1. ASSESSMENT OF REHABILITATION REQUIREMENTS IN
TSUNAMI AFFECTED VILLAGES
Prepared By
Maj K C Monnappa
January 25, 2005
For
Oxfam India – New Delhi and Prepare-India Chennai
This report has been prepared by Maj KC Monnappa, mailto:monaps1@gmail.com , for Oxfam
India, New Delhi and Prepare-India, Chennai, purely for policy and strategy development use.
This report in no way claims to be authoritative and exhaustive.

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TABLE OF CONTENTS
Assessment of Rehabilitation Requirements in ......................................................................................1
Tsunami Affected Villages .....................................................................................................................1
ASSESSMENT.......................................................................................................................................4
INTRODUCTION ..............................................................................................................................4
SCOPE OF ASSESSMENT...............................................................................................................4
Afforestation...................................................................................................................................6
Alternate locations for resettlement of the affected villagers .........................................................7
Water sources..................................................................................................................................7
Damage to fishing boats and nets ...................................................................................................7
Health/Sanitation.............................................................................................................................7
Training of manpower.....................................................................................................................7
ITINERARY .......................................................................................................................................7
TIME FRAME....................................................................................................................................7
CONDUCT.........................................................................................................................................7
DAMAGE SUMMATION .....................................................................................................................9
AREAS OF CONCERN .......................................................................................................................10
SOCIAL ASPECTS ..........................................................................................................................10
Gender roles ..................................................................................................................................10
Social and economic consequences ..............................................................................................10
Domestic and sexual violence.......................................................................................................10
Social taboos .................................................................................................................................11
HYGIENE AND SANITATION......................................................................................................11
HEALTH AND NUTRITION..........................................................................................................11
Communicable Diseases ...............................................................................................................11
Environmental Health (access to safe water and hygiene, sanitation situation) ...........................11
Other health issues (Mother and child health, mental health etc).................................................12
Health system and infrastructure (functioning health facilities, access etc).................................12
Post Traumatic Stress Disorders ...................................................................................................12
CHALLENGES & RECOMMENDATIONS.......................................................................................13
Near Term (days to weeks) ...............................................................................................................13
Middle Term (weeks to months).......................................................................................................13
Long Term (months to years)............................................................................................................14
RECOMMENDATIONS FOR OTHER CORE AREAS OF CONCERN...........................................15
Hygiene promotion...........................................................................................................................15
Evaluation of current hygiene practices............................................................................................15
Promotion of good hygiene PRActices.............................................................................................16
Implementation of plan.....................................................................................................................16
Identification of motives for behavioural change .............................................................................16
Hygiene messages need to be positive ..............................................................................................16
Identification of appropriate communication channels.....................................................................16
Mixing of communication channels..................................................................................................16
Materials............................................................................................................................................17
Facilitators.........................................................................................................................................17
Monitoring and evaluating the programme to see whether it is meeting targets ..............................17
Community participation..................................................................................................................17
Preventing defecation in certain areas ..............................................................................................17

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Defecation fields ...............................................................................................................................18
Intermediate measures.......................................................................................................................18
Trench latrines...................................................................................................................................18
Mobile package latrines ....................................................................................................................19
Borehole latrines ...............................................................................................................................19
Long-term solutions ..........................................................................................................................19
Community mobilization..................................................................................................................19
Group meetings.................................................................................................................................19
Individual contact..............................................................................................................................20
Labour ...............................................................................................................................................20
SOLID WASTE MANAGEMENT IN EMERGENCIES ....................................................................21
Intermediate response (6 months).....................................................................................................21
Immediate response (1 month)..........................................................................................................21
Waste generation, density and sources .............................................................................................21
Immediate response...........................................................................................................................21
On-site household disposal...............................................................................................................21
Intermediate solutions.......................................................................................................................22
Community issues.........................................................................................................................22
Community pits.............................................................................................................................22
Collection and storage...................................................................................................................22
Recycling and composting............................................................................................................22
Management and implementation.................................................................................................22
Long-term waste management......................................................................................................23
Other important factors .....................................................................................................................23
Incineration...................................................................................................................................23
Care of equipment .........................................................................................................................23
Emergency response waste ...........................................................................................................23
Disposal.........................................................................................................................................23
Staff...............................................................................................................................................23
HEALTH AND NUTRITION..........................................................................................................23
Pregnancy and Nutritional Status..................................................................................................24
Recommendations .........................................................................................................................24
Lactation........................................................................................................................................25
Immediate Interventions related on Water and Sanitation:...............................................................26
OBSERVATIONS ON SOCIAL FACTORS WITH SPECIAL EMPHASIS ON WOMEN ..........26
CONCLUSION.....................................................................................................................................30
References:- ......................................................................................................................................31

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ASSESSMENT
INTRODUCTION
The Tsunamis that hit Coromandel Coast of India were caused by a massive earthquake on the
Indian Ocean near Sumatra in Indonesia. Tamil Nadu was one of the worst affected due to Tsunami.
The devastating tidal waves that lashed several coastal districts of Tamil Nadu (Chennai,
Thiruvallur, Kancheepuram, Cuddalore, Nagapattinam, Tiruvarur, Thanjavur, Thoothukudi,
Ramanathapuram, Tirunelveli and Kanniyakumari) have left at least 7975 dead and rendered many
people homeless.
The overall purpose of this assessment was to assist PREPARE in identifying needs for
disaster relief assistance and to facilitate a timely, appropriate response by them. The report has been
prepared on the basis of visits made to several villages along the affected coast with members of the
PREPARE team and local NGOs working at the sites between 17 and 21 January 2005. The figures
reported (if any) are not verified, are approximate and are intended purely to convey approximate
quantities. The information gathered and compiled is based on empirical observations made by the
author at the various sites visited by him. The interventions suggested are based on the experiences of
the author and various reference materials referred to on related subjects on the issue.
The team made an on - site assessment of:
• The nature of the disaster;
• Damage, including secondary threats;
• Effects on the population;
• Ongoing relief activities and local response capacity;
• Needs for mid term and long assistance;
• Means of delivering assistance;
• Expected developments.
SCOPE OF ASSESSMENT
The team carried out the assessment by incorporating a combination of the following:-
(a) Needs Assessment
A Needs assessment was carried out with an aim to define the level and type of assistance
required for the affected population. This assessment aimed to further identify resources and
services for emergency measures to sustain the lives of the affected population. It was
conducted at the site of the disaster as well at the location of the displaced population. It also
aimed to identify the need for continued monitoring and reassessment of the unfolding
disaster.

