Australasian Emergency Nursing Journal (2011) 14, 1725

available at www.sciencedirect.com

journal homepage: www.elsevier.com/locate/aenj

RESEARCH PAPER

Tsunami preparedness of people living in affected

and non-affected areas: A comparative study in
coastal area in Aceh, Indonesia
Rachmalia, MNS a,, Urai Hatthakit, RN, PhD b, Aranya Chaowalit, APN, PhD b
a

Community Health Nursing Department, Nursing Program, Faculty of Medicine, Syiah Kuala University, Banda Aceh, Aceh
Province, Indonesia
b
Nursing Administration Department, Faculty of Nursing, Prince of Songkla University, Hat Yai, Thailand
Received 14 May 2010; received in revised form 26 October 2010; accepted 29 October 2010

KEYWORDS
Disaster;
Tsunami;
Preparedness;
Indonesia

Summary The aims of this descriptive comparative study are to: (i) describe the level of
tsunami disaster preparedness of people who live in areas affected and not-affected by the
December 2004 tsunami and (ii) to compare the tsunami disaster preparedness of these two
groups of people. A total of 304 subjects were recruited using a multistage-stratied random
sampling from both of the areas along west coast of Aceh Province, Indonesia that is located
close to epicenter of earthquake that caused the tsunami. The data was collected by questionnaires developed by the researcher. The independent t-test and MannWhitney U-test were
conducted to analyze the data. The ndings showed a moderate level of tsunami preparedness
of people living in both areas including level of the variables that cover knowledge, individual
emergency planning, and resources mobilization capacity. The mean scores for each variable
of people living in affected areas were signicantly higher than people living in non-affected
areas (p < .05). Subvariables also had higher mean scores except for one subvariable related
to individual emergency planning: skill related to disaster preparedness that had a low mean
score. This study provided evidence that direct and indirect tsunami experience has a signicant
impact on peoples tsunami preparedness.
2010 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights
reserved.

Introduction
The Indian Ocean Tsunami of December 2004 had a major
impact on the human, social and economic sectors of soci-

Corresponding author. Tel.: +62 8126942094.

E-mail address: rachma lia@yahoo.com ( Rachmalia).

eties. In the worst affected region of Indonesia, especially

Aceh Province which is located close to epicenter of earthquake, more than half of districts were affected by the
disaster (FAO, 2005 as cited in1 ). The human toll according to
the governments disaster coordinating agency (BAKORNAS)
reported that in Aceh Province 123,598 bodies were buried,
113,937 people were missing and 406,156 were displaced,
though the full impact of the tsunami may never be known.2

1574-6267/$ see front matter 2010 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.
doi:10.1016/j.aenj.2010.10.006

18

Rachmalia et al.

What is known about the topic?

The Indian Ocean Tsunami of December 2004 had a
major impact on the human, social and economic
sectors of societies. In the worst affected region of
Indonesia, especially Aceh Province which is located
close to epicenter of earthquake, more than half of
districts were affected by the disaster.

What this paper adds or contributes?

This paper describes and compares the tsunami
disaster preparedness of people who live in areas
affected and not-affected by the December 2004
tsunami.

Other reasons for the enormity of the tsunami were

absence of warning systems,3 lack of knowledge and lack
of preparedness at an individual level.4 Best technology
like tsunami detection networks cannot guarantee to help
the people who live near the coastal areas. Indonesia has
just developed a thorough disaster warning system however there are still failures in its implementation.5 Disaster
response from outside sources will be on the scene soon after
a disaster but lives may not be saved if the people are not
prepared themselves to respond to the tsunami.6
Tsunami disaster preparedness requires specic care and
preparedness. Improvement of preparedness should occur
to minimize tsunami impact.3 In Indonesia, it is anticipated
that tsunami disaster frequently occur in the future based on
the occurrence of tsunami in the past few years.7 Based on
recommendations of Emergency Management Queensland,8
preparedness at individual level includes preparation for
emergency planning, emergency kits and safety houses. The
other factors related to individual preparedness include
ensuring their homes meet or exceed the relevant building
standards and that they have provisions for survival after a
disaster before getting aid from outside sources.9
The focus of this study is to examine the tsunami
preparedness of people living in tsunami-affected and nonaffected areas and compare tsunami preparedness of people
who live in coastal areas of Aceh Province, Indonesia. The
people in tsunami-affected areas should be more prepared
because personal experience of disaster makes people better understand the risks, the hazard identication and the
impact on the community (Greening & Dollinger, as cited
in10 ). Many communities in non-affected areas that do not
face the direct threat of the disaster tend to avoid the need
for disaster planning,11 however Matsuda and Okada12 state
that Motivation for disaster preparedness become stronger
when the people face the disaster as a self-experience,
or when they become nervous about possible earthquakes
after they observed others suffering by the disaster (p.
155). The ndings of this study will provide baseline data for
healthcare providers to provide appropriate interventions to
promote preparedness of people living in areas affected and
non-affected by the December 2004 tsunami.

