkok from 21 to 23 March 2007, provided an excellent opportunity to consoli - date what has been done so far by the participating tsunami-affected countries (Indonesia, the Maldives, Sri Lanka and Thailand) in documenting the progress, the achievements and the challenges of the tsuna - mi recovery. The workshop was also an opportunity for the affected countries and the main internation - al organizations that have contributed to the tsunami relief and recovery effort to share their experiences of TRIAMS implementation to date. In addition, the workshop gave rise to a rich discussion on the way forward for the overall recovery process, which is far from being concluded in the countries concerned, and on what still needs to be accomplished or improved through the replanning of recovery activities.

Section II of this publication, which alone constitutes almost half of the report, is based primarily on the presentations given by the countries on the first day of the workshop. It shows the status of TRIAMS implementation in the four participating countries, selected examples of sectoral analysis in these coun - tries, and brief results of some of the studies documenting the impact of the overall recovery process on the health status and quality of life of tsunami-affected populations. These examples clearly indicate that it is both possible and mandatory to address the five key questions formulated in the TRIAMS Concept Paper of March 2006. 1

In particular, the documentation produced so far by the TRIAMS initiative provides evidence of the need to address in any future recovery process the questions of whether pre-existing inequalities or inequities can and/or should be addressed and whether the use of resources made available by the recovery process is generating new inequalities or inequities. The TRIAMS initiative has shown that the monitoring sys - tem to capture this dimension is feasible, cheap and necessary. It can not be set up, however, without the involvement of local governments, line ministries, civil society and the beneficiaries.

Section III presents the revised list of TRIAMS core indicators, which was the outcome of an intense dis - cussion on the use of these indicators over the previous year, the difficulties, feasibility and sustainability of collecting the related information, and their relevance in informing and guiding the replanning of the recovery activities in each sector and to the overall recovery process. Some indicators on disaster risk reduction were added to the list of TRIAMS core indicators.

Section IV is a summary of the presentations and subsequent discussion on the monitoring of disaster risk reduction activities during the recovery process. There is a clear window of opportunity to direct appro - priate resources during the recovery to disaster risk reduction, but not enough has been done to monitor this aspect during the first phase of the tsunami recovery. The introduction of specific disaster risk reduc - tion indicators in all four countries is an important step in assessing the impact of innovative disaster risk reduction policies developed in the aftermath of the tsunami.

1 UN, WHO and International Federation, Tsunami Recovery Impact Assessment and Monitoring System (TRIAMS) Workshop Report , 2006, Annex IV , p. 73. Both the report and the concept paper can be found at www.who.int/hac/triams. Executive summary 5

Section V presents the individual country plans of action for the implementation of TRIAMS-related activities during the period 2007–2009. Not all of these plans of action are at the same stage of elabora - tion, but all express the countries’ commitment to pursue the TRIAMS initiative as a key element in monitoring the tsunami recovery and in supporting the replanning of its final phase.

Section VI summarizes the main conclusions of the workshop and outlines the next steps of the TRIAMS initiative to be taken at international level, in support of the country action plans.

In tandem with this publication, a dedicated TRIAMS web site (www.who.int/hac/triams) has been cre - ated containing all the documents, surveys, studies and maps produced in the framework of the TRIAMS process, including the reports of this and the previous regional workshops. The site has a general section and separate sections for each of the four participating countries. It will be regularly updated with the lat - est information and analysis on the progress of TRIAMS implementation as it becomes available.

It is clear that TRIAMS must continue and that it still needs the attention and support of the internation - al community. The reasons for this are threefold. First, the recovery process is not complete in any of the four participating countries. Second, and probably more importantly, because the initiative is still in its infancy, there is a need to find suitable methodologies and modalities for the TRIAMS core indicators to be collected and analysed in a systematic and periodic way by local actors in the different sectors of the recovery. Third, and most importantly, there has to be a proper investment in capacity-building in order to enable central and local governments, dedicated recovery agencies, line ministries and civil society to make full use of the results of the analysis of the TRIAMS indicators in the planning and implementation of the recovery activities that remain to be conducted. 6

Section I Setting the scene

Introduction

The Indian Ocean earthquake and tsunami of 26 December 2004 was a disaster of unprecedented pro - portions and, as such, elicited an unprecedented response from governments, the international commu - nity, international and local aid agencies and the public. The extent of the loss of life and devastation prompted a humanitarian operation on a scale never witnessed before, with pledges of financial support exceeding US$ 13.5 billion. 2 Relief and rescue efforts in the days and weeks following the disaster rapid - ly gave way to rehabilitation and reconstruction programmes.

During this phase, it became clear that if those involved in the reconstruction genuinely wanted to “build back better” and to ensure their programmes were addressing the evolving needs of the affected popula - tions, without generating new inequalities or inequities, there had to be a mutually agreed monitoring and evaluation system that went beyond the mere tracking of financial inputs. This would enable governments of the countries concerned, agencies supporting the recovery, donors and affected populations to see how the vast resources being allocated to the post-tsunami reconstruction were being spent, assess the impact of recovery programmes and identify gaps or unmet needs. The aim of such an initiative would be to refo - cus the priorities of the overall recovery process regularly during its life span, estimated at around five to six years in the most-affected countries such as Indonesia and Sri Lanka.

With this in mind, a concept for a Tsunami Recovery Impact Assessment and Monitoring System (TRIAMS) was developed during the first half of 2005 by the International Federation and WHO, in close collaboration with the five countries most affected by the tsunami – India, Indonesia, the Maldives, Sri Lanka and Thailand – and in consultation with other international partners and United Nations (UN) organizations. A first regional workshop was held in Bangkok, Thailand in May 2006 to finalize the TRIAMS Concept Paper, to reach consensus among the countries concerned and partners on the core indicators that would be used to track the recovery effort and assess its impact, and to define the process - es to be adopted in order to apply these indicators.

Almost one year down the road, the second regional TRIAMS workshop, also held in Bangkok, took the process to another level. It set out to: G review the progress achieved in four of the countries concerned (Indonesia, the Maldives, Sri Lanka and Thailand) in adopting the TRIAMS platform and in applying the core indicators to monitor the tsuna - mi recovery and assess its impact on the quality of life of the affected populations; G to examine the lessons learned and challenges encountered; G to improve and refine the indicators; and G to establish new country action plans based on the experiences of the past year.

2 Tsunami Evaluation Coalition, Synthesis Report , July 2006, p. 16 , www.who.int/hac/triams. Section I I Setting the scene 7

What is TRIAMS? The Tsunami Recovery Impact Assessment and Monitoring System (TRIAMS) is a sub-regional initiative that defined, promoted and supported a common system to monitor recovery activities and assess their overall impact in four countries most affected by the 2004 Indian Ocean earthquake and tsunami – Indonesia, the Maldives, Sri Lanka and Thailand. The purpose of the TRIAMS initiative is to assist governments, aid agencies and affected populations in assessing and monitoring the rate and direction of tsunami recovery in the countries covered over a period of five years. It aims to examine if: • living conditions and standards have returned to pre-existing levels; • recovery interventions are: – targeting the poorest households and communities; – addressing pre-existing inequalities and/or inequities; – not generating new inequalities and/or inequities. TRIAMS has four components: • core and country-specific output indicators (quantitative), collected through routine government monitoring systems and other partners’ information systems; • core and country-specific outcome indicators (quantitative), largely collected through existing government surveys, with samples adjusted to detect changes in tsunami-affected populations and to compare outcome indicators between tsunami-affected populations and non-affected populations; • beneficiary perspectives – to better understand how affected people view recovery progress; • triangulation and alternative explanations – using qualitative and other methods to help analyse and interpret the quantitative numbers and investigate unexplained differences. Impact assessment and monitoring focuses on four key areas of recovery: • vital needs (e.g. food, water, shelter, etc.); • basic social services (e.g. health care, education); • infrastructure (e.g. public works, social infrastructure); • livelihoods (e.g. formal and informal income generation). Ideally, information gathered through the TRIAMS system would be used to inform: • the ongoing planning of recovery efforts by all stakeholders; • beneficiaries of the progress and impact of recovery efforts; • donors, partners and the public on the use of resources and the outcomes; • the development of monitoring and evaluation systems in future disaster response and recovery efforts.

While TRIAMS was first conceived to monitor, from an early stage, the recovery process across all sectors in the specific context of the tsunami, there was a strong sense during the second workshop that it was now time to consider what eventually needs to be added in order to monitor the transition from the sec - ond and closing phase of the recovery process to the return to normality, with an eye to related develop - mental aspects specific to each country. To do this, two additional elements were considered for the next phase of TRIAMS: G to document major changes in sectoral policies and strategies that were introduced during the first two and a half years of the tsunami recovery; G to define and introduce in the TRIAMS framework a first set of risk reduction indicators to document what has been done or is going to be done to avoid recreating the conditions of risk that contributed to the disaster in the first place. 8 Second regional TRIAMS workshop

A further element considered was the need to ensure that the collection of core and country-specific indi - cators in the context of TRIAMS can be accomplished largely by routine national data collection systems and that the data management and analysis take place at the most peripheral levels (district and sub- district) in order to inform the planning of recovery activities.

Lastly, the development of TRIAMS as a generic recovery monitoring and evaluation tool for use in future disasters was put forward as a challenge to be taken up collectively by all the countries and partners involved so far in the TRIAMS process.

The evolution of TRIAMS May 2005 The International Federation develops the concept. July 2005 The concept is endorsed and supported by WHO. June 2005 The concept is endorsed by President Bill Clinton, the Office of the Special Envoy. September 2005 The concept is endorsed by the Global Consortium for Tsunami-Affected Countries, and the mandate to develop and implement it is given to the International Federation and WHO as a separate process from the Tsunami Evaluation Coalition. September 2005 Sri Lanka takes a policy decision to modify the national sampling frame of the Demographic Health Survey in order to have a representative sampling of the tsunami- affected population. June–October 2005 Initial work on the first draft of impact indicators is completed. January–March 2006 A draft concept paper is developed and a list of core output and outcome indicators is revised and validated through field discussions with tsunami-affected countries and other partners. May 2006 First regional workshop in Bangkok establishes a consensus on indicators and the overall framework. June–August 2006 Additional field work is undertaken, with support from the Karolinska Insititutet, to assist countries in operationalizing indicators. August 2006 UNICEF invests in UNORC/IAS to help the Aceh and Nias Rehabilitation and Reconstruction Agency (BRR) in monitoring of recovery activities , adopting the TRIAMS framework. June–November 2006 Ongoing technical and operational support is provided to targeted countries. December 2006 UNDP joins the initiative at the satellite TRIAMS meeting, during the last meeting of the Global Consortium. January–March 2007 Four national workshops are held to assess the scope, scale and results of recovery monitoring and evaluation systems and to prepare the draft plan of action for TRIAMS implementation to be presented at the second regional TRIAMS workshop. March 2007 Second regional workshop takes place in Bangkok. Section I I Setting the scene 9

Objectives and expectations of the workshop

Objectives

G Illustrate the progress achieved in applying the monitoring and evaluation indicators by area of recov - ery and overall by country. G Discuss the incorporation of disaster risk reduction measurements in recovery programmes. G Discuss the country action plans on the monitoring and evaluation of local recovery programmes. G Share learning on monitoring and evaluation in tsunami recovery and arrive at learning and guidelines for recovery programmes in general.

Participants’ expectations

Country delegations (Indonesia, Maldives, Sri Lanka and Thailand) G Share experiences and lessons learned from impact assessment and monitoring processes already being implemented in other countries. G Review progress so far and incorporate experiences and lessons learned into revised national action plans. G Discuss how to improve data-collection and monitoring systems for tsunami reconstruction. G Revisit, analyse and fine-tune the indicators identified earlier. G Develop country-specific and context-specific indicators that are more meaningful for local govern - ments and more useful for decision-making. G Find ways to ensure the TRIAMS process is properly integrated into national data-collection mechanisms. G Look at funding sources from partners and donors for data collection. G Use the exercise to influence national policy and improve recovery efforts.

Partners (International Federation, UNICEF, UNDP, WHO, Swedish International Development Cooperation Agency (SIDA), Spanish government, All India Disaster Mitigation Institute (AIDMI), ProVention, Asian Disaster Preparedness Center (ADPC), European Commission Humanitarian Aid Department (ECHO)) G Capture the experiences of the different tsunami-affected countries. G Get a good understanding of how the data is being collected and analysed. G Get a picture of the reality and where there are still needs. G Agree on a simple set of indicators and procedures that are not too complicated to implement. G Determine the value, worth and merits of the tsunami response of the past two years and look ahead to the next three years. G Put some real meaning into the term “build back better” in an evaluation sense and determine how to measure it. G Take TRIAMS to the next level and see how it can be applied in other recovery programmes. G Assess whether our activities are relevant and appropriate. G See what progress has been made and incorporate learning from the TRIAMS experience in the differ - ent countries into our own toolkits. G See what support is needed to continue the process. 10

Section II Monitoring the progress of tsunami recovery: Country experiences

The four countries participating in the TRIAMS initiative − Indonesia, the Maldives, Sri Lanka and Thailand − reported on progress achieved in the recovery effort using the TRIAMS framework. 3

National workshops were held in all four countries in March 2007 in the lead-up to the regional work - shop. The national workshops brought together the relevant government agencies and partner organiza - tions to assess the status of TRIAMS implementation and to identify challenges and specific ways to strengthen monitoring and data collection systems. The outcomes of the national workshops informed the discussion in the regional workshop.

For detailed information on the progress of post-tsunami recovery and reconstruction in each country, refer to the year-end reports for 2006. 4 Analysis by sector of recovery is covered in Section III (see p. 55).

Status of TRIAMS implementation

Indonesia Responsibility for coordination and implementation of TRIAMS in Indonesia lies with the Aceh and Nias Reconstruction and Rehabilitation Agency (BRR). The BRR was established by the Indonesian government on 16 April 2006 with a four-year mandate to oversee and coordinate the recovery and recon - struction effort in Aceh province. Nias was included following the earthquake that struck the island on 28 March 2005, causing widespread damage. In order to ensure broad coverage of the tsunami-affected areas and the sustainability of recovery work, the BRR established 6 regional offices to cover the province’s 15 tsunami-affected districts, plus Nias island.

The Office of the United Nations Recovery Coordinator for Aceh and Nias (UNORC) was established in September 2005 to support the government of Indonesia in the tsunami reconstruction and recovery and to coordinate and provide policy and strategy direction to UN agencies, the international NGO com - munity and bilateral donors assisting in this effort. At the beginning of its mandate, UNORC took over the Humanitarian Information Centre established in the aftermath of the tsunami by the UN Office for the Coordination of Humanitarian Affairs (OCHA), keeping the same staff and changing the name of

3 Unless otherwise specified, the statistics quoted in this report relating to the progress of the recovery effort in each coun - try were presented by the official government delegations at the second regional TRIAMS workshop in Bangkok in March 2007. 4 www.who.int/hac/triams. Section II I Monitoring the progress of tsunami recovery: Country experiences 11

this group to the United Nations Monitoring and Information System (UNMIS). The unsatisfactory per - TRIAMS brings all of us together, bringing all formance of UNMIS and a lack of funding led to its the people concerned (line ministries, etc.) closure in June 2006. UNICEF financially supported with the tsunami recovery effort together at the creation of the Information Analysis Section (IAS) one table. That is what we have been waiting in June 2006, with a two-year commitment. for for a long time, that is, to work collectively. TRIAMS is a process and as a vehicle has UNIAS is located in UNORC’s offices. A full turnover been working very successfully. One of the of local and international staff took place during the reasons why we have been able to put together a master plan, an action plan and a second half of 2006. A steering committee provides the good coordination that we are seeing was strategic direction. At its first meeting in July 2006, the something that was initiated from being part steering committee clearly stated the importance of of the TRIAMS process. involving the kecamatan (district) offices in data collec - tion and analysis. Maldives government official

In November 2006, UNIAS produced the first Tsunami Recovery Information Package (TRIP) report, using the TRIAMS framework and core and country-specific indicators. 5 This report provided more detail than the BRR’s second year-end report, but data were still only aggregated at district level. There was also a lack of analysis.

In preparation for the second regional TRIAMS workshop, a provincial workshop was held in early March 2007 in Banda Aceh to assess the status and results of recovery monitoring and evaluation systems, par - ticularly the TRIAMS indicators. Participants included UNORC, UNIAS, UN-Habitat, the BRR and numerous government agencies. They recommended that monitoring and evaluation systems focus more on the quality aspects of recovery in the infrastructure, public services and labour sectors and the use of more specific indicators to capture the recovery reality, such as recovery in urban centres.

Indonesia is anxious to move beyond mere data collection towards more analysis and the creation of a sus - tainable information management system. In the future, after the BRR ends its mission, local govern - ments will maintain the information system, supported by the Bureau of Public Statistics (BPS) and the Electronics Data Processing Body (BPDE).

Maldives In the Maldives, the Ministry of Planning and National Development has set up a task force consisting of government agencies, the UN, the International Federation and its member National Societies, NGOs and others from the donor community to act as a coordinating mechanism for TRIAMS implementation. It has also established a core team of key government officials and created a focal point within the min - istry to collect tsunami recovery indicator updates.

Important monitoring activities in the Maldives have been accomplished in the aftermath of the tsunami. The Tsunami Impact Assessment Survey (TIAS), a countrywide socio-economic assessment at household level supported by UNDP, was carried out in mid-2005 to examine the poverty situation, comparing data collected during Vulnerability and Poverty Assessments (VPAs) 1 and 2 in 1997 and 2004 respectively and the situation in 2005 after the tsunami struck.

5 www.who.int/hac/triams. 12 Second regional TRIAMS workshop

Good progress has been made in integrating the TRIAMS framework into tsunami recovery reporting. TRIAMS indicators have been set as a component within MaldivInfo (the national adaptation of the UN’s DevInfo) and provided the basis for the second year-end report. In addition, data collection at atoll and island level has been a regular practice in the Maldives for some time. The Census 2006 results have been released and analysis is under way. Data from the Household Income and Expenditure Survey (HIES), the TIAS and additional surveys conducted in 2006 (Reproductive Health Survey, Multiple Indicator Cluster Surveys I and II, statistical yearbooks) have been incorporated into an integrated database of Millennium Development Goal (MDG) and other indicators, including the TRIAMS indicators. This database is being developed jointly by the Ministry of Planning and National Development and UNICEF. Lastly, tsunami reconstruction and recovery and disaster risk reduction have been mainstreamed in the 7th National Development Plan.

Sri Lanka In Sri Lanka, the Reconstruction and Development Agency (RADA) has been the leading government actor in TRIAMS implementation, in cooperation with the Office of the UN Resident Coordinator. A working group comprising mainly government and UN agencies has been active since 2005 to support TRIAMS.

To date, Sri Lanka has: conducted a baseline study of tsunami-affected households; modified the sampling frame of future national household surveys to enable reporting on this tsunami-affected cohort; modified some national surveys to examine issues of particular importance for tsunami-affected populations; and begun work on an MDG localization exercise with the Department of Census and Statistics that will derive MDG data for DS division levels.

In addition to the TRIAMS work already completed, Sri Lanka will pilot-test the full range of TRIAMS indicators in two districts, Matara in the south and Ampara in the east, to analyse pre-existing inequalities across the sub-districts and their possible evolution during the tsunami recovery process. Preliminary findings from Matara were presented at the workshop (see pp. 36-47 ). The full results of the pilot-test in both districts will be available at a later date.

To introduce a qualitative component in tsunami recovery impact assessment and monitoring, Sri Lanka is carrying out a survey at six-monthly intervals to gauge beneficiaries’ perspectives of and satisfaction with interventions in the four areas of recovery covered by TRIAMS, i.e. vital needs, basic social services, infra - structure and livelihoods. The findings can be generalized to the entire tsunami-affected population. As the survey is repetitive, it enables analysis to measure the improvement of the recovery from the recipi - ent’s (tsunami survivor’s) point of view. The ultimate aim is to gather evidence of the changes effected by recovery interventions, in order to inform stakeholders regularly of unmet needs and to influence the replanning process.

As tsunami-affected populations continue to recover, new priorities are surfacing, such as the needs of people displaced by the escalating conflict. There is an emerging consensus within the UN Country Team that the exercise must move beyond the tsunami recovery effort to look more broadly at strengthening sub-national data capacities with a focus on monitoring recovery and developmental activities as well as assess - ing the impact of these interventions . In the context of Sri Lanka, this reorientation offers a number of different opportunities: G to support the government’s policy of targeting “lagging” DS divisions by producing high quality and reliable data that would shed light on inter- and intra-district disparities with a particular focus on human development indicators; Section II I Monitoring the progress of tsunami recovery: Country experiences 13

G to bring together different UN efforts to strengthen data gathering and analytical capacities at both national and local levels; G to pilot a system that will support improved monitoring of recovery efforts tied to the escalation of the conflict and future natural and man-made disasters. In this regard, the conceptual framework of TRIAMS will be sustained for some time and will be used to inform other emergency as well as devel - opmental priorities.

Thailand Thailand had some constraints in moving forward with the TRIAMS initiative after the first TRIAMS workshop in May 2006. There are 30 departments from 10 ministries involved in collecting data on the 55 TRIAMS indicators, underscoring the need for good coordination and information exchange. Moreover, most indicators have to be reported at provincial, district and sub-district levels, which has made data collection and collation more complicated.

In preparation for the second regional TRIAMS workshop, a national workshop was organized in March 2007. The Ministry of Interior’s Department of Disaster Prevention and Mitigation (DDPM) was desig - nated as the focal point for TRIAMS. The DDPM successfully organized the national TRIAMS work - shop, with good participation at the national level and of officials of the six tsunami-affected provinces representing all the sectors involved in the tsunami recovery.