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(b) In-Depth/ Sectoral Assessment
An In - depth assessment to the best possible means available at hand was also attempted. It
started after the initial surveys and covered critical sectors that have to be addressed for
medium- and longer-term relief as well as rehabilitation and reconstruction assistance. The
aim of the present assessment team does not replace a traditional inter-agency mission for an
in-depth analysis of medium and long-term rehabilitation/reconstruction needs emanating
from an emergency. The team focused to determine the extent of the disaster and its impact on
the population as well as needs for assistance during the midterm and long term relief phase
with regard to medical assistance, water supply, food and nutritional needs, shelter and
sanitation.
On January 17,18,19,20 and 21, the author accompanied by Mr. Nandeesh of PREPARE
toured the following areas:
District Block Villages to be covered
1.MahabalipuramKancheepuram
2.Meyyur
3.Sadras
4.Pudupattinam
Thirukalikundram
5.Uyallikuppam
BLOCKS : 2
VILLAGES : 12
FAMILIES : 2750
1.Old Nadukuppam
2.New Nadukuppam
3.Vadapattinam
4.Thenpattinam
5.Perunthuraikuppam
6.Paramantheni
Lathur
7.Alambakuppam
1.CoonimedukuppamVillupuram- I
2.Nochikuppam
3.Muthaliyarkuppam
4.Anichamkuppam
BLOCKS : 1
VILLAGES : 5
FAMILIES : 2403
Marakkanam
5.Pudhukuppam
1.MandaputhurKaraikal
2.Kalikuppam
3.Akkampet
4.Kasakudimedu
5.Kilinjalmedu
6.Kottucherrymedu
BLOCKS : 1
VILLAGES : 16
FAMILIES : 2430
7.Karaikalmedu
8.Karukalcherry
9.Pattinacherry
10.Vanchur
Karaikal
11.Ammankoilpathu

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12.Paravaipet
13.MGR Nagar
14.Rajivganthi Nagar
15.Vanjurpet
16.Thomas Arulthidal
Sambanar Koil Block
(Tarangabadi Area)
1. ChandrabadiNagapattinam North
2. Kuttitantiur
3. Perumalpettai
4. Karantheru
5. Puthupalayam
6. Kesavanpalayam
BLOCKS : 3
VILLAGES : 32
FAMILIES : 13290
7.Chinnalurpettai
8. Annaikoil
9. Chinnamanikkapangu
10. Puthupettai
11. Periamanikkapangu
12. Tharangampadi
13. Vellakoil
14. Thalampettai
Vedaranyam Block 1.Arrukathu thuraiNagapattinam South
2.Kodiyakarai
3.Thoppu thurai
4.Manian Theru
5.Poovan thoppu
6.Kollai theru
BLOCKS : 4
VILLAGES : 30
FAMILIES : 31272
7.Pushpavanam
8.Kodiyakadu
9.Pudhupalli
Thalainayar Block 1.Kovil Pathu
2.Vella Palam
3.Vanaman Mahadevi
4.Nalu Vedapathi
5.Periyakuthakai
The following areas were told to be assessed:-
Afforestation
o The attitude of the fisher folk towards the development of a green belt in the coastal areas.
o The attitude towards mangroves.
o Suitable species of trees that could be planted.
o Use of biomass by the villagers.

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Alternate locations for resettlement of the affected villagers
o Likely locations for the construction of suitable tenements for the displaced
o Suitability and opinion of the villagers with regards to alternate areas for settlement
Water sources
o Condition of present water sources
o Option of alternate water sources
Damage to fishing boats and nets
o Condition of fishing boats/nets
o Assess the potential and scope for repair at the village
o Cost of the boats/nets both new as well as that incurred on repair
Health/Sanitation
o Assess the nutritional requirements especially of children, pregnant and lactating mothers
o Assess the general health condition of women, children, adolescent girls, community
o Assess the sanitary conditions of the people especially in the temporary shelters
Training of manpower
o Assess the feasibility of training the affected villagers in alternate vocations
o Assess the feasibility of training the manpower in Disaster Preparedness
ITINERARY
The itinerary consisted of visiting all the above mentioned districts and their respective blocks
and villages carry out the requisite surveys and halt at the district for the night. The entire journey
was to be executed by road.
TIME FRAME
No strict time limit was laid out to complete the assessment.
CONDUCT
The assessment was conducted using the following techniques:-
(a) Meeting with the local authority.
(b) Walk through of areas.
(c) Visit to markets, schools, community centres.
(d) Listening to people.
(e) Asking questions.
(f) Triangulating information with different group of people.

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This Team was guided by and held discussions with Mr Jerome of ARWEL at
Mamallapuram, Mr. and Mrs. Vijaykumar of VBEDS and Mr. Ramachandran of the Indian National
Rural Labor Union, at Karaikal.

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DAMAGE SUMMATION
Several villages were visited over the course of five days between Mamallapuram to
Nagapattinam as mentioned above. Varying levels of damage to human life and property were
observed depending on the location of the village, the occupations of the people, the construction of
their homes, and foliage in and around them. The following is a brief summation of the observations
made:
o Fisher folk have either lost their boats and nets completely or have been left with irreparable
damage to them.
o Most of the existing open-wells and bore wells have been rendered useless because of sea
water intrusion into the groundwater.
o The loss of livelihood of fisher folk and farmers has directly impacted several dalit (laborer)
villages. People from these villages typically earned a living by working in these coastal
farms and for the fisher folk.
o Most villages located within 1000 meters of the coast have suffered considerable destruction,
including partial to complete loss of their homes, personal items (clothes, utensils, money,
etc.).
o Many agricultural properties in some cases up to 2 km from the coast have been affected.
Fields with crops ready to be harvested were flooded with seawater and sand deposits. In
addition to losing the crops, these farms face the daunting task of rehabilitating the fields free
of salt and sand.
o Sources suggest that this process could take about 5 years and no less than 2 years if
undertaken aggressively.
o In addition to the above-mentioned material damage, many people in these coastal villages
have suffered severe shock and trauma, and are developing a phobia of the sea.

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AREAS OF CONCERN
SOCIAL ASPECTS
Gender roles
Women’s vulnerability to the impact of the tsunami increased due to socially determined
differences in roles and responsibilities of women and men and inequalities between them in access
to resources and decision-making power. Excess deaths among females following the tsunami in
Nagapattinam were attributed to women being in homes damaged by the killer waves and men being
in open areas/sea. Men were either out fishing and were away from the home and many men were
away from affected areas as they were employed in other parts of the district. Traditional gender roles
are also played out in the response phase of disaster situations; women were responsible for caring
for family members, stocking supplies and preparing the household while men were responsible for
securing external areas of the house. It was observed that while men would build roads and houses
the role of putting lives back together was the women’s.
Cultural norms have been found to inhibit women from visibly accessing relief centres, or
they cannot leave their homes to go to relief centres due to child care responsibilities. In some
settings women are forbidden to interact with male members of the relief team, they may have
difficulties in accessing relief services from male relief workers. Further, where food distribution
targets household heads, women may be systematically marginalized, as they would only be
registered as household heads if no adult male was present.
Social and economic consequences
Loss of the ability to take care of the family may cause adjustment difficulties for some men,
especially those with more traditional gender role norms such as fishing. Others may view receiving
financial aid as a stigma and feel challenged in their role as breadwinner. Women may find
themselves burdened with even greater responsibilities than before. If immediate action is not taken
post disaster “flight of men” often occurs, leaving women as sole earners. This trend might be seen
especially in Dalit villages. At the same time, lower literacy levels and very low levels of ownership
of land and other productive assets may leave women on the verge of destitution.
Domestic and sexual violence
Although hard evidence on the influence of tsunami on domestic and sexual violence was not
found in the present case, several past reports suggest that the safety of women experiencing violence
in the home may be compromised in the aftermath of disasters and they may not have access to
disaster relief and recovery resources. These women often live in a world of narrow social networks.
Attending to preparedness or evacuation warnings, stabilising their lives in a disaster-stricken
neighbourhood, or accessing recovery resources may be impossible tasks. Women and girls are more
vulnerable to sexual abuse in disaster situations and may be coerced into sex for basic needs such as

