Post Nargis

Post-Nargis Periodic Review I
FOREWORD
On 2 May 2008, Cyclone Nargis struck the coast of Myanmar. Over two days, the Cyclone moved
across the Ayeyarwady Delta and southern Yangon Division resulting in a tragic loss of life and
widespread destruction. This disaster affected Townships with a total population of more than seven
million. Many of the people affected suffered devastating losses of family members, homes and
livelihoods. This report presents a snapshot of the situation on the ground half a year after Cyclone
Nargis with a focus on the current needs of the Cyclone-affected population.
In September 2008, the Tripartite Core Group, which brings together the Association of Southeast
Asian Nations (ASEAN), the Government of the Union of Myanmar and the United Nations undertook
to conduct a series of reviews of the situation of the Cyclone-affected population over 12 months.
The humanitarian relief and early recovery support to the affected population continues to help people
overcome the devastation caused by Cyclone Nargis, with extensive efforts by the Government of
the Union of Myanmar, local communities, non-governmental organisations, the United Nations and
private individuals. The Periodic Review process seeks to generate data that will be a useful tool
for monitoring the ongoing relief efforts, identify the needs of the affected population and facilitate
strategic decision making to continue support for the affected population.
The findings of the first Periodic Review are contained in this report. It was produced from the
analysis of comprehensive and credible needs assessments conducted between 29 October and 19
November 2008 in the Ayeyarwady and Yangon Divisions. The methodology of this Review built on
the Village Tract Assessment conducted in June 2008.
This report was prepared jointly by the members of the Tripartite Core Group with the support of
the humanitarian and development community. The Tripartite Core Group appreciates the continued
engagement and contributions of our partners to this important process. Above all, we give our
sincere thanks to the people affected by Cyclone Nargis for their participation in the surveys that
form the foundation of this first Periodic Review.
On behalf of the Tripartite Core Group,
H.E. Mr. Bansarn Bunnag H.E. U Kyaw Thu Mr. Bishow B. Parajuli
Ambassador of Thailand Deputy Foreign Minister UN Resident/Humanitarian
to the Union of Myanmar and Government of the Union of Myanmar Coordinator
Senior ASEAN Member of the TCG Chairman of the TCG United Nations in Myanmar
UN Representative in the TCG
ii
Acknowledgements
The Tripartite Core Group wishes to express its sincere appreciation to the many people who have
made the first Periodic Review possible. The ASEAN Humanitarian Task Force for the Victims of
Cyclone Nargis, the ministries of the Government of the Union of Myanmar and agencies of the
United Nations have all contributed to the success of the Review. Our thanks to the Clusters for
their participation. We also extend our thanks for the generous financial support of the donor
community.
The data and analysis that is presented in this report was compiled through the efforts of the Periodic
Review Team.
This report would not have been possible without the generous participation of the people affected
by Cyclone Nargis.
iii
Table of Contents
Foreword ............................................... i
Acknowledgements ............................................... ii
Table of Contents ............................................... iii
List of Abbreviations and Acronyms ............................................... vi

Executive Summary ............................................... 1
Section 1: Introduction ............................................... 3

1.1 Impact of Cyclone Nargis ............................................... 3
1.2 Periodic Review process ............................................... 3
The Tripartite Core Group (TCG) ............................................... 4
1.3 Other post-Nargis reports ............................................... 5
1.4 Methodology of the Review ............................................... 5
The Plug-in ............................................... 7
Wealth Index ............................................... 7
1.5 Data interpretation and usage ............................................... 7
What is an indicator? ............................................... 7
What is spatial sampling? ............................................... 8
How do I read the maps and histograms? ............................................... 8
What is in the text boxes? ............................................... 8
1.6 Next steps ............................................... 8
Section 2: Findings ............................................... 9

2.1 Health ............................................... 10
2.2 Nutrition ............................................... 18
2.3 Food ............................................... 20
2.4 Water supply, Sanitation and Hygiene (WASH) ........................................... 25
2.5 Shelter ............................................... 35
2.6 Education ............................................... 40
2.7 Livelihoods ............................................... 46
2.7.1 Credit ............................................... 48
2.7.2 Agriculture ............................................... 49
2.7.3 Livestock ............................................... 56
2.7.4 Fisheries ............................................... 60
2.8 Cross cutting issues ............................................... 64
2.8.1 Vulnerability and protection ............................................... 64
2.8.2 Wealth ............................................... 66
2.8.3 Receipt of aid ............................................... 67
2.9 Conclusions ............................................... 68
First priorities ............................................... 68
1) Needs are diverse ............................................... 69
2) Depth and coverage of assistance is required .......................................... 69
3) Need for more integrated programming ............................................... 69
Summary ............................................... 70
iv
Section 3: Annexes ............................................... 71

3.1 Methodology of the first Periodic Review ............................................... 71
3.1.1 Quantitative methodology ............................................... 71
3.1.2 Quantitative assessment tools ............................................... 73
3.1.3 Qualitative methodology ............................................... 96
3.1.4 Qualitative assessment tools ............................................... 98
3.1.5 Qualitative results ............................................... 99
Case 1) Thawtar Khin ............................................... 99
Case 2) Daw Mya Sein ............................................... 100
Case 3) Daw Thet Thet Swe ............................................... 100
Case 4) Daw Myint Thein ............................................... 102
Case 5) U Khin Moe ............................................... 102
Case 6) U Hla Soe ............................................... 103
Case 7) U Toe Kyi ............................................... 103
Case 8) U Maw Thane ............................................... 104
Case 9) Daw Kyi Ohn ............................................... 104
3.2 List of Townships in assessment area ............................................... 106
3.3 Contributing agencies ............................................... 107
v
List of Figures
Figure H1: PHC facilities are within 1 hour travel time ............................ 10
Figure H2: Waiting time at PHC facilities is less than 1 hour ............................ 11
Figure H3: Health workers in the community ............................ 12
Figure H4: Coverage of Measles vaccination ............................ 13
Figure H5: Medicine available at PHC facilities all or most of the time ............................ 14
Figure H6: Prevalence of diarrhoea ............................ 15
Figure H7: Prevalence of fever ............................ 16
Figure H8: Received medical assistance since Cyclone Nargis ............................ 17
Figure N1: Global acute under nutrition ............................ 18
Figure N2: Inappropriate treatment of diarrhoea ............................ 19
Figure F1: Proportion of households with poor food consumption ............................ 21
Figure F2: Moderate or Severe food insecurity ............................ 22
Figure F3: Severe food insecurity ............................ 23
Figure F4: Received food assistance since Cyclone Nargis ............................ 24
Figure W1: Use of improved drinking water sources ............................ 25
Figure W2: Drinking water sources ............................ 26
Figure W3: Use of an adequate water treatment method ............................ 27
Figure W4: Methods of water treatment ............................ 28
Figure W5: Sanitation method ............................ 28
Figure W6: Use of improved sanitation facility ............................ 29
Figure W7: Adequate disposal of childrens faeces ............................ 30
Figure W8: Washing hands before food preparation ............................ 31
Figure W9: Water received ............................ 32
Figure W10: Water storage and transport equipment received ............................ 33
Figure W11: Soap or hygiene equipment received ............................ 34
Figure S1: Inadequate shelter conditions ............................ 35
Figure S2: Plastic, tarpaulin or canvas is used in walls or roof ............................ 36
Figure S3: Preparedness for storms and flooding ............................ 37
Figure S4: Received emergency shelter, construction materials or tools ............................ 38
Figure E1: Proportion of Children aged 5 to 10 years attending school ............................ 40
Figure E2: Reasons for non-attendance at school (ages 5 to 10) ............................ 41
Figure E3: Proportion of Children aged 11 to 15 years attending school ............................ 42
Figure E4: Reasons for non-attendance at school (ages 11 to 15) ............................ 43
Figure E5: Proportion of households with Parental involvement in PTAs ............................ 44
Figure E6: Received education assistance ............................ 45
Figure L1: Livelihoods before and after Cyclone Nargis ............................ 46
Figure L2: Principal livelihoods before and after Cyclone Nargis (grouped) ........................ 47
Figure L3: Principal activities before and after Cyclone Nargis (grouped) ........................... 48
Figure A1: Paddy lost and not yet recovered ............................ 50
Figure A2: Reasons for loss of paddy ............................ 51
Figure A3: Tree crops (perennial) lost and not yet recovered ............................ 52
Figure A4: Reasons for loss of tree crops (perennial) ............................ 53
Figure A5: Home garden lost and not yet recovered ............................ 54
Figure A6: Received agricultural inputs ............................ 55
Figure LS1: Poultry lost and not yet replaced ............................ 56
Figure LS2: Reasons for loss of poultry ............................ 57
Figure LS3: Reason for loss of pigs ............................ 57
Figure LS4: Pigs lost and not yet replaced ............................ 58
Figure LS5: Buffalo and cattle lost and not yet replaced ............................ 59
Figure LS6: Reasons for loss of buffalo and cattle ............................ 60
Figure FI1: Boats lost and not yet replaced ............................ 61
Figure FI2: Reasons for loss of boats ............................ 62
Figure FI3: Reasons for loss of fishing nets ............................ 62
Figure FI4: Fishing nets lost and not yet replaced ............................ 63
Figure V1: Estimates of the proportion of households in each category of vulnerability 64
Figure WE1: Wealth index ............................ 66
Figure R1: Local organisations working in communities ............................ 67