Health indicators in documenting the tsunami recovery in Thailand are the most complete. Mahidol University’s Faculty of Tropical Medicine, in collaboration with the federal Ministry of Health, support - ed the six Provincial Health Offices in conducting several studies linked to the collection and analysis of data related to TRIAMS health indicators. In late 2005, health facilities in the six tsunami-affected provinces in southern Thailand were mapped using the Geographic Information System (GIS), and data on demographic distribution, deaths and orphans by village and information on health facilities and other basic social services and infrastructure were collected and analysed by sub-district in a comprehensive report. Mahidol University and the Provincial Health Offices have also carried out an assessment of disability and quality of life and mental health in the tsunami-affected areas using the WHODAS II (World Health Organization Disability Assessment Schedule II) questionnaires and monitored key health indicators at the sub-district level in tsunami-affected provinces to assess health impacts using TRIAMS indicators in order to create a database of these indicators.

Summary Some of the challenges reported by the four countries were in the following areas: G·coordination between different line ministries involved in data collection; G·lack of baseline data from before the tsunami; G·availability of data on some indicators and the reliability of some data; G·comparison between tsunami-affected and non-affected populations; G·disaggregation of data down to sub-district level and the collation of data from many different levels; G·limited resources, manpower and capacities; G·the involvement of local authorities in data collection and analysis; G·sectoral and intersectoral analysis at peripheral level, time pressures and constraints; G·and, in the case of Sri Lanka, the collection of data in conflict-affected areas.

The difficulties and limitations facing tsunami-affected countries will need to be kept in mind as they imple - ment the TRIAMS framework and related indicators in the monitoring of ongoing recovery interventions. 14 Second regional TRIAMS workshop

Progress of recovery efforts by country

Indonesia In Indonesia, significant progress has been achieved, but much remains to be done. The second year-end report presents the achievements of the recovery process according to the proposed TRIAMS framework, but with information aggregated only by district. 6 A few examples of complementary data analysis at sub- district level supported by TRIAMS for the housing and health sectors are presented below.

While housing is over its peak, it is still the priority sector. By December 2006, 57,000 of the planned 120,000 permanent housing units had been completed, leaving around 51% of needs still to be met.

Figures 1 and 2 present the housing needs assessment by district carried out in Aceh province in May 2005 by the BRR Garansi Survey and the housing needs estimated by the BRR in November 2006 respective - ly. The maps show that the impact of the tsunami was greatest on the tip and on the west coast of the

Figures 1 and 2

Housing needs by district in Aceh province, Housing needs by district in Aceh province, May 2005 November 2006

6 www.who.int/hac/triams. Section II I Monitoring the progress of tsunami recovery: Country experiences 15

Figures 3 and 4

Housing needs by kecamatan (sub-district) Housing needs by kecamatan (sub-district) in Aceh province, May 2005 in Aceh province, November 2006

northern part of Aceh province. The five districts shown in red on the map each recorded more than 10,000 houses destroyed or damaged, even though the three districts on the west coast had a much lower population density than other districts.

Analysis of the housing needs by kecamatan (sub-district), as shown in Figures 3 and 4, reveals that the worst-affected districts present a homogeneous pattern, with well over 1,000 units needed per kecamatan, whereas on the east coast the needs are much less homogeneous across the kecamatan.

The east coast of the northern part of Aceh province has a much higher population density than the west coast, reflected in the smaller surface area of each kecamatan, and has a good road network. Moreover, tsunami damage to infrastructure, in particular to primary and secondary roads, bridges and harbours, was much greater on the west coast. These factors help explain the difference in the speed of recovery in the housing sector between the east and west coasts, as shown in Figures 5 and 6.

Estimates of the housing needs for the whole of Aceh province increased from 102,310 houses in May 2005 to 128,805 in November 2006, a 26% rise. The possible reasons for this increase are multiple, indicating the evolution from damage to loss (e.g. new needs arising from extended families, who may 16 Second regional TRIAMS workshop

Figures 5 and 6

Housing completed by district in Aceh province, Housing completed by district in Aceh province, May 2005 November 2006

have shared a house before the tsunami, now claiming for separate houses) and/or reflecting the adoption of new policies in the housing sector (e.g. the provision of permanent houses to the more than 7,000 households who were renting their homes at the time of the tsunami and who have been accommodated for a long time in former army barracks). They may also reflect the low occupancy of new permanent houses in some areas where houses have been built, while the intended occupants are still living in tem - porary shelters. The absence of basic community infrastructure, such as water supply and sanitation sys - tems, and of access to basic social services may explain this phenomenon.

The BRR is playing a crucial role in promoting the creation of new settlement areas and discussing the operational implications with line ministries, implementing agencies and donors. It is adopting a more comprehensive approach to the planning of these new settlement areas, seeing them as a full package com - prising not only the construction of new housing needed but also the provision of an adequate water sup - ply, appropriate sanitation infrastructure, roads and basic social services. These plans have been submit - ted for new partnerships, including with the private sector, particularly in urban and peri-urban areas.

Lastly, the continuing rise in housing needs is a reflection of the BRR’s policy not to close the list of ben - eficiaries in this sector. This has led to constant negotiations with local communities and implementing Section II I Monitoring the progress of tsunami recovery: Country experiences 17

partners on where and how many new houses are Figure 7 needed in a context where the speed of construction is clearly very different from one area to another but Percentage of permanent houses committed compared in general much slower than expected. with the November 2006 housing needs

In this regard, it is important to underline the enor - mous challenge facing the BRR in coordinating the high number of partners and implementing agencies operating in the housing sector. Often more than one NGO is working in the same village, sometimes with different standards and at different speeds. Again, the BRR’s role in refining the recovery plans is crucial as needs become partially covered.

Figure 7 highlights the critical importance of needs assessment and of constant monitoring of needs and commitments. The areas with diagonal blue lines show where commitments to build permanent hous - ing are higher than the needs assessed in November 2006. Accountability is an issue that must be addressed jointly by all the partners involved. It seems inevitable that overcommitment will occur, close to areas where all the needs are not covered. The issue is how to put in place efficient corrective measures to redirect the available resources.

A beneficiary verification process is under way to ensure recipients of permanent housing meet the cri - teria for eligibility. The new policy adopted by the provincial government of providing a permanent house also to households that were renting before the tsunami has prompted a significant increase in the number of beneficiaries in this area. But this does not seem to be the only reason for the further rise in needs resulting from the most recent beneficiary survey. Further analysis is needed on this point once the full data are available.

Analysis of the findings in the health sector in Indonesia revealed that in some districts more health clin - ics have been built than the needs assessed (324 health facilities have been built or rebuilt overall, com - pared with the 127 units destroyed in the tsunami). By the end of the reconstruction, Aceh will have a more extensive health network than anywhere else in Indonesia, including West Java. The challenge will be to ensure that the health facilities are properly equipped and staffed and sustainable beyond the recov - ery phase. Both health infrastructure utilization and housing occupancy will need continued monitoring and analysis for some time.

Figures 8 and 9 show investment in health infrastructure, i.e. puskesmas (auxiliary health centres) and pustus (health posts), in Simeulue district in Aceh province. The average number of inhabitants per pustu per kecamatan before the tsunami was 3,412, with a total of 24 pustu covering between 1,700 and 10,000 inhabitants per pustu across the 9 kecamatan of this district. A joint WHO and Provincial Health Office 18 Second regional TRIAMS workshop

assessment and mapping of the health facilities in Simeulue district found that the new district average in March 2007 had decreased to 1,687 inhabitants per pustu, owing to the rehabilitation/reconstruction of damaged or destroyed pustu and the construction of an additional 26 new pustu. The range is now between 996 and 4,879 inhabitants per pustu. The average number of inhabitants per pustu in Nias Selatan district is around 7,500, with coverage ranging between 4,259 and 11,132 inhabitants, while in Aceh Tamiang district the average is 8,480 inhabitants per district, with coverage ranging from 4,645 to 12,322 inhabitants per pustu.

The notion of building back better should be applied consistently across the districts and sub-districts of the overall province. It seems that this is not the case. The statistics show that inequalities in geographi - cal access to basic health services have been generated by the tsunami recovery.

In addition, there appears to be a need to identify which services to strengthen as a priority. For example, Figure 10 presents the average kecamatan population covered by one village midwife in Simeulue district. The average for the whole district is 4,017 inhabitants per midwife, with three of the eight kecamatan

Figure 8

Location of puskesmas and pustu and average population per kecamatan in Simeulue district, November 2004 Section II I Monitoring the progress of tsunami recovery: Country experiences 19

Figure 9

Location of pre-existing and new puskesmas and pustu and the average population per keca - matan in Simeulue district, March 2007

with no midwife deployed at village level, and with a range between 1,092 and 4,879 inhabitants per midwife. The coverage of this crucial health service is now far below that of the pustu.

The need to develop a strategic plan for the use of the remaining available resources in the health sector is urgent, given that the building of additional new health infrastructure has already been planned for the second half of 2007 and for 2008.

Some of the other vital needs have proved difficult to monitor in Indonesia. In other cases, monitoring of indicators, e.g. household food consumption, has revealed that the situation is worse for people in areas not affected by the tsunami. In tsunami-affected areas, there are many organizations providing nutrition - al assistance, but this does not extend to unaffected parts of the country.

Other recovery statistics from Indonesia show that by December 2006, 50,340 ha of agricultural land of the 60,000 ha destroyed by the tsunami had been restored to production; 1,510 km of the 3,000 km of roads, 158 bridges (38 more than before the tsunami) and 7 out 14 seaports had been rebuilt or repaired. 20 Second regional TRIAMS workshop

Figure 10

Average population coverage by village midwives per kecamatan in Simeulue district, March 2007

While 2,500 teachers perished in the tsunami, 5,400 (more than double) have been trained, but only 747 of the 2,006 schools needed have been built.

Other recovery statistics from Indonesia show that by December 2006, 50,340 ha of agricultural land of the 60,000 ha destroyed by the tsunami had been restored to production; 1,510 km of the 3,000 km of roads, 158 bridges (38 more than before the tsunami) and 7 out 14 seaports had been rebuilt or repaired. While 2,500 teachers perished in the tsunami, 5,400 (more than double) have been trained, but only 747 of the 2,006 schools needed have been built.

Maldives The situation was unique in the Maldives because although loss of life was much lower than elsewhere, the whole country was affected by the tsunami. The country is made up of 1,190 islands, 199 of which are inhab - ited. The average height above sea level is 1.8 metres, making many of the islands unsafe for habitation. The government has adopted a population consolidation policy to reduce the number of inhabited islands to pro - vide for safer settlements and more efficiency in the provision of the necessary infrastructure, such as schools, hospitals and harbours. In terms of housing, 5,940 people were still in temporary shelters, while 1,073 had been housed either in their old homes or in new homes, indicating that there is still a significant gap. Section II I Monitoring the progress of tsunami recovery: Country experiences 21

Figure 11

Housing needs in the Maldives (as established in July 2005) 22 Second regional TRIAMS workshop

Figure 12 Maldives: Percentage of houses repaired in January 2005, July 2005, January 2006 and July 2006 respectively Section II I Monitoring the progress of tsunami recovery: Country experiences 23

Figure 13 Maldives: Percentage of houses reconstructed in January 2005, July 2005, January 2006 and July 2006 respectively 24 Second regional TRIAMS workshop

In the health sector, 16 health facilities have been completed and handed over, but primary health care services are still weak owing to lack of funding and capacities. Both infant and maternal mortality rates had improved, after a rise in 2004.

The provision of safe water in the Maldives is of vital importance as sources are limited. In order to boost rainwater collection, 20,000 water storage tanks were distributed to households and internally displaced people (IDPs) on 90 islands. Sewage systems have also been constructed to reduce pollution of ground - water supplies and reverse osmosis desalination plants established on some islands to ensure access to potable water. Maintenance and utilization of this new infrastructure rely on sustainable solutions being delivered through partnerships between the government and the communities.

The education sector in the Maldives was hard hit. Where IDPs had gathered, there was overcrowding in “host” schools, which created initial difficulties. Around 50 temporary classrooms (25% of which have since been made permanent) and 10 toilets were established on 6 different islands pending the construc - tion of more permanent buildings. An additional 40 schools are currently being upgraded, and 7 new preschools, 16 primary schools and 20 teacher resource centres are under construction.

Attracting funding for reconstruction of harbours and jetties has been especially difficult because they are perceived by donors as commercial infrastructure rather than as a primary access for island communities.

A lingering problem in the Maldives has been that of psychological well-being. According to the TIAS, in the 14 most-affected islands about two-thirds of the women and half of the men still have less confidence in the future or feared more for the security of their families. To address this, some aid agencies are con - ducting psychosocial programmes.

An assessment of the current status of TRIAMS implementation was carried out and has since been updat - ed to take account of the changes in the indicators made at the second regional workshop in Bangkok. An overview of the resulting indicators, by type, is given in Table 1.

Of the 49 indicators listed, information on 9 has not been available so far, and nor is it likely to become available over the next three years.

The list of TRIAMS indicators was reviewed from three different angles, namely: G Are the data relevant for the situation in the Maldives? G Are the data on a given indicator regularly available? G Are other data regularly available that are relevant but not included in the list?

Regarding the relevance of the data, the indicator relating to land titles is not applicable in the Maldives. The indicators on which information is available but static and therefore not relevant are: the number of functioning island offices; the number of latrines for the population in temporary housing; and the per - centage of tsunami-affected communities consulted (all have been consulted on a number of occasions). Therefore, these indicators are of no use either for monitoring progress or for evaluation.

On the issue of the regularity of data availability, the answer can be found in the source of information. For a number of indicators, data have to be collected through large-scale surveys such as the VPA, the HIES, the Demographic and Health Survey (DHS) or the census. These are not conducted on a regular basis and therefore only provide a few observation points. Such information can be used for evaluation Section II I Monitoring the progress of tsunami recovery: Country experiences 25

Table 1: Maldives: List of TRIAMS indicators suggested at Bangkok meeting

Type of Indicator Total Yes No Not required/not applicable

Vital Needs OUTPUT Indicators 7 5 1 1

Vital Needs OUTCOME Indicators 9 8 1 0

Basic Services OUTPUT Indicators 11 7 2 2

Basic Services OUTCOME Indicators 3 3 0 0

Infrastructure OUTPUT Indicators 5 4 1 0

Infrastructure OUTCOME Indicators 1 0 0 1

Livelihoods OUTPUT Indicators 9 6 3 0

Livelihoods OUTCOME Indicators 4 3 1 0

Total 49 36 9 4

but is not adequate for monitoring progress. Indicators on which data are regularly gathered, either through the education or health data collection systems or the monthly monitoring of progress carried out by the National Disaster Management Centre, can be used for both evaluation and monitoring. The monthly data on progress are especially useful for monitoring.

Regarding the gaps in the coverage of the proposed TRIAMS indicators, analysis of the monthly NDMC data shows that more information is available on the physical progress of reconstruction/recovery than is covered by the indicator list. Three separate data series on IDPs and housing reconstruction and repair are available to supplement the vital needs output indicators and four series on the reconstruction of various facilities can be added to the infrastructure output indicators.

The modified list of indicators is presented in Table 2. As mentioned earlier, the indicators derived from large-scale surveys can serve for programme evaluation, but cannot be used for monitoring progress. Most of the information relating to these indicators is available for 2004 and 2005 from the VPA2 and TIAS, respectively. Some is also available from the 2006 population census, but it is envisaged that only two new surveys will be conducted before the end of the monitoring period. A DHS is planned in 2007, while a HIES/VPA is pencilled in for 2009. As data analysis for such surveys takes a substantial amount of time, survey results are expected to be available only in 2008 and 2010 respectively.

The information in Table 2 has been relabelled in Table 3, whereby regularly available data are deemed suitable for monitoring, while the information available only from the two large-scale surveys that are planned for the coming years can be used only for evaluation. Furthermore, the number of indicators 26 Second regional TRIAMS workshop

Table 2: Maldives: Modified list of TRIAMS indicators

Of which: Not required/ Not available from Type of Indicator Total Regular Surveys HIES/VPA 2009 only not applicable 2007 onwards

Vital Needs OUTPUT Indicators 9 4 3 1 1 1

Vital Needs OUTCOME Indicators 9 4 4 0 0 1

Basic Services OUTPUT Indicators 11 7 1 0 2 1

Basic Services OUTCOME Indicators 3 3 0 0 0 0

Infrastructure OUTPUT Indicators 9 8 0 0 0 1

Infrastructure OUTCOME Indicators 1 0 0 0 1 0

Livelihoods OUTPUT Indicators 9 5 1 0 0 3

Livelihoods OUTCOME Indicators 4 0 4 4 0 0

Total 55 31 13 5 4 7

that are only available for the coming years if the HIES/VPA is conducted in 2009 are listed for ease of reference.

The most serious problem is that all livelihood outcome indicators in the list are derived from the HIES/VPA and therefore will be available only if the survey is conducted in time.

With respect to the infrastructure outcome indicators, only the number/percentage of functioning island offices has been included. As all island offices were fully functioning again (though not always from per - manent structures) shortly after the tsunami, this is a static characteristic that does not need to be tracked.

Overall, information is regularly available for 31 indicators. This includes 10 data series to be obtained from the monthly monitoring carried out by the National Disaster Management Centre, another 10 from the health system and 4 from the education system. The remaining 7 indicators are to be obtained from the unpublished administrative information available from various ministries, as indicated in Table 4. Section II I Monitoring the progress of tsunami recovery: Country experiences 27

Table 3: Maldives: TRIAMS indicators by type of use

Of which: Type of Indicator Monitoring Evaluation HIES/VPA 2009 only

Vital Needs OUTPUT Indicators 4 3 1

Vital Needs OUTCOME Indicators 4 4 0

Basic Services OUTPUT Indicators 7 7 0

Basic Services OUTCOME Indicators 3 3 0

Infrastructure OUTPUT Indicators 8 8 0

Infrastructure OUTCOME Indicators 0 0 0

Livelihoods OUTPUT Indicators 5 5 0

Livelihoods OUTCOME Indicators 0 0 4

Total 31 13 5

For the indicators that can be used for regular monitoring, it is important that all information be made available in a standardized format to facilitate the monthly updating of the database. The most important aspects of this are consistency in the format used and the precoding of various characteristics, especially the location (island), as there are many islands with similar (and sometimes identical) names, which can easily cause coding errors.

In conclusion, implementation of the monitoring system using the 31 indicators regularly available is pos - sible without too many additional inputs once the framework has been put in place. For evaluation, it is important that additional information become available as planned from the DHS in 2007 and the HIES/VPA in 2009.

If other data series are available from administrative sources that may shed light on developments in areas not adequately covered by the series presented in Table 4, these could be added. No such information is known to be available at this moment. 28 Second regional TRIAMS workshop

Table 4: Maldives Government monitoring and evaluation

Currently If collected, If no, Frequency of Indicators collected most recent why data collection (Y es /N o) data value

Vital needs OUTPUT Indicators Yes, but proxy % of population with access to water from indicators 5 years an improved source, by administrative level available Yes, but proxy % of population without basic sanitation indicators 5 years facilities, by administrative level available No survey on food Household food consumption (24 hour recall) No consumption/ 5 years security

Proportion of tsunami-affected population with housing damaged/destroyed living in emer - Yes Quarterly gency shelter/temporary houses/permanent houses, by sub-district, by time period

Measles immunization coverage, Yes Annually by administrative level # of titles of land given, by economic status Yes and gender, by district

Contraceptive prevalence rate Yes 5 years 37%

Vital needs OUTCOMES Indicators

% of children under 5 who are underweight Yes 5 years

% of children under 5 who are wasted Yes 5 years (moderate or severe) % of children under 5 who are stunted Yes 5 years (moderate or severe)

% of low birth weight newborns Yes Annuall y/ 5 years

Yes, but proxy % of children under 5 who have experienced indicators Quarterly a diarrhoea episode in the past 2 weeks available 12/1,000 live Infant mortality rate Yes Annually births (2005) % of population with worse functioning No survey yet No (WHODAS II) conducted % of population under stress Yes or with poor well-being 72/100,000 Maternal Mortality Ratio Yes live births Section II I Monitoring the progress of tsunami recovery: Country experiences 29

plan 2007 –2009 using TRIAMS indicators

Resources required to Other Current or potential data source collect data routinely comments

Census/DHS

Census/DHS

HIES

NDMC/relevant sectors

RHS, 1999, 2004

MICS I, MICS I I/ DHS 2007

MICS I, MICS I I/ DHS 2007

MICS I, MICS I I/ DHS 2008

VR S/ MICS I, MICS I I/DHS 2009

Attack rate for Disease surveillance system children <5

VRS

DHS funding gap – DHS, 2007 US$ 200,000

TIAS, Census 2006

VRS 30 Second regional TRIAMS workshop

Table 4 (contd.): Maldives Government monitoring and

Currently If no, Frequency of If collected, Indicators collected why data collection most recent data value (Y es /N o)

Basic Services OUTPUT Indicators

# of primary school children per school, 250 students per Yes Annually by sub-district primary school (2006)

18 primary # of primary school children per teacher, Yes Annually students per teacher by sub-district (2006)

# of hospital beds per 10,000 population, Yes Annually (inpatient and maternity) by sub-district/district

No, but can be collected # of outpatient consultations per person from health facility Annually per year, by administrative level data systems % of children of 12 –23 months who are Yes, but proxy data on fully immunized against all antigens, vaccination coverage is Annuall y/ 5 years by administrative level available for atoll level # of health facilities with emergency obstetric care per 10,000 population, Yes Annually by sub-district/district Adequate ante-natal coverage (at least Yes, but national level 5 years 98% 4 visits during a pregnancy), by sub-district currently available

% of sub-district covered by mobile No psychological support workers, by district

No survey Out of pocket expenditure for health No conducted

# of people per latrine (for tsunami-affected N/ A people living in temporary campsites)

% of tsunami-affected communities consulted N/ A by implementing agency, by district

Basic Services OUTCOMES Indicators

99% (almost achieved Net primary school enrolment ratio Yes Annually universal primary education) (2006)

3% (reliability question: Primary school drop-out rate Yes Annually mismatch between NER and drop-out rate) (2006)

% of births attended by a skilled Annuall y/ Yes 85% birth attendant 5 yearly Section II I Monitoring the progress of tsunami recovery: Country experiences 31

evaluation plan 2007 –2009 using TRIAMS indicators

Current or potential data source Resources required to collect data routinely

Redevelop EMIS software including fully integrated Annual school census data collected for the EMIS automated data input system US$ 60,000. Capacity (EMIS however is not fully functional owing to problems with software) building (training programme) US$ 110,000

Health care service records

Improvement of medical records Health facility data systems and registration systems

MICS I/MICS II, DHS 2007 Child Health & Nutrition tracking online database system (2008 onwards), MICS I/MICS II, DHS 2007 Child Health & Nutrition Capacity building tracking online database system (2008 onwards)

Health Care service records

Capacity building for analysing/collating data RHS, 1999, 2004 from island level registers Proxy data on number of persons trained at island level are available, in terms of access to psychosocial support services

DHS 2007

Annual school enrolment data collected for the EMIS from schools as numerator. Denominator obtained from age-specific population projections based on national Funding gap for DHS 2007 census data provided by Ministry of Planning and National Development.