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food, shelter and security. The sex industry often becomes part of the interaction between the
refugee or displaced population and the local community. Men and boys may also be at risk of sexual
abuse in such circumstances.
Social taboos
During the survey, social taboos around menstruation and norms about appropriate behaviour
for women and girls were found thereby contributing to health problems in some young women in the
temporary shelters. In some cases, adolescent girls reported perineal rashes and urinary tract
infections because they were not able to wash out menstrual rags properly in private, often had no
place to hang the rags to dry, or access to clean water. They reported wearing the still damp cloth, as
they did not have a place to dry them.
HYGIENE AND SANITATION
The threat of hygiene and sanitation if not checked would prove to be a problem in the long
run. It was observed that most of the men use the sea shore for defecating and other ablutions. Post
tsunami, the women who also had the same habits, now do not go near the sea. The result being that
they now use open fields and spaces to carry out the ablutions. The situation tends to aggravate with
lack of clear-cut guidelines for bathing points, defecating areas and areas for washing clothes and
utensils etc. Hygiene promotion is not simply a matter of providing information. It is more a dialogue
with communities about hygiene and related health problems, to encourage improved hygiene
practices. Hence educating the affected community is crucial, as well as the planning and layout of
the temporary relief camps too gains more prominence.
HEALTH AND NUTRITION
Communicable Diseases
People of the affected areas are now under serious threat of disease outbreaks as a result of
damaged water and sanitation systems, sea water contamination, and the congested and crowded
conditions of the displaced. No outbreaks of diseases have been reported so far. There could however
be an immediate INCREASED RISK of waterborne diseases i.e. cholera, typhoid fever, shigellosis
and hepatitis A and E, related to unsafe drinking water and inadequate sanitation. Outbreaks of these
diseases could occur at any moment. The use of standard treatment protocols in health facilities with
agreed upon first-line drugs is also crucial to ensure effective diagnosis and treatment for acute
respiratory infections, malaria, sexually transmitted infections and for the main epidemic -prone
diseases (including cholera, dysentery, typhoid, hepatitis, dengue, leptospirosis, measles, and
meningitis) was found lacking in most of the smaller villages. Infection control guidelines were not to
be found in place.
The people of these areas consume seafood to some extent, it forming part of their diet on a
regular basis. The lack of this diet in the relief meals being provided has some obvious effect on the
health of the affected population.
Environmental Health (access to safe water and hygiene, sanitation situation)
All affected areas have severe problems of lack of safe water and sanitation. Sewage systems
are damaged and several areas are reporting to have an erratic supply of water owing to damaged
fresh water bore wells and taps.

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Other health issues (Mother and child health, mental health etc)
Affected populations show signs of psychological trauma on account of acute anxiety and
shock. This is more apparent on lactating mothers, pregnant women. The absence of lady doctors has
added to the trauma and stress of these categories of women.
Health system and infrastructure (functioning health facilities, access etc)
Damage and destruction to infrastructure is extensive, only near the sea shore, health facilities
are not damaged in the affected areas. Functioning health facilities are running full speed and
additional supplies are reaching. Temporary facilities are being set up near the affected areas.
Post Traumatic Stress Disorders
Psychological responses to disasters include short term effects such as shock, anxiety, sleep
disturbances and guilt which were found in abundance during the assessment. There were differences
between women and men and girls and boys in the nature of psychological impact. A greater
proportion of women and girls reported suffering from emotional disorders and distress as compared
to men and boys. Also an instance of children refusing to return home and other such instances were
found in abundance.

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CHALLENGES & RECOMMENDATIONS
NEAR TERM (DAYS TO WEEKS)
Challenges: The author observed various other NGOs, humanitarian organizations and government
agencies providing relief at the villages visited. Unfortunately the net result seems to be less than
satisfactory, with a serious lack of coordination and absence of a plan. For example many villages
have had an excess amount of food, clothing and utensils distributed to them. On the other hand,
some villages have barely had some food distributions and not much else (mostly Dalit villages).
Duplication of effort on the part of aid agencies has added to the problem. The short term challenge
of survival assistance, although disorganized, has been addressed reasonably well by the NGOs and
the government.
Recommendations:
o An NGO coordination cell is the immediate requirement for coordinating the relief efforts to
the affected villages. Coordinating activities with the State Government should be initiated
immediately. This will help organize and focus the right aid at the right places and help form
a cohesive team to effectively deal with the challenges ahead.
o Withhold the immediate distribution of all food, utensils, clothes and other domestic items
until a clear need for these items is identified in a particular area.
o Hold post-disaster counseling sessions in areas where this has not been done with distinct
focus on children, women and men separately.
o Try to select 10/20 villages for long-term involvement and development activities. Setup a
volunteer office in each of these villages. The volunteer’s role would be to log the visits of
every NGO and government agency, and their current and long-term service objectives in the
village.
MIDDLE TERM (WEEKS TO MONTHS)
Challenges: The biggest and most obvious task in the coming months is the restoration of livelihood
activities in the affected villages. The secondary mid-term undertaking should have to do with design
and construction of viable, healthy and safe permanent accommodation after re-allotment of land
where applicable.
Recommendations:
o Initiate cash for work schemes in all affected villages.
o Take steps to supplement and add to the relief efforts of the government and other NGOs.
o To do this, the government’s plan for distribution of boats, nets, land for relocation, and aid
for construction of new permanent homes must be obtained and understood.
o In constructing new settlements, due importance should be given to their viability, safety, and
hygiene. Planning experts should be utilized to properly zone and permit construction such