vi
List of Abbreviations and Acronyms
ASEAN Association of Southeast Asian Nations

C.I. Confidence Interval
DALA Damage and Loss Assessment
FCS Food Consumption Score
HCW Health Care Worker
INGO International non-Governmental Organisation
IASC Inter-Agency Standing Committee
LQAS Lot Quality Assurance Sampling
MIMU Myanmar Information Management Unit
MUAC Mid-Upper Arm Circumference
NGO Non-Governmental Organisation
OCHA United Nations Office for the Coordination of Humanitarian Affairs
PCA Principal Components Analysis
PHC Primary Health Care
PONJA Post-Nargis Joint Assessment
PONREPP Post-Nargis Recovery and Preparedness Plan
PTA Parent Teacher Association
SAG Periodic Review Strategic Advisory Group
SIM Social Impact Monitoring
TAG Periodic Review Technical Advisory Group
TCG Tripartite Core Group
VTA Village Tract Assessment
WASH Water, Sanitation and Hygiene
WHO World Health Organization
UN United Nations
UNICEF United Nations Childrens Fund
Conversions
1,000 Kyat = 0.91 USD
(exchange rate at the ASEAN-UN International Pledging Conference, Yangon, 25 May 2008)
1 Pyi = 2.13 kgs of milled rice (approximately 2 litres)

1
Executive Summary
When Cyclone Nargis struck the coast of Myanmar in May 2008, an estimated 140,000 lives were
lost. Similar to other recent natural disasters, such as the Indian Ocean Tsunami in Aceh, Indonesia,
the sheer scale of this disaster requires ongoing relief and recovery assistance for the affected
population. Half a year after the disaster and the provision of aid and assistance, the Tripartite Core
Group (TCG) commenced a series of periodic reviews to assess the needs of people and communities,
and progress towards recovery. This is the first report of this effort.
Over the next nine months, the Periodic Review process will seek to inform humanitarian
assistance strategies and programme change to benefit the people affected by Cyclone Nargis.
By providing relevant data on the situation and needs of the affected people, coordination may be
strengthened across sectors and between international and domestic actors. The comprehensive
geographic and multi-sectoral coverage of the Review pioneers a new approach to post-disaster
needs assessment and monitoring.
This report does not seek to evaluate in detail the success of the assistance provided or to make
policy recommendations. Instead, it presents findings from analysis of data collected from
2,376 households in 108 communities spread across the area of Myanmar worst affected by Cyclone
Nargis.
The findings of the first round of the Periodic Review process are presented here by sector and take
into account cross-cutting issues. They provide a snapshot of the situation for communities living in
the Cyclone-affected areas. It is important to note that the areas covered by the survey were affected
to different degrees and that the situation of the surveyed communities was not homogenous prior
to the Cyclone. Subsequently, it is not possible to attribute all of the results presented in this
report directly or exclusively to the Cyclone, or to subsequent relief efforts.
Indicators for the health sector reveal good results for access to health care and outreach
into communities. However, the findings raise concerns around the functioning of the health
system as only one third of households reported that medicine was available at local clinics all
or most of the time. In addition, the prevalence of fever and diarrhoea in communities suggests
problems with infectious disease in the centre and west of the Delta and north of Yangon.
Findings for nutrition and food security are interlinked with health outcomes, as nutrition
reflects the health status and food availability for a population. The proportion of children suffering
undernurtition is highest around Yangon (over 15 per cent) and may represent a chronic
problem, rather than being directly related to the impact of Cyclone Nargis. By contrast, inappropriate
treatment of diarrhoea is most common in the Delta.
Food aid had reached every surveyed community along the path of the Cyclone. However,
food insecurity persists in the southwest and around Yangon and food consumption is poor across
the west. Again, this may reflect chronic problems as well as the impact of Cyclone Nargis.
Across the survey area, the majority of households are either using an improved (safe) water
source, or treating their water effectively, with the exception of a small area south of Yangon.
The percentage of households using chlorine tablets is low, less than three per cent. With the end
of the Monsoon season, households are using less rainwater (down from 30 per cent reported in the
Village Tract Assessment (VTA) in June to around 20 per cent) and more surface water, from ponds
for example. There is concern that increased dependence on surface water and the salination of
ponds caused by the storm surge may result in water shortages as the dry season continues. By
contrast, the use of unsanitary practices almost halved since the VTA.
High proportions of households remain in inadequate shelters that are often overcrowded and
offer little protection from the heat and rain. In only around 10 per cent of communities surveyed
did every household report adequate living conditions, the same or better than before the Cyclone.
Of particular concern is the very high proportion of households using plastic or canvas for
their roofs or walls in the area of the southern delta where the storm surge struck. These are
temporary repairs, not rebuilding, and occur in around 30 per cent of villages surveyed.
2
Education is widely available and the main barrier to school attendance are the costs associated,
such as for the school uniform. For older children, needing to work, either to earn income or
as a carer in the home, is also an important factor. There is good awareness of Parent Teacher
Associations (PTAs), which were mobilised to assist with reconstruction of schools, and areas of low
PTA participation are correlated with areas where school attendance rates are lower.
Livelihoods have been disrupted across the affected area as fishing, livestock rearing and
agriculture all suffered heavy losses. Along the path of the Cyclone, communities are a long
way from fully recovering these losses, for example in poultry stocks, arable land, buffalo for
ploughing, fishing nets and boats. Recovery will take several years both because of the types of
loss suffered (salinated land and fallen trees) and the breadth of need (the very large numbers of
livestock and fishing equipment that need to be replaced). Social structures around employment
and access to credit have been disrupted with both lack of access and more unfavourable terms
observed. People also lost assets and savings, which has reduced their capacity for self
recovery and increased indebtedness.
While the assistance that has been delivered is making an impact, the depth and geographic
coverage is not yet sufficient to meet all needs. In particular, assistance is not reaching the
western delta and some of the larger towns and periurban areas as effectively as the eastern delta.
The persistence of need, even in areas that received substantial aid, means that the depth of that
assistance is not yet sufficient and greater efforts are required if these needs are to be met.
Many of the issues facing the Cyclone-affected communities are interlinked and cut across
sectors. These include: the interaction of the health system, nutrition, food, shelter and sanitation
for improved health outcomes; and the need for recovery in livelihoods to improve food security.
Others, such as increasing concerns over water availability through the dry season, will have knock
on effects in other sectors.
The needs of people vary between and within communities according to the nature and extent of
the damage caused by the Cyclone and the vulnerability of members of communities. Meeting the
needs of those traditionally considered most vulnerable in a sustainable way requires rehabilitating
the communities in which they live.
In order to effectively address the complexity in interdependence of issues identified in this report,
greater coordination and horizontal integration of programming may be required. As
peoples immediate needs are met, and the shift from relief to recovery begins, it is important
that assistance to communities addresses the diversity of needs in the community and works with
existing social and economic structures.
The diversity of needs between and within communities means that ongoing relief as well as
recovery assistance is required. Review and reform of programme modalities may be required
to meet these evolving needs. Some people remain dependent on emergency assistance to meet
their daily needs. While for others, what is required is an opportunity to re-establish and secure
their livelihoods.
3
Section 1:
Introduction
On 2 May 2008, Cyclone Nargis struck the coast of Myanmar with devastating effects for the
Ayeyarwady and Yangon Divisions.1 Of the 7.35 million people living in affected Townships, it is
estimated that 2.4 million people were severely affected by the Cyclone. The scale of the disaster
means that continued early recovery assistance is needed for the affected population.
The Periodic Review process seeks to inform humanitarian assistance strategies for the people
affected by Cyclone Nargis by providing relevant data on their current situation and needs. The
comprehensive geographic and multi-sectoral coverage of the Review pioneers a new approach
to post-disaster needs assessment and monitoring. It is hoped that through this strengthened
coordination of the process across sectors and between international and domestic actors, that the
Cyclone-affected population can be assisted more effectively.
1.1 Impact of Cyclone Nargis