Aims
The aims of this study were to: (i) describe the level of
tsunami preparedness of people living in tsunami-affected
and non-affected areas and (ii) to examine the differences
of tsunami preparedness of people living in tsunami-affected
and non-affected areas in Aceh Province, Indonesia.

Method
Denition of terms
For the purposes of this paper, the following denitions will
apply.
Tsunami preparedness refers to an individuals perception of the extent of being prepared to confront with future
tsunami. There are three parameters of tsunami preparedness: (i) knowledge, (ii) individual emergency planning and
(iii) resources mobilization capacity that an individual prepares for the purpose of minimizing potential risks and
mitigating the effects of future tsunami.
A tsunami-affected area was an area which was directly
affected by losing population and socio-economic aspects
along west coast of Aceh Province post Tsunami December
26, 2004.
A non-affected area was an area which was not directly
affected by losing population who were present in the
affected areas, either tourists or residents and socioeconomic aspects along west coast of Aceh Province post
Tsunami December 26, 2004.

Research design and conceptual framework

A descriptive comparative design was used in this study. The
conceptual framework of this study was derived and synthesized from the concept of individual preparedness and
knowledge from tsunami preparedness literature.1214 There
are three parameters used in preparedness at individual
level: (i) knowledge, (ii) individual emergency planning and
(iii) resource mobilization capacity.
Knowledge is an important and key factor in preparedness. Specic knowledge includes the nature of tsunami,
appropriate responses to signs of tsunami, basic preparedness for emergency, existing warning system and sources
of information for tsunami warning. Second parameter is
the individual emergency planning. Preparations for individual emergency planning were preparing an emergency
plan, implementing activities that should occur to save the
people in a tsunami event, preparing a disaster supplies kit
that provides some emergency supplies, and having safety
skills. The third parameter is resource mobilization capacity.
The preparation for this parameter includes preparing self
for rehabilitation period and preparing to seek help from
signicant others.

Participants and setting

The tsunami-affected and non-affected populations in this
study were people living in coastal areas of Aceh Province,
Indonesia with equal numbers of subjects in each group. The
tsunami-affected area was 15 of the 21 villages from Johan

Tsunami preparedness of people living in affected and non-affected areas

Pahlawan subdistrict, Aceh Barat District. The non-affected
area was 8 of the 15 villages in Tapaktuan subdistrict, Aceh
Selatan District. Sample size was determined by power analysis (power = .80, alpha = .05, and effect size = .02) which
can be categorized as a small effect size study.15 A total of
152 subjects from each area were recruited by a multistagestratied random sampling. There were: (stage 1) made a
list of sub-districts from the affected areas (n = 12) and nonaffected areas (n = 16), (stage 2) randomly selected one-sub
district from each study area; then listed the villages (n = 21
and 15 for affected and non-affected area, respectively)
each sub-district, (stage 3) randomly selected at least half
of the total number of villages of the sub-districts, and listed
the housing units in the village, (stage 4) randomly selected
a number of housing units from each representative village,
then (stage 5) listed the residents of the housing units and
randomly selected the subject who met inclusion criteria
that stratied by age and gender. The study inclusion criteria were: (i) living for at least one year in the area of
study, (ii) direct experience in tsunami for subjects living in
tsunami-affected areas, (iii) able to communicate in Indonesian language, and (iv) willing to participate in this study.