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that there is enough space between homes, and there is easy access to the
village from the arterial roads.
o Even in villages where the government plan covers construction of permanent homes, fringe
support can be provided such as the digging of bore wells or the construction of schools, and
medical clinics.
o Technical assistance needs to be provided to farm owners for desalination and removal of
sand deposits from their fields.
LONG TERM (MONTHS TO YEARS)
Challenges: The tasks beyond the immediate work at hand have to do with mitigating the
vulnerability of these communities to disasters in the long run. This involves reducing their
dependence on external assistance by strengthening their self-managed support systems.
Recommendations:
o Network with allied agencies involved in similar relief work to bring about long term
interventions and to avoid duplication.
o Initiate projects for Afforestation and growing of mangroves along the coastal belt to form a
shelter belt against future such incidences.
o Participate in various government initiatives/projects aimed at amelioration of the affected
population.
o Increase scope for cash for work schemes.
o Similarly provide training in Dalit villages for youth to acquire skills other than providing
labor for fishing and farming, such as: two-wheeler repair, carpentry, plumbing etc.
o Work to ensure that all property and people in these areas are insured.
o Reduce the near total dependence of these communities on fishing and farming. For example,
provide some skill training to the women in these villages to create a Self Help Group (SHG)
to weave baskets, make ropes, or bricks, and market them.
o Provide a viable outlet for the educated youth of these villages by helping them form
businesses to help their own village folk. For example, youths in a fishing village can form a
cooperative to market, manage and sell their fish directly to national and international markets
thereby reducing the current loss of margins to middle men.
o Provide technical assistance to coastal farmers to select suitable crops (or fresh water fish
culture) that can be grown in slightly saline/sandy conditions while the land is being
rehabilitated. The farmers can then be properly guided to continue growing these same crops
or switch to other varieties that have a better yield while consuming lesser amounts of water
than paddy for example.
o Provide basic emergency management and disaster awareness and first aid training.
o Research and development on essential interventions to promote the health of newborns,
children, adolescents and adults, to facilitate the development of life-saving new vaccines
against infectious diseases, to foster good sexual and reproductive health and to ensure access
to adequate prevention, treatment, care and support for those in need, thus reducing excess
mortality and morbidity, especially among poor or marginalized populations. Generation and
dissemination of evidence-based norms and standards for prevention, treatment, care,
support, and their application to promote healthy lifestyles and reduce risk factors

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RECOMMENDATIONS FOR OTHER CORE AREAS OF CONCERN
HYGIENE PROMOTION
Agencies can intervene in hygiene promotion campaigns. The immediate provision of clean
water supplies and sanitation facilities in refugee camps is essential to the health, well-being and, in
some cases, even the survival of the affected population. Sanitation is usually allocated a much lower
priority than clean water, but it is just as important in the control of many of the most common
diseases found in the temporary camps.
Sanitation is the efficient disposal of excreta, urine, refuse, and sullage. As indiscriminate
defecation is normally the initial health hazard in such camps. The goal of hygiene promotion is to
help people understand and develop good hygiene practices to prevent disease and promote positive
attitudes towards good health practices. Focus of hygiene promotion in emergencies is to:
o Lower high-risk hygiene behaviour; and
o Sensitize the target population to the appropriate use and maintenance of facilities.
This latter point is important. The efforts should be directed at encouraging people to take
action to protect their health and make best use of the facilities and services provided. In carrying out
hygiene promotion the following activities need to be carried out:
o Evaluate current hygiene practices.
o Plan what is needed to be promoted.
o Implement the plan.
o Monitor and evaluate the plan.
EVALUATION OF CURRENT HYGIENE PRACTICES
There will be a need to identify the key hygiene behaviour risks and judge the probable
success of any promotional activity. The main risks are likely to be:
o Excreta disposal.
o Use and maintenance of toilets.
o Lack of hand washing with soap or alternative.
o Unhygienic collection and storage of water.
o Unhygienic preparation and storage of food.
Prioritize these by choosing those which pose the greatest health risk. One should look at the
resources available to the target population taking into account local behaviours, knowledge and
cultural norms. The needs of vulnerable groups should be given particular attention.

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PROMOTION OF GOOD HYGIENE PRACTICES
The understanding one gains from the above evaluation should be used to plan and prioritize
assistance. Priority is to be given to targeting those behaviours which pose the greatest health risks.
Target a small number of practices for each user group: sustained and repeated messages covering a
small number of practices are likely to have greater impact than a large amount of promotional
messages centred on several practices. The key is to identify the most harmful practices in each user
group and focus on these. Implement a health promotion programme that meets community needs
and is understandable by everyone.
IMPLEMENTATION OF PLAN
It is important to know who the audiences are and to direct messages at groups responsible for
carrying out the activity. It is desirable that all gender groups (women, men, children and those with
disabilities), should receive equal attention. There are reasons why this does not always happen.
Women, for example, will shoulder domestic responsibilities in most households. As a consequence,
most promotion activities are directed at women, on the premise that if they understand, accept and
act upon the messages, the benefits will be immediate. Men, on the other hand, might understand and
accept the messages but not act upon them if they are not involved in domestic duties.
IDENTIFICATION OF MOTIVES FOR BEHAVIOURAL CHANGE
People may change their behaviour for reasons not necessarily related to potential health
benefits, but for totally unrelated reasons. It is important to identify and understand cultural norms
and use this knowledge as a basis for articulating motives for change.
HYGIENE MESSAGES NEED TO BE POSITIVE
Hygiene messages should be presented in a positive light making use of humour wherever
possible. Nobody likes being lectured to: people will be much more receptive to positive messages.
IDENTIFICATION OF APPROPRIATE COMMUNICATION CHANNELS
It is important to know how different target audiences prefer to receive information and any
cultural aspects to this. Do they listen to the radio, pick up information through informal discussions,
use health facilities, rely on religious functions, theatre and dance and so on? It is usually more
effective to use the channel that the audience identifies with and regards as trustworthy.
MIXING OF COMMUNICATION CHANNELS
A message received through a variety of channels is more likely to be remembered. However,
there are costs to take into account. Broadcast media is less expensive per capita than is say, face-to-
face communication, but information provided one-to-one has greater impact than an impersonal
message received through the media. The need, therefore, is to balance the costs of using a channel
against its effectiveness.

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MATERIALS
These should be designed in a way that messages will reach illiterate members of the
population. Participatory methods and materials that are culturally appropriate offer opportunities for
groups to plan and monitor their own hygiene improvements.
FACILITATORS
It is important to select the right people as facilitators as they are the single most important
factor for the success of a hygiene promotion campaign. Generally speaking, facilitators should be
selected from among the target population. They should be able to communicate in the local language
and, where possible, be people who are respected within the community. A reasonable standard of
education and an enthusiasm for community work are desirable. They should be aware of the
constraints that may cause people not to adopt good practices. Staff may be recruited from among
elders with a lot of life experience, teachers, community leaders, health workers, religious leaders,
traditional birth attendants and so on. Although there are no hard and fast rules, a ratio of one
facilitator to every five hundred people or one hundred families is recommended.
MONITORING AND EVALUATING THE PROGRAMME TO SEE WHETHER
IT IS MEETING TARGETS
The hygiene promotion programme should be monitored regularly. Ideally, members of the
community should be involved to ensure that issues important to them are covered. The review
should evaluate members’ feelings about the hygiene message and whether they need more
information. Reviews should also mean to gain feedback about how to improve the programme. It is
a good idea to have members decide the frequency of reviews. All information gathered during
monitoring and evaluation should be shared with the wider community and interested stakeholders.
COMMUNITY PARTICIPATION
Affected people have views and opinions, just like any others. There is no reason to treat them
any differently than other communities except to make allowances for the trauma they have
experienced. Involving communities in the planning and design process is beneficial to their recovery
as it gives them self respect and promotes continued independence. The affected community should
be involved as soon as a decision has been made to intervene, this usually means at the detailed
design stage.
PREVENTING DEFECATION IN CERTAIN AREAS
When a large group of people are excreting indiscriminately, it is necessary, first of all, to
protect the food-chain and water supplies from contamination. This means preventing people
defecating on:
o The banks of rivers, streams, or ponds which may be used as a water source. If water is to
be abstracted from shallow wells, then it is important to ensure that these wells are
situated upstream of the defecation areas; or
o Agricultural land planted with crops, particularly if the crops are soon to be handled or
harvested for human consumption. Keeping people away from such areas may not be
easy, particularly where traditional habits make such practices common. It may be