Figure 1: Myanmar
Cyclone Nargis made landfall at the western edge of the
Ayeyarwady delta about 250km from Yangon, most populous
city in Myanmar (Figure 1). Over 2 and 3 May, the Cyclone Bhutan
China
moved inland across the delta towards Yangon. It caused a India
devastating loss of life with an estimated 140,000 people Bangladesh
killed or missing.2 The lives and livelihoods of survivors were

also severely disrupted with up to 800,000 people displaced, Myanmar
450,000 houses destroyed and substantial losses of food stocks, Laos
equipment, infrastructure and paddy.
The destruction caused by Cyclone Nargis resulted from two Thailand

main elements: high-speed winds of up to 250 kilometres per
hour (135 knots); and a 3.6 meter (12 foot) storm surge. The
type of damage caused by the cyclonic winds and the damage
caused by the storm surge were different. Subsequently the
relief and recovery needs are different for the areas affected by
both the storm surge and high winds, and those that suffered
principally from high winds (Figure 2).
Half a year later, the resilience and resourcefulness of people affected by Cyclone Nargis and the
accommodating attitudes of communities hosting displaced people are striking. However, many
people still require humanitarian assistance efforts to meet their basic needs.
1.2 Periodic Review process
The Periodic Review is a process of assessment, monitoring and reporting on the needs of people and
communities affected by Cyclone Nargis. It is being conducted by the Tripartite Core Group (TCG).
The goal of the Review is to generate data that can be used to target assistance, inform future
assessments and thereby help alleviate suffering and accelerate the process of recovery.
1 TCG (June 2008) Post-Nargis Joint Assessment, p 1.

2 MIMU (31 October 2008) Integrated Monitoring Matrix, source: Government of the Union of Myanmar.
4
The Tripartite Core Group (TCG)

The TCG was formed on 31 May 2008 in response to the needs of people affected by Cyclone Nargis.
The TCG brings together the Association of Southeast Asian Nations (ASEAN), the Government of
the Union of Myanmar and the United Nations (UN). It is an ASEAN-led mechanism that seeks to
cultivate the trust, confidence and understanding necessary to facilitate relief and recovery efforts
in Myanmar.
The TCG comprises nine members, three each from ASEAN, the Government of the Union of
Myanmar and the UN. Deputy Foreign Minister U Kyaw Thu from the Government of the Union of
Myanmar is the Chair of the TCG.
Figure 2: Cyclone Path and Tidal Surge affected area

Bago West Division
Thayarwady
Rakhine State
Bago East Division
Thandwe Hinthada
Bago
Bay Kayin State
of Hpa-An
Bengal Yangon Division Bago
Ayeyarwady Division Yangon (North)

Thaton
Pathein Maubin Yangon (East)
Hpa On
Pathein Yangon
Yangon (South)
Yangon (West)
Myaungmya
Mawlamyine
Pyapon
Mawlamyine
Gulf of Mottama
Mon
(Gulf of Martaban
State
The Periodic Review process started in September 2008 and will run until August 2009 with
three rounds of assessments and reporting planned. This document reports on the first round of
assessments carried out from 29 October to 19 November 2008. The next round of assessments is
expected in March 2009 and the final round in July 2009.
By monitoring selected indicators at regular intervals, the Periodic Review assessments will produce
a series of snapshots of the situation of people and communities that were affected by Cyclone
Nargis. Each of these assessments aims to show the needs at that point in time, and as part of a
series will also show the process of recovery over time. The provision of this data seeks to assist
and inform strategic decision making for relevant stakeholders.
Inclusiveness, cooperation and consultation have been, and will continue to be, fundamental to the
Periodic Review process. At each step in the process for the first Review, from selecting indicators
and survey design to setting thresholds and analysis of data, there was an extensive process
of consultation. This included: the Government of the Union of Myanmar and the international
humanitarian community through the Cluster approach.
The Periodic Review process builds on the Village Tract Assessment (VTA) that was conducted in June
2008 and formed part of the Post-Nargis Joint Assessment (PONJA) published in July 2008. The
Reviews will cover the same geographic area as the VTA and the design used for the first round of
assessments drew upon lessons learnt in the VTA to optimise and simplify the design while making
the process more consultative.
5
The Periodic Reviews Technical Advisory Group (TAG) and Strategic Advisory Group (SAG) were
responsible for overall guidance of the Periodic Review process. Each of the TCGs three components
is represented in the TAG and the SAG.
The aim of the TAG is to provide technical advice and background information to the Periodic Review
Team on methodological matters relevant to the Periodic Review process. The Group consults and
advises on the scientific aspects and applications of the Periodic Review.
The aim of the SAG is to provide strategic advice to the Periodic Review Team. The SAG provides
this guidance in order to ensure that the Periodic Review is implemented successfully by: mobilising
necessary resources; ensuring that progress towards the goal of the Review is effectively
communicated to all stakeholders; and ascertaining that the combined expertise and resources of
all stakeholder groups are utilised.
The members of the TAG and SAG represent the members of the TCG, including local and international
NGOs. The TAG met weekly and the SAG met when required or requested by the TAG. The SAG is
mandated with final editorial control of the first report of the Periodic Review.
1.3 Other post-Nargis reports
This report on the first Periodic Review assessment is part of a second generation of post-Nargis
reports being prepared by the TCG. The results from the first assessments, the VTA and the Damage
and Loss Assessment (DALA), were contained in the PONJA, which was published two months after
Cyclone Nargis.
The PONJA included guiding principles for the humanitarian and recovery strategy and a commitment
to put in place a mechanism for a system for monitoring progress in meeting humanitarian and
recovery needs.3 In August 2008, the Periodic Review process was established by the TCG to fulfil
this purpose.
The TCG is preparing two other reports simultaneously with this first Periodic Review report. The
Post-Nargis Recovery and Preparedness Plan (PONREPP) is a multi-sectoral indicative plan for
medium-term recovery. The report on Social Impact Monitoring (SIM) uses qualitative research to
examine the impacts of Cyclone Nargis in 40 villages in eight Townships. It focuses on three areas:
the effectiveness of aid; the impacts of the Cyclone (and the aid effort) on the socio-economic
structure of village life; and impacts on social relations and cohesion.
1.4 Methodology of the Review