Annual school census data collected for the EMIS Same as indicators 12 & 13

RHS, VRS 32 Second regional TRIAMS workshop

Table 4 (contd.): Maldives Government monitoring and

Currently Indicators collected If yes, most recent data value (Y es /N o)

Infrastructure OUTPUT Indicators

8 completed, # of harbours/jetties rehabilitated Yes 4 in progress, 16 funding confirmed by type, by district 24 funding sources/not confimed

51 primary schools/secondary schools/preschools will be rehabilitated. 25 school facilities completed, 17 primary schools # of destroyed/damaged schools rebuilt or and 9 preschools in process of construction. Yes rehabilitated, by category, by sub-district 1 vocational school to be constructed. 20 Teacher Resource Centres in process of construction, 2 completed

% of destroyed/damaged health facilities rebuilt or rehabilitated, by category, Yes 16 completed, 4 in progress by sub-district

# of sq km of natural habitat, No restored, by type

# of km of coastal protection constructed/ 2,200m revetments – approximately 3,000m repaired, by type (biofencing, sea walls, Yes of cement sand bag revetments quay walls, breakwaters), by district

Infrastructure OUTCOMES Indicators

% of local administration office N/ A fully functioning, by district Section II I Monitoring the progress of tsunami recovery: Country experiences 33

evaluation plan 2007 –2009 using TRIAMS indicators

Current or potential data source Resources required to collect data routinely

Extra note: Ministry of Construction and Public Infrastructure has very limited data analysing capacity (human resources) and burdens its Ministry of Construction and Public Infrastructure industry development unit, to analyse the monitoring units data. Hence need in-house coastal infrastructure monitoring programme data analysis personnel. Capacity building to train existing and new staff is required. 2 professional demographic statisticians (6 months each) + continu - ous on-the-job training for 5 staff – $200,000

Ministry of Health projects department

All of the Maldives is not mapped, hence the damage caused to natural habitats is also not fully mapped. Urgent assistance is required to map and accurately locate all islands in the Maldives. This would also help in disaster management activities of all sectors. National land survey - $200,000

Extra note: Ministry of Construction and Public Infrastructure has very limited data collection capacity (human resources) Ministry of Construction and Public Infrastructure and burdens its industry development unit to analyse in-house coastal infrastructure monitoring programme the monitoring unit data. Hence need data analysis personnel, as indicated above.

Ministry of Atolls Administration 34 Second regional TRIAMS workshop

Table 4 (contd.): Maldives Government monitoring and

Currently If no, Indicators collected why (Y es /N o)

Livelihood OUTPUT Indicators

Maldives has data on the agriculture sector of affected islands but the area was not measured in the aftermath # of sq km of land returned to crops No of the tsunami. Indicator 35 can capture information on progress or impact.

Yes, but need to define % of tsunami-affected population who have the denominator of received loans the indicator

% of population of tsunami-affected districts Yes, but not gender who have received grants, by administrative disaggregated level and by gender

% of tsunami-affected population enrolled Can be collected if there is coordination between No in social protection programme, by gender the Red Cross & the Ministry of Gender and Family

# of people employed by different sectors Yes

% of damaged/destroyed boats repaired/replaced, by use (fishing, tourism, Yes ferrying and other income-generating activities) and by island

Some households discontinued home # of home gardens affected and regained No gardening after the tsunami

# of people receiving fishing gear, by gender Yes

# of hotel rooms available compared Yes with before the tsunami

Livelihood OUTCOMES Indicators

% of population living below No, but income data national poverty line available

Average household income, Yes by administrative level and by gender

Labour force participation rate, by gender Yes

% of households that have regained Significant no. of households have changed Yes their pre-tsunami livelihoods, by gender their livelihoods after the tsunami Section II I Monitoring the progress of tsunami recovery: Country experiences 35

evaluation plan 2007 –2009 using TRIAMS indicators

If collected, Resources required Frequency most recent Current or potential data source to collect data routinely data value

No baseline data exist, therefore not meaningful to collect endline data

No. of loans disbursed to Bank of Maldives, Ministry of Atolls Development Quarterly females: 118; No. of loans and Ministry of Family and Gender disbursed to males: 346

Quarterly Cash grants: 63,477 Ministry of Finance and Treasury

Need better coordination between NGOs and line ministries

VPA II, TIAS 2005 and Census 2006

Ministry of Fishing, Agriculture Quarterly 82% and Marine Resources

Difficult to collect

Quarterly 97%

Quarterly Ministry of Tourism and Civil Aviation

Financial assistance for DHS – 5 years Ministry of Planning and National Development $200,000 gap

Financial assistance for DHS – 5 years Ministry of Planning and National Development $200,000 gap

53% total; 63.7% male, Financial assistance for DHS – 5 years Census 2006 36.7% female $200,000 gap

No baseline, not relevant to collect 36 Second regional TRIAMS workshop

Sri Lanka In Sri Lanka, most sectors, starting with agriculture, are recovering well. Progress is slower in the social services sector, for example in the reconstruction of education infrastructure, as this requires big build - ings. In the housing sector, 51% of needs are covered. However, there are disparities in the progress of reconstruction between southern areas and the north and east, owing to the escalation of the conflict in the latter two areas. The conflict has also made data collection difficult in these areas.

According to the results of an HIES comparing tsunami-affected populations and non-affected popula - tions, the coastal population is more prosperous than that of the hinterland, as has been the case histori - cally. The significant infusion of resources in coastal areas has had an unusual impact, in that income is now higher than that of the country on average. In most areas of Sri Lanka, access to safe water and san - itation is very good. Immunization coverage is also very good, reaching up to 90%, as is the case with the other TRIAMS health indicators.

WHO supported the Federal Ministry of Health and the Matara Health District Office in carrying out a detailed analysis at sub-district level of selected TRIAMS health indicators and other country-specific health indicators. These were collected and analysed through the routine health information system at dis -

Figures 14 and 15

Sri Lanka district divisions GN divisions, Matara district Section II I Monitoring the progress of tsunami recovery: Country experiences 37

Figures 16 and 17

Health facilities and main roads in Matara district Total population and population density (inhabitants/km 2), by GN division, 2006

trict level and, when possible, for the years 2004, 2005 and 2006. The outcome of this process was dis - cussed at the national workshop held in March 2007 in advance of the second regional TRIAMS work - shop. The maps and text below are a synthesis of this work. The Ministry of Health of Sri Lanka indicat - ed in the TRIAMS plan of action its intention to standardize this data collection and analysis in order to extend it to other districts.

Matara district is part of the coastal region of Sri Lanka that was severely affected by the 2004 tsunami. Only the four DS divisions (sub-districts) of Matara directly along the coast were affected by the tsunami.

Matara district reported 16,928 people affected by the tsunami, with 1,243 deaths and 612 people miss - ing. The number of completely damaged and unusable partially damaged housing units was 2,392, while 3,837 houses were damaged but still usable. The damage was distributed across the 70 tsunami-affected GN divisions out of the total 203 GN divisions in Matara district. In the 70 affected GN divisions, 296 out of the total 431 census blocks were affected. The reported population directly affected by the tsuna - mi represents 2.1% of the total district population in 2006. 38 Second regional TRIAMS workshop

Table 5: Selected health indicators, by Ministry of Health Area, by health facility, Matara distric t * Ministry of Out Number In Caesarian Caesarian Caesarian sec - Health Facility Type – Location Health Area patients of beds patients sections 2004 sections 2004 tions 2006 (Q.1–2) Central Dispensary – Rotumba 8,640 Akuressa Central Dispensary – Maramba 12,484 247 281 135 District hospital – Akuressa 62,502 140 8334 Deniyaya District hospital – Deniyaya 42,366 148 7600 Rural hospital – Devinuwara 19,014 15 Devinuwara 109 155 92 Central Dispensary & Maternity – Thalalla 32,623 15 123 District hospital – Dickwella 71,711 82 6,000 Dickwella 147 177 98 Rural hospital – Urugamuwa 19,976 8 510 Central Dispensary – Hakmana 40,737 Hakmana Peripheral unit – Gangodagama 37,918 60 4,368 80 102 62 Peripheral unit – Naravelpita 44,420 69 2,910 Base hospital – Kamburupitiya 99,428 172 13,141 Central Dispensary & Maternity home – Kamburupitiya 34,876 6 149 154 96 Kirinda Rural hospital – Ruhunugama 38,642 23 Central Dispensary & Maternity home – 21,673 12 238 Kotapola Pallegama 122 127 75 Central Dispensary – Kotapola 31,251 Central Dispensary – Horagoda 4,844 Malimboda 120 117 75 Central Dispensary – Thelijjawila 16,354 Central Dispensary – Kekanadura 23,144 Matara 371 453 245 General hospital – Matara 40,6550 1,064 91,604 Central Dispensary – Beralapanathara 7,126 Central Dispensary – Derangala 15,200 Morawaka Central Dispensary – Dihigaspe 12,837 96 137 68 Central Dispensary – Makandura 6,500 Peripheral unit – Morawaka 58,332 98 Peripheral unit – Mawarala 40,585 96 2,678 Mulatiyana 114 129 61 Rural hospital – Deiyandara 24,922 56 2,683 Pasgoda Rural hospital – Urubokka 36,580 67 4,838 118 139 78 Central Dispensary – Thihagoda 6,358 Thihagoda 106 114 81 Central Dispensary – Yatiyana 27,662 Central Dispensary – Galbokka 37,200 Central Dispensary – Kamburugamuwa 23,397 Weligama Central Dispensary – Mirissa 25,602 244 205 131 District hospital – Weligama 54,714 161 7,709 Rural hospital – Midigama 23,518 12 16 Welipitiya Central Dispensary – Denipitiya 12,837 147 186 97 Total 1,482,523 2,304 152,752 2,170 2,476 1,394

* Sources: Office of the Deputy Provincial Director of Health Services, Health Bulletin , 2005, and the consolidated quarterly reports of the District Health Office into yearly reports for 2004 and 2005 and for the first two quarters of 2006. Section II I Monitoring the progress of tsunami recovery: Country experiences 39

Ministry of Health Areas coincide with the sub-district administrative divisions, with the exception of two areas (Akuressa and Kamburupitiya), which are both made up of two sub-districts.

While the physical destruction was limited to a slim coastal strip, and few people in Matara district were directly affected, the impact of the tsunami has been huge on the district’s local economies, not only in the coastal belt but throughout the district.

Matara has one of the highest population densities in Sri Lanka, increasing from 599 inhabitants/km 2 in 2001 to 661/km 2 in 2006. The sub-districts along the coast have the highest population density, with val - ues between three to four times higher than those in the northern part of the district.

The road network and distribution of health facilities ensure that the populations of all sub-districts have very good geographical access to health facilities.

The Matara General Hospital, with 1,064 beds, has a huge volume of work. Some health facilities are located very close to one another, with very low utilization of inpatient services, as in the Weligama Ministry of Health Area. Here, a rural hospital with 12 beds reported 16 inpatients during 2005, while the district hospital with 161 beds, just 5 km away, reported 7,709 admissions for the same year.

Figure 18 illustrates the number of inpatient beds available (including maternity beds) per 10,000 people within each Ministry of Health Area in 2005.

The fact that certain sub-districts present a 0 value for the number of beds per 10,000 population in the southern part of Matara district does not indicate a low geographical accessibility of health services for these populations, owing to their proximity to the health facilities of neighbouring sub-districts, both to the south and to the north. By contrast, the low value of this indicator in the northern sub-district of Kotapola, with only 12 inpatient beds available, and the distance from the nearest district or rural hospi - tals exceeding 20 km, would seem to indicate poor access to hospital care for the 60,000 inhabitants of this sub-district.

Figure 19 presents the number of outpatient consultations per person per year carried out in 2005. Again, it seems that the low value of this indicator (less than one visit per person per year) reflects a very low uti - lization of basic health services in the two northern sub-districts compared with the other sub-districts of Matara district. However, the very low and low values of the indicator for the Welipitiya and Malimbada sub-districts seem not to reflect a very low utilization, owing to the high value of the indicator in the southern sub-districts of Weligama and Matara, whose health facilities are close by and are also providing services to the populations of the two aforementioned neighbouring sub-districts. 40 Second regional TRIAMS workshop

Figure 19 presents the number of outpatient consultations per person per year carried out in 2005. Again, it seems that the low value of this indicator (less than one visit per person per year) reflects a very low utilization of basic health services in the two northern sub-districts compared with the other sub- districts of Matara district. However, the very low and low values of the indicator for the Welipitiya and Malimbada sub-districts seem not to reflect a very low utilization, owing to the high value of the indi - cator in the southern sub-districts of Weligama and Matara, whose health facilities are close by and are also providing services to the populations of the two aforementioned neighbouring sub-districts.

In general, it seems that the very good geographical accessibility of health facilities highlighted by Figure 19 corresponds to a good utilization of out- and inpatient services, as indicated by the analysis of outpatient visits and inpatients treated by the health facilities in 2005 presented in Table 5.

The indicator represented in Figure 20 for the years 2004, 2005 and 2006 is the percentage of caesarean sections performed over the total number of attended deliveries by sub-district. The number of caesarean sections performed by sub-district and by year are presented in Table 5.

Only two health facilities perform caesarean sections in Matara district. Nevertheless, the registration of this service is recorded by the sub-districts that referred the pregnant women. The recording of this information seems reliable and consistent over the three-year period. Figure 18 The pattern of this indicator over the three years seems Number of inpatient beds per 10,000 people, by GN, Matara district, 2005 to suggest that the tendency to over-diagnose the need for a caesarean section is increasing over time but shows important differences in the value of this indi - cator between the northern and southern sub-districts.

The percentage of deliveries managed through caesare - an section are extremely high in the overall district, but particularly in the southern part. There is a need to investigate if the high number of caesarean sections in the Matara General Hospital is linked to the number of patients referred by other districts, and if this is the case, to what extent.

The over-medicalization of deliveries does not neces - sarily translate into further reductions in maternal and perinatal mortality. A retrospective study of these indi - cators over the same period may help to assess if the high costs represented by the caesarean sections have a positive health outcome for the beneficiaries.

The Body Mass Index (BMI) of pregnant women at the first antenatal visit is an important parameter in the individual follow-up of these women, but it can also be used as an anthropometric indicator highlight - ing the nutritional status of the overall population of Section II I Monitoring the progress of tsunami recovery: Country experiences 41

pregnant women. The coverage of pregnant women Figure 19 attending antenatal care in Sri Lanka is very high, and among them the detection of BMI is also very high. Number of outpatient consultations per person per year, by GN, Matara district, 2005 The indicator, as presented in Figure 21, also shows important differences between the northern and southern sub-districts of Matara district, with a small deterioration in the northern district of Kotapola, from 38.9% in 2004 to 43.8% in 2006, which is the only sub-district above the threshold of 40%, general - ly considered the value indicating an alarming nutri - tional situation among the assessed population. In the rest of the sub-districts, the indicator presents neither significant negative nor positive changes.

The pattern of the low birth weight indicator over the 2004–2006 period and across the sub-districts mirrors the findings of the BMI index among pregnant women at the first antenatal visit.

More that 90% of deliveries take place in health facil - ities, where almost all newborns are weighed. So the coverage of this indicator, based on data provided by routine information systems, seems quite reliable and represents almost the whole population, with uniform coverage across the sub-districts.

Although the indicator is below the national average of 17% reported in 2002 in all the sub-districts, there are important inequalities again between the northern and southern sub-districts. In addition, the situation seems to be quite stable across the three-year period.

Weight for age is an anthropometric indicator highlighting undernutrition but can not detect acute or chronic malnutrition.

The data presented in Figure 23 are consolidated in the Ministry of Health Areas’ quarterly reports on the growth monitoring programme. This programme collects data for children below one year of age, those between two and three years of age, and those between four and five years of age. The data have been aggregated for the under-five population.

As the purpose of the programme is to monitor the children’s growth, the children were weighed several times during the same year. These data can not be taken as showing the prevalence of undernutrition. Nevertheless, the distribution of undernutrition across the age groups reflects the expected pattern, being higher in the age group of children above one year of age.

Despite the above-mentioned limitation, it seems that children under five have a better nutritional status in the coastal belt than in the northern sub-districts. 42 Second regional TRIAMS workshop

Figure 20 Percentage of caesaran sections over the total number of deliveries registered, Matara district, 2004, 2005, 2006 respectively Section II I Monitoring the progress of tsunami recovery: Country experiences 43

Figure 21 Percentage of pregnant women with a BMI less than 18.5, Matara district, 2004, 2005, 2006 respectively 44 Second regional TRIAMS workshop

Figure 22

Percentage of low birth weight, Matara district, 2004, 2005, 2006 respectively Section II I Monitoring the progress of tsunami recovery: Country experiences 45

Figure 23

Percentage of children under 5 below 3 rd centile, Matara district, 2004, 2005, 2006 respectively 46 Second regional TRIAMS workshop

Table 6 shows a very high immuniza - Figure 24 tion coverage with several antigens across all the sub-districts, as well as Coverage of sanitation, by GN division, consistency between the reported and Matara district, 2005 estimated denominators.

As seen in Figure 24, coverage of hous - es with latrines in 2005 is quite high across all sub-districts, with the excep - tion of Weligama sub-district.

Preliminary analysis and further questions G The brief analysis presented along with each figure is very preliminary. G These preliminary findings neverthe - less highlight inequalities in the nutritional status of pregnant women and newborns between the northern and southern sub-districts of Matara district that need to be investigated. G One hypothesis is that the lower household food security in the northern sub-districts is due to lower income. G Is the allocation of resources to build a large number of new health facilities in the coastal sub-district justified? G Is this choice sustainable in terms of human resources and maintenance costs? G Can resources available for restoring livelihoods in the tsunami-affected population have a positive spill- over effect for the disadvantaged rural communities of the northern part of the district, in order to address pre-existing inequalities? G If yes, which actions are needed from the livelihood sector in order to facilitate redressing these inequal - ities within the district? G What are the obstacles to this happening? Section II I Monitoring the progress of tsunami recovery: Country experiences 47

Table 6: Selected health indicators by GN division, Matara district, 200 5*

DPT3 DPT3 Measles Measles Estimated Registered Estimated Sub-districts DPT3 Measles coverage coverage coverage coverage live births live births infants (est. pop.) (reg. pop.) (est. pop.) (reg. pop.)

Akuressa 1,521 1,217 1,202 1,405 1,413 117 103.63 118 104.15 Devinuwara 920 755 746 695 668 93 87.69 90 85.77 Dickwella 1,017 862 851 942 1,012 111 98.96 119 106.31 Hakmana 638 527 521 625 595 120 98.17 114 93.76 Kamburupitia 1,065 822 812 939 1,093 116 83.47 135 80.53 Kotapola 1,228 1,003 991 1,217 1,229 123 106.81 124 107.86 Malimboda 634 528 522 580 559 111 102.96 107 96.89 Matara 2,123 1,522 1,503 1,554 2,170 103 62.84 144 89.7 Morawaka 1,014 813 803 859 870 107 104.48 108 105.58 Mulatiyana 890 782 772 946 909 122 111.17 118 106.82 Pasgoda 1,062 823 813 969 970 119 92.03 119 92.13 Thihagoda 628 503 497 432 456 87 71.31 92 75.27 Weligama 1,289 1,108 1,094 1,234 1,225 113 98.34 112 97.62 Welipitiya 925 825 815 806 913 99 90.13 112 102.1 Tota l/ Average 14,954 12,090 11,943 13,203 14,082 111 – 118 –

* Source: Office of the Deputy Provincial Director of Health Services, Health Bulletin , 2005.

Documenting achievements at the country level using the TRIAMS framework and selected indicators

The impact of the disaster in terms of lives lost: the case of the most-affected districts in Aceh province The final draft of the TRIAMS framework was presented and discussed at the first regional TRIAMS work - shop in Bangkok in May 2006. The framework proposed four broad areas in which to group the overall recovery effort, namely vital needs, basic social services, infrastructure and livelihoods. This framework was used to develop and reach consensus on the core and country-specific output and outcome indicators.

At the same time, the framework indicated the need to carry out a more structured analysis of the impact of the tsunami on local communities. It provided some technical indications and a tool to facilitate this analysis, and applied them to some examples. 7

7 See WHO and Karolinska Institutet, Conceptual Framework for Analysis of TRIAMS Data – A Pathway to Provide Context to Data Analysis: Indonesia Case Study, February 2007, unpublished, www.who.int/hac/triams . 48 Second regional TRIAMS workshop

One of these examples was built on the officially reported numbers of deaths and missing people aggre - gated by district in the aftermath of the tsunami (Figure 25) and on the detected changes in the popu - lations by district (Figure 26) in four selected districts in the severely affected northern part of Aceh province. The surface of each histogram representing each of the four districts is proportional to the size of its population before the tsunami in order to help visualize the impact of the tsunami on these dis - tricts’ populations.