Research instrument
The Individual Tsunami Preparedness Questionnaire was
constructed by the researcher based on a review of
the literature.1214 The tsunami preparedness parameters
were used to measure the people tsunami preparedness
including knowledge preparedness, individual emergency
planning, and resources mobilization capacity. The instrument required responses using a ve-point Likert scale.
Each item was scored from 0 to 4: 0 = not at all, 1 = a
little, 2 = somewhat, 3 = much, and 4 = very much. The questionnaire was validated by three experts from Faculty
of Nursing, Prince of Songkla University and had content
validity index (CVI) of 0.95 indicating acceptable level of
content validity. To examine reliability, a pilot test using
20 subjects was conducted and testretest was used to
evaluate stability of Individual Tsunami Preparedness Reliability testing was also performed to test the Indonesian
version of the instruments. The testretest reliability coefcients of each variable were 0.99 for knowledge, 1.0
for individual emergency planning, and 0.99 for resources
mobilization capacity. The mean of means score for each
parameter of tsunami preparedness given by people living in coastal area was categorized into three levels:
0.001.33 = low preparedness, 1.342.67 = moderate preparedness and 2.684.0 = high preparedness.

Ethical consideration and data collection

The research approval was obtained from the Institutional
Review Board (IRB) of the Faculty of Nursing, Prince of
Songkla University, Thailand. The researcher asked for the
permission from the Head of Johan Pahlawan Sub-district
in Aceh Barat District and Head of Tapaktuan Sub-district in
Aceh Selatan District and the responsible community leaders
where this study was conducted. The researcher selected
and met the subjects in the areas of the study who met
the inclusion criteria. All subjects were informed about the

19

study. The researcher was explained the purpose of the

study, expectations of participation and potential harms
such as feeling ash backs, sad, depressed, and despair during completing the questionnaires. The researcher asked and
allowed the subjects to feel calm, stop completing questionnaire for a while and waited until the subjects felt
better. If the subject felt they could not continue completing the questionnaire, they had a right to withdraw from this
study at any time without fear or negative consequences.
Informed consent was verbally obtained and the researcher
explained how to complete the questionnaires. A total of
304 questionnaires were completed and returned.

Data analysis
The data was analyzed using descriptive statistics. Most
variables and sub variables of tsunami preparedness in this
study were normally distributed, thus independent t-test
was used to examine differences of tsunami disaster preparedness among the people living in tsunami-affected and
non-affected areas. For variables that were not normally
distributed, MannWhitney U test was applied.

Results
There were a total of 304 subjects: 152 subjects from
tsunami-affected and 152 subjects from non-affected areas.
The demographic characteristics of the subjects are shown
in Table 1. Subjects recruited by stratied random sampling,
improve the likelihood that factors such as age and gender
were equal. Over half the subjects were young and aged
between 17 and 34 years (55.3%) and 50.1% were female.
There was statistically signicant difference in demographic characteristics of the two groups (Table 1). People
in non-affected areas had higher levels of education, were
more likely to be employed in government or business (80.9%
versus 58.5%, p < 0.001) and higher monthly income. People in tsunami-affected areas were more likely to have
tsunami experience (100% versus 29.6%, p < 0.001), perceived an increased likelihood of tsunami occurrence in near
future (50% versus 28.3%, p < 0.001) and perceived that local
authorities had adequate preparation to respond to the possibility of tsunami impact (99.3% versus 44.1%). People living
in tsunami-affected areas were more likely to seek information from books and reading materials (94.7% versus 83.6%,
p < 0.001), television or radio (100% versus 95.4%, p = 0.01)
or participation in drills (99.3% versus 34.9%, p < 0.001) but
less likely to use the internet (31.6% versus 52%, p < 0.001).
People living in tsunami-affected areas had signicantly
higher mean scores different for knowledge, individual
emergency planning and resource mobilization than those
living in non-affected areas (Table 2). The sections to follow will examine each of these three themes in detail by
presenting the results related to the sub-variables for each
theme.

Knowledge
People living in tsunami-affected areas had higher overall
mean knowledge score (3.03 versus 1.9, p < 0.001). People

20
Table 1

Rachmalia et al.
Frequency and percentage of socio-demographic characteristic of the subjects (n = 304).