The Periodic Review process aims to monitor indicators over time and space on the status of the
affected people of Myanmar. The purpose is to inform strategic decision making for implementing
agencies. The first round of the Periodic Review process aims to build on the VTA conducted in June
2008, surveying the same geographic area using a multi-sectoral approach.
The first round of the Review improved on the methodology of the VTA in two important ways.
Firstly, the methods were improved by reforming the questions and the sampling method, trying
where possible, to maintain an ability to compare results with the VTA. Secondly, a qualitative plug-
in assessment was included allowing a greater depth of information to be collected about vulnerable
people in cyclone-affected areas, using the quantitative survey to direct follow-up intervention.
The Periodic Review will make a series of assessments between November 2008 and June 2009.
These assessments will cover the same geographic areas within the Delta, but not necessarily collect
data in the same communities each time. Furthermore, the methodology will be reviewed with each
round of assessment to improve the quality of data and to reflect the stages of response moving
from relief to early and mid-term recovery.
The sampling area, defined as the area worst affected by the Cyclone, was divided into non-overlapping,

6
equal areas using a hexagonal lattice (Figure 3 below). This sample design is appropriate because it
is highly unlikely that the needs assessed will be evenly spatially distributed. Using an even spatial
sample allows needs to be mapped across the survey area.
Figure 3: Periodic Review survey area with hexagon overlay

Bago West Division
Thayarwady
Rakhine State
Bago East Division
Thandwe Hinthada
Bago
Bay Kayin State
of Hpa-An
Bengal Yangon Division Bago
Ayeyarwady Division Yangon (North)

Thaton
Pathein Maubin Yangon (East)
Hpa On
Pathein Yangon
Yangon (South)
Yangon (West)
Myaungmya
Mawlamyine
Pyapon
Mawlamyine
Gulf of Mottama
Mon
(Gulf of Martaban)
State
Figure 4: Satellite image with hexagon overlay
The community nearest to the centre of the hexagon was selected using post-Cyclone satellite
imagery (Figure 4). Using this method, 113 communities
were selected and 22 households were selected within
the communities for assessment using representative
sampling methods that involved rapid mapping of
villages with local community members.4
A multi-sectoral questionnaire and indicator set was used

covering areas such as health, agriculture, livelihoods
and education. The questionnaire was carried out at
the household level.
The Plug-in
The qualitative assessment, or plug-in, used information from the large-scale quantitative household
survey to identify households that fell into pre-defined categories of vulnerability. The purpose of
the qualitative study was to improve understanding of how formal institutions and social networks
respond to an unanticipated natural calamity. For each vulnerable household, closed and open-
ended interview protocols for assessing vulnerability were applied. The Plug-in was conducted
from 5 to 19 November 2008. While the Periodic Reviews plug-in and the SIM are both qualitative
assessments, they seek to explore different issues.
Wealth Index
4 Where a community consisted of less than 22 households, all households in that community were assessed.
7
The wealth index presented in this report was created using the asset scoring method used in
Demographic and Health Surveys and UNICEFs Multiple Indicator Cluster Surveys. This method
assigns a relative socio-economic position to households. Wealth indices created using this method
allow comparisons to be made between households in the population for which an index was
developed, but do not allow comparisons to be made between different populations. The wealth
index identifies areas of relative wealth and poverty across the survey area. More information on the
method used to develop the wealth index can be found in the methodological annex.
1.5 Data interpretation and usage
The data in this report is presented using maps that show the spatial distribution of indicator
proportions over the survey area. Each is accompanied by a histogram that shows the distribution
of estimates of indicator proportions in each of the sampled communities. Additional information is
presented in tables for some indicators. Data from the qualitative plug-in is integrated into the text
and presented in text boxes.
Presenting the data in map form allows the Periodic Review to identify areas of highest need and can
be used to inform strategic programming decisions. The first round of the Periodic Review may also
be seen as providing a baseline against which progress will be measured by examining changes in
indicators between survey rounds.
What is an indicator?
For the purposes of the Periodic Review, an indicator is a characteristic that varies across different
people, households and communities being surveyed and which can be measured. Measurements
may be collected by questionnaire survey or using simple and rapid techniques such as observation
or physical measurement by surveyors.
Indicators are usually answers to simple yes / no questions. An indicator may be the answer to a
single question or it may be derived from a set of answers to questions that are combined using logic
of varying complexity. For example, the definition of the indicator for exclusive breastfeeding used
in the Periodic Review is derived from a combination of four variables: the age of the child; they are
breastfed; they take solid or pured food; and they take fluids other than breast milk.
These are combined using the following logic:
If the child is: aged six months or younger; the child is breastfed; and the child does not take
solid or pured food; and does not take fluids other than breast milk - then the child is exclusively
breastfed.
The variables and logic used to create a definition of an indicator are called the criterion of the
indicator. This is the characteristic that the indicator is intended to reflect. In some contexts,
indicators may be associated with a standard that specifies a threshold.
For some indicators, the Periodic Review can be seen as a needs assessment, and for others a
performance assessment.
What is spatial sampling?
The use of a grid sample means that communities surveyed are roughly the same distance apart.
Spatial sampling was used because the assumption that the results for an indicator would be
similar across the entire survey area (spatial homogeneity) was considered to be an unrealistic
representation of the true situation.
The impact of a cyclone varies dramatically depending on the strength and duration of the storm in a
particular location, whether areas were affected by high winds and/or the storm surge, as well as the
geography of the area exposed to the storm. For the same reason, spatial sampling was used for the
VTA. Spatial heterogeneity is also the reason why summary statistics for the entire survey sample
are not presented, as these are often misleading when there is considerable spatial diversity.
The Periodic Review used a nearly even first-stage spatial sample to select communities and a
8
representative second-stage sample to select households within the selected communities. This
approach differs from population-based approaches that seek to give each person in the survey
area an equal chance of being surveyed and thereby bias the distribution towards towns and more
populated areas. By using a spatial sampling technique and a representative second stage sample,
analysis across geographic areas can be used and presented in maps.
How do I read the maps and histograms?
Each indicator is mapped across the survey area and is presented in a figure that includes a map
and a histogram. The colours on the map represent estimated proportions of households or, in some
cases, individuals meeting the criteria associated with a given indicator which is given in the title of
the map and explained in the associated text. The colours used on these maps are consistent with
red always representing the poorest result and dark green representing the best result. A gradation
of orange, light green and yellow represent values between the extremes of the collected data.
The legend at the bottom right of the map shows the highest and lowest of the indicator ranges.
These are most often 0 and 100 per cent, but the range is restricted for some indicators (e.g. the
incidence of global acute under nutrition).
Each map is accompanied by a histogram which shows the distribution of the estimated proportions
of households or, in some cases, individuals meeting the criterion associated with a given indicator in
each of the sampled communities. Additional graphs are provided for some indicators (e.g. reasons
for non-attendance at school). These graphs present supplementary information that can assist in
interpretation of the data.
What is in the text boxes?
The text boxes contain stories collected from the qualitative interviews with vulnerable households.
They were selected to illustrate how the situation presented using maps and graphs is being
experienced by individuals in the affected communities.
For each extract used, the full text from which it was selected is available in the Qualitative Results
annex. The names of people and places given in this report are fictional and were changed to protect
the anonymity of the interviewees.
1.6 Next steps
Two additional rounds of the Periodic Review are planned. In order to monitor changes in indicator
values over time, future rounds will concentrate on collecting data needed to create the indicators
that proved most useful in the first round of the Periodic Review. Additional work will be required on
further definition of the indicator set.
The qualitative data presented in this report was collected using an epidemiological case-series
approach in which households sampled in the core Periodic Review survey that met pre-defined case-
definitions (e.g. female-headed households with young children) were selected to be revisited for
in-depth interviews. This plug-in approach is general in the sense that it could be used to investigate
a wide range of phenomena and may be repeated in future rounds of the Periodic Review.
9
Section 2:
Findings
This section presents the findings of both the quantitative and qualitative research conducted for
the first round of the Periodic Review. Information from the quantitative survey is presented in the
maps and histograms while extracts from the quantitative research are presented in text boxes.
Supplementary text draws on both qualitative and quantitative information, and is informed by
consultation with the Clusters.
Thawtar Khins story
We want to rebuild our home. The tent we built is not in good shape. The whole family is living
in it and it may collapse. Theres a very big puddle with a bad smel nearby that makes the tent
unliveable. Im looking forward to the day when my children can attend school. Right now food is
our greatest need.
The findings are presented by sector. Taken together, they provide a snapshot of the situation for
communities living in the areas worst affected by Cyclone Nargis. The principal focus of the findings
is a needs assessment. The receipt of relief and steps towards recovery since May 2008 are also
considered to some extent.
It is important to note that many of the challenges facing the Cyclone-affected population are
interlinked and cut across sectors. For example, the loss of boats directly affected the ability of
people who caught fish before the Cyclone to earn a living. However, without boats to travel on
the networks of rivers and canals that link the communities of the Delta, the mobility of the entire
population was reduced. This made it more difficult to reach education and health services or to
trade goods at markets. Similarly, the lack of boats makes delivering aid and assistance more
difficult. Therefore it is recommended that results be considered in an integrated manner, drawing
linkages between sectors.
Where possible, results from the VTA are used to inform the analysis. However, having drawn on the
experience of the VTA to improve the methodology used for the Periodic Review, direct comparisons
are not always possible.
Some indicators, such as those relating to aspects of Figure 5: Quantitative sample size
maternal and child health, have not been collected
Number of Communities 108
for the Periodic Review. This is because a general
household survey may yield very small sample sizes Number of Households 2,376
for indicators that apply to a small proportion of the Household population 13,546
population being surveyed. Such small sample sizes Number of Children 4,862
give rise to very imprecise estimates at the community
< 6 months 170
level that can be very difficult to map. For example,
in 108 communities analysed there were only 170 6 months to 5 years 1,456
children, on average just one or two children per > 5 years to 15 years 3,236
community. Figure 5 shows the sample size from the
quantitative survey.
10
2.1 Health
Three components reflecting the health situation in the Cyclone-affected area are covered in this
chapter: the functioning of the existing health system; disease burden in the community; and
receipt of relief items. In addition, linkages are drawn with nutrition and WASH. The VTA reported
that close to 75 per cent of health facilities in the survey area were damaged. At the same time, an
additional burden of health problems could be expected in the community as a result of the Cyclone,
in particular, gastro-intestinal and mental health problems..1
In a well functioning health sector, people have access to facilities and staff, health services are
available from those facilities and staff, and those services are utilised. The indicators used here
seek to give an overview of these characteristics.
Figure H1: PHC facilities are within 1 hour travel time
Time to nearest PHC is <= 60 minutes