At the first regional TRIAMS workshop in March 2006, a discrepancy was noted between the reported number of deaths and missing persons in Banda Aceh (15,394) and the overall change in population in this district, with more than 105,394 people no longer living in this district in March 2005, compared with the estimated pre-tsunami population of November 2004. The explanation provided at that time was the inaccuracy of the recording of deaths and missing persons in the aftermath of the tsunami, with the bodies of many people living in Banda Aceh district identified in the surrounding Aceh Besar district.

According to the second year-end report, since the first TRIAMS workshop peripheral local government structures (at the sub-district or kecamatan level) have been encouraged to take a more active role in the recovery process. A critical area for this to happen is in information management and the regular provi - sion and use of vital data.

The data presented in the four maps in Figures 27–30 illustrate the absolute numbers and the percent - ages of deaths and missing persons recorded among the total pre-tsunami population by the kecamatan offices of the Banda Aceh district following the tsunami. Figures 27 and 28 present this information by urban and peri-urban area within each kecamatan, while Figures 29 and 30 present the information by kecamatan. 8

It is important to emphasize that through the consolidation of the data collected by the nine kecamatan offices, the total number of deaths and missing persons recorded for the Banda Aceh district rose from 15,394 to 57,263. The kecamatan offices collected and consolidated the information by urban, peri-urban and rural area. This has made it possible to present the information for each area in visual form, provid - ing a level of detail which can be very useful in planning the provision of basic social services, both in set - ting priority areas for intervention and in determining the resilience of the affected communities. A much lower response capacity can be expected in communities where more than 70% of the population died and where the survivors may need more support from the district authorities and international partners in the reconstruction effort.

A focused analysis of tsunami mortality in the Banda Aceh district is presented in the maps in Figures 27–30. They compare absolute numbers and percentages of deaths and missing persons, as well as the same information aggregated by urban area/rural villages (Figures 27 and 28) versus kecamatan (Figures 29 and 30).

Analysis of the mortality data aggregated by kecamatan suggests that the impact of the tsunami was greater and much more homogeneous in the two western coastal kecamatan, Meuraksa and Kuta Raja. These two were the only ones of the nine kecamatan of the Banda Aceh district that reported more than 10,000 deaths or missing persons and that had the highest percentages of deaths and missing persons (more that 65% of the total pre-tsunami population).

8 Source: Kecamatan offices . Section II I Monitoring the progress of tsunami recovery: Country experiences 49

Figure 25 Reported number and percentages of deaths and missing persons among the total pre-tsunami population in four districts of Aceh province

5.4 35 21.3 8.6 % change -15,394 -107,342 -16,874 -13,785 Total population change 100 n o i t a l u p o p d

e 50 t c e f f a f o % Change Remaining

0 Banda Aceh Aceh Besar Aceh Jaya Aceh Barat District name 283,819 306,716 79,218 160,755 Population size

Figure 26 Comparison between the pre-tsunami and March 2005 population in four districts of Aceh province, as percentages and absolute numbers

37.3 3.3 23.4 6.4 % change -105,938 -10,175 -18,558 -10,305 Total population change 100 n o i t a l u p o p d

e 50 t c e f f a f o % Change Remaining

0 Banda Aceh Aceh Besar Aceh Jaya Aceh Barat District name 283,819 306,716 79,218 160,755 Population size 50 Second regional TRIAMS workshop

Figures 27 and 28

Percentage of tsunami deaths and missing persons Number of tsunami deaths and missing persons over the total pre-tsunami population, by urban area/ (total 57,263), by urban area/rural village, rural village, Banda Aceh district 1 Banda Aceh district 2

1 Source: Kecamatan offices 2 Source: Kecamatan offices

The four coastal kecamatan all reported more than 6,000 tsunami-related deaths or missing persons each, ranging from 22,718 in the westernmost kecamatan to 6,107 in the easternmost. The four kecamatan in the centre and south of Banda Aceh district reported between 75 and 620 deaths and missing persons each. The exception was the south-western kecamatan of Jaya Baru which, despite being far from the coast, reported 5,966 deaths and missing persons.

Analysis of the number of deaths and missing persons reported by the individual urban and rural areas within each kecamatan confirms the homogeneous pattern of the mortality data in the worst-affected coastal kecamatan in the west, all of which reported more than 60% of the pre-tsunami population dead or missing. The two transitional kecamatan towards the east and the south of the district, Kuta Alam and Jaya Baru respectively, show a different picture, with the percentages of the pre-tsunami population who died or were missing ranging widely from 0.5% to 75%, suggesting very different resilience capacities of Section II I Monitoring the progress of tsunami recovery: Country experiences 51

communities within the same kecamatan. This information needs to be cross-checked with the damage to infrastructure and material losses incurred as a result of the tsunami. For example, was the destruc - tion higher where more deaths have been reported or is the devastation and the need to rebuild houses and social services as great in those areas reporting fewer deaths and missing persons?

This information and the kind of analysis that was done in March 2007 should have been made avail - able much earlier in the recovery process in order to assist the social services in determining which areas needed to be targeted as a priority for the reconstruction of health facilities and schools. The data have long been available in the kecamatan offices but were not used to inform the planning process. The dis - connect between local government authorities, line ministries and the BRR is a key concern that has been addressed recently through the creation by the BRR of six regional offices whose role it is to inter - act with the district authorities in the recovery effort. It may nonetheless still represent a challenge.

Figures 29 and 30

Percentage of tsunami deaths and missing persons No. of tsunami deaths and missing persons over the total pre-tsunami population, by kecamatan (total 57,263), by kecamatan office, office, Banda Aceh district 1 Banda Aceh district 2

1 Source: Kecamatan offices 2 Source: Kecamatan offices 52 Second regional TRIAMS workshop

Properly documenting the impact of the disaster is crucial to inform the planning of relief operations, but a deeper analysis of damage and losses is essential as the situation stabilizes and the planning of recovery gets under way.

The early involvement of local government offices at district and sub-district levels in providing reliable and timely information can be a first step in ensuring a key role for local government (district and sub- district offices) and communities in the planning of the recovery, through a bottom-up planning process. This involvement can also ensure that more attention is paid over time to assessing damage and related losses that must also be taken into consideration in the planning of recovery interventions.

The heterogeneous capacity of the kecamatan government offices in playing this pivotal role has to be con - sidered. Early in the recovery process, a specific effort in this field is required, with proper allocation of resources for operational support and/or capacity-building of local government structures when needed.

The overall impact of recovery activities on health status and quality of life in tsunami-affected communities At the first regional TRIAMS workshop in March 2006, the tsunami-affected countries agreed on a com - mon set of output and outcome indicators. 9

The outcome indicators included a group of indicators to assess the overall impact of the recovery, name - ly: the percentage of the population with worse functioning (WHODAS II); the infant mortality rate; and the percentage of the population with poor quality of life. The main characteristic of these indicators is that they can not be directly linked to one single area of the recovery process but to all. It is the concur - rence of all recovery efforts and the related level of development achieved that contribute to the crude or infant mortality rate and the overall quality of life and health functioning of the affected populations.

TRIAMS advocated the adoption of standardized tools to collect some of these indicators, preferably dur - ing already planned household surveys. A difficulty has been to adapt the sampling methodology of national or sub-national surveys in order to have a stratification of the sampling for the tsunami-affected versus non-affected populations. The technical reasons for this are linked to the fact that the tsunami- affected population is often just a small fraction of the district population, which is frequently the small - est unit of these surveys, and/or to the huge movements of people displaced by the tsunami across differ - ent locations. The latter has been compounded by other, new population movements resulting from the peace consolidation in Aceh province and the resurgence of the internal conflict in eastern coastal districts of Sri Lanka.

That said, the WHODAS II set of 12 questions to assess health functioning in the population was added to the health survey conducted in Aceh province in August−September 2006. In Thailand, a dedicated household survey was carried out in December 2006 using the WHODAS II questions together with the WHO Quality of Life (QoL) questionnaire and a short questionnaire on mental health.

Table 7 presents the results of the mean score of the WHODAS II in Aceh province in Indonesia and in the six tsunami-affected provinces in Thailand, compared with the reference population.

9 UN, WHO and International Federation, Tsunami Recovery Impact Assessment and Monitoring System (TRIAMS) Workshop Report , 2006, pp. 36−37 , www.who.int/hac/triams. Section II I Monitoring the progress of tsunami recovery: Country experiences 53

Table 7: Mean score of WHODAS II in Indonesia and Thailand

Reference population Indonesia Thailand (WHODAS II surveys in N: 10,598 N: 1,190 14 countries with over September 2006 December 2006 100,000 respondents in the general population)

WHODAS II 8.41 13.01 6.48 mean score

Both WHODAS II surveys in Indonesia and Thailand show a higher mean disability score, which clear - ly indicates a worse health functioning of the investigated populations than of the reference population.

The Aceh health survey is representative of the population of the whole province. It is not possible to detect any significant differences in the variables across the districts or between the tsunami-affected pop - ulation and the non-affected population. Nevertheless, the findings highlight the need for further inves - tigation, owing to the complexity of the situation across the whole province. The overlap of different high - ly vulnerable groups, such as the tsunami-affected populations that have remained in their places of origin, people displaced by the tsunami and people moving as part of the consolidation of the peace process, as well as populations living in conflict-affected areas which have hitherto had very limited access to basic social services for a long time but now have increased accessibility, has generated much more diversified needs than the simple physical reconstruction of damaged infrastructure. Further investigation should focus on the specific areas that have led to the higher disability score and on whether any of the aforemen - tioned groups is showing a higher disability score than others.

In Thailand, the ad hoc household survey to assess the overall impact of the recovery process on the pop - ulations of the six tsunami-affected provinces was conducted in December 2006. The sampling allows a representative sample of the tsunami-affected and non-affected populations in the six provinces. Three main outcome indicators were investigated, namely health status, quality of life and mental health. The sampling methodology enabled these indicators to be compared between villages not affected by the tsunami, villages affected by the tsunami where no deaths were reported and villages affected by the tsuna - mi where deaths were reported.

It is important to underline the coherence of the results of the three main outcome indicators assessed in this survey, as presented in Table 8. Consistently, all are significantly worse in tsunami-affected villages, both with or without deaths.

Table 8 also shows that besides being in a worse state of health, respondents in the tsunami-affected vil - lages were also more dissatisfied with different aspects of life (i.e. had a worse quality of life) and were suf - fering greater stress levels several months after the event.

Table 9 presents the outcome of the WHODAS II questionnaire investigating health functioning by domain and by category of village. 54 Second regional TRIAMS workshop

Table 8: Mean scores for WHODAS, Quality of Life (QoL) and Mental Health questionnaires by village categories

Village category WHODAS II WHOQoL Mental Health

Unaffected 8.3 2.3 2.0

Tsunami-affected without deaths 12.3 2.4 2.1

Tsunami-affected with deaths 14.2 2.4 2.3

Total 13 2.4 2.2

P Value: < 0. 01 0.01 < 0.0

Table 9: WHODAS II household survey, Thailand, December 2006: General mean score and by domain

WHODAS Cognition Mobility Life activities Society Village category score score score score score

Unaffected 8.3 7.0 12.0 12.7 11.3

Tsunami-affected without deaths 12.3 12.5 15.4 22.4 14.6

Tsunami-affected with deaths 14.2 16.0 19.6 21.8 16.4

Total 13.0 14.0 17.6 20.7 15.3

The survey results reveal that despite a fairly long gap between the occurrence of the tsunami and the assessment, problems of poor physical and mental health persist in the affected villages. Besides the significant loss of life caused by the tsunami, respondents living in affected areas continue to report worse health and have difficulty carrying out activities related to their daily lives. They continue to experience a greater need for health care and are spending less days performing their usual roles. This in turn is associated with dissatisfaction with life in general, reported higher stress levels and greater unhappiness in this population. In other words, despite efforts at reconstruction, the tsunami-affected population seems still to be worse off. The implications of these findings for current and future interventions need to be discussed. 55

Section III Review of TRIAMS indicators

Adoption and utilization of the TRIAMS indicators, by area of recovery

The workshop broke up into four working groups, each one comprising representatives of the four par - ticipating countries, donors and implementing organizations, in order to review the progress of the adop - tion and utilization of the TRIAMS indicators in each area of recovery: vital needs, basic social services, infrastructure and livelihoods. Countries pooled information on the various indicators in their respective sector, compared successes and difficulties encountered, and came up with recommendations to improve the TRIAMS indicators and the process as a whole. Each group then presented the results of their discus - sions in a plenary session.

Vital needs

The working group looked closely at the progress made so far in the vital needs sector in the four coun - tries. Topics discussed were IDPs, shelter, land, water and sanitation, nutrition, mortality and measles vac - cination – issues that need to be addressed in order to get the population back on the road to recovery.

Tracking of assistance to IDPs in transitional shelters is going well in the Maldives and Sri Lanka. In Indonesia, registration and validation of beneficiaries of housing programmes is still under way, and in Thailand it is no longer an issue. Supply of housing is still a major priority. In three of the four countries, with the exception of Thailand, at least 40% of housing needs remain to be covered. In these three coun - tries, there are a number of cross-cutting issues: relocation often crops up as a difficulty, as does how to deal with specific categories of people, such as renters, particularly in Indonesia and Sri Lanka.

As the overall recovery process moves on, activities and their associated monitoring indicators related to water and sanitation, nutrition and selected health outputs, such as measles vaccination, no longer fall into the category of what is considered “vital” but shift to other areas of recovery such as basic social services or infrastructure. Water and sanitation have also not proved easy for the three countries to monitor sepa - rately in the tsunami context. Access to water and sanitation is being tracked more at the settlement level than at the housing level.

In all four countries, there is little to capture or that is being captured in this sector other than in Indonesia, where land certification is being tracked. 56 Second regional TRIAMS workshop

Challenges G How do you detect the gradual shift of specific activities in this area in the continuum between relief, recovery and development? G In terms of basic social services, how do you deal with the equity issue related to investment of tsunami funding between tsunami-affected and non-affected areas? In Sri Lanka, it is going to be trou - blesome to deal with conflict areas and non-conflict areas on an equal footing in terms of the tsunami response for years to come. In Thailand, TRIAMS reporting is ongoing, but it has not been institution - alized and there is no plan to update it routinely. G In the Maldives, the issue is how to link TRIAMS reporting with the national agency for disaster man - agement and with disaster risk reduction and how to integrate the issues into planning for monitoring and evaluation to influence the decisions made. G In Indonesia, there is a tendency towards localization, that is, to develop monitoring so that data is useful locally and that local authorities can access and use the information in decision-making. G The monitoring of vital needs is coming to a close in most countries, and the focus should now shift to public policy issues.

Recommendations G There is a need for a concerted effort to track occupancy of transitional shelters until there is no one left in transitional shelters and everyone has been provided with permanent housing. G Monitoring and impact assessment indicators related to specific health and nutrition activities consid - ered linked to vital needs during the relief and the early recovery phases are probably better detected by routine information systems within the framework of national line ministries. G Monitoring of housing, land and access to clean water cannot easily migrate to national systems, since settlement recovery is not routinely tracked in these systems. In view of the billions of dollars that are being poured into settlement reconstruction, perhaps there is a mandate for TRIAMS to keep on track - ing impacts through purpose-made monitoring and evaluation formats, with the deep involvement of local governments at district as well as sub-district level.

Basic social services

The working group on basic social services found that progress in all four countries was uniform and the challenges were very similar.

Generally speaking, data to calculate indicators related to the delivery of basic social services are integrat - ed into routine information systems and periodic national surveys, and if not they are mostly available from the line ministries upon request.

The group looked at the relevance of the TRIAMS indicators, what decision each one is leading to and how they link into the national development process and the MDGs.

Challenges G Even if the data exist, they are not being routinely reported or fed into one coordinating agency. G Not all output indicators are relevant to measure a desired outcome/impact. Section III I Review of TRIAMS indicators 57

G Sometimes data exist from routine data collection systems, but the quality is questionable owing to lim - ited capacity or the politicization of data collection. G In some countries there is limited functionality of routine data collection systems, e.g. Education Management Information System, Health Management Information System in Indonesia. G Data may exist for TRIAMS indicators, but they do not help to identify gaps, e.g. does the enrolment ratio measure the number of children not attending school? What proxy indicators or additional infor - mation can be used to measure these? G Resources for collecting data on indicators are limited. G A lot of data collection is going on at both national and international level − MDGs, TRIAMS, nation - al development indicators. These efforts should be streamlined.

Recommendations G There is a need to ensure that TRIAMS is integrated into and converged with national and internation - al data collection systems. G A set of common indicators that are collected from various sources and put into common databases with easy accessibility is needed. G Investments should be made to improve data reliability and quality. G Routine data collection systems should be strengthened in preference to conducting one-off surveys. G Capacities for data collection at district/sub-district level need to be strengthened. G Data coordination is essential. G Targets for indicators should be identified in line with international, national or provincial targets in order to measure progress.

Infrastructure

The working group on infrastructure looked at the individual components from a slightly different perspective. As with the basic social services group, it did not concentrate on the values that came out of the data collection exercise but rather on the availability of the data and whether there was a monitoring programme for each indicator or not. Indicators were broken down by country.

In the Maldives, there is no regular monitoring of reconstruction/repair of roads and bridges. Rehabilitation of harbours and jetties is monitored twice a year. Data on the reconstruction or rehabilita - tion of schools are available from the Ministry of Education, which produces an annual report. Monitoring of reconstruction/rehabilitation of health facilities is ad hoc and tsunami-specific data are available. Data on the restoration of the natural habitat are not available in the Maldives, but coastal protection is monitored twice a year nationwide. The functioning of local administrations is assessed by the Ministry of Atolls Administration.

In Sri Lanka, data on reconstruction/repair of roads and bridges are collected quarterly by the Road Development Authority and of harbours and jetties by the Ministry of Fisheries. Likewise, there is regu - lar, monthly monitoring of reconstruction/rehabilitation of schools and health facilities by the ministries concerned. Ad hoc tracking of restoration of the natural habitat and coastal protection is carried out by the Ministry of the Environment and the Coast Conservation Department respectively. Data on the func - tioning of local administrations are available from the Ministry of Public Administration. 58 Second regional TRIAMS workshop

Thailand, for the most part, conducted one-off assessments of the status of reconstruction of various kinds of infrastructure, the results of which are available from the relevant ministry (transport, health, natural resources and the environment) or in the case of schools from the provincial authority (Provincial Education Office). Data on the functioning of local administration offices are available from the Provincial Office.

In Indonesia, data are available on all the indicators in the infrastructure sector but the source and frequency of data collection were not specified.

A general comment was that monitoring in this area of recovery was losing momentum and was unlikely to continue for more than a couple of years. Attention is increasingly focusing on national development rather than tsunami-specific recovery. The group felt that the indicators needed to be fleshed out and a more complex measurement system designed.

Challenges G TRIAMS indicators related to infrastructure have not been properly applied yet in all the countries. G Infrastructure indicators should also measure outcomes, not just outputs. G In Thailand, tsunami reconstruction work is completed, making the need for a tsunami recovery sys - tem redundant in this particular area of the recovery. Some line authorities see no benefit in monitor - ing certain recovery indicators. G The quality of information may be questionable. There is no independent check on data. G There is a danger that TRIAMS is duplicating/fragmenting existing data collection and analysis, and placing an additional burden on a country’s resources. G Focusing exclusively on tsunami recovery widens the disparity between tsunami victims and other peo - ple in the same social group. G Some indicators are oversimplified, e.g. km of road repaired/new.

Recommendations G TRIAMS should be a part of national monitoring systems, since infrastructure projects are usually part of national development projects. G It is time to pass on acquired analytical skills to the line agencies. G The transition can now be made from the recovery to the development stage and tsunami-related infra - structure projects integrated into national development programmes.

Livelihoods

The concept of livelihoods is less tangible than some of the indicators in other areas of recovery and groups a whole range of different activities under the one heading. The working group suggested devel - oping a better-rounded definition of what is meant by livelihoods during recovery processes and revis - iting some of the indicators to bring them more in line with some of the work that is being done on sustainable livelihoods. Currently the indicators are specific to the tsunami destruction. With this in mind, the group reviewed the experiences collected on each indicator separately by country, with the exception of Thailand. Section III I Review of TRIAMS indicators 59

Some countries had difficulty obtaining disaggregated sub-district or district-level data on the number of square kilometres of land returned to crops. 10

In the Maldives, the tsunami destroyed whole islands, increasing water salinity to the point that it is difficult or impossible for the land to return to its normal state. Sri Lanka and Indonesia, however, have collected data on this indicator. Indonesia reported that 68% of land (54,300 ha) has been rehabilitated.

On the percentage of the tsunami-affected population who have received loans, Indonesia reported 43,263 loans disbursed; the Maldives has so far disbursed 464 loans for a total amount of US$ 1,066,551.65 (75% to males and 25% to females); Sri Lanka counted the number of borrowers at 57,862 to a total of US$ 200 million.

Again, in some countries it is sometimes difficult to obtain information on the percentage of the population of tsunami-affected districts who have received grants. It was proposed to change the indicator to specify the type of loan by sector, e.g. fishing industry, agriculture, etc. In Indonesia, every household has received some kind of grant, but the specific figures are not available. In Sri Lanka, 175,595 grants have been disbursed for all recovery activities. In the Maldives, approximately 63,477 beneficiaries have received cash grants.

Indonesia has so far replaced or repaired 4,420 (32%) of the 13,828 fishing boats damaged or destroyed. Sri Lanka has repaired 100% and replaced 95%. In the Maldives, the figure is 82% (542 out of 644 dam - aged fishing boats). As regards fishing gear, Sri Lanka has replaced 100% of that lost and the Maldives has so far replaced 67.6%.

Graphics were presented showing the number of people employed by sector and by gender in Indonesia, the Maldives and Sri Lanka.