Participant
characteristics

Tsunami-affected
area (n = 152)

Non-tsunami affected
area (n = 152)

Age
1734
84
55.3
84
3554
52
34.2
52
>54
16
10.5
16
Gender
Female
77
50.7
77
Male
75
49.3
75
Marital status
Single
38
25
44
Married
84
55.3
88
Separated
30
19.7
20
Level of education
No formal education
6
3.9
2
Elementary school
21
13.8
5
Junior high school
46
30.3
15
Senior high school
62
40.8
64
College or above
17
11.2
66
Occupation
Fisherman
19
12.5
5
Farmer
11
7.2
3
Government employee
25
16.4
54
Business64
42.1
69
man/businesswomen
Others
33
21.7
21
Income/month
<500,000 IDR
42
27.6
55
500,001
80
52.6
30
IDR1,000,000 IDR
1,000,001
29
19.1
37
IDR2,000,000 IDR
>2,000,001 IDR
1
.7
30
Have tsunami experiences
Yes
152
100
45
Perceived likelihood and ability to cope with the impact of tsunami event:
Tsunami is likely to
76
50
43
occur in near future
time
Tsunami is likely to
98
64.5
93
occur in the living area
151
99.3
67
The local authorities
have good enough
preparation to respond
to the possibility of
tsunami impact
Sources of the information for tsunami preparedness:
Reading books or other
144
94.7
127
disaster related
materials
48
31.6
79
Reading disaster
related materials from
internet
Obtaining information
152
100
145
from TV or radio
Participating in drill or
151
99.3
53
simulation related to
disaster

2

%
55.3
34.2
10.5

55.33

0.16

50.7
49.3

.00

28.9
57.9
13.2

2.53

0.28

1.3
3.3
9.9
42.1
43.4

56.56

<0.001

3.3
2
35.5
45.4

40.43

<0.001

52.6

<0.001

29.6

Fishers exact

<0.001

28.3

15.04

<0.001

61.2

.22

44.1

Fishers exact

<0.001

83.6

8.7

<0.001

52

12.17

<0.001

95.4

Fishersexact

0.010

34.9

Fishers exact

<0.001

13.8
36.2
19.7
24.3
19.7

.63

Individual emergency planning

People living in tsunami-affected areas had higher overall mean scores related to individual emergency planning
(2.35 versus 1.68, p < 0.001). People living in tsunamiaffected areas had higher mean scores for the following
sub-variables: activities to save self from tsunami and
disaster supplies kits (Table 4). There was no difference
between groups in responses to sub-variable safety skills
related to disaster preparedness (Table 4). When categorized as low, moderate or high levels of knowledge, people
living in tsunami-affected areas had higher levels of knowledge related to disaster supplies kits and activities to save
self from tsunami. Both groups had low scores related to
safety skills (Table 4).

<0.001
<0.001
<0.001
15.93t
8.88U
7.35t
0.82
0.9
0.92
1.9
1.42
1.68
1.35
t = Computed value of t test; U = computed value of MannWhitney U test.

High
Moderate
Moderate
0.26
0.51
0.64
3.03
2.32
2.35
2.41
1. Knowledge
2. Individual emergency planning
3. Resources mobilization capacity

Level

Level
SD
M
Mdn
SD
M
Mdn

21

living in tsunami-affected areas had higher mean scores

for each sub-variable related to knowledge: nature of
tsunami, responses to signs of tsunami, basic preparedness for emergency, the source of the information for
tsunami warning and existing warning systems (Table 3).
When categorized as low, moderate or high levels of knowledge, people living in tsunami-affected areas had higher
levels of knowledge related to nature of tsunami, the source
of the information for tsunami warning and existing warning
systems. Both groups had moderate knowledge of responses
to signs of tsunami and basic preparedness for emergency.

Moderate
Moderate
Moderate

p
Value
Non tsunami-affected area (n = 152)
Tsunami-affected area (n = 152)
Variables

Table 2

Comparison of tsunami preparedness of people living in tsunami-affected area and non tsunami-affected area (n = 304).

Tsunami preparedness of people living in affected and non-affected areas

Resources mobilization capacity

People living in tsunami-affected areas had higher overall mean scores related to resources mobilization capacity
(2.32 versus 1.42, p < 0.001). People living in tsunamiaffected areas had higher mean scores for the following
sub-variables: preparing self for rehabilitation period and
preparing to seek help from signicant others (Table 5).
People living in tsunami-affected areas also had higher
scores related to nding other people for assistance. Both
groups had moderate scores related to post-disaster preparation (rehabilitation).
For additional analysis, MannWhitney U test was used to
measure the differences in tsunami preparedness between
people that participated and those did not participate in
drill or simulation related to disaster. The result showed that
there were signicant differences in tsunami preparedness
between two groups toward participating in drill or simulation related to disaster (Table 6).