gal
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
For access to health care indicators, high

proportions with good access to health care
is the desired outcome and shown in green
on the Maps.
The percentage of households in surveyed

communities that reported travel times to
Primary Health Care (PHC) facilities being
within one hour ranged from 0 to 100 per
cent.
In more than half of the communities surveyed,

almost all households said that their travel
time was less than one hour (the highest bar in
the histogram and shown in green and yellow
on Figure H1). Communities in the southern
and central parts of the Delta, such as Myaungmya District, and Bogale and Ngapudaw Townships,
reported the lowest access to PHC as measured by travel times (shown in red on Figure H1).
1 TCG (June 2008) Post-Nargis Joint Assessment, pp 7-8.

11
Figure H2: Waiting time at PHC facilities is less than 1 hour

f Ben
gal
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 63%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
When people arrive at PHC facilities, the

waiting times are usually less than one hour.
The percentage of households reporting

waiting times of less than one hour ranges
from 100 per cent to a low of around 60 per
cent in the far south of the Delta and parts of
greater Yangon (shown in red on Figure H2).
In more than 80 per cent of communities,
almost all households reported waiting time
of less than one hour (the highest bar in the
histogram and shown in green and yellow on
Figure H2).
Thawtar Khins story
Currently, Thawtar Khins mother is sick and the family does not have enough money to send her
to a clinic. There is no doctor in the village and the nearest one is very far away, so they cannot
send her.
12
Figure H3: Health workers in the community

f Ben
gal
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
Community Health Care Workers (HCWs) are

particularly important in rural and remote
settings, where accessing health facilities can
be costly in terms of time and transport costs.
These considerations are less important in
urban settings which may explain the
concentration of low values (shown in red on
Figure H3) around Yangon.
The percentage of households reporting the

presence of a HCW in their communities ranged
from 0 to 100 per cent. As seen for previous
indicators, the most common response was in
the 90 to 100 per cent bracket (the highest
bar in the histogram and shown in green and
yellow on Figure H3).
Together, H1, H2 and H3 give a picture of the level of access to health facilities and HCWs. The areas
that have the least access across the three indicators are concentrated in the Delta south of Labutta
and Bogale.
13
Figure H4: Coverage of Measles vaccination

l ga
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 44%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
The coverage of Measles vaccination directly

represents the protection of a population from
Measles, and is also a proxy indicator of
outreach by the health system into
communities and the coverage of other
vaccines.
The range of coverage is from 44 to 100 per

cent. The benefits of herd immunity2 begin at
around 80 per cent coverage (the two tallest
bars of the histogram and shown in green and
yellow on Figure H4). Less than 20 of the
communities surveyed had coverage below
80 per cent, concentrated in Bogale Township
(shown in red on the Map).
2 Herd immunity is the resistance of a group or community to invasion by the spread of an infectious agent. It results from
the lower probability of the agent being transmitted from an infected person to a susceptible person when a high proportion
of people are immunised.
14
Figure H5: Medicine available at PHC facilities all or most of the time
l ga
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
Availability of medicines is a proxy indicator

for the functioning of the health system.
In only one third of communities did all

households report that medicine was
available all or most of the time at Primary
Health Care (PHC) facilities (shown in green
on Figure H5). On the histogram, the
distribution of communities is more spread
out than for previous maps where results
were concentrated on the far right.
There is also a discontinuity between access

to health care and availability of medicine.
The greatest issues with availability occur in
the central part of the Delta north of Bogale
around Mawlamyinegyun (shown in red on Figure H5) where access to health care, as indicated on
Figures H1 and H2, is relatively good.
15
Figure H6: Prevalence of diarrhoea

al g
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 55%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
For indicators of disease prevalence, a low

prevalence is the desired result and is shown
in green on the maps.
The prevalence of diarrhoea in children

reported by 14 day maternal recall (mothers
recollection of the 14 day period preceding the
household survey) shows significant spatial
variation.
The most common results are between 0 to 20

per cent (shown in green and yellow on Figure
H6), with around one in four communities
having a prevalence of diarrhoea in children
of more than 20 per cent. The highest
percentage of households in a community
reporting diarrhoea was up to 55 per cent. Prevalence of more than 40 per cent was found in part
of Ngapudaw Township and Myaungmya District (areas shown in red on Figure H6).
Of particular concern is part of Ngapudaw Township (west of Labutta) where there is also a high
proportion of households with severe food insecurity (see Figure F3). The combination of food
insecurity and diarrhoea predisposes communities to increased rates of undernutrition. The same
area appears to have relatively poor sanitation practices (see W6 and W7) that may also contribute
to the prevalence of diarrhoeal disease.
16
Figure H7: Prevalence of fever

l ga
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 80%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
The distribution of the prevalence of fever by