Challenges G There is a lack of reliable baseline data, for example on the percentage of land returned to crops. G Adequate disaggregating indicators at sub-district or district levels are lacking. G Countries don’t always define indicators in the same way. G The accessibility of financial assistance for women in the islands is a major concern, as women are having difficulty getting access to loans and could be monitored only if the indicator was disaggregated by gender. G There is a lack of coordination across various sectors in obtaining TRIAMS data.

Recommendations G Some indicators can be collected yearly rather than quarterly, e.g. the number of boats repaired/replaced might not change across the whole year (although it was acknowledged that the frequency of data collection was determined by each country). G Alternative ways of measuring livelihoods should be found. People may not necessarily have resumed the livelihood they had before the tsunami. G The indicator on the number of square kilometres of land returned to crops needs to be modified. G Livelihood outcome indicators need to be cross-referenced with health, nutrition and education indica - tors during the intersectoral analysis of the recovery process.

10 Countries, particularly the Maldives, did create country-specific indicators in May 2006 to reflect the uniqueness of the tsunami recovery in their own country. 60 Second regional TRIAMS workshop

Revision of the core TRIAMS indicators

The workshop provided a good opportunity to improve/update the list of the TRIAMS core indicators defined during the first regional workshop in May 2006. The result was a new version of the indicator table (see pp. 64-65) based on the outcomes and recommendations of the working groups, on suggestions from individual participants, and on the final plenary discussion.

The plenary discussion focused on the reformulation of the indicators to capture the change of thinking since the first regional workshop. The agreed new version was then used by the country teams to finalize their action plans.

The amendments to the indicators in all the sectors reflect a clear trend away from focusing exclusively on tsunami-affected populations. While retaining indicators that were defined to capture progress during the early recovery phase, new indicators were developed to capture the transition between recovery and development.

After the adoption of the core TRIAMS indicators, it is now clear that some indicators need to be disaggregated at sub-district level, while others are relevant in gaining a specific picture at district level. These administrative levels may differ from one country to another. It was agreed, therefore, to put “by administrative level” for every indicator, on the understanding that the countries would disaggregate to the smallest denominator possible according to how the indicator can be collected, and at which level the indicator better illustrates the information and facilitates the analysis. This, it was stressed, is the key to the TRIAMS approach because it is the unavoidable first step in enabling analysis of the recovery progress in each sector to take place at peripheral level and for the bottom-up planning of recovery activities.

Vital needs

The following modifications to the vital needs indicators were proposed:

Output indicators G Add “tsunami-affected and/or overall population” to the indicators on access to water and sanitation and to housing/temporary shelter occupancy, in order to eventually broaden the denominator of the tsuna - mi-affected population to include the whole population, whether tsunami affected or not. Often the figures of the tsunami-affected populations within the districts or sub-districts are not known or are inaccurate, owing to the subsequent movements of the displaced populations. G Delete the indicator on household food consumption. This indicator has not been collected by any country so far, owing to the complexity of data collection. G Introduce the concept of new houses occupied rather than simply rebuilt or built. This makes it possi - ble to cross-check how many people are still living in temporary shelters. G Delete “by economic status” from the indicator on land titles given. G Add “meeting or exceeding local hazard-resistance standards” to the percentage of new housing built, thus incorporating a disaster risk reduction element in monitoring this important recovery activity. Section III I Review of TRIAMS indicators 61

Outcome indicators G Add an indicator on percentage of overall population living in safe and durable housing. G Add an indicator on percentage of the population issued with land certificates (specific to Indonesia), while retaining the one under output indicators on the number of land titles given. G Add percentage of households without home ownership. With this indicator, the specificity of the tsunami-affected population is lost, but it will help to identify the more vulnerable households in the overall population.

After much discussion, the proposal to add “meeting or exceeding local hazard-resistance standards” was changed to “meeting applicable local hazard-resistance standards” since it was felt that if a standard exists, there is no obligation to exceed it. It was also agreed that the local authority that checks and approves these structures as compliant with applicable local standards should be the source of information for this indicator and that the onus should not be on the agencies managing the housing programme to check if a house meets the required safety standards.

Basic social services

The following modifications were proposed to the basic social services indicators:

Output indicators G Add number of physicians, nurses and midwifes per 10,000 population, thus introducing a health human resources component into the monitoring of recovery. G Revise the indicator on immunization to “percentage of one-year-olds immunized with DPT3”. The concept of “full immunization” (the previous wording) differs from country to country; in all the countries, however, there is a target to achieve full coverage of DPT3 within the first year, and the system in place to collect this information is part of the health information system. This uniformity enables comparability across countries. G Rephrase the indicator on “percentage of sub-district covered by outreach psychological support by community workers” to “number of trained health workers providing psychosocial support per 10,000 population”.

Outcome indicators G Move indicator on “adequate antenatal coverage (at least 4 visits during pregnancy)” from output to outcome indicators.

Following further discussion on the indicator on the provision of psychosocial support, the word “health” was taken out as it was successfully argued that workers providing psychosocial support were not neces - sarily “health workers” but often trained community workers.

There was some discussion as to whether to add the term “trained” for health professionals (physicians, nurses and midwives) and teachers, since this would add a qualitative component. However, it was argued that this might eliminate a lot of people, as many programmes just provide basic services. The assumption is that all physicians, nurses, midwives and teachers are “trained”, but there is no means of verifying it. 62 Second regional TRIAMS workshop

With respect to the timing of the four antenatal visits and whether there were systems in place to meas - ure this, it was clarified that it was not important to capture if visits happened at the right time but rather that at least four visits take place during pregnancy.

Regarding the number of primary schoolchildren per school by sub-district, there was a proposal by the working group on basic social services, supported by some participants, to modify the indicator to the ratio of pupils per classroom.

Another suggestion was made to delete the indicator on number of outpatient consultations per person per year, as this has proven difficult to capture and reporting is patchy. The recommendation was to keep it, however, as the number of consultations shows what the health system is capable of delivering and the degree of utilization of the health service. It provides a rough idea of the real accessibility of a health facil - ity. Even if there is geographical proximity to a health facility, it may not be financially accessible.

Infrastructure

The following modifications were proposed to the infrastructure indicators:

Output indicators: G Replace “number of damaged/destroyed schools rebuilt or rehabilitated by category” with “number of new/rebuilt/rehabilitated schools, by category”. G Add a new indicator on “number of new/rebuilt schools by category that meet applicable hazard- resistance standards”. G Replace “number of damaged/destroyed health facilities rebuilt or rehabilitated by category” with “number of new/rebuilt/rehabilitated health facilities, by category”. G Add a new indicator on “number of new/rebuilt health facilities by category that meet applicable hazard-resistance standards”.

The changes in wording of the indicators on schools and health facilities were described as “substance not semantics” since they show a move away from the concept of simply rebuilding/rehabilitating infrastruc - ture that was damaged or destroyed to one in which the network of schools and social services is upgrad - ed according to changing needs in an area. For example, a new school may need to be built in a different area, because people in the area in which the old school was destroyed by the tsunami have moved else - where. This also encompasses the notion of “build back better” rather than just “build back”.

As with housing, the word “exceeding” was removed from “meeting applicable hazard-resistance stan - dards” for both schools and health facilities. Similarly, it was pointed out that rehabilitated schools or health facilities could not be expected to meet hazard-resistance standards, only those that were built new.

It was decided to keep the indicator on the number of schools because it is linked to a sector in which there are a lot of resources still to be used in the next two years. The challenge is to ensure that schools are rebuilt according to the new population patterns across the different districts. There is also a need to see how and where governments and aid agencies are working together to build new schools. A proposal was also accept - ed to include the number of school buildings , since some schools can be made up of several buildings. Section III I Review of TRIAMS indicators 63

The indicator on the percentage of local administration offices fully functioning was retained even though collecting this information may be difficult. The indicator is important to show the engagement of sub-district government offices in the overall recovery process. The challenge of the recovery process is to involve the local government offices at peripheral level. This is why there is the effort to decentral - ize data analysis at the local level.

With respect to the functioning of local administration offices, a suggestion was made to track whether a hazard or disaster management component is included in local or district plans. This was excluded, as it was considered too ambitious to expect from local government offices at the present time.

The decision was taken to add the volume of trade and passengers through ports to the outcome indi - cators. This proposal was made in the Indonesia national workshop but it had not been taken up in the infrastructure working group. The exchange of goods and people through specific entry points is an indi - cator of successful rehabilitation of ports and a sign of economic development. These indicators are measured through national statistics, so reporting would not pose a problem.

Livelihoods

The following modifications were proposed to the livelihoods indicators: G Delete the indicator on the number of square kilometres of land returned to crops, since the baseline data do not always exist and in countries other than Indonesia and Sri Lanka the data are hard to find. G Reword the indicators on the “percentage of the tsunami-affected population who have received loans” and “percentage of the tsunami-affected population enrolled in social protection programmes” to include “overall population” as well as the tsunami-affected population. t was pointed out that in Aceh it was mostly people in areas not affected by the tsunami who were living below the poverty line, while in tsunami-affected areas there are a lot of people above the poverty line. The challenge, therefore, is how to use resources intended for tsunami-affected populations to benefit populations who were worse off before the tsunami and still are. Through the indicators, the TRIAMS process helps to highlight such inequities and to challenge governments and donors to consider where investments should be made so as not to increase the disparities between the richest and the poorest. This is one of the dilemmas that needs to be documented and addressed.

A concern was raised that if you delete the indicator on the percentage of land returned to crops, you no longer have an indicator to represent the agricultural sector. It was therefore suggested that a new indicator be added under the outcome indicators that would give an idea of the overall development in this sector.

From the perspective of Sri Lanka, it was suggested that in the area of livelihoods, there is a need for indicators that capture processes rather than simply the number of loans/grants. Livelihoods are better gauged by assessing the asset base of a household, i.e. its access to land, labour, skills and social networks. The outcome would be a rise above the poverty level. There should be more flexibility in how different countries approach issues of livelihoods and what the most meaningful calculation of this is for them. 64 Second regional TRIAMS workshop

The Maldives also stressed that some people have changed their livelihoods after the tsunami. For exam - ple, fishermen or those engaged in agriculture may have chosen to adopt a different occupation. So an indicator stating that production has increased does not answer the question why. There is a qualitative

Table 10: Revised matrix presenting selected indicators by area of recovery and by type of indicator Area of recovery Recovery OUTPUT indicators

G % of tsunami-affected and/or overall population with access to water from an improved source, by admin. G % of tsunami-affected and/or overall population without basic sanitation facilities, by admin. G proportion of tsunami-affected and/or overall population with housing damaged/destroyed living in emergency shelter/temporary houses/permanent houses, by admin., by time period Vital needs G measles immunization coverage, by admin. in relief and G # titles to land given, by gender, by admin. (modified by specific country definition) recovery G % of housing built meeting applicable hazard-resistance standards, by admin.

G # primary schoolchildren per school, by admin. G # primary schoolchildren per teacher, by admin. G # hospital beds per 10,000 population (inpatient & maternity), by admin. Basic Social G # of physicians, nurses and midwifes per 10,000 population, by admin. Services G # outpatient consultations/person/year, by admin. G % of one-year-olds immunized with DPT3, by admin. G # of health facilities with emergency obstetric care per 10,000 population, by admin. G # trained workers providing psychosocial support per 10,000 population, by admin.

G # km of repaired/new road by type of road, by district G # bridges repaired by district G # harbours/jetties rehabilitated by type, by district G # of new/rebuilt/rehabilitated schools, by category, by admin. Infrastructure G # of new/ rebuilt schools by category that meet the applicable hazard resistance standards, by admin. G # of new/rebuilt/rehabilitated health facilities by category, by admin. G # of new/rebuilt health facilities by category that meet applicable hazard-resistance standards, by admin. G # sq km of natural habitat restored, by type G # km of coastal protection constructed/repaired, by type (bio-fencing, seawalls, quay walls, breakwaters), by admin.

G % of tsunami-affected and/or overall population who have received loans, by type of loan, by gender, by admin. G % of tsunami-affected and/or overall population enrolled in social protection programmes, by type, Livelihoods by gender, by admin. G # people employed by different sectors, by gender, by admin. G % of boats damaged/destroyed repaired/replaced, by use (fishing, tourism, ferrying and other income-generating activities) and by district Section III I Review of TRIAMS indicators 65

aspect to the question and this reinforces the need for qualitative approaches within the TRIAMS frame - work to help interpret the quantitative data. Thus far, only Sri Lanka has undertaken the qualitative work of TRIAMS.

Recovery OUTCOME indicators

G % of children below 5 who are underweight, by admin. G % of children below 5 who are wasting (moderate and severe), by admin. G % of children below 5 who are stunting (moderate and severe), by admin. G % of low birth weight newborns Outcome indicators G % of children under 5 who have experienced a diarrhoea episode during the not linked to a specific previous 2 weeks, by admin. area of recovery G % of overall population living in durable and safe housing, by admin. G % of population with worse functioning G % of population issued with land certificates that have changed name or (WHODAS II) collateralized in past year (country specific), by admin. G % of population under stress or with poor G % of households without home ownership, by admin. well-being

G % of population with poor quality of life G net primary school enrolment ratio, by admin. G Primary school drop-out rate, by admin. Infant mortality rate G % of births attended by a skilled birth attendant, by admin. G % of tsunami-affected communities G adequate antenatal coverage (at least 4 visits during a pregnancy), by admin. consulted by implementing agencies, by district

G % of local administration offices fully functioning, by district G volume of trade (MT) through ports G # passengers through ports

G % of population earning below national poverty line, by admin. G average household income by gender, by admin. G labour force participation rate by gender G % of households that have regained their pre-tsunami livelihoods, by gender, by district G crop and cash crop agricultural production, by admin. 66

Section IV Incorporating disaster risk reduction into recovery

There is an important window of opportunity during the recovery phase following a major disaster to introduce strategies, policies and practices that will help to reduce the risk of a future hazard having a sim - ilar impact. The notion is encompassed in the term “build back better” coined by former US President Bill Clinton in his role as UN Special Envoy for Tsunami Recovery.

The workshop devoted a good half-day to the issue of disaster risk reduction, the importance of incorpo - rating it into recovery programmes, and the desirability of measuring if and how this dimension has been addressed by the recovery interventions in the context of the tsunami.

The session was led by UNDP, which has been cooperating with a number of governments and other stakeholders in introducing disaster risk reduction measures in ongoing tsunami recovery programming. In so doing, it hopes to lay the foundations for disaster risk reduction in future recovery programmes.

In all the affected countries, the tsunami recovery processes provided the impetus for national level reform of institutions and legislation with a view to minimizing the risks of a future disaster on this scale. Indonesia and Sri Lanka both made clear policy pronouncements in the wake of the tsunami, when fear of a recurrence of the tsunami was at its height.

Making policy statements and developing guidelines is one thing. However, there is a clear need to meas - ure the extent to which disaster risk reduction efforts have been undertaken by the tsunami recovery. To this end, the ProVention Consortium proposed a number of ways in which disaster risk reduction ele - ments can be included in theTRIAMS indicators across the four areasof recovery.

Following this, the country teams were invited to come up with three key recommendations for moni - toring the integration of disaster risk reduction in post-tsunami recovery and to keep these in mind in the development of their country action plans.

ProVention Consortium The ProVention Consortium is a global alliance of donor governments, international financial institu - tions, international development and humanitarian organizations, UN agencies, academic institutions, NGOs and the private sector. It was created by the World Bank in 2000 and is currently hosted bythe International Federation Secretariat in Geneva, Switzerland. The aim of ProVention is to look at critical issues of disaster risk and vulnerability and their link to poverty and development. Its current areas of programme interest are mainstreaming disaster risk reduction, risk analysis, community risk assessment, recovery, risk transfer and micro-insurance, pri - vate sector engagement, risk research and learning, and knowledge management. Section IV I Incorporating disaster risk reduction into recovery 67

What is disaster risk reduction?

All of us are essentially vulnerable. The key concept in disaster risk reduction is to manage that vulnera - bility; it is not possible to eliminate it entirely. Disasters are an extreme shock to the system, and disaster risk reduction is about protecting against those shocks.

Disaster risk is a vicious cycle: risk accumulation leads to increased exposure to risk and vulnerability; this in turn leads to greater disaster losses, which set back development gains, increasing poverty and inequality and decreasing the capacity to cope; this causes risk to accumulate, and so the cycle is perpet - uated. The idea is to transform these patterns into a virtuous cycle whereby disaster risk reduction lowers exposure to risk, leading to a more appropriate response to emergencies and to more successful, sustained development that reduces exposure to hazards and susceptibility to harm.

The Economic Commission of Latin America studied the effects of disasters on develop - ment in Gujarat over the last 15 years in rela - tion to the projected growth that would have On the disaster risk reduction side, we are still occurred if those disasters had not caused challenged to think about what “building back better” such severe impacts. The resulting graphic really means: reducing risks and reducing (see Figure 31) shows that disasters lead to vulnerability. It is a complex subject. Even though the aims seem really simple, how to get there and how to real development losses and setbacks, wiping do it requires taking account of a lot of different out years of development investment. These aspects to the solution – social, technical, economic investments need to be protected from the and funding implications. This kind of monitoring fluctuations caused by exposure to risk. system (TRIAMS) really has the potential to provide the feedback we need to diagnose and treat the risk A lot of emphasis is placed on the physical and issues. I hope your interest in disaster risk reduction obvious elements of disaster risk reduction, will continue and, although it seems like a formidable such as making houses stronger (hazard resist - challenge, so will the notion of finding new ways to ant), but there is a very little on what kind of measure and track aspects of it. ProVention is processes can be put in place to make sure that interested in supporting new approaches and tools it really happens. that test disaster risk reduction. This is where a lot of our interest lies. We are open to suggestions and Building back better does not necessarily ideas to bring all that learning together and use it mean build back bigger. It has a quality com - in other countries as well. ponent with respect to being inclusive of com - Ian O’Donnell, ProVention munity concerns, minimizing wastage and integrating community participation. There is 68 Second regional TRIAMS workshop

a need to look at transformative processes and recognize that decision-making happens at community and local level and that decisions are also being made every day at individual and household level.

It is important that reconstructed communities are left not only with reduced risk but also with the capac - ity to manage future risk. This means not just building back better this one time but building back bet - ter every time. Disaster risk reduction indicators are relevant, therefore, to track changes during both the recovery and longer-term development.

Figure 31 Impact of disasters on GDP in Gujarat, India

25

20 E 15 A D R R T O C U D H 10 C Y G F Y R C Q F D H L O L D R C L U R T O L U O O O O G A O O 5 U O N U D N H E D K D G S E T R E S G H O H T U T 0 G 5 6 7 8 9 0H 1 2 3 -9 -9 -9 -9 -9 -0 -0 -0 -0 94 95 96 97 98 99 T 00 01 02 19 19 19 19 19 19 20 20 20 -5

SGDP with disasters Potential growth without disasters Log. (Potential growth without disasters) Log. (SGDP with disasters)

The challenges of disaster risk reduction in practice

There is nothing new about the idea of reducing disaster risk. Statements to this effect are made after every disaster. Yet, the experience in past recovery programmes shows that it is not so easy to put into practice. In Gujarat, for example, the same village has been flattened twice by earthquakes in the past 50 years because it was rebuilt to inadequate standards. There are numerous examples around the world of the same infrastructure being rebuilt in the same way by the same bilateral donors and financial institutions. Section IV I Incorporating disaster risk reduction into recovery 69

Following Hurricane Mitch in Central America in 1998, there was talk of “transformation”. Although many good things were done, it did not go as far as everyone wanted, mainly because donor interest and coordination were not cohesive enough.

So, even though the rhetoric is there, things are not necessarily “built back better”. The question that needs to be asked is why.

The reasons are multiple and complex. In the aftermath of a disaster, there is a rush to rebuild quickly, sometimes in clearly impossible time frames of twelve, six or even as little as three months. The pressure is therefore there not to be inclusive and not to take the disaster as an opportunity to build back better.

The work involved and some of the prerequisites for ensuring risk reduction are time-consuming. In the Maldives, for instance, risk assessment undertaken after the tsunami took two years to complete. Few gov - ernments have the luxury to tell people who have lost their homes that they have to wait two years while a risk assessment is performed before rebuilding can start.

Moreover, resettling people from hazardous zones where they have perhaps been living for generations is potentially controversial and divisive: Who owns the land? How will people’s livelihoods be sustained if they are located far from their income source? What about their cultural attachments, particularly when generations of families have been living in a village or district or on an island for hundreds of years?

Some people question the cost benefit of disaster risk reduction. Is it really worth it? What is the pay- off? The difficulty lies in measuring the benefits of disaster risk reduction. Successes in risk reduction need to be measured in terms of the damage and losses that have been prevented and do not occur in the future. However, measuring these hypothetical impacts is quite difficult. As was demonstrated earli - er in Figure 31, disasters certainly cause significant development losses and wasted investment. The ques - tion that we should really be asking in relation to incorporating disaster risk reduction in recovery programming is: Can we afford not to?

Disaster risk reduction efforts in the context of the tsunami: country presentations

The delegations of Indonesia, the Maldives and Sri Lanka reported on the steps they have taken so far to tackle the issue of disaster risk reduction in their national recovery contexts. Although Thailand has taken similar steps, it did not present them at the workshop.

Indonesia: Developing policies and guidelines to reduce risk

Indonesia is one of the world’s most hazard-prone countries. Central Java and Sumatra are located in the “Line of Fire”, an area where there is a high probability of earthquakes and volcanic eruptions. In little more than two years, there has been a massive tsunami in Aceh, earthquakes in Nias and Yogyakarta, a 70 Second regional TRIAMS workshop

small tsunami in west Java and an earthquake in the city of Bandang. Other areas of Indonesia are sim - ilarly prone to a range of hazards. A national effort is therefore needed to deal with the issue.

The responsibility for disaster risk reduction in Indonesia lies with the central government. Every govern - ment agency has some policies related to disaster risk reduction, and several claim that they should be the ones to host this effort. But it is still not clear who will take responsibility when disaster strikes.