18. 18
o necessary to construct a physical barrier, such as a fence, which may need patrolling.
Immediate measures to control indiscriminate defecation should not be solely negative,
though; it is much better to designate areas where defecation is allowed than to fence off
those that are not.
DEFECATION FIELDS
Areas with fixed boundaries within which defecation is permitted are known as 'excretion' or
defecation' fields. The use of these fields localizes pollution, and makes the management and the
cleaning of the site easier. They should be located carefully so that they are easily reached by the
community but do not pollute water supplies or sources of food. It is better if there are a number of
fields at roughly equal intervals over the site area, as this will reduce the walking distance for most
users and allow for flexibility of operation and the separation of the sexes. The defecation field
should be as large as possible, but it should not be open for use all at once. It is better to divide the
field into strips so that a different strip can be used each day. The area of the field farthest from the
community should be used first, so that people do not have to walk across contaminated ground to
reach the designated area.
INTERMEDIATE MEASURES
The life-span of the excretion fields is not long because the areas polluted by excreta cannot
be used again unless a system is established to cover the excreta with soil. Their purpose is to allow
time for latrines to be built. The ideal solution is to provide each family with their own latrine, but
unless this is the simplest of structures, it is neither feasible nor advisable immediately. In the early
days it will not be known how long it will be before the situation which has caused the disruption to
the community will return to normal. Furthermore, the affected population will naturally be unsettled
at this stage, and may be unable or unwilling to commit themselves to the maintenance of permanent
or semi-permanent structures that may suggest that their displacement will last a long time. An
intermediate solution is required. It is usual for this to be some form of communal latrine, as
communal latrines are quick and cheap to construct. Some are commercially available, but these are
expensive and take time to transport to the site. In most cases, 'trench' latrines provide the simplest
solution.
TRENCH LATRINES
A trench latrine is a rectangular hole in the ground. The hole should be dug as deep as
possible — about 2m and may be lined with timber where there is danger of collapse. It may be of
any convenient length, usually between 5 and 10m, and between 1 and 1.5m wide. The trench is
spanned by pairs of wooden boards on which the users squat. There is a gap between the boards
through which the users excrete. An alternative (and better) solution is to use plastic squatting slabs
overlaying the boards if these are available. Preferably, each pair of boards is separated by a simple
screen to provide privacy. In wet weather a roof is needed to prevent the trench from filling up with
rainwater. A drainage ditch should be built to divert surface water. Each week the contents of the
trench are covered by a 100 to 150mm-deep layer of soil. This will reduce the smell and prevent flies
from breeding in the trench. When the bottom of the trench has risen to within 300mm of the surface,
the trench is filled in and the latrine is closed. A trench latrine system is very labour-intensive and
requires constant supervision. Not only must the contents of each latrine be covered each day, but

19. 19
new latrines must be prepared, old ones filled in, and regularly used latrines cleaned. Close
supervision is essential. A poorly maintained latrine will quickly become offensive to the community
and will not be used.
MOBILE PACKAGE LATRINES
These days mobile package latrines are common. There is no reason why they cannot be used
in other places provided provision is made for the ultimate disposal of the excreta.
BOREHOLE LATRINES
In areas with deep soil, many borehole latrines can be built in a short time using hand augers.
The holes are usually 30 to 50cm in diameter and 2 to 5m deep. The top of each hole is lined with a
pipe, and two pieces of wood comprise the footrests. Borehole latrines should be closed when the
contents are only 500mm from the surface.
LONG-TERM SOLUTIONS
Trench or borehole latrines are only an intermediate solution because their operation is so
labour-intensive and requires constant supervision. As soon as it becomes obvious that the
community is likely to remain disrupted for any length of time, longer-term solutions should be
sought. In most cases, some form of on-site sanitation will be most appropriate.
COMMUNITY MOBILIZATION
The safe disposal of excreta in temporary camps is primarily the result of good supervision
and management, and this can only be achieved with the full co-operation of the community. It is
essential, therefore, that the community is fully consulted at all times and that their views are
considered and their suggestions implemented. Problems may arise as immediate sanitation measures
usually conflict with personal habits and social customs, but strict control measures at the outset,
when people are still disorientated, will usually help them to become accustomed to new ideas and
methods. Later, the supervision of the excretion fields and the policing of protected areas can easily
be done by the community itself. The co-operation of the community will only be gained and retained
if it is kept fully informed of what is being done and why. Information is communicated best through
group meetings and personal contact.
GROUP MEETINGS
Group meetings can be used to advise the community about what is proposed, how the
systems will operate, and why they are important. Such meetings should give the community an
opportunity to question and advice on what is being proposed. It is important that every effort is
made to include as many of their views as possible. In the early stages, the community is usually too
tired and confused to contribute to the proposals, but this stage quickly passes and soon the
community will start to take a lively interest in its surroundings.

20. 20
INDIVIDUAL CONTACT
Group meetings are effective at passing on general information, but there is a possibility that
some sections of the community will not be reached and these meetings are not appropriate for
dealing with individual problems. For these situations, personal contact is more appropriate.
Improving hygiene awareness, particularly among mothers, is usually better achieved on a one-to-one
basis or within very small groups. Such education is long term and slow, but it should be started as
soon as possible since it is often easier to establish new behaviour patterns in a community before it
becomes established.
LABOUR
The day-to-day operation of latrines and programmes of education require substantial labour.
While key management posts are likely to be provided from outside the area, much of the initial
routine work can be done by the community. In most cases the community is only too willing to help
since it gives people something to do, prestige, and possibly a source of income. Latrine supervision
is not a popular job and will almost certainly have to be paid for. Motivation may be improved by
providing a uniform and protective clothing or installing special bathing facilities for supervisors.
People working on latrine operation require little or no training; those involved in health education
and information dissemination will require more.