14 day maternal recall, which is a non-specific
indicator of infectious disease, is clustered
within the high prevalence areas. This
clustering is consistent with infectious
phenomenon.
As reported by maternal recall during the 14

day period preceding the household survey,
the prevalence of fever ranges from 0 to 80
per cent. The highest prevalence is in the
central delta region (shown in red on Figure
H7).
Taken together, the indicators of fever,

diarrhoea (Figure H6) and undernutrition
(Figure N2) suggest a significant infectious disease issue in the central and western areas of the
Delta, mainly in Myaungmya District, and north of Yangon.
17
Figure H8: Received medical assistance since Cyclone Nargis

f Ben
gal
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 68%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
In around one third of communities, at least

one of the households surveyed had received
medical assistance since Cyclone Nargis
(green and yellow on Figure H8). This is a
simple indicator of reach, not the depth of
coverage or of provision being sustained over
time.
The assistance given is geographically

concentrated in the areas along the path of
the Cyclone, particularly around Bogale where
more than half the households had received
medical relief assistance (shown in dark green
on the Map). This includes northern Bogale
Township and parts of Mawlamyinegyun and
Pyapon Townships).
Lower rates of assistance may reflect less need in some cases (particularly in the less affected areas
to the north), less access in others (such as Ngapudaw and Labutta Townships) or also a combination
of the two.
18
2.2 Nutrition
Nutrition reflects both the health status and food availability for a population. Following the Cyclone,
the PONJA reported that peoples diets had become more limited and that the population faced
increased risk of malnutrition.3 Three indicators of nutrition are discussed here: the proportion of
children under six months exclusively breastfeeding; the proportion of children from six months to
five years suffering from global acute under nutrition; and appropriate treatment of diarrhoea.
Figure N1: Global acute under nutrition

gal
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 30%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
The proportion of households where children

aged 6 months to 5 years (or between 65 cms
and 110 cms in height) were suffering global
acute under nutrition was measured by Mid-
Upper Arm Circumference (MUAC) of less
than 125mm or the presence of bilateral
pitting oedema.4
In most communities the proportion of

households where children are undernourished
is less than 10 per cent (the highest bar on the
histogram and shown the green on Figure N1).
However, in some communities the proportion
was over 15 per cent (shown in orange and
red on Figure N1). This is principally in the
periurban areas of greater Yangon and may
reflect a chronic problem rather than being
directly related to the Cyclone.
Of the 170 children under 6 months included in the survey, 86 were exclusively breast fed. This
is estimated at 50.6 per cent (95% C.I. 43.1% - 58.0%), this is higher than expected and is not
mapped due to the small sample size.

4 Bilateral pitting Oedema is an indicator of malnutrition.
19
Thawtar Khins story
When the Cyclone destroyed the food stock in their house, they could not afford to buy food. Since
Thawtar Khin is also breast feeding her two year old daughter, she has lost a lot of weight.
Figure N2: Inappropriate treatment of diarrhoea

al g
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 50%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
Diarrhoea that is treated inappropriately can

result in undernutrition and death. Appropriate
treatment is principally maintaining liquids
and oral rehydration.
The proportion of households using

inappropriate treatment of diarrhoea was low
in two out of three communities (shown in
green and yellow on Figure N2 and represented
by the highest bar on the histogram). In
some communities between Labutta and
Mawlamyinegyun, the rate of inappropriate
treatment rose to over half of the households
surveyed (red on Figure N2). Undernutrition
in this area was around 15 per cent (Figure
N1).
20
2.3 Food
Cyclone Nargis damaged and destroyed food stocks, crops, livestock and equipment. When the VTA
was conducted in early June, 55 per cent of the households reported having food stocks for only one
day or less.5 Half a year later, results of the Periodic Review assessment indicate that food aid had
reached every surveyed community along the path of the Cyclone and indicators of food vulnerability
show a clear impact in the areas where food aid efforts were concentrated.
U Hla Soes story
We find it difficult just to find food each day, how can we repair our house or support our
children?
Food insecurity persists in some areas. In some of the communities that are food secure, this
may be due to the receipt of food aid, rather than a recovery of production or purchasing power
of communities. The problems facing the recovery of food production (including seed quality and
harvest) and purchasing power may take some years to address. Food insecurity around Yangon and
Pathein may be a result of chronic problems, rather than resulting directly from Cyclone Nargis.

21
Figure F1: Proportion of households with poor food consumption

l ga
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 73%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
Areas with poor food consumption are shown

in red, and good results are shown in green.
For the histogram, low scores (bars to the far
left) correspond to the green areas on the
Map.
A high proportion of households within a

community with a poor Food Consumption
Score (FCS) (below a threshold of 42) indicates
food access, availability and consumption
problems.6
In more than half of the communities

surveyed, less than 10 per cent of households
had a poor FCS (shown in green on the Map
and the highest bar on the histogram). The
households with poor consumption were concentrated in Pathein District and across to Myaungmya
Township (the western part of the survey area) and southeast of Yangon (shown in red and orange
on Figure F1).
6 The FCS was based on seven-day recall of the type and frequency of food consumed. The threshold was set at 42 due to
the high intake of oil and fruit in the population.
22
Figure F2: Moderate or Severe food insecurity

l ga
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 68%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
The proportion of households in a community

that are facing moderate or severe food
insecurity ranges from 0 to 68 per cent (from
green to red on Figure F2).
The proportion of households that are food

insecure was highest in the southwest of the
Delta and from Yangon south to Kungyangon
with patches of food insecurity through the
southern part of the Delta. However, the most
severely food insecure households (Figure
F3) were concentrated in the far southwest
of Ngapudaw.
23
Figure F3: Severe food insecurity

l ga
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 50%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
The highest proportion of households in

surveyed communities with severe food
insecurity was 50 per cent in the far southwest
of Ngapudaw (shown in red on Figure F3).
In almost two thirds of the surveyed

communities, a very low proportion of
households were severely food insecure
(areas shown in green and yellow on the Map
and represented by the tallest bar on the
histogram).
Some of the people interviewed for the

qualitative survey expressed anxiety over
food stocks, not knowing whether it was
better to risk having rice taken by other
hungry villagers while they looked for work outside the home, or to stay at home and protect a
dwindling food supply in order to meet the immediate needs of their children.
24
Figure F4: Received food assistance since Cyclone Nargis

f Ben
gal
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
Communities where 90 to 100 per cent of

households had received some form of food
assistance since Cyclone Nargis are shown in
green on Figure F4. All communities along
the path of the Cyclone, with the exception of
an area south of Yangon, had received food
aid.
This is a simple representation of reach

and does not indicate if the assistance was
sufficient or sustained over time. However,
areas that are shown as food secure and
having good food consumption around Bogale
and Pyapon (Figures F1, F2 and F3) are
correlated with areas where food aid is being
provided. Figure F4 also shows the food aid
had reached the southwest where there was a high proportion of food insecure households (shown
in Figure F3).
Some interviewees from the qualitative plug-in identified problems with food relief ranging from
intermittent, irregular, and sporadic distribution of food aid to no food aid being provided. This may
in part be due to the remoteness of many communities in the Delta region. In some instances,
the staged changes in the classification of phases of response from disaster to recovery reduced
available food relief. For example, one woman who was the head of her household, stated that the
reduction of food aid from 8 Pyi (17.0 kgs) to 3 Pyi (6.4 kgs) of rice meant that hunger is now more
of an issue than in the immediate post-Nargis period.
25
2.4 Water supply, Sanitation and Hygiene (WASH)