The BRR has chosen to step forward and set an example by developing policies and guidelines to main - stream disaster risk reduction into the recovery of Aceh and Nias and its future development in order to reduce disaster risk and enhance resilience and sustainability. It is hoped that the work done now in the post-tsunami context will serve to reduce risk in future disasters.

The BRR has a limited life span, so it is important to ensure that the work it does now in disaster risk reduction can be sustained beyond 2009. With this in mind, it has been working with Unsyiah University to develop the disaster risk reduction policy and guidelines. In future, Unsyiah University will be respon - sible for continuing this work, and to this purpose has created a Disaster Mitigation Unit. It is up to the central government, rather than external donors, to allocate resources for this initiative.

Besides the role of central government in national-level policy and planning, disaster risk reduction needs to be understood and implemented in government administrations at the provincial, district, sub- district and village levels. Government offices at these, local, levels need re-energizing and their capaci - ties building so that they may take their significant place in disaster risk reduction, as well as in response and recovery efforts.

There are two prerequisites for disaster risk reduction to work in practice. One is the political will. You can have resources, you can have policies and guidelines, but it will not work if there is no political will to support them. The other is that it should be rooted in the community. The community is the first line of response in a disaster; the people are the ones who manage emergencies at the household and community levels. By man - aging emergencies well, they prevent the escalation of these emergencies into disas - ters. If readiness and capacity are insuffi - cient, if vulnerabilities are too great, if the scale of the hazard is too great, then the risk Usually, when we talk about data collection, is too high, emergencies may not be man - evaluation, lessons learned and transfer of experiences, we put lessons learned in aged locally and the communities may not suitcases and carry them from one country to cope. Disaster will occur. another. What was learned in Afghanistan we take to Indonesia and then to Pakistan. It is a When a small tsunami struck West Java very one-way form of communication. I think recently, although the possibility of a what is important in TRIAMS is that now for tsunami was detected two hours in two years in sequence, four countries try to advance, there was no system of warning make sense out of what should be monitored, people, and people would not have what can be started and what is the way known how to react to such a warning. forward. So we do away with the suitcase This has to be solved and prepared for model and develop a sharing model. through capacity-building at the commu - Bruno Dercon, UN Habitat nity level. This is something that the Indonesian Red Cross is beginning to do. Section IV I Incorporating disaster risk reduction into recovery 71

Proposed community-based disaster risk reduction activities: G Raising public awareness regarding hazards and disaster risk reduction. G Capacity-building of BRR regional offices and local government offices in disaster risk reduction and how to incorporate it into all programming. G Developing a culture of safety. G Developing and promoting a community-based disaster risk reduction strategy and an early warning system.

To achieve these outputs, the BRR is proposing an intersectoral strategy because all sectors, from health and education to the economic sector, have a stake in disaster risk reduction.

A “safer islands” approach in the Maldives

Long considered to be relatively “safe” from large-scale disasters, the Maldives was for the first time made aware of its vulnerability to high-impact, regionwide hazards after the tsunami of December 2004. This prompted the government to seek practical ways to integrate disaster risk reduction and risk management into its planning and policy agenda.

The challenges facing the Maldives are unique. The country is not fully mapped; only 60% of the islands have so far been mapped, making it difficult to carry out a nationwide risk assessment. Moreover, the aver - age height of the islands above sea level is only 1.8 metres. The question in the Maldivian context, there - fore, is where do you go to protect yourself against risk?

The tsunami underlined the critical importance of providing environmentally safe zones for isolated communities. The government of the Maldives therefore initiated a programme for voluntary migration to larger islands with the long-term objectives of reducing the number of inhabited islands and consoli - dating the population in smaller groups of settlements across an identified number of islands. The idea is to develop “safer islands” with better natural protection and enhanced coastal defences. The locations where environmental changes are expected to increase vulnerability are to be identified and communicat - ed to decision-makers to support planning and long-term development and risk reduction.

A comprehensive risk assessment is being carried out. The physical hazard assessment is complete but the economic and social assessments are still under way. The integration of the hazard profile with the socio- economic profile will provide decision-makers with the exact implications of the proposed “safer island” strategy and planned “growth centres”.

Meanwhile, a number of steps have already been taken. The Ministry of Education is reviewing the school curriculum with a view to integrating chapters on disaster risk reduction at primary level and to develop - ing preparedness plans in schools. A Disaster Management Act has been drafted and is undergoing final review prior to being tabled in parliament. A national disaster management plan has been developed, as well as specific plans by the Health and Tourism ministries. Lastly, building codes and byelaws are being revised or updated in order to integrate standards to address hazard risk patterns.

Another concern is the rehabilitation of existing structures that are inside risk zones. Protecting individ - ual and essential structures, such as power stations and public works facilities, that would be directly in the way of a future tsunami is also a challenge that needs to be addressed. 72 Second regional TRIAMS workshop

A further challenge is the creation of a nationwide early warning system, which is not something the Maldives can do by itself. An early warning system does not yet exist for the Indian Ocean, and this ini - tiative needs to be taken at the international and regional level before it can be fully implemented at local and national level in the Maldives.

One last problem for the Maldives, which has already been mentioned, is the issue of primary access to islands. The only way for the population to access the islands is through small harbours. However, recon - struction of harbours is viewed as a commercial venture, not a humanitarian one, for which it has been difficult to raise funding. In the case of the Maldives, it should be viewed as vital infrastructure and needs to be incorporated into risk assessment and risk reduction frameworks, along with better policy, and funded accordingly.

Integrating disaster risk reduction in recovery: capturing post-tsunami experiences in Sri Lanka

The tsunami was the stimulus for the development of a national disaster risk management strategy in Sri Lanka. In May 2005, the government passed the Sri Lanka Disaster Management Act No. 13. The Act provided for the creation of the National Council for Disaster Management, within which the Disaster Management Centre was set up to act as lead agency in the country for disaster risk management. The Ministry of Disaster Management was established in December, and renamed the Ministry of Disaster Management and Human Rights a month later.

A big achievement was the development of a “Road Map for Disaster Risk Management”, which is a com - prehensive document articulating the immediate and longer-term priorities and resource requirements for the next ten years in relation to disaster prevention, mitigation, preparedness and response. 11 A National Disaster Management Plan and Policy is also being developed.

The Sri Lanka team presented examples from two sectors, livelihoods and housing, in which efforts are being made to integrate disaster risk reduction into the recovery process.

One of the projects in the livelihoods sector is a palmyra planting initiative in Hambantota district. The palmyra nursery is an alternative livelihood project for women, supported by UNDP. Palmyra has multi - ple uses and is therefore economically viable. It also plays a critical environmental and disaster risk reduc - tion role through the prevention of soil erosion along vulnerable coastlines. Palmyra is more commonly found in the north and east of the country, areas afflicted by the internal conflict. Establishing market linkages between the north and south are seen as a way to contribute to peacebuilding efforts.

Mainstreaming disaster risk reduction concepts into housing projects has proved to be more of a chal - lenge. Extreme time pressure to construct permanent housing has meant that risk reduction concerns were swept away in the rush to rebuild by many, but not all, stakeholders. Moreover, although there has been a lot of discussion about disaster risk reduction at the national level, it has not filtered down to those

11 Ministry of Disaster Management, Disaster Management Centre, Towards a Safer Sri Lanka: Road Map for Disaster Risk Management , Colombo, December 2005. Section IV I Incorporating disaster risk reduction into recovery 73

implementing the projects, and knowledge of the subject is lacking at the field level. These factors have led to risks being recreated, such as: G hazard assessments of potential sites not being carried out; G building guidelines on safe construction techniques not being adequately developed and included in housing reconstruction policy; G masons, contractors, inspectors and project managers not being trained in disaster-resistant construc - tion techniques; G insurance policies for newly rebuilt homes not widely provided, although some small-scale initiatives have been taken in this area.

There are several disaster risk reduction tools and methodologies that are being applied in Sri Lanka. These include community-based hazard mapping in tsunami-affected districts and developing disaster preparedness and response plans in ten tsunami-affected districts. Based on these, simulation/evacuation drills are being conducted in local areas.

Emphasis is placed on initiatives at the local level. These include: mobilizing communities; creating aware - ness using participatory rural appraisal techniques; developing community-based hazard maps and response plans; training village disaster management committees in first aid and search and rescue; and updating early warning plans.

A risk profile is also being undertaken. This is a compilation of district-level hazard zonation maps for five key hazards affecting the country (floods, landslide, cyclone, drought, coastal erosion) with overlays of vul - nerable elements at risk and a description of existing coping capacities. Its purpose is to depict risk spa - tially, guide the formulation of disaster management policies, and aid the development of mitigation and preparedness plans and the allocation of resources for disaster risk reduction.

One of the key challenges facing the introduction of disaster risk reduction measures is that they take time to implement satisfactorily and at all levels. The pace is very slow, which is why the Road Map is a ten- year plan. It is very important to sustain donor interest and to measure progress against this time frame.

Risk reduction indicators in the context of TRIAMS

TRIAMS is an ideal opportunity to monitor the extent to which disaster risk reduction is being incorpo - rated into the recovery process in tsunami-affected countries. With this in mind, in June 2006 the ProVention Consortium solicited working papers from several experts on four aspects of disaster risk reduction: linking risk to relief and development; social vulnerability; institutional capacities; and infra - structure and municipal planning. 12

The purpose of the exercise was to look at ways to add a disaster risk reduction dimension to existing measurements. For example, rather than simply calculating the number of houses reconstructed, the meas - urement could be the number of houses reconstructed according to established building codes or that have

12 http://www.ifrc.org/Docs/pubs/Updates/triams-risk-reduction.pdf. 74 Second regional TRIAMS workshop

incorporated hazard-resistant features. In the case of infrastructure, such as schools and health facilities, the measurement could be not only are they built in a safe way but also how many children/people have access to these facilities.

On the basis of the four working papers and feedback from a larger review group, a set of indicators was identified as being the most adaptable and feasible for immediate implementation within TRIAMS using data sources that are likely to exist already (see Table 11).

Disaster risk reduction was not included in the set of indicators developed at the first regional TRIAMS workshop in part due to the lack of technical expertise among the workshop participants. Given the inter - est of the participants in this area, the International Federation agreed to engage ProVention after the workshop to look further into the options for inclusion of such indicators. For the purposes of TRIAMS, the relevant indicators have been grouped according to the four areas of recovery.

Household budget surveys and local employment surveys.For some of the indicators, the information already exists; for others, systems will need to be developed on the ground. In addition, it is crucial to obtain more qualitative information about what is really going on in the population in terms of their awareness of hazards, their perceptions of risk and safety, and the adoption of safe behaviours, a role that the Red Cross Red Crescent would be well suited to undertake. It was also noted that other indications of reduced vulnerability probably do exist with various national government monitoring systems, and fur - ther review of these national systems is warranted.

The approach is intended to be flexible, as all the countries participating in TRIAMS were affected in different ways and their outlook towards future risks is influenced by different patterns of hazard and vulnerability.

The International Recovery Platform (IRP) is the thematic platform of the International Strategy for Disaster Reduction (ISDR) with responsibility for advancing a sustainable recovery agenda towards the achievement of strategic goal (c) of the Hyogo Framework for International Action: the systematic incorporation of risk Recovery Platform reduction approaches into the design and development of emergency preparedness, response and recovery programmes in the reconstruction of affected communities. The IRP focuses on mainstreaming a culture of prevention, mainly by supporting and facilitating the adoption of appropriate recovery practices by disaster-affected populations and their govern - ments, with particular emphasis on high-risk/low-capacity countries. In this context, TRIAMS represents an important initiative. Making a concerted effort across the countries affected by the Indian Ocean tsunami to adopt key indicators for the monitoring of recovery interventions and to periodically assess the impact of what has been achieved so far is crucial to support - ing effective recovery and to contributing to advancing good international recovery practice. Section IV I Incorporating disaster risk reduction into recovery 75

Table 11: Proposed disaster risk reduction indicators for TRIAMS

Area of recovery OUTPUT indicators OUTCOME indicators Data source

G % of houses Surveys conducted to determine constructed occupancy as source for other according to building TRIAMS indicators codes with appropriate hazard- resistant features

G % of population with G % of population practising Surveys in schools and markets, Vital needs appropriate safer behaviours as a particularly in high-risk areas awareness of result of disaster Evidence of local preparedness disaster hazards and preparedness awareness plans and drills preparedness steps

G % of population perceiving Surveys, particularly in high-risk that they are safe (vs. areas unsafe, powerless, etc.)

G Number of citizens G Restoration of social Registration and governmental and other interest capital for promoting local recognition of such groups; local groups (small disaster resilience press coverage can be mined for Access to basic business owners, the existence and range and frequency of activity of such social services fishermen, women, etc.) that have been groups formed or restarted since the tsunami

G Number and % of G % of children attending Municipal data, Ministry of schools rebuilt, re- schools in safe structures Health and education data located, or retrofitted and school environments Local economic surveys. This Rehabilitating & to take into account G Reestablishment of trade should be an indicator of service their exposure to reconstructing and transport links restoration for the infrastructure future hazards infrastructure between disaster affected output indicators in the TRIAMS rural areas and markets core list for products, labour and services

G Depth of poverty and Registration for social protection poverty severity (need to and safety net services look beyond just incidence Poverty gap is often measured as of poverty to evaluate the mean percentage distance extent to which below the poverty line multiplied inequalities are changing by the proportion of people that Livelihoods and whether the live below the poverty line vulnerabilities associated with poverty are being Household budget surveys and mitigated) local employment surveys. G Diversity of livelihood and local economic activities 76 Second regional TRIAMS workshop

Key messages and recommendations

Key messages G After the tsunami, all four countries introduced disaster risk reduction measures. A number of them have come up with new legislation and new or strengthened institutional arrangements and are carry - ing out risk assessments. But there is still a long way to go between doing the assessments and applying them, particularly right from the beginning of a complex recovery process after a huge natural disaster. G Risk reduction is fine as a concept, but recovery takes place under serious time constraints. There is no easy way around it except to plan before a disaster happens (and to communicate more clearly to affect - ed populations, donors and the public realistic timeframes for recovery). For example, if a hazard map exists prior to a disaster, it is more likely that it can be used to plan the recovery. A comprehensive approach to risk management can help to deal with the time pressure in a recovery situation. G Risk reduction needs to be seen – and measured – in the context of ongoing development and not as a one-time “recovery” exercise. G Not enough is being done to monitor the disaster risk reduction aspects of recovery programming. Much remains to be done in terms of developing indicators, integrating them into the four areas of recovery, collect - ing information on them and making sure the information feeds into risk reduction efforts during recovery.

Recommendations G Proper disaster preparedness and planning will help reduce the need to respond under heavy time pres - sure. Existing skills need to be consolidated and updated and new skills added and imparted. G A multi-hazard approach is needed if recovery programmes are to be sustainable and development issues addressed. Risk assessments must take into account all potential hazards, such as flooding, cyclones and landslides, and not just the recurrence of a tsunami. G Countries need to set aside resources for disaster risk reduction. This is important for the sustainability of risk reduction measures beyond tsunami programmes. There needs to be some financing by the gov - ernments and some community financing. G In all four countries, as well as in UN agencies, monitoring and evaluation of specific activities address - ing risk reduction in tsunami recovery programmes need to be mainstreamed and institutionalized – both so that this monitoring becomes an ongoing activity with a solid institutional commitment and base and so that “normal” development decision-making is also reviewed with an eye on risk reduction. G There is a need to look at poverty as one of the core drivers of vulnerability, and the potential to exac - erbate inequalities in recovery programmes. Some activities to restore services, for example, may have negative and disruptive effects on patterns of access to those services. G To be effective in the long term, disaster risk reduction measures need to be integrated into all recovery and development projects. Ultimately, all recovery as well development activities should leave people with greater resilience and capacity to cope with natural hazards than before the activity began. G The need for local and national governments to respond appropriately when standards are not met places critical emphasis on monitoring the effectiveness of inspection and enforcement systems. G Many lives could have been saved during the tsunami if an early warning system had been in place. Establishing an early warning system is the concern of all the affected countries and requires investments at the international level. More importantly, it requires investments in building capacities at the nation - al, provincial, district and community levels. As the small tsunami in Java showed, these efforts should be made in parallel, and necessary investments in strengthening community awareness and prepared - ness should not wait until comprehensive alert systems are completed. The last mile needs to be com - pleted first in order to be better placed to save lives now. Section IV I Incorporating disaster risk reduction into recovery 77

Country recommendations for incorporating disaster risk reduction

Each of the four participating country teams were asked to come up with three key recommendations on technical and institutional aspects for monitoring disaster risk reduction in post-tsunami recovery. All the groups recognized the need to integrate disaster risk reduction as a cross-cutting issue into all areas of recovery. They also acknowledged the need for a “champion of the cause” that can pursue this in each country and with the different sectors.

Indonesia G Make one institution/agency responsible and accountable for disaster risk reduction. In meantime, BRR will continue to build on recent efforts and progress. G Finalize the technical and financial aspects of disaster risk reduction. Ensure financial allocation is made for it across sectors. G Transfer responsibility from the BRR to the agreed agency.

Maldives G Strengthen the Maldives institutional disaster management capacity. G Integrate disaster preparedness and disaster risk reduction into the education system, to embed them in the long-term memory of the nation. G Make disaster risk reduction the output or the outcome of all development and recovery projects.

Sri Lanka G Expedite the process of vulnerability mapping at community level. G Conduct regular monitoring of construction to ensure that disaster risk reduction building guidelines are being met. G Conduct perception surveys among members of the community to see how vulnerable or how safe they feel (indicator: % of population feels safe).

Thailand G Develop key indicators at national level, clearly define them and create a database system. G Harmonize the outcome indicators with the national set-up. Development of analysis system – accord - ing to standardized criteria, benchmarking. G Develop institutional responsibility for monitoring. G redefine where responsibility lies for disaster risk reduction; G create working committees at national level bringing together the different institutions involved in disaster risk reduction; G create a working group to monitor progress. 78

Section V Country action plans

The final part of the workshop was devoted to discussing and finalizing the action plans for the implemen - tation of TRIAMS in each country in the coming three years and to identifying the likely resource require - ments. The country teams worked on the draft action plans prepared before the workshop in their groups and then presented the results to the plenary. Most of them noted that at the end of this process the plans were still in a draft form and would need to be subsequently refined. Refer also to the report of the first TRIAMS workshop in Bangkok in which the indicators, their sources and frequency are detailed. 13

Indonesia

In Indonesia, the adoption of TRIAMS indicators is undertaken by the BRR and by the different line min - istries involved in the recovery effort. The UN Office of the Recovery Coordinator hosts the IAS, which has fully incorporated the TRIAMS framework and indicators in documenting recovery progress. An oversight committee comprising the BRR, UNICEF, UNORC and several government institutions (planning, statis - tics, etc.) guides the overall work plan of the IAS and works to ensure application of its results.

Objectives

G Enhance the capacity to support data analysis and utilization for management decision-making and improved planning. G Incorporate both structural and non-structural aspects of disaster risk reduction in recovery programming. G Institutionalize TRIAMS in the BRR and local government.

Key actions − overall and by area of recovery

Overall G Develop a realistic capacity-building plan for both local government and targeted ministries which will take over the key responsibilities of BRR. G Develop a monitoring and evaluation plan for disaster risk reduction and include it as part of the TRIAMS action plan. G Develop a detailed budget for key activities, acknowledging the US$ 2 million input from UNICEF to date.

13 UN, WHO & International Federation, Tsunami Recovery Impact Assessment and Monitoring System, TRIAMS Workshop Report , September 2006 , www.who.int/hac/triams . Section V I Country action plans 79

G Map beneficiary perspective assessments and other qualitative efforts under way in Aceh and develop an approach to enhance qualitative interpretations of TRIAMS indicator analyses.

Vital needs G Migrate from recovery output indicators to development indicators (e.g. locational and structural risk reduction, tenure security, mass land certification, neighbourhood upgrading and community-based engagements, etc.). G Key implementing agencies will not only be limited to tsunami-recovery agencies (i.e. BRR, NGOs, UN agencies) but will shift to long-term development institutions (government, BPS, BPDE, Ministry for Housing and Settlement (Dinas Perkim)).

Basic social services G Stakeholders in the health sector need to have an in-depth discussion with the Provincial Health Office and BPS to find out: G the schedule of surveys; G surveys conducted/to be conducted and methodology; G indicators and outcomes of each survey; G how the process of monitoring and evaluation is implemented. G Improve the collection of qualitative information on education through donor appeals to support the Ministry of National Education in collecting data to/from the district offices and by establishing an edu - cation monitoring and information system. G Discuss with the relevant government agencies (Provincial Health Office, BPS, Ministry of Health, Education Management Information System, Ministry of National Education and Bappeda) the impor - tance of long-term regional collection of indicators on basic social services for Aceh and Nias.

Infrastructure G Infrastructure output indicators should be completed with targets. G More outcome indicators in the infrastructure sector are needed. G TRIAMS team should discuss how to ensure through appropriate indicators that infrastructure results in: G quality (technical, safeguards, economic feasibility); G user satisfaction demand side; G good utilization rates demand side; G sustainable operations and maintenance. This is the critical issue: after all the infrastructure is built, what will happen after the BRR is disbanded in 2009? Who will maintain the hospitals, for example?

Livelihoods G Indonesia may retain some of the indicators that were deleted from the TRIAMS indicator table as part of its country-specific indicators (e.g. sq km of land rehabilitated, as this remains relevant in Aceh). G Each individual indicator will be clearly defined (why it is being measured) along with specific targets and baselines. 80 Second regional TRIAMS workshop

G Work will be carried out to improve both the accuracy and reliability of data used to build the indica - tors, so that the analysis of this information can more effectively influence programming. G Focus will be increased on overall economic health indicators along with the breakdown within each sector to assist in future programming strategies. This will also provide the context to measure individ - ual project successes and long-term sustainable development. Potential information on which to devel - op appropriate indicators include: G # of days/cost to start a business, attractiveness to investors, real GDP, inflation, etc.; G % of people employed by companies versus self-employed (shows consolidation and economic growth); G follow-up is needed with appropriate expert organizations/personnel working in each sector to ensure the accuracy of indicators and data collection procedures.