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SOLID WASTE MANAGEMENT IN EMERGENCIES
Solid waste refers here to all non-liquid wastes (e.g. rubbish or garbage). Sometimes solid
waste may contain faeces. Solid waste can create significant health problems and a very unpleasant
living environment if not disposed of safely and appropriately. It can provide breeding sites for
insects and vermin (e.g. rats) which increase the likelihood of disease transmission, and can attract
snakes and other pests. Unmanaged waste can also pollute water sources and the environment.
INTERMEDIATE RESPONSE (6 MONTHS)
Developing collection and disposal system and building landfill pits away from settlements.
Consulting and educating users.
IMMEDIATE RESPONSE (1 MONTH)
Clearing scattered waste and introducing onsite and community pits.
WASTE GENERATION, DENSITY AND SOURCES
Waste is produced by households, shops, markets, businesses, medical centres and
distribution points. Generation rates vary considerably according to seasons, diets (e.g. changes from
fresh vegetable to packaged aid goods) and even the day of the week. An average of around 0.5kg/
capita/ day is common in low-income cities. Waste densities also vary considerably. Densities for
low-income cities are usually around 200-400 kg/m3. Where lots of packaging is used in emergency
situations, densities are likely to decrease.
IMMEDIATE RESPONSE
Activities should be prioritised according to present and future health hazards of different
waste types and sources. Activities are likely to focus on clearing of existing scattered waste and
managing waste from households and markets.
ON-SITE HOUSEHOLD DISPOSAL
Suitable where space is not too limited and where waste has a high organic content (as it will
decompose and reduce in volume). Also useful in areas where access is difficult. Pits should be 1m
deep and be frequently covered with ash/soil to prevent access to waste by insects and rats, and to
reduce odours. Note that on-site disposal is labour-intensive and requires advanced household
cooperation.

22. 22
INTERMEDIATE SOLUTIONS
Community issues
o Consultation. It is useful and important to consult potential users of a waste management
system before and during design and implementation.
o Education. It is important for participating communities to understand how good solid waste
management can be achieved and can benefit their health.
Community pits
Must be located within 100m walking distance of any household. As a rough guide, 50 people
will fill 1m3 of a pit each month, depending on generation rates and density. These are rapid to
implement and requires little operation and maintenance. Note that some people may object to
walking 100m to deposit waste.
Collection and storage
In some situations on-site, community pits may be a suitable medium-term solution, whilst in
others it will be necessary to devise ways of removing and disposing of waste. This will usually
involve the following:
o storage in the house;
o deposition at intermediate storage point; and
o Collection and transport to final disposal.
In the home, plastic bags or a small container with a lid make suitable storage containers. For
intermediate storage points in communal areas bins of maximum 100 litre capacity are required
(when full this will weigh around 40kg). Oil drums cut in half can be suitable. Ideally the bin will be
arranged so that it can be emptied easily (e.g. hinged so it can tip into a handcart). A 100 litre bin is
required for each 50 people or for a few market stalls. Bins require daily emptying, and this is labour-
intensive.
Recycling and composting
In time it may be possible to work with local recycling industries to encourage entrepreneurs
or waste collectors to gather recyclable items. This can provide a source of income as well as
reducing the amount of waste requiring disposal. Home composting can also be an effective means
by which to reduce the volume of waste requiring collection and disposal.
Management and implementation
It is important to consider management structures and implementation methods. At times in
emergency situations, particularly early on, activities may have to be strongly enforced until more
participating systems can be introduced. Continuously review, monitor and response to the nature of
waste, pervading conditions and levels of community participation.

23. 23
Long-term waste management
In the long-term, capacity of landfill sites need to be increased, leachate needs to be contained
and treated and the overall sustainability of waste management practices must be considered. Long-
term solutions are beyond the scope of this technical note.
OTHER IMPORTANT FACTORS
Incineration
Incineration is not usually a favourable option for solid waste management as it requires a
large capital input and care for operation and management to ensure nonpolluting bone. Where
burning is deemed necessary (e.g. to reduce waste volume), it must be done at least 1km downwind
of settlements, and ashes should be covered with soil daily. On-site burning of household waste can
be highly-polluting and can be a fire hazard.
Care of equipment
Waste can often be corrosive, so it is important to paint all metal waste management
equipment and to wash it frequently. Such activity can significantly increase the life of equipment.
Emergency response waste
Packaging of emergency response provisions (e.g. food, water, medicine, shelter) can produce
serious waste problems, this should be considered where procurement and where possible manage
packaging waste at point of distribution to prevent its widespread scattering.
Disposal
As a medium-term solution, larger-scale landfill pits can be constructed. Without leachate
(liquid runoff) treatment these are not suitable for long-term use. They should be situated at least1km
downwind of settlements, at a location selected in consultation with the population. They should also
be situated downhill of water sources and at least 50m from surface water sources. Carefully consider
drainage where the pit is on sloping ground and erect fences to keep animals and scavengers out.
Staff
Approximately 3 workers are required for 1000 community members. Protective clothing and
equipment need to be considered (e.g. gloves, boots, visibility jackets).
HEALTH AND NUTRITION
In disasters, a marginal or deficient diet for a pregnant or lactating woman has repercussions
not only for her own health, but also for the health of the unborn, and the young infant.
The basic assumption is that the economically vulnerable should be targeted and that intra-household
distribution will benefit pregnant and lactating women. The assessment approaches the needs for
nutrition intervention in an 'individual' way e.g. all women in their 3rd trimester of pregnancy should
be included in a feeding programme as well as (depending on available resources):

24. 24
o lactating mothers of malnourished infants younger than6 months;
o lactating mothers with young infants whose breast-milk production has stopped, or is
reduced;
o All lactating mothers up to 6 months after delivery.
Pregnancy and Nutritional Status
The tsunami has rendered a large number of people especially pregnant women vulnerable to
a series of problems. This could result in low birth weight or still born children being delivered. One
obvious way to intervene is to supplement the dietary intake of pregnant women. The intended effect
of supplementation during pregnancy is to increase birth-weight via an increase of maternal weight.
Various researchers suggest that in emergency conditions, a direct relationship exists between
maternal dietary intake and birth-weight, without the intermediary step of increasing maternal weight.
This shortcut seems to take place below a threshold in dietary intake of 1600 - 1750 kcal per day. The
implication is that in emergency situations all pregnant women should be supplemented regardless of
their anthropometric status. The supplementation should be started as soon as possible, in order to
facilitate the growth of breast, uterus, blood volume, and fat stores.
The most suitable indicator for monitoring nutritional status of pregnant women is weight
gain during pregnancy. This however requires an efficient antenatal care system. Mid Upper Arm
Circumference (MUAC) is the most useful measurement for identifying pregnant women with
increased risk of Low Birth Weight (LBW), Intra Uterine Growth Retardation (IUGR) or foetal/
infant mortality compared to all other anthropometric indicators investigated (weight-for-gestational-
age, weight gain, absolute weight, pre- or early pregnancy weight, BMI, pre- or early pregnancy
BMI). MUAC is relatively stable throughout pregnancy and independent of gestational age and can
therefore be used in all stages of pregnancy. The measurement is simple and no other information is
required. Other indicators like weight-for-gestational age, weight gain and BMI are also valid for
identifying pregnant women at risk, but these indicators have no particular advantages above MUAC.
Moreover, several of these measurements are not easily made in emergencies, e.g. pre-pregnancy
weight, age of the woman, and require two sets of measurement.
Teenage pregnant girls require a different approach for risk determination as the girls are still
growing themselves. Their metabolism gives priority to the growth of the tissues involved in the
pregnancy. These girls are therefore at risk of impaired physical development and, as a consequence,
subsequent pregnancy risks. Height may be an appropriate measure for selecting at risk teenage girls
and subsequent monitoring.
Recommendations
o Foods prepared locally with local ingredients are preferable to imported foods. In case
unfamiliar foods or new methods of cooking and preparation have to be introduced to the
population, simple nutrition education is important.
o If possible, organize dried food distribution to allow families to prepare their own meals.
o Infants, children, pregnant and lactating women, the sick and elderly are often most
vulnerable to malnutrition and have special needs.
o Cereals should only be provided at the onset of an emergency.
o Do not include dried/skimmed milk into a general food distribution.
o Prevalence of micronutrients deficiencies for population age less than 5 years.