The quantitative indicators used to assess WASH were taken from the WHO/UNICEF Core Questions
on Drinking-Water and Sanitation.7 Closely linked to health outcomes, the WASH indicators in
this chapter cover: the safety of drinking water; sanitary disposal of human waste; and hygienic
hand washing practices. Sanitation improved since the VTA, but with the end of the monsoon and
beginning of the dry season, there is less rain water available for drinking. Combined with salination
of ponds, there are concerns about possible water shortages.
Figure W1: Use of improved drinking water sources

gal
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
An improved water source is one that

provides safer water. The proportion of
households using improved drinking water
sources ranges from 0 to 100 per cent across
the survey area. This diversity is reflected in
the distribution shown in the histogram.
In the south of the Delta, where rain water

collection tanks are common, there was a
very high proportion of households using
improved water sources (shown in green on
Figure W1). The proportion of households
using improved water sources was very low in
the central north of the survey area, around
Maubin District (red and orange on the Map).
During the rainy season, rain water harvesting provided 30 per cent of the water supply for
communities affected by Cyclone Nargis.8 However, with the beginning of the dry season (November
to April), there was an increased dependence on other water sources including surface water. Figure
W2 shows the drinking water sources for 2,356 households.
7 WHO and UNICEF (2006), Core Questions on Drinking-Water and Sanitation for Household Surveys, WHO Press.
26
Figure W2: Drinking water sources
Bottled water
Cart with tank / drum
Protected spring
Unprotected spring
Other
Piped water supply
Tubewell / borehole
Unprotected well
Protected well
Rainwater collection
Surface water
0 10 20 30 40
Percentage of households
There was extensive salt contamination of water reservoirs from the storm surge as far north and
east as the Yangon area, which may strain water availability across and within communities over the
dry season.
Several qualitative interviews revealed concerns about dwindling water supplies when the monsoon
end. In areas of the Delta that were hardest hit by the Cyclone, interviews revealed patterns of
migration that are placing increased demands on existing reserves of potable water. The cost of
moving and purchasing water is a problem for poorer, more vulnerable households.
Thawtar Khins story
Before the Cyclone, the family got water and sold it to other people. Sometimes they made money
by doing odd jobs. After the Cyclone, no one bought their water anymore and there were no offers
for any odd jobs.
27
Figure W3: Use of an adequate water treatment method

f Ben
gal
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
In areas where use of improved water

sources is not common, the proportion of
households using adequate water treatment
methods was high (shown in green on Figure
W3), particularly through Maubin District.
However, south of Yangon the proportion
of households using either improved water
sources or adequate water treatment was low
(shown is red on Figures W1 and W3).
Multiple methods of water treatment (shown

in Figure W4) are normally used with 2,356
households reporting 5,139 methods. This
means that water is treated using, on average,
two to three methods before drinking.
However, less than 5 per cent of households
used bleach or chlorine tablets.
28
Figure W4: Methods of water treatment
Solar disinfection
Other methods
Add bleach / chlorine
Ceramic / sand filter
Stand and settle
Boil
Strain through cloth
0 5 10 15 20 25 30
Percentage of households (multiple methods allowed)
The most common sanitation method used was a pit latrine, used by over 40 per cent, followed by
no sanitation facility with less than 15 per cent (Figure W5 below). This is an improvement from the
situation in June when 40 per cent of the population was using unsanitary practices.9 1,828 toilet
facilities were reported by 2,354 households with a total survey population of 12,941 people (around
7 people per toilet facility).
Figure W5: Sanitation method
Composting toilet
Flushed elsewhere
Bucket
Other
Flushed to piped sewer
VIP latrine
Flushed to septic tank
Hanging latrine
No facility
Pit latrine
0 10 20 30 40

29
Figure W6: Use of improved sanitation facility

l ga
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
The proportion of households using improved

(safe) sanitation ranges from 0 to 100 per
cent across the survey area. This variation is
also evident in the distribution of the
histogram.
The worst results in the Delta are around

Ngapudaw, Myaungmya, Labutta and Bogale
Townships where less than half of the
households were using improved sanitation
(shown in red and orange on Figure W6). The
areas around Ngapudaw and Labutta also had
a high prevalence of diarrhoea (Figure H6),
which may be due partly to poor sanitation.
There are very good results east of Yangon

(shown in green). Within Yangon Division,
Kungyangon Township had the worst results.
30
Figure W7: Adequate disposal of childrens faeces

l ga
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
Compared to the results for sanitation facilities

(Figure W6), a much higher proportion of
households do not dispose of childrens faeces
in a sanitary way. There are several
communities where less than 10 per cent of
households had sanitary practices for disposal
of childrens faeces (shown in red on Figure
W7).
1,134 households reported disposal of

childrens faeces. The most common methods
of disposal for child faeces were flushing into
a latrine, drain or ditch.
31
Figure W8: Washing hands before food preparation

l ga
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 13%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
The proportion of people who wash their

hands with soap before preparing food is an
indicator for hygiene standards.
The proportion ranges from 13 to 100 per

cent with better hygiene in the east (shown
in green on Figure W8) than in the west
(shown in orange). In around a quarter of the
communities surveyed, almost all households
reported that food preparers wash their hands
with soap (the highest bar in the histogram).
32
Figure W9: Water received

l ga
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
The indicators of receipt of water or hygiene

relief items, shown in the next three figures,
are simple measures of reach, showing only
whether households reported to have or not
to have received assistance.
Areas where a high proportion of households

reported receiving aid are shown in green and
a low proportion in red in Figure W9. The
range is 0 to 100 per cent for the three maps
with 0 to 10 per cent of households report
having received assistance.
Areas, where little or no assistance was

given, may not have been badly affected
by the Cyclone and therefore may not need
assistance.
Across the three indicators of water and hygiene relief, the reach of water assistance is the most
concentrated and the reach of hygiene relief is the most widespread.
33
Figure W10: Water storage and transport equipment received

al g
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
Provision of water storage and transport

equipment such as jerry cans and buckets is
more spread along the south of the Delta than
water assistance. The coverage is across the
area mostly affected by the storm surge as
shown in Figure W10.
34
Figure W11: Soap or hygiene equipment received

f Ben
gal
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
Distribution of soap and hygiene kits had the

widest coverage of the three indicators of
receipt of relief goods.
Figure W11 illustrates that hygiene assistance

reached some of the areas in the far west with
poor hygiene practices (Figure W8) and high
prevalence of diarrhoea (Figure H6).
35
2.5 Shelter
The shelter available for people in the area of the Delta affected by the storm surge remains very
poor. It is estimated that 450,000 housing units were destroyed by Cyclone Nargis and 350,000
more were damaged.10 While shelter assistance is being provided, the breadth and depth of coverage
is significantly less than is required to adequately house the population in need. The shelter that
does exist is in many cases of poor quality and provides limited protection from heat, rain or from
future storms, and is often overcrowded.
Figure S1: Inadequate shelter conditions

al g
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 90%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
This indicator shows the proportion of

households that are living in shelters that are
hotter, wetter or more crowded than before
Cyclone Nargis.
The range is from 0 to 90 per cent. None

of the surveyed communities along the path
of the Cyclone had fully recovered shelters to
pre-Nargis levels of adequacy (shown in red,
orange and yellow on Figure S1).
Thawtar Khins story
..After the wind blew down the house, the [family] did not have enough money to rebuild it. So
instead they built a small tent in which all the members live. Since the tent is small it is quite
crowded.