Resource requirements

These need to be determined more precisely but are estimated at around US$ 6 million for 2007–2009 to address capacity-building needs and disaster risk reduction.

Maldives

In the Maldives, TRIAMS continues to be led by the Ministry of Planning and National Development, with significant support and leadership from the UNDP country team. The International Federation and WHO provided technical support during 2006 and early 2007 to assist in the harmonization of data-sharing and to conduct a trend analysis of the TRIAMS indicators according to the 2006 action plan identified during the first regional workshop in Bangkok. The government and implementing part - ners are eager to build on the TRIAMS process through the creation of MaldivInfo, using the TRIAMS framework to bridge the gap between recovery and development. Additionally, the challenges in build - ing and utilizing this type of analytical framework are well known to the government. This has led to the creation of a very realistic and viable action plan.

Objectives

G Strengthen existing data collection and management systems. G Strengthen coordinating mechanisms already in place. G Develop capacities – manpower and resources

Key challenges and actions

Challenge Mainstreaming and coordination of data collection. Section V I Country action plans 81

Actions: G Identify/recruit a TRIAMS coordinator (local person for two years 2007−2008). G Identify/strengthen existing data-collection systems within line ministries and build decentralized systems for output indicators in line with the requirements of donor/international agencies. G Produce common definitions, standards/procedures for data analysis (international consultant for one month, September 2007).

Expected result: Capacity established at Ministry of Planning and National Development (coordinating agency for TRIAMS) for regular collection of data from the relevant sources.

Actions: G National workshop to mainstream TRIAMS indicators into national planning process and 7th National Development Plan (2007). G Integrate TRIAMS responsibilities into routine functions of the line ministries and National Disaster Management Centre. G Develop plan of action for routing TRIAMS data to Ministry of Planning and National Development (2007). G Produce annual TRIAMS report and utilize it for budget planning (local consultant, March 2008).

Expected result: TRIAMS indicators are incorporated into national development planning and reporting processes and a formalized structure for monitoring and reporting on TRIAMS established within the government.

Challenge Limited national capacity for data analysis.

Actions: G Conduct a skills audit for assessing and improving existing capacity to implement TRIAMS (interna - tional consultant for one month, September 2007). G Training courses (2007−2009), long term and short term. G Training workshops (mentoring activities, on-the-job learning). G Biannual development planning workshops (6 workshops over three years, 2007−2009).

Expected result: Improved national capacity for data analysis, reporting mechanisms, and strategic and policy analysis for TRIAMS.

Challenge No consistent collection of standard indicators by various national surveys.

Actions: G Use three studies already planned to collect data on TRIAMS indicators: G Demographic Health Survey (2007); G National Land Survey (2007); G Household Income and Expenditure Survey (2008). 82 Second regional TRIAMS workshop

Expected result: Surveys and studies conducted to collect outcome indicators identified in TRIAMS and the results analysed.

Challenge No national database exists with coordinated data input, both for emergency preparedness and recovery monitoring purposes. The recent sea swells (May 2007) in the Maldives and the resulting appeal could have greatly benefited from such a database with a clear evidence base.

Actions: G Strengthen planning and aid coordination mechanisms through support to MaldivInfo and DAD (2008). G Incorporate emergency preparedness/risk reduction indicators into MaldivInfo and project formulation and management processes (2008).

Expected outcome: A coordinated national database with emergency preparedness and situation-related data.

Resource requirements G Technical resources – local/ international consultants. G Financial resources – US$ 1,013,000.

Sri Lanka

The need for effective monitoring and evaluation systems at all levels has been recognized from the outset of the recovery effort in Sri Lanka. The leadership exhibited by RADA and other key government agencies and the support of various UN partners notwithstanding, the monitoring of recovery has been fragment - ed and not well linked to either the replanning of recovery efforts or to national data-collection systems.

While the need for TRIAMS has been widely recognized, and some preliminary steps taken, further work is needed to ensure that TRIAMS supports national and local efforts to monitor tsunami recovery while also strengthening national systems. The Sri Lanka action plan is an initial attempt to accomplish these aims.

Objectives

G Strengthen the capacity of the district administration to track and monitor progress. G Utilize the data gathered for planning purposes at the local level. G Build on existing investments by establishing linkages to support MDG localization efforts at both district and divisional levels and the promotion of DevInfo by national counterparts (Lanka info launched last year).

Challenges

G Lack of analysis capacity at local level. G Weak coordination between local data gathering mechanisms. Section V I Country action plans 83

G Different administrative boundaries between Ministry of Health areas and DS divisions (second admin - istrative division). G Capacity development needs. G Training to enhance analytical capabilities at the district level. G Development of methodologies and strategies to enable existing data collection mechanisms to gather required information at sub-district level. G Promotion of coordination efforts at sub-district level through local government authorities.

Actions

Pilot TRIAMS initially in 2-3 districts (representing distinct geographical areas).

Expected outcomes

G Availability of high-quality disaggregated data to be used for planning purposes and for comparison across districts. G An integrated data-collection system at local level focused on the MDGs and TRIAMS indicators. G Promotion of DevInfo as the common system for tracking both sets of indicators. G Integration of TRIAMS indicators into the national data collection systems.

Time frame

The pilot phase for TRIAMS is planned for between April and June 2007, after which a comparative analysis will be conducted and the methodology refined.

Depending on the lessons learned in the pilot districts and availability of further funding, the project will be expanded during the second half of 2007 to an additional four districts in the south that have been tsunami impacted but do not have other constraints. Expansion to the north and east will depend in part on accessibility issues related to the conflict.

Resource requirements To be determined. 84 Second regional TRIAMS workshop

We collect the data but it is never used for Thailand information. We never analyse and synthesize it deeply enough to create knowledge. TRIAMS means “prepared” in Thai. Many govern - Concluding remarks of a Thai government official ment officials supporting the TRIAMS process have during the workshop acknowledged that the recovery process is not yet over in Thailand and additional work is needed. Furthermore, some are interested in using this process in order to be better prepared, in terms of analysis, for the next disaster. In order to achieve both these aims − to monitor current recovery and to be better pre - pared for the next time − Thailand’s action plan will focus largely on capacity building of the government at local, provincial and national levels.

Objectives

G Conduct monitoring in tsunami-affected areas to address unmet needs and inequalities. G Strengthen the coordinating role of the Department of Disaster Prevention and Mitigation, with the Ministries of Public Health and Interior and partner organizations (international agencies, Thai NGOs and local institutes/universities) in support.

Challenges

G Lack of availability of some data in the routine reporting system in Thailand. G Lack of understanding of indicators and knowledge of data collection. G Coordination problems among various sectors. G Lack of a coordinated data base and data-collection system. G Insufficient or lack of trained manpower. G No national plan for recovery.

Actions

G Organize meetings for all stakeholders at national, provincial, district/sub-district and community levels to determine TRIAMS priorities and action steps for each level. G Hold a workshop on TRIAMS to coordinate among agencies and develop the process and activities. G Ensure full commitment to TRIAMS by setting up a memorandum of understanding among the vari - ous ministries concerned defining their respective responsibilities and identifying activities: G to adapt indicators to the Thai situation; G create templates (questionnaires and report forms) and the time frame for the indicators. G Capacity building − human resource development at provincial level: G household survey/special survey; G data collection and analysis; G reporting and presentation at national and local level. G Improving knowledge of data management. G Ensure sufficient budget allocation. Section V I Country action plans 85

G Establish an information centre which regularly updates information/data. G Improve implementation procedures, e.g. creating user-friendly data collection tools.

Time frame

Short term: March 2007–February 2008 G 1 national workshop. G 2 technical workshops. G 2 executive workshops.

Long term (March 2008–December 2010) G Development of training courses in: G disaster risk assessment; G disaster management, e.g. Public Health and Emergency Management in Asia and the Pacific (PHEMAP) course; G United Nations Economic Commission for Latin America and the Caribbean (UNECLAC) methodology; G Executive meeting once a year (three in total). G Training in above courses: G pilot phase in six tsunami-affected provinces: G expanded to nationwide training (70 provinces not tsunami affected).

Resource requirements

G Short term (US$ 200,000−250,000): G administration/coordination; G implementation; G capacity building.

G Long term (US$ 500,000–600,000): G administration/coordination; G implementation; G capacity building. 86

Section VI Conclusions and next steps

Main challenges for the next phase of the TRIAMS initiative

The organizations involved in facilitating and implementing TRIAMS have had some unique experiences this past year and a half. Clear lessons and recommendations are emerging both for TRIAMS and for humanitarian response in general, which deserve special attention.

1. Data should be disaggregated to the lowest level possible if we are to monitor inequalities. Strict targeting criteria may contribute to inequalities.

The ability of those working in recovery to truly address ongoing needs and redress inequities will largely be influenced by their ability to disaggregate and utilize reliable data. There is a need to disaggregate data to the lowest level possible in order for the information to be most useful. There is a danger that our inter - ventions will be too localized and too tsunami specific and therefore contribute to inequities with popula - tions not affected (e.g. Aceh inland populations versus coastal populations, Sri Lanka tsunami-affected ver - sus conflict-affected populations). Effective monitoring and evaluation, in this case TRIAMS, can help produce the evidence base to demonstrate to decision-makers that their targeting criteria and donor poli - cies are causing harm. Although many purport to “do no harm” and to “build back better”, these tenets are not always supported by policies or practices. Perhaps with the right evidence base, agencies will feel more empowered to include less-affected or non-affected populations in their recovery programmes.

2. Monitoring systems must adapt as recovery priorities change. Monitoring and evaluation data must be used to validate or update plans.

The need for continuous needs assessments in post-disaster situations is well known, as the needs of affected populations do change. However, too often we assume certain needs are static, and memoranda of understand - ing and project agreements are not modified accordingly. Needs assessments, planning and monitoring and eval - uation should be part of one, continuous, circular system. As the environment and needs change, so too must our monitoring and evaluation systems to ensure that we are capturing, analysing and reacting to these impor - tant changes in the environment. Whilst the TRIAMS indicators are changing in recognition of the evolving recovery situation, more work is needed to ensure that analysis informs plans. Hence, if monitoring data show oversupply or gaps, memoranda of understanding with governments and other partners should be modified. Section VI I Conclusions and next steps 87

3. We have a responsibility to build capacity both within the governments of affected countries and within our own agencies to achieve better data collection and analysis.

Throughout the tsunami-affected countries, a lot of data has been captured, but there is still a long way to go in analysing that data. Data must be turned into useful information and that information must be fed in appropriate ways to decision-makers on a regular basis. Data management ideally should be done more at the local level. Although experts could be brought in to assist in the data collection and analysis, this will not lead to sustainable capacity within organizations or governments; it may also lessen the incen - tive to use data, if stakeholders do not generate it themselves. In post-disaster situations, additional efforts must be made to build the capacities of humanitarian actors, be they local, national or international.

4. Coordination among the various sectors is crucial as some TRIAMS data are already available but are not routinely shared.

While coordination has been a buzzword for some time, actors supporting relief and development are still not doing enough to share data. More importantly, we are not doing enough to share useful information and discuss analysis. Only the latter can lead to successful joint planning. Isn’t this really the point of coor - dination? Working together on shared assumptions and analysis in order to plan interventions in the most efficient and effective way possible?

Although it can be difficult, given limited capacities, it is important to address impact issues such as occu - pancy, as well as outstanding risks (e.g. safety, flood risk, tenure security). Without such monitoring, there is a danger that we will not identify the real constraints faced by affected populations to rebuild sustain - able and resilient communities. 88 Second regional TRIAMS workshop

Next steps

Facilitating organizations UNDP, the International Federation and WHO will actively support a three-pronged approach over the next two years. This will include: 1. Mobilization of resources. The three co-sponsoring agencies will each play a facilitating role in ensuring appropriate resource mobilization to support the continued country-level implementation of TRIAMS. 2. Evaluation of the TRIAMS framework and results to date to identify lessons learned. This will begin in early 2008 and will be coordinated by the International Federation. 3. Development of a Recovery Indicators and Monitoring and Evaluation Toolkit. UNDP will coordi - nate this phase, which is expected to begin later in 2007.

Implementing agencies Governments in the affected countries (reconstruction agencies and line ministries), together with their UN, Red Cross Red Crescent, NGO and local partners, need to continue implementation of TRIAMS according to their own localized action plans. Within this, several items should be prioritized for 2007, including: G finalizing the country action plan for 2007–2009, with a particular emphasis on the capacity-building component and corresponding budget; G operationalizing the new TRIAMS indicators adopted during the second regional workshop, particular - ly the risk reduction indicators that may also have financial implications; G considering a follow-up national workshop in August 2007 with implementing stakeholders to discuss the findings and the implications of TRIAMS data and analysis, which is now available in several countries.

Lastly, several countries still need to elaborate the qualitative component of their TRIAMS action plans, sequencing activities in a way that allows the qualitative analysis to assist in the interpretation of the quan - titative findings.

Partners, donors and other stakeholders TRIAMS progress and success to date is largely due to the hard work of implementing countries, support - ed by key partners. To date, SIDA, through WHO, has provided considerable financial support to facili - tate the development and testing of the TRIAMS conceptual framework. UNICEF has also made signif - icant investments in several countries, providing the necessary environment to allow TRIAMS to build momentum. The American Red Cross and the International Federation have provided support for key personnel in both the Office of the Special Envoy for Tsunami Recovery since 2005 and in the International Federation in Geneva since 2006. These are just a few of the important partners financially supporting TRIAMS to date.

To continue to learn from the tsunami experience and to ensure comprehensive data analysis supports the recovery process, additional financial support is needed. Without continued support from the current TRIAMS partners, as well as from new partners, much momentum will be lost. Resources are needed to: G assist countries in continued implementation of TRIAMS, including the adoption of the risk reduction indicators; G evaluate and comprehensively identify the lessons learned from the TRIAMS framework; G support the development of the recovery indicator and corresponding recovery monitoring and evalua - tion toolkit. Section VI I Conclusions and next steps 89

The interest in and enthusiasm for TRIAMS, despite considerable challenges and barriers, was noted throughout the workshop. Take the perspectives shared during the workshop by some of the external stakeholders:

There are three obvious paths for TRIAMS – direct use for impact assessment, capacity building in monitoring and evaluation, and a way of generating lessons that can be applied to other emergencies. Is it somehow too late to do the first one? Do we have extra time? Or are we just interested in capacity building and lessons learned? To my mind, we should focus on the first thing. It’s not too late. What we see is 50% of the tsunami funds overall have been utilized and over the last three days we have seen a number of potential pitfalls, e.g. oversupply of facilities or underutilization of certain facilities or potential for interventions to exacerbate existing inequalities. These things require us to have a system rather urgently to see this information entered into the context, to review it and to make decisions. So I am leaving this with a renewed sense of urgency to have good systems for monitoring and acting on this information.

Robert Ondrusek, UNICEF Tsunami Support Unit

TRIAMS is important for three reasons and on three levels: 1 Important to establish a direct follow-up of what is happening and has happened with the tsunami- related interventions. TRIAMS provides a direct measurement of the outcome and perhaps also the impact of these interventions. It is important as a management tool for decision-making and for accountability – reporting back to citizens and financiers and so on. 2 It is more about methodology, attitude and so on, where you work with indicators and sets of indicators and you have the opportunity during the work to reflect on what do these indicators really mean. How can we use them? How can the experience of discussing them in detail be transferred to other ways of measuring both tsunami interventions and other development efforts in the various countries? 3 Capacity-building. Learning by doing and capacity building in the sense that you create space for monitoring and hopefully also for evaluation in the proper sense. What I see as a donor representative is that we have failed by underutilizing the capacities in the countries we are cooperating with, bypassing, creating our own mechanisms for follow-up and evaluation. Here we have very concrete capacity building for countries’ own purposes but also to illustrate and very concretely show the capacity that exists and that donors can cooperate directly with for future evaluations and also for a more effective follow-up. It serves your own need for follow-up but also reporting back to donors. I think it is a very good initiative with enormous importance for the future.

Stefan Dahlgren, Swedish International Development Agency (SIDA) 90 Second regional TRIAMS workshop

We recognize the incredible work that the country delegations have done. I know myself that we are wrestling with our own accountability framework. It is not easy to do. The next steps for TRIAMS − the challenge is to refine the work you are doing and utilize it, especially in the activities under way and changing plans to make the most effective use of resources that are available and ultimately integrating them at national level so that they can be sustained not just for tsunami recovery but also for development activities and future disasters in the long run. In terms of support, we are hopeful that other agencies with mandates to support this kind of work will become more actively engaged. It would be a waste to stop this now. We need to see support for this effort.

Jerry Anderson, Sr. Director, Tsunami Recovery Programme, American Red Cross

Implementing TRIAMS is quite different from a field office perspective. To be really honest and realistic, it is hard work to do in such a short time, to put in place systems that are reliable and produce qualitative data and to improve the capacity of how to use the data in a set-up that is integrated in the normal, regular system. It is a challenge but it is feasible with good coordination among the UN and other stakeholders (governments and NGOs). It is a task which I hope will have a spill over in the country itself. We know the complaints in the past that M&E is very important but it is always the same problem: the data are not available or they are not reliable. So I hope that this exercise is not only related to tsunami but to the long term. It is an opportunity for us to do this and I think it will run. I hope to say this time next year that it is working.

Ingrid Kolb-Hindarmanto, UNICEF

Information is a key factor for decision-making processes, and in this sense the quality of information we rely on is crucial. TRIAMS has proven to be a great and useful tool to define what information is needed, how to collect it, how to process all the data and how to read and use it to get a good picture of the reality. The tsunami recovery process has been a very good opportunity for learning but we have to also realize there is still a long way to go. I would like to highlight one challenge: the necessity of finding a balance between the specificities and particularities of every single disaster and a homogeneous information system. I think this is very important so that we can link the information and the data that we gather now to the MDGs in the future. This could make us more cost-efficient in the job we do. Finally, in promoting and supporting the ownership and role of local governments, the role of the international community should be to encourage and support local authorities in this process, so that they can lead the process of gathering the information and take advantage of it in this process. Ugo Blanco, Spanish Agency for International Cooperation 91

Annex I Outcomes statement

The second regional TRIAMS workshop set out to facilitate learning based on an exchange of experiences between countries in implementing TRIAMS and in improving the way in which the tsunami recovery is being monitored. To this end, more than 60 people representing governments, the United Nations, the Red Cross Red Crescent, donors, specialized agencies, local universities and other stakeholders came together to share perspectives and progress to date. Cross-fertilization was apparent across the four coun - tries attending the workshop notable by the intense dialogue and active participation of all.

At the first regional TRIAMS workshop, indicators were developed with the aim of illustrating the con - tinuum from relief to recovery, but now, at the second workshop, the need to capture the continuum between recovery and development was strongly recognized as a challenge.

With this in mind, the need to enhance local and national capacities to perform proper monitoring of the recovery process in all the main sectors was further reiterated, as was the need to conduct analysis of the core and country-specific indicators over time, in order to illustrate trends. Moreover, the analysis must be used to replan operations where challenges, gaps or even over-commitments are noted. To date, the use of such analysis as a reflection of changing needs to inform plans has been weak. Another weakness noted over the past year concerns the lack of cross-sectoral analysis conducted at the local level. This requires further emphasis and should be complemented by qualitative approaches which will make it possible to better understand unexplained differences within and between various districts.

In light of the workshop discussions and the exchange of experiences, the set of core indicators was improved, with new indicators added, existing ones reformulated and others that did not reflect the emerging priorities of recovery deleted.

The overall monitoring and impact assessment framework was further enhanced through an exchange on both the progress and the challenges of not only incorporating disaster risk reduction into recovery but also of measuring its outputs and outcomes. Through the sharing of experiences and the recommenda - tions on disaster risk reduction presented by the ProVention Consortium, a few core risk reduction indi - cators were added to the TRIAMS framework.

Following this, countries further operationalized and updated their plans of action, identifying ways to address the significant challenges surfacing in year one of implementing TRIAMS. Within these plans, country-specific indicators were also modified based on learning, recommendations and exchange of expe - riences, including the adoption of a few risk reduction measures.