Discussion
The results of this study show major differences in the characteristics and disaster preparedness between people living
in areas affected and not-affected by the December 2004
tsunami in Aceh Province, Indonesia. The differences were in
all three areas examined: knowledge, resource mobilization
capacity and individual emergency planning.

Knowledge
People living in tsunami-affected areas had higher overall knowledge scores and also scored higher on all of the
sub-variables related to knowledge: nature of tsunami,
responses to signs of tsunami, basic preparedness for

Rachmalia et al.

Low
Moderate
Moderate
Moderate
Moderate
0.58
1.00
1.09
0.93
1.10
1.67

1.11
2.16
1.82
1.96
1.55
3.33

Note. t = Computed value of t test; U = computed value of MannWhitney U test.

Moderate
Moderate
Moderate
High
High
0.35
0.60
0.63
0.35
0.64

SD
M
Level
SD
M

1.91
2.45
2.48
3.17
3.37
Nature of tsunami
Responses to signs of tsunami
Basic preparedness for emergency
The sources of the information for tsunami warning
Existing warning systems
1.
2.
3.
4.
5.

Mdn
Mdn

Level

Non tsunami-affected area (n = 152)

Tsunami-affected area (n = 152)
Variables

Table 3

Comparison of knowledge preparedness of people living in tsunami-affected area and non tsunami-affected area (n = 304).

Value

14.5t
3.06t
6.47t
14.93t
12.44U

<0.001
0.002
<0.001
<0.001
<0.001

22

emergency, the sources of the information for tsunami

warning and existing warning systems.
The study ndings indicated that people living in areas
affected by the December 2004 tsunami have good knowledge for preparing themselves for future tsunami events and
that people living in non-affected areas recognize their risk
of the future event and had moderate knowledge levels. This
may be explained by the difference in information sources
used by the two groups. People living in tsunami-affected
areas were more likely to read materials, participate in drills
and less likely to use the internet. Both groups reported high
use of television and/or radio as information sources.
People living in non-affected areas had low levels of
knowledge related to the nature of tsunami and this is due
to lack of direct tsunami experience. Two sub-variables of
knowledge in which people living in tsunami-affected areas
had high mean scores were the sources of the information for tsunami warning and existing warning systems.
This nding may be due to urgent installation of tsunami
early warning systems in the Indian Ocean post December
2004 and also the process of disseminating information about
early warning systems.5
Post the December 2004 tsunami, people living in
tsunami-affected areas obtained a large amount of aid from
international organizations and aid agencies in organizing
and coordinating relief effort.7 The aids was not only material support but also educational support in many ways about
disaster preparedness and response including training or
simulation in drill related to tsunami disaster and knowledge
in basic preparedness for emergency that was at a moderate
level. This support may have increased knowledge related
to tsunami preparedness.
Although people living in tsunami-affected areas had
higher scores, both groups had moderate knowledge regarding responses to signs of tsunami. All of respondents in
affected areas reported that direct involvement in the
December 2004 tsunami gave them a chance to identify
nature of tsunami and appropriate response when signs of
the tsunami are detected from direct experience such as
evacuation plan to higher inland.14
Most of the people living in affected areas already
obtained the knowledge through the personal impact of the
tsunami imposed on them and in non-affected areas they
received and observed the information about what they
should know and do in order to minimize the impact of
a tsunami. A study conducted by ISDR/UNESCO,14 showed
that the December 2004 tsunami experience made most
of the subjects in affected areas able to identify tsunami
warning signs and safe place for shelter. Aid from donor
organizations to people living in tsunami-affected areas
also provided other important knowledge in tsunami preparedness including knowledge in basic preparedness for
emergency, existing warning system and source of the information for tsunami warning. People living in non-affected
areas received knowledge from indirect sources such as
television or radio, reading material related to disasters
such as leaets and books or by mass media that proved
an effective method of disseminating information. In this
study, the signicant differences in mean scores for knowledge preparedness might be due to information from ofcial
sources not really encouraging tsunami preparedness and is
supported by other studies that show awareness of emer-