25. 25
Lactation
Increased dietary intake could improve lactation performance with an initial effect on
maternal nutritional status (weight gain or limited weight loss). The mother therefore benefits directly
from supplementation through reduced weight loss or an increased physical activity or work output
capacity. There is no conclusive evidence to indicate which anthropometric indicator best identifies
lactating women at risk of poor lactational performance in terms of quantity, or lactating women who
might benefit from a supplementation programme. Weight loss (more then 600-700 grams/month)
during lactation can also be used as an indicator for selection of lactating women who might benefit
from a supplementation programme. BMI could have a similar role (a monthly reduction of 0.3
would indicate the need for selection) but has no particular advantage over weight loss.
Criteria for inclusion of pregnant and lactating women in a nutrition intervention programme
in relief situations
(in the form of supplementary feeding on top of general ration distribution)
Include women only on
basis of anthropometry:
Pregnancy
weight gain of <1.5
kg/month in 2nd and 3rd
trimester and/or MUAC
cut-offs of 21-23 cm
Lactation
MUAC cut-offs of 21-23
cm and/or BMI < 20.3 at
birth with gradual
decrease of 0.3 kg/m2
monthly to 18.5 six
months postpartum and
mothers with
malnourished infants who
are breast fed
Include women only on basis of
anthropometry:
Pregnancy
weight gain of <1.5 kg/month in 2nd and
3rd trimester and/or MUAC cut-offs of 21-
23 cm and
all pregnant teenagers
Lactation
MUAC cut-offs of 21-23 cm and/or BMI
< 20.3 at birth with gradual decrease of 0.3
kg/m2 monthly to 18.5 six months
postpartum and all lactating mothers with
infantile twins mothers with malnourished
infants who are breastfed all teenage
mothers that breastfeed lactating mothers
with malnourished children under 5 years
mothers with LBW infants
Include:
Pregnancy
all pregnant women
regardless of anthropometry
and stage of pregnancy
Lactation
all lactating women
regardless of anthropometry
* Food security in this context is defined as 'access by all people at all times to enough food for an
active healthy life. Essential in this is availability of food and ability of the target group to acquire it.

26. 26
IMMEDIATE INTERVENTIONS RELATED ON WATER AND SANITATION:
o People can survive longer without food than without water: providing water demands
immediate attention.
o An adequate quantity of reasonably safe water is preferable to a smaller quantity of pure
water. Treatment should be avoided, if possible. Minimum quantities of reasonably safe water
should be provided as close to homes as possible. Safe storage of water should be provided at
the community and household levels.
o Availability will generally be the determining factor in organizing a supply of safe water. An
assessment of available sources of water must be made by specialists. If these sources are
inadequate, new sources have to be developed or water has to be delivered.
o In an emergency situation, act first and improve later. Temporary systems to meet immediate
needs can be improved or replaced later. The swift provision of a basic human waste disposal
system is better than the delayed provision of an improved system. The simplest technologies
should be applied.
o Ensuring uninterrupted provision of safe drinking water is the most important preventive
measure to be implemented following such as flooding, as in the present case, in order to
reduce the risk of outbreaks of water-borne diseases;
o Free chlorine/ hypochlorite is the most widely and easily used, and the most affordable of the
drinking water disinfectants. It is also highly effective against nearly all waterborne
pathogens;
o UNHCR and WHO recommend that each person be supplied with at least 20 litres of clean
water per day;
o The provision of appropriate and sufficient water containers, cooking pots and fuel can reduce
the risk of cholera and other diarrhoeal diseases by ensuring that water storage is protected
and food is properly cooked;
o In addition, adequate sanitation facilities should be provided in the form of latrines or
designated defecation areas;
o Personal hygiene and hand washing is essential to reduce diarrhoeal, skin and eye infections.
o Surveillance, monitoring and evaluation sexually transmitted infections, health during
infancy, childhood and adolescence, sexual and reproductive health and the health of women
o Advocacy and technical support for the building of normative, technical and managerial
capacity in affected areas for the implementation of effective interventions that result in
equitable and sustainable health systems
o Strengthening partnerships and building consensus for the development, implementation,
monitoring and evaluation policies and strategies that foster an enabling policy and
institutional environment.
OBSERVATIONS ON SOCIAL FACTORS WITH SPECIAL EMPHASIS ON
WOMEN
Gender equality and risk reduction principles must guide all aspects of disaster mitigation,
response and reconstruction. The “window of opportunity” for change and political organization
closes very quickly. Based on the assessment and survey carried out, a plan to evolve the following
must be initiated to:
o Respond in ways that empower women and local communities.