The various partners actively involved in the meeting reaffirmed their interest in and commitment to identifying lessons from the ongoing monitoring and evaluation of the tsunami recovery process. Such les - sons can contribute to the development of a global approach and eventually to a toolkit to better inform the monitoring, assessment and planning of recovery processes in the future following natural and man- made disasters. 92 Second regional TRIAMS workshop

Partners need to remain engaged to mobilize needed resources and support countries in the ongoing implementation of TRIAMS. Collectively, building on the analysis supported by the TRIAMS frame - work, we need to find ways to ensure resources are used in a way that contributes to the overall develop - ment of the countries affected by the 2004 Indian Ocean earthquake and tsunamis. 93

Annex II Agenda Day 1: Wednesday, 21 March Time Activity Responsible Notes 8:00 – 8:30 Registration and Network Coffee and refreshments will be served 8:30 – 8:45 Welcome to the meeting 8:45 – 9:15 Opening Remarks and Meeting Co-sponsoring agencies Objectives and Expected Outcomes Facilitator 9:15 – 9:45 Participants’ introductions and Head of each delegation expectations from the workshop 9:45 – 10:00 Administrative Issues and Facilitator Housekeeping 10:00 – 10:30 Strengths and weaknesses of the Nevio Zagaria, WHO, Presentation on the TRIAMS Conceptual monitoring of the recovery Margaret Stansberry, Framework interventions, progress achieved International Federation so far on the development of the TRIAMS conceptual framework 10:30 – 11:00 COFFEE BREAK Section 1: Current state of tsunami recovery and of its M&E 11:00 – 13:00 M&E as critical tools to document Plenary country Countries’ presentations focused on: Tsunami recovery progress at presentations (15’ each) 1. outcome of analysis of the monitoring and impact country/local level, and guide the assessment recovery indicators by sector/area of strategic re-planning recovery and across the areas/sectors 2. how the dimension of the disaster risk Plenary discussion reduction has been addressed by the recovery interventions so far 13:00 – 14:00 LUNCH BREAK 14:00 – 15:30 Four Working Groups, one for each Each working group should Each Working Group should: area of the tsunami recovery: have at least one a) review the progress in each area 1. Vital needs representative from of the tsunami recovery 2. Basic social services each country b) Discuss the lessons learned in conducting M&E 3. Infrastructure Each working group will c) Highlight the remaining challenges linked to 4. Livelihood appoint a lead facilitator the use of TRIAMS core and country specific based on sectoral expertise indicators in performing M&E d) Streamline and update TRIAMS framework for their assigned area based on the current stage of recovery (output, outcome, impact indicators and recommended qualitative approaches) 15:30 – 16:00 COFFEE BREAK 16:00 – 17:00 Continuation of the 4 working Each working group should have The power point presentation for the plenary groups and preparation of the one rapporteur; non-country session should clearly indicate the proposed power point plenary presentation specific persons and technical changes , improvement of the indicators and/or the advisors for recovery areas data collection, and analysis methodologies should float between groups 17:00 – 17:30 Quick feedback on discussions Group comes back to give some quick feedback and day’s proceeding 17:30 Close 18:00 – 19:30 Reception hosted by UNDP 94 Second regional TRIAMS workshop

Day 2: Thursday, 22 March Time Activity Responsible Notes 8:30 – 9:30 Presentation of outcomes of the Plenary A 15' power point presentation for each of the day 1 working group working groups 9:30 – 10:30 Discussion Plenary Consensus should be reached in improvement of TRIAMS indicators (risk reduction indicators to be added after Section 2) 10:30 – 11:00 COFFEE BREAK 11:00 – 11:30 Continuation of the discussion Plenary Summary and discussions on improvements / modifications of TRIAMS indicators and methodologies for data collection and analysis 11:30 – 12:30 Other M&E of Tsunami Recovery: Plenary Presentation by Stefan Dahlgren, SIDA and TEC Linking Relief to Rehabilitation to member (30 minutes including Q&A) Development (LRRD), Tsunami Evaluation Coalition Study

Donor Assistance Database (DAD), TBC presentation by UNDP 12:30 – 13:30 LUNCH Section 2: The challenge of addressing disaster risk reduction dimension during the recovery process in the tsunami-affected countries 13:30 – 14:45 New thinking and experiences in Panel Session led by Kamal Background papers: addressing DRR during the Kishore and Sanny Jegillos, ProVention concept paper on risk reduction recovery: the local, national and UNDP: indicators global perspectives 1. ProVention Rapid DRR assessment in the Maldives 2. Maldives The steps to achieve a national DRR policy: the 3. Indonesia example of Indonesia Each group presenting will have 25 minutes including time for Q&A 14:45 – 16:00 Facilitated plenary discussions on Plenary discussion Outcome of this session should be concrete indicators to monitor the adoption indicators and methodologies for data collection and implementation of appropriate and analysis at local level of the M&E of DRR measures addressing disaster risk interventions reduction 16:00 – 16:30 COFFEE BREAK 16:30 – 18:30 Working groups for each of the Working group by country Finalization of TRIAMS national plan of action for tsunami affected countries on the 2007–2009, including budget and including the developing a TRIAMS Plan of operationalization of selected disaster risk Action reduction indicators Annex II I Agenda 95

Day 3: Friday, 23 March Time Activity Responsible Notes Section 3: The development of national plan of action for the M&E of the tsunami recovery 8:30 – 9:30 Working groups for each of the Working group by country Finalization of TRIAMS national plan of action for tsunami affected countries on the 2007–2009 developing a TRIAMS Plan of Action 9:30 – 10:30 Donors and partners perspective Plenary with presentations Presentation or comments by donor agencies on on investing through M&E during and reflections by donor & investing in M&E during recovery – challenges, recovery partner agencies successes, how TRIAMS may help address these challenges; (can also include reflection on Good Humanitarian Donorship Initiative, accountability, equity dimension, Paris Declaration etc.) 10:30 – 11:00 COFFEE BREAK 11:00 – 13:00 The challenges of the national Plenary Country presentations focusing on the future of recovery and the future role of the recovery monitoring and impact assessment TRIAMS initiative: Country Plans of culminating with a detailed plan of action along Action with resource requirements.

Plenary discussion 11:30 – 12:30 Other M&E of Tsunami Recovery: Plenary Presentation by Stefan Dahlgren, SIDA and TEC Linking Relief to Rehabilitation to member (30 minutes including Q&A) Development (LRRD), Tsunami Evaluation Coalition Study

Donor Assistance Database (DAD), TBC presentation by UNDP 13:00 – 14:00 LUNCH BREAK 14:00 – 15:30 Summary recommendations for recovery monitoring and impact assessment – including future applications 15:30 – 16:00 COFFEE BREAK 16:00 – 17:00 Discussion of next steps Plenary Possibly a set of recommendations summarizing the key points of each section of the workshop will be presented and agreed during this final session 17:00 – 17:30 Meeting Adjourned 96

Annex III Participants

Global Kishore, Kamal Vyas, Kamlesh Regional Disaster Reduction Advisor TRIAMS Workshop Facilitator (Supreme Quality Anderson, Gerald United Nations Development Programme Services ht Ltd.) Senior Director, Tsunami Recovery Program (UNDP), BCPR Address: C-7/103, PWO, Sector 43, Gurgaon – American Red Cross Address: 55, Lodhi Estate, New Delhi -110003 112002, India Address: 2025 E Street NW, 2nd Floor NW2-077, India Tel: 091-98117 08456(M) Washington DC 20006 Tel: +919810095470 E-mail: [email protected], kam - Tel: +1 202 303 5272 E-mail: [email protected] [email protected] E-mail: [email protected] O’Donnell, Ian MacDonald, J. Wayne Almgren, Ola Senior Officer Senior Project Officer Senior Recovery Advisor ProVention Consortium, Disaster Preparedness Office of Evaluation, UNICEF Bureau for Crisis Prevention and Recovery-UNDP and Response Dept. Address: Three United Nations Plaza New York, Address: Palais des Nations, CH-1211 Geneva 10 International Federation NY 10017,USA Tel: +41 22 917 8556 Address: Chemin des Crêts 17 CP 372 1211 Tel: +1 212 326 742 E-mail: [email protected] Geneva 19 E-mail: [email protected] Bermeo, Miguel Tel: +41 22 730 4373 Zagaria, Nevio Deputy Director Geneva E-mail: [email protected] Coordinator Bureau for Crisis Prevention and Recovery-UNDP Ondrusek, Robert Recovery and Transition Programmes, E-mail: [email protected] Programme Officer Health Action in Crises, WHO Blanco, Ugo Tsunami Support Unit, Programme Division, Address: 20 Avenue Appia 1211 Geneva 27 Coordinator of the Spanish Agency for UNICEF Tel: +41 22 791 2534 International Cooperation in Indonesia Address: 3 United Nations Plaza, New York E-mail: [email protected] Development Attaché 10017 Embassy of Spain, Jakarta Tel: +212-326-7195 Indonesia Address: Jl. H. Agus Salim 61 E-mail: [email protected] Tel: +62 21 3142355 Petragallo, Samuel Azwar, Teuku Fax: +62 21 31935134 Technical Officer NAD PHO, Indonesia E-mail:[email protected] ugoblan - WHO Tel: + 62 811 68 2303 [email protected] Address: 20, Avenue Appia 1211 Geneva 27 E-mail: [email protected] Cox, Aidan Tel: +41 22 791 1235 Besana, Franco Regional Advisor – Aid Management E-mail: [email protected] Technical Officer Address: UNDP Regional Centre in Bangkok R. Bhatt, Mihir Health facility Assessment Tel:+66 2 288 2735 All India Disaster Mitigation Institute WHO Indonesia E-mail: [email protected] Address: 411, Sakar Five, Near Natraj Cinema, Tel: +62 812 1011631 E-mail: [email protected] Cunliffe, Scott Ashram Road, Ahmedabad - 380 009, India Regional Disaster Risk Reduction Advisor Tel:+91-79-26586234/26583607 Darajat, Eddie Rasyid Address: UNDP Regional Centre in Bangkok E-mail: [email protected] Chief Information Officer (CIO) Tel:+66 2 288 2751 De, Saumik BRR NAD-Nias, Indonesia E-mail: [email protected] Regional Coordination Associate Tel: +62 812 699 1717 / 0811917817 E-mail: [email protected] Dahlgren, Stefan United Nations Development Programme Senior Evaluator (UNDP), BCPR Dercon, Bruno Department for Evaluation and Internal Audit, Address: 55, Lodhi Estate, New Delhi -110003 Housing Policy Adviser SIDA India UN-HABITAT’s Aceh Nias, Settlements Support Address: SE-105 25 STOCKHOLM, Sweden Tel: +911124628877 ext. 462 Programme Tel: +46 8 698 5069 E-mail: [email protected] Address: Menara Thamrin Building Suite 1406 E-mail: [email protected] Stansberrry, Margaret Jalan M.H. Thamrin Kav. 3 Jakarta 10250, Indonesia Grisewood, Christina Senior Officer Tsunami Response Planning Monitoring, Tel: + 62 21 314 1 Editor, Independent +1308 ext. 181 Address: St. Colman’s Scariff Co. Clare Evaluation and Reporting (PMER) Dept Address: International Federation E-mail:[email protected], Ireland, Republic of [email protected] Tel: +353 6 192 1685 Tel: +41 22 730 4571 E-mail: [email protected] E-mail: [email protected] Fahrian Bin Marjasin, Dedy Teckle, Nescha Kasubdit Pengembangan Sarana & Prasarana Jegillos, Sanny Wilayah Regional Programme Coordinator Regional CPR Advisor/ Team Leader Address: UNDP Regional Centre in Bangkok BAPPEDA NAD, Indonesia Address: UNDP Regional Centre in Bangkok Tel: +62 812 698 26 00 Tel:+6622882536 Tel:+66 2 288 2701 E-mail: [email protected] E-mail: [email protected], E-mail: [email protected] [email protected] Annex III I Participants 97

Fithriadi, Mohammad (Riri)Monitoring Officer Aboobakuru, Maimoona Hewavithana, Nishantha Kumara UNDP Indonesia Deputy Director Manager Operations E-mail: [email protected] Ministry of Health Centre for Policy Alternatives Social Indicator Kolb-Hindarmanto, Ingrid Address: H. Bright Corner, Male’ (CPA-SI) Planning Officer Tel: +960 7795502 Address: 105, 5th Lane, Colombo 03, Sri Lanka UNICEF Banda Aceh Zone Office E-mail: [email protected] Tel: +94 237 0474 / +94 77 614 4580 Address: Jl. Mesjid Ashadaqah No 2 Lamlagang Ahmed, Inaz E-mail: [email protected] Banda Aceh 23243 Indonesia Assistant Director E-mail: [email protected] Tel: +62 812 699 0484 Ministry of Planning and National Development Malalasekera, Prashan E-mail: [email protected] Address: M. Goodness, Male’ Project Liaison Officer (Tsunami Recovery) Mudjiharto Tel: +960 7782897 UNDP Sri Lanka Crisis Centre E-mail: [email protected] Address: 202-204 Bauddhaloka Mewatha Ministry of Health, Indonesia Fathimath, Yumna Colombo 07 Tel: +62 816 110 3585 Deputy Director E-mail: [email protected] E-mail: [email protected] Ministry of Gender and Family M.D.M. Fernando M Kes, Mafrawi (Drg.) Address: G. Mehura, Male’ Senior Statistician Head of Basic and Referral Health Division Tel: +960 334 33 46 Dept. Of Census and Statistic PHO-NAD, Indonesia E-mail: [email protected] Address:15/12 Maitland Crescent, Sri Lanka Tel: +62 813-603-33300 Guirguis, Sherine Tel: +94 2676195 E-mail: [email protected] Monitoring and Evaluation Officer, UNICEF Perera, Rachel C. Nuaimi, Moris Address: UN Building, Bruzu Magu, Male’ Director Donor Coordination Planning Officer Tel: +960 32 4501 Ext. 246 RADA (Reconstruction and Development Agency) BAPPENAS, Republic of Indonesia E-mail: sguirguis@unicef Address: 41 Janadhipathi Mawatha, Colombo 1, Tel: +62 813 9909 6911 Nashia, Aminath Sri Lanka E-mail: [email protected] Deputy Director Tel: +94 2496800-4 E-mail: [email protected] Poulsen, Uffe Department of External Resources Head, Information Analysis Section Address: M. Nash, Male’ Ranasinghe, Thushara UNORC, Indonesia Tel: +960 7778241 Ministry of Health, Sri Lanka E-mail: [email protected] Purwanto, Eddy R. Kesavan Chief Operating Officer (COO) Naushad, Abdullah WHO, Sri Lanka BRR NAD-Nias, Indonesia Director, Engineering Sobhan, Babar Tel: +62 812 699 1706 Ministry of Construction and Public Infrastructure M and E Advisor E-mail:[email protected] / Address: M. Shaama, Male’ Office of the UN Resident Coordinator [email protected] Tel: +960 7756454 Address: 14 Gregory’s Road, Colombo 7, Sri E-mail: [email protected] Suemantri. Soeharsono Lanka Senior Researcher Shafeeu, Ahmed Tel: +94 11 2 580 6918 ex. 128 National Institute for Health Research and Director E-mail: [email protected] Development, Ministry of Education Sumanapala, Pathiranehelaya Ministry of Health, Indonesia Address: V. Edhuruvehi 3GC Flat Director Tel: +62 812 801 3628 Tel: +960 7775039 National Planning Department, Ministry of E-mail: [email protected] E-mail: [email protected] Finance and Planning Suhaimi, Uzair Sinnan, Hussain Sri Lanka Kasubdit statistic Pendapatan Tenaga Kerja Research Officer Tel: +94 11 248 2591 BPS (Pusat)/ Jakarta, Indonesia Ministry of Fisheries, Agriculture and Marine E-mail: [email protected] Tel: +62 813 802 3721 Resources E-mail: [email protected] Address: M. Iruzuvaage, Male’ Thailand Tel: +960 7774642 Sulasmi E-mail: [email protected] Calderon, Luis Jorge Perez Field Medical Officer Deputy Executive Director WHO AFO, Indonesia Sri Lanka Address: Asian Disaster Preparedness Center Tiadi, Kuning Tel: +66 2 354 9199 Head of Data & Information De Saram E.M. Sunil E-mail: [email protected] Indonesia Deputy Director Tel: +62 815 885 8475 Duangkeo, Siriluksana Ministry of Plan Implementation Chief of Research and Development Sub-Bureau Tripathi, Satya Sundar Address: Central Bank of Sri Lanka, Research and International Cooperation Bureau UN Recovery Coordinator Janadhipathi Mawatha, Colombo 1,Sri Lanka Address: Dept. of Disaster Prevention and UNORC, Indonesia Tel: +94 11 238 9458 Mitigation: DDPM Tel:+62 8121050837 E-mail: [email protected] 3/12 U-Thongnok Road, Dusit District, Bangkok, Fax: +62 651 41913 Dissanayake, Lakshman Thailand 10300 E-mail: [email protected] Director, Community Extension Centre Tel: +66 2 81 174 3930 University of Colombo, Community Extension E-mail: [email protected] Maldives Centre, Sri Lanka Kriengsonthikul, Wimonrat Tel: +94 77 780 3423 Programme Associate of our IPDP Unit Abdulla, Abdul Bari E-mail: [email protected] Assistant Resident Representative (Programme) Address: UNDP Thailand Livelihoods and Decentralization , UNDP 12th Floor, UN Building, Rajdamnern Nok Address: UN Building, Bruzu Magu, Male’ Avenue, Bangkok, Thailand Tel: +960 7795511 Tel: +662-288- 2146 E-mail: [email protected] E-mail: [email protected] 98 Second regional TRIAMS workshop

Mallik, Arun K. Suwee, Wilas WHO Thailand Director, Bureau of Statistical Forecasting Permanent Secretary Building, 3,4th Floor Address: National Statistical Office Ministry of Public Health Tel: +66 2 281 0333 ext 1400 Tiwanon Road, Nonthaburi 11000 Thailand E-mail: [email protected] Tel: +662 590 1524, +661 921 5486 Tomar, Bhupinder E-mail: [email protected] Programme Coordinator Moller. Jesper Thailand Tsunami Recovery Programme Unicef Regional Office East Asia Pacific 100/158-9 Moo 6, Main Road E-mail: [email protected] Srisuchart Village, chalermprakiat R.9 (Bypass), Paksuchon, Amornthip T. Ratsada, A. Muang Human Resource Development Officer Phuket 83000, Thailand Address: Dept. of Disaster Prevention Tel: +66 76 376 253/54 and Mitigation (DDPM) E-mail: [email protected] 3/12 U-Thongnok Road, Dusit District, Bangkok, Van ‘t Hoff, Bastiaan Thailand 10300 UNICEF Thailand Tel:+66 2 243 5279, +66 8 9735577 Address: 19 Phra Atit Road E-mail: [email protected] Bangkok 10200, Thailand Panjapiyakul, Pornpet Tel: +66 2 356 9486 Chief of research and development E-mail: [email protected] in health section Wangdee, Chayanit Bureau of Health Service System Development UNICEF Thailand Address: Department of health service support Address: 19 Phra Atit Road Ministry of Public Health Bangkok 10200, Thailand Muang district, Nonthaburi province, Thailand, 11000 Tel: +66 2 590 1689, +66 2 590 1803-4 Mobile: +66 81 802 2385 E-mail: [email protected], porn - [email protected] Potisat, Korakot Plan and Policy Analyst Address: Dept. of Disaster Prevention and Mitigation (DDPM) 3/12 U-Thongnok Road, Dusit District, Bangkok, Thailand 10300 Tel: +66 2 243 5279, +66 8 9098526 E-mail: [email protected] Rattanalangkarn, Pakamas Socio Economic Statistician Address: National Statistical Office Tel: +66 2 281 0333 ext 1407 E-mail: [email protected] Sattayawuthipong, Wanchai Phuket Provincial Chief Medical Officer Address: Phuket Provincial Health Office Tel: +66 2 243 0020 ext 3551 E-mail: [email protected] Seetamanotch, Wiwat Deputy Provincial Chief Medical officer Address: Tel: +62-288-1887 E-mail: [email protected] Singhasivanon, Pratap Dean of Faculty of Tropical Medicine, Mahidol University Address: 402/6 Rajavithi Rd. Ratchathewi Bangkok 10400 Tel: +66 2 354 9199 E-mail: [email protected] Sittiprasertkul, Pikul Address: National TRIAMS Workshop Consultant Bangkok Tel: +66 2 81 925 7798 E-mail: [email protected] The Fundamental Principles of the International Red Cross and Red Crescent Movement

Humanity The International Red Cross and Red Crescent Movement, born of a desire to bring assistance without discrimination to the wounded on the battlefield, endeavours, in its international and national capacity, to prevent and alleviate human suffering wherever it may be found. Its purpose is to protect life and health and to ensure respect for the human being. It promotes mutual understanding, friendship, cooperation and lasting peace amongst all peoples.

Impartiality It makes no discrimination as to nationality, race, religious beliefs, class or political opinions. It endeavours to relieve the suffering of individuals, being guided solely by their needs, and to give priority to the most urgent cases of distress.

Neutrality In order to enjoy the confidence of all, the Movement may not take sides in hostilities or engage in controversies of a political, racial, religious or ideological nature.

Independence The Movement is independent. The National Societies, while auxiliaries in the humanitarian services of their governments and subject to the laws of their respective countries, must always maintain their autonomy so that they may be able at all times to act in accordance with the principles of the Movement.

Voluntary Service It is a voluntary relief movement not prompted in any manner by desire for gain.

Unity There can be only one Red Cross or Red Crescent Society in any one country. It must be open to all. It must carry on its humanitarian work throughout its territory.

Universality The International Red Cross and Red Crescent Movement, in which all societies have equal status and share equal responsibilities and duties in helping each other, is worldwide. Th I I Hot Wor D b i i nt ni nt mpact rou ecm ti n er n er is ativ el l d ght Indoesia d ation a in ocum e tiona H be In A toge B an ea previous s r a al d lt tandem 204 n has l studie en es h gko, and aid t t Fe TRIAMS he o t Organi sment informat countries. de de is r agenci − ben gover rat ci a separt Thailnd, Indoesia, de synthei i zation on regional and with and implentao es nm jointly w w of creatd proces, and ent Monit Red (W maps this on It t off he the don and r H w. w eport section wil Maldives 21 ic O) oring Cr workshp. way ia ors Maldives, publicaton, os t h w ls and contaig o anlysi be produce of includg from t forwa d 23 o S .who a the ystem reviw nd the regulary Gen . o March four for second as Red Sri United n i in r int/hacrms ( al what of Lank each on TRIAMS it monitrg 207. Crescnt h / t The s the a withn becoms al the e the regional c Nation has deicat update t countries io the and a i r t / c a of site The reports n ), ben progres Sri whic the Thailnd s the Societs documents, workshp the has workshp Devlopm Lank achi worst four remai avilbe. framewok tok with of a evd TRIAMS − sm genral (Int ni this aff of particng place as was ent the on ectd nat er g s TRIAMS o wel r ecovry t and f organ Pr he at ar survey, lates ional ogram as by t t Tsunam he hrough of section web repr the ized th Am Thailnd the F e activ edration), me es ts ari joi site th unami i enta ntl ties (U Wa Recovry e y TRIAMS NDP). tives terga . by of the the 26 of It

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