Tsunami preparedness of people living in affected and non-affected areas

23

Table 4 Comparison of individual emergency planning of people living in tsunami-affected area and non tsunami-affected area
(n = 304).
Variables

1. Disaster
supplies kits
2. Activities to
save self
from tsunami
3. Safety skill

Tsunami-affected area (n = 152)

Non tsunami-affected area (n = 152)

Mdn

Mdn

SD

Level

2.81

0.45

High

2.12

1.95

1.07

Moderate

0.5

0.68

0.67

Low

Value

<0.001

SD

Level

1.62

0.98

Moderate

13.59t

1.24

1.05

Low

5.64U <0.001

0.67

0.88

0.93

Low

1.11U

.266

Note. t = Computed value of t test; U = computed value of MannWhitney U test.

Table 5 Comparison of resources mobilization capacity of people living in tsunami-affected area and non tsunami-affected
area (n = 304).
Variable

1. Preparing
self for rehabilitation
period
2. Preparing to
seek help
from
signicant
others

Tsunami-affected area (n = 152)

Non tsunami-affected area (n = 152)

Level

2.06 .65

Moderate

1.51

.98

2.79 .83

High

1.94 1.06

SD

gency management comes from spontaneous knowledge

acquired from the lived experiences rather than from ofcial/technical sources.16
The higher level of knowledge about preparedness did
not mean a high level of preparedness as there are many
other high priority problems in peoples lives.17 Therefore,
although the people living in tsunami-affected areas have a
high level of knowledge, that it is not enough for them to
prepare their resources mobilization capacity and individual
emergency planning scores were moderate levels.

Individual emergency planning

In this study, people living in tsunami-affected areas had
high scores related to disaster supply kits and people in
non-affected areas had moderate scores in this sub-variable.
This may be explained by people in tsunami-affected areas
having higher awareness of the possibility of occurrence

SD

Moderate

5.77

<0.001

Moderate

7.75

<0.001

Level

of future tsunami events and that most people living in

tsunami-affected areas received help including a disaster
emergency kit from the donor organizations.14 For people in non-affected areas, most of the subjects perceived
increased risk of earthquakes and tsunamis however it was
not enough to increase their preparation for future disaster
in terms of disaster supply kits.
Most subjects had implemented disaster supply kits with
items that were easy to assemble without spending signicant money and time such as important and valuable
documents. The previous 30-year civil conict experience
where the burning of homes of villagers accused of assisting rebels was a common violent act18 highlights the risk of
losing valuable items such as important documents.
When asked about activities to save themselves from
tsunami events, people living in tsunami-affected areas had
moderate scores and people in non-affected areas had low
scores. The socio-demographic characteristic may inuence
sub-variable, particularly gas people living in tsunami-

Table 6 Degree of tsunami preparedness between people participating and those who did not participate in drill or simulation
related to disaster (n = 304).
Participating in drill or
simulation related to disaster

Mean rank

Sum of ranks

Yes
No

204
100

189.59
76.85

38675.50
7684.50

10.511

<0.001

24
affected areas were more likely to be low income earners.
The low income may result in people prioritizing work over
tsunami preparedness which may limit the capability for
detailed disaster planning.19 The nding of the study is consistent with the study of Corps and FEMA20 and found that
individuals with lower income were less likely to take preparedness measures and indicated an increased need for
help in evacuation.
The results of this study revealed that safety skills related
to disaster preparedness were at low levels for both groups.
This might be due to high levels of perceptions by subjects
living in tsunami-affected areas that the local authorities
had good enough preparation in responding to the possibility of a tsunami impact. However, for people living in
non-affected areas, even though most of them perceived an
inadequacy of local authority response (55.9%), the level of
safety skills related to disaster preparedness was also low.
This indicated that an indirect disaster experience is not
enough to encourage them to get training about safety skills
related to disaster preparedness.
Most of the subjects living in tsunami-affected areas had
junior high school education so they did not nd rst aid
and CPR skills easy to understand if the responsible institutions such as local emergency services did not give them
enough support. It is reported that when disaster preparedness training is not conducted regularly or takes place years
ago, people who attended the training did not have enough
knowledge and capability to distribute the information.16
Programs from outside such non-governmental organizations and emergency rescue services that came following
the 2004 disaster supported people living in affected areas
in emergency planning for future events.21 According to
Corps20 , Individuals who had volunteered to help in their
community or during a disaster were more likely to have
a disaster supplies kit and a household plan in place, were
more willing to prepare for disaster, and had more condence in their abilities to prepare for disasters (p. 6).