27. 27
o Rebuild in ways that address the root causes of vulnerability, including gender and social
inequalities.
o Create meaningful opportunities for women’s participation and leadership.
o Fully engage local women in hazard mitigation and vulnerability assessment projects.
o Ensure that women benefit from economic recovery and income support programs, e.g.
access, fair wages, nontraditional skills training, child care/social support.
o Give priority to social services, children’s support systems, women’s centers, women’s
“corners” in camps and other safe spaces.
o Take practical steps to empower women, among others.
o Consult fully with women in design and operation of emergency shelter.
o Deed newly constructed houses in both names.
o Include women in housing design as well as construction.
o Promote land rights for women.
o Provide income-generation projects that build nontraditional skills.
o Fund women’s groups to monitor disaster recovery projects.
Gender analysis is not optional or divisive but imperative to direct aid and plan for full and
equitable recovery. Nothing in disaster work is “gender neutral.” Therefore the following needs are to
be initiated:
o Collect and solicit gender-specific data.
o Train and employ women in community-based assessment and follow-up research.
o Tap women’s knowledge of environmental resources and community complexity.
o Identify and assess sex-specific needs, e.g. for home-based women workers, men’s mental
health, displaced and migrating women vs. men.
o Track the (explicit/implicit) gender budgeting of relief and response funds.
o Track the distribution of goods, services, opportunities to women and men.
o Assess the short- and long-term impacts on women/men of all disaster initiatives.
o Monitor change over time and in different contexts.
Women’s community organizations have insight, information, experience, networks, and
resources vital to increasing disaster resilience. Working with and developing the capacities of
existing women’s groups such as:
o Women’s groups experienced in disasters.
o Women and development NGOs; women’s environmental action groups.
o Advocacy groups with a focus on girls and women, e.g. peace activists.
o Women’s neighborhood groups.
o Faith-based and service organizations.
o Professional women, e.g. educators, scientists, emergency managers.
It is important to base all initiatives on knowledge of difference and specific cultural,
economic, political, and sexual contexts and not on false generalities. The followings observations
are made:
o Women survivors are vital first responders and rebuilders, not passive victims.
o Mothers, grandmothers and other women are vital to children’s survival and recovery but
women’s needs may differ from children’s.
o Not all women are mothers or live with men.
o Women-led households are not necessarily the poorest or most vulnerable.

28. 28
o Women are not economic dependents but producers, community workers, earners.
o Gender norms put boys and men at risk too, e.g. mental health, risk-taking, accident.
o Targeting women for services is not always effective or desirable but can produce
backlash or violence.
o Marginalized women (e.g. low caste,) have unique perspectives and capacities.
o No “one-size” fits all: culturally specific needs and desires must be respected, e.g.
women’s traditional religious practices, clothing, personal hygiene, privacy norms.
Democratic and participatory initiatives serve women and girls the best. Women and men
alike must be assured of the conditions of life needed to enjoy their fundamental human rights, as
well as simply survive. Girls and women in the present crises are at increased risk of:
o Sexual harassment and rape.
o Abuse by intimate partners, e.g. in the months and year following this disaster.
o Exploitation by traffickers, e.g. into domestic, agricultural and sex work.
o Erosion or loss of existing land rights.
o Early/forced marriage.
o Forced migration.
o Reduced or lost access to reproductive health care services.
o Male control over economic recovery resources.
Respect and develop the capacities of women by:-
o Identifying and supporting women’s contributions to informal early warning systems,
school and home preparedness, community solidarity, socio-emotional recovery, extended
family care.
o Materially compensating the time, energy and skill of grassroots women who are able and
willing to partner with disaster organizations.
o Providing child care, transportation and other support as needed to enable women’s full
and equal participation in planning a more disaster resilient future.
By all accounts, women and children were very hard-hit in the tsunami:
o Women and girls typically not taught to swim.
o Mothers sought to save children.
o Physical factors: pregnancy, strength, clothing slowed down their response time.
Girls and women are at high risk in the immediate aftermath:
o Reproductive health needs (pregnancy, childbirth).
o Cultural devaluation of girls in some regions.
o Sex segregation norms can preclude publicly seeking help.
o Disproportionately high rates of poverty, malnutrition, illiteracy.
o Social exclusion of women on their own (e.g. widows, household heads).
o Earning opportunities lost, economic needs increased.
o Male needs and interests tend to be asserted and visible.
In the immediate aftermath, women and girls need:
o Representation in decision-making about relief— now.

29. 29
o Participation in all community consultations, especially about emergency shelter and
temporary encampments.
o Culturally appropriate clothing.
o Sanitary supplies and privacy.
o Support for pregnant women and new mothers including food supplements.
o Culturally appropriate opportunities for worship.
o Security against sexual assault and extortion (sex for food).
o Protection from trafficking (girls/boys).
o Income support, targeted economic recovery programs.
o Support as caregivers with expanded responsibilities.
Gender patterns neglected now produce gender inequalities later:
o Work through existing women’s and community groups.
o Recruit local women for assessments and other response work.
o Recruit women staff and volunteers to reach local women.
o Seek out informal women leaders with community knowledge.
o Develop gender-balanced teams to work with residents about short- and long-term
recovery and reconstruction.
o Insist on women’s full representation in “community” groups and meetings.

30. 30
CONCLUSION
Relief programs can set the stage for rapid recovery or prolong the length of the recovery
period. Every action in an emergency response will have a direct effect on the manner and cost of
reconstruction. Many common relief programs can create dependencies and severely reduce the
survivors' ability to cope with the next disaster. For example, food commodities brought into a
disaster area without consideration for the local agricultural system can destroy the local market and
cause future food shortages where self sufficiency had been the norm. Another example is when
relief supplies, equipment or technology are sent in that cannot be sustained by the survivors. When
this assistance wears out or is used up, the survivors may be left in the same condition as immediately
following the disaster.
Recommendations suggested are simple and support the use of local materials and systems
and if implemented are generally sustainable by the affected community. There is a general lack of
research on sex and gender differences in vulnerability to and impact of disasters. The limited
information available from small scale studies suggests that there is a pattern of gender differentiation
at all levels of the disaster process: exposure to risk, risk perception, preparedness, response, physical
impact, psychological impact, recovery and reconstruction. When compounded by a calamity, the
comparatively lower value ascribed to girls in some societies may take on lethal manifestations. Men,
on the other hand, may suffer other disadvantages in different situations and for different reasons
from women, because of their gender-role socialization.
The present assessment should not be seen as an end in itself, but rather as one part of a
continuing process of re assessing the needs and appropriateness of responses to the disaster situation.
Virtually all the devastated areas have long -standing chronic needs in most, if not all, sectors. It is
important to design a long term relief programme that will distinguish between chronic and
emergency needs. The aid agencies must differentiate between what is normal for the location and
what is occurring as a result of the disaster, so that emergency food aid, health care and other
assistance can be provided at the appropriate level.

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o Capt K C Monnappa, Disaster Preparedness, Akshay Publications, New Delhi.
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programme design. WEDC, Loughborough University, UK.
o Howard, A.G. (2002) Healthy Villages: A guide for communities and community health,
WHO, Geneva.
o SPHERE Guidelines, The Sphere Project (2004), Humanitarian Charter and Minimum
Standards in Disaster Response,
o The Sphere Project: Geneva, Switzerland (Distributed worldwide by Oxfam GB)
http://www.sphereproject.org/ handbook/index.htm
o Harvey, P., Baghri, S. and Reed, R.A. (2002), Emergency Sanitation – Assessment and
programme design, WEDC, Loughborough University, UK.
o Harvey, P., Baghri, S. and Reed (2002) Emergency Sanitation – Assessment and programme
design, WEDC, Loughborough University, UK.
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the composition of human breast milk. Act Paediatr Hung 1991; 31: 5-422.
o Budd SC, Erdman SH, Long DM, Trombley SK, Udall JN: Improved lactation with
metoclopramide. Clin. Pediatr 1993; 32:53-57
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