Resources mobilization capacity

In terms of resources mobilization, people living in tsunamiaffected areas had higher scores related to post disaster
preparation but both groups had moderate level preparedness in this area. Saving money was one of the choices made
by people following December 2004 tsunami because saving
is useful as preparation for urgent needs of money.14 Insurance was not a possibly for most people because most people
did not have enough monthly income. When asked about
alternative places of stay if a tsunami occurred, mosques
were the most common alternative location to use as a
tsunami evacuation site. Mosques are the centre of each
village in Islamic society where people gather daily for worshipping and for other purposes. It was evident that mosques
in Aceh survived the earthquake and tsunami with only
minor damage as the mosque construction provides space
for water ow. In addition, Muslims in Sri Lanka, Maldives
and Indonesia may select a temple or mosque as the optimal location for tsunami event because of their high level
of trust in religious facilities.22
Many subjects in non-affected areas described open
safety places that are higher inland locations and

Rachmalia et al.
religious practice place for example mosques as naturally provided places surrounding their living area that can
be used as temporary shelter. This is important as facilities for mass sheltering are not provided in these areas.
This plan was learned from local knowledge/folk story and
observations of the impact of the December 2004 tsunami
event which have contributed to subjects understanding of
tsunami ooding. During the last tsunami event in 2004, traditional wisdom in oral histories and songs of local people
from Simeulu Island saved their lives when so many others
perished.23
In terms of preparing to seek help from signicant others,
people living in tsunami-affected areas had higher scores
than those living in non-affected areas. Many individuals in
tsunami-affected areas reported seeking the help of neighborhood or friends. The support from neighborhood/friends
can be material or psychological support and assist with coping with the situation post disaster. This choice may also be
inuenced by experiences of the December 2004 tsunami
where many people reported needing help from their relatives but were separated from family due to the impact
of the disaster. Community agencies can be an alternative
choice for help following a disaster21 as a lot of community agencies have readiness to assist the people that need
their help. For example, in Padang Indonesia which is a vulnerable tsunami area, a group called KOGAMI (an acronym
for Tsunami Alert Community, in Indonesia) exists to help
prepare residents living in that area.17
For people living in non-affected areas and living in community villages, there is still a culture of mutual cooperation
and high level relative relationships.14

Conclusion
The results indicated that people living in tsunami-affected
and non-affected areas had signicantly different mean
scores for knowledge, individual emergency planning and
resource mobilization. The mean scores for each variable
of people living in affected areas were signicantly higher
than people living in non-affected areas. Direct disaster
experience and indirect disaster experience can be a signicant factor that inuences preparedness and aid from
outside organizations also inuences who gets to undertake
disaster preparedness. Indirect experience with December
2004 tsunami increased awareness of people in non-affected
areas to be more prepared however preparedness was not
at maximum levels.
The ndings of this study have several implications for
community health nursing, and nursing research. Community health nursing is a common model of care in Indonesia,
should consider use of media information including social
networks and local wisdom as effective ways to encourage
people in dissemination of information about disasters and
enable people to prepare together. Further investigation of
the beliefs, attitudes and behaviors related to preparedness
that can be transferred as local wisdom may also encourage
preparation of people facing a future disaster event.
Limitation in this study, the researcher only measured
general information about the peoples familiarity with
evacuation plans, sources of warnings and existing warning
systems. And the researcher did not investigate how indi-

Tsunami preparedness of people living in affected and non-affected areas

viduals keep maintaining their preparedness, because some
items such as food that are perishable have an expiry date
that needs to be checked and replaced regularly.

Funding
None.

Competing interests
None.

Acknowledgements
The author would like to express sincere gratitude to all
respondents who participate in this study, the advisors for
suggestion and recommendation during the research study,
The Institute for Research and Development on Health
and Epidemiology Unit, Faculty of Medicine and Graduate
School, Prince of Songkla University Hat Yai, Thailand for
granting partial funding support for this study.

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