36
Figure S2: Plastic, tarpaulin or canvas is used in walls or roof

f Ben
gal
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 6
Labutta
Low: 0
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
The proportion of households living in shelters

that are still using plastic, tarpaulin and
canvas in their roofs and walls is highly
concentrated in the area of the storm surge
(shown in red on Figure S2). These shelters
were repaired using temporary or emergency
measures, rather than being rebuilt.
In 45 per cent of communities more than

five per cent of households were living in
makeshift shelters using plastic (yellow
and red on Figure S2). In 7 per cent of the
surveyed communities more than half of the
households were living under plastic.
Communities with a high proportion

of households using plastic in construction often lack the materials to rebuild with. Traditional
sources of building materials were damaged or destroyed by the Cyclone. This includes the loss
of trees and bamboo, as well as destruction of leaves used for thatching. Over-harvesting of local
construction materials has occurred since the Cyclone and has implications for the sustainability of
these resources.
37
Figure S3: Preparedness for storms and flooding

f Ben
gal
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 6
Labutta
Low: 0
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
The proportion of households in communities

that are prepared for future flooding and
storms is poorest in low-lying geographic
areas around the southern part of the Delta
between Labutta and Bogale Townships
(shown in orange and red on Figure S3).
Preparedness was measured by a score

of between 0 (no preparation) to 6 (well
prepared) given to shelters. The score takes
into account: whether a shelter is raised above
ground; presence of wind breaks (trees); short
side of shelters facing windward; appropriate
roofing; and a safe haven (a building that
could protect from a Cyclone) existing within
half a mile (0.8 kilometres). Not a single
dwelling scored 6 out of 6 and the average
was below 3 out of 6.
Daw Myint Theins story
The[family] hut is built of bambo and they use palm leaves for the roof. The height is too low for a
grown person to stand up in and the hut is near foul-smelling mud and polluted water...Daw Myint
Theins husband died two years before the Cyclone, when her family lived in a house her husband
had built made of wood and bamboo. During the Cyclone, the whole house was washed away and
they had to run for their lives and take shelter at a monastery. The place where they had lived
their lives full of pride and joy had turned into a devastated hovel overnight.
The destruction of natural resources such as mangroves and palm trees also has major implications
for future disaster preparedness. The damage to mangroves, both pre-Nargis and as a result of the
Cyclone, means the loss of an effective buffer against storm surges, whilst the loss of wind-breaks
due to the damage to shelter trees increases the vulnerability of dwellings to future storms.
38
Daw Thet Thet Swes story
Even though they are supported with some materials to build their house again, they could not
complete the house as they could not afford it. Because her husband is a farm labourer, her family
could borrow money from the land owner with high interest, but they still could not afford the cost
of rebuilding the house.
Figure S4: Received emergency shelter, construction materials or tools

al g
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
The proportion of households in communities

that reported receiving emergency shelter,
construction materials or construction tools
ranges from 0 to 100 per cent. Most of the
assistance provided was emergency shelter
materials such as plastic and tarpaulins,
rather than materials for reconstruction.
Households in some of the areas of inadequate

shelter such as Bogale Township and southern
Yangon Division (Figure S1) reported having
received some shelter assistance, indicating a
targeted response (green and yellow on Figure
S4). However, the geographic coverage across
the Delta and depth of coverage within the
communities that are being reached remains
inadequate. This is demonstrated by Figures S1 and S2 which show that households are still living
in inadequate housing, so they were unable by themselves or with community or donor support, to
rebuild to pre-Nargis standards.
There is a concentration of emergency shelter and construction materials provided between the
three population centres of Mawlamyinegyun, Pyapon and Bogale. Delivery beyond this triangle,
particularly to the west, appears to be limited.
39
U Hla Soes story
U Hla Soe and his family lost their home in a Township in Yangon Division during the Cyclone.
They could not afford to rebuild in the same place and so moved in to share with relatives in his
grandmothers house in the same Township. Now nine family members have to survive together
in this tiny hut.
40
2.6 Education
The basic education systems in the surveyed area appear to have recovered well considering that
the VTA reported that more than 60 per cent of schools in the area were damaged or destroyed by
Cyclone Nargis.11
School attendance is presented by age group, children aged 5 to 10 years and children aged 11 to
15 years.
Figure E1: Proportion of Children aged 5 to 10 years attending school

gal
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 33%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
The proportion of children aged 5 to 10 years

attending school ranges from 100 per cent in
many communities (shown in green on Figure
E1) to a low of 35 per cent (shown in red).
From the histogram we can see that in around
half of the communities surveyed, between
90 and 100 per cent of primary school aged
children attend school. However, there is
considerable regional variation.
Of particular concern are the areas around

Labutta and Yangon. The results around
Yangon are from the periurban areas of
greater Yangon.

41
Who will feed us? They feed only my husband, so I have to stay here with my five children,
pointing to her eldest son of 18, another of 15, two daughters of 13 and 8, and the youngest son
of 4. She also added, Just to feed them every day is so difficult, how can we send them to school?
Before the Cyclone, we could still send two of them to school. After the Cyclone, we had to drop
the middle daughter out of school and made her help me make and sell food. Now we only have
one child attending school.
Figure E2: Reasons for non-attendance at school (ages 5 to 10)
Child looks after others in household Female

Parents uninterested Male
Child required for work

No school
Child uninterested
Child sick / disabled
School too far away
Other reasons
Costs associated with education
30 20 10 0 10 20 30
Percentage of children
The most common reason given for non-attendance at school for children 5 to 10 years, with a
sample size of 174 children (Figure E2), is the cost associated with sending a child to school.
Distance to school is a more common barrier for girls than for boys. Usual costs associated with
education include uniforms, books and stationery as well as community contributions to the upkeep
and improvement of school facilities.
Daw Kyi Ohns story
For the family to survive, Daw Kyi Ohns son had to drop out of the 6th grade and work on a duck
farm, where he gets 700 kyat per day. Since she does not have any money to buy vegetables to
sell, she has to find odd jobs or daily work. She told us that finding this type of work is difficult
and so she has to rely on her sons salary to survive. She cannot continue sending her daughter to
school, who was attending the 5th grade.
42
Figure E3: Proportion of Children aged 11 to 15 years attending school

gal
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 11%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
The proportion of children attending school is

lower for 11 to 15 year olds and the lowest
value reported was just 11 per cent. The
proportion of older children attending school
is between 40 and 80 per cent for most
communities (the 4 highest bars on the
histogram).
This is principally due to children leaving

education to work in both domestic and
income generating jobs.
The geographic distribution of the areas of

lowest attendance is similar for primary school
education (red and orange on E1 and E3).
Low rates of school attendance at younger
ages leave a smaller cohort of children able
to progress through the school system. There are also considerably fewer secondary schools than
primary schools.
These results do not represent whether children are in age-appropriate levels of education (e.g. a
child aged 12 years attending the first year of education where students are typically 5 to 6 years
old). This information is presented below.
Thawtar Khins story
Thawtar Khins 16 year-old brother helps the family by selling water around the community. Her
11 year-old sister just stays at home and helps her with the housework since they do not have
money to send her to school. She said that when her sister grows up, she wil ask her to get a job
to support the family
43
For older children (11 to 15 years), the cost of schooling remains the most common reason for
non-attendance with a sample size of 430 children (Figure E4). However, needing to work is the
second most important barrier for boys. For girls, needing to work or to be a carer for others in the
household are almost equally common.
Figure E4: Reasons for non-attendance at school (ages 11 to 15)
Parents uninterested Female

No school Male
School too far away

Child sick / disabled
Other reasons
Child looks after others in household
Child uninterested
Child required for work
Costs associated with education
40 20 0 20 40
Percentage of children
The percentage of children attending classes that are not appropriate for their age increases with
age. Over the survey area around 46 per cent of children are in classes that are not age-appropriate
and around 25 per cent are in classes that are more than 1 year different from what is appropriate for
their age. A total of 204 children aged 11 to 16 attended classes 1 to 4 at the time of the survey.
44
Figure E5: Proportion of households with Parental involvement in PTAs

al g
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 80%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
Formal schools in Myanmar have Parent

Teacher Associations (PTA). These PTAs were
mobilised to assist with school rebuilding and
education recovery. Results from the
assessment supported the fact that all schools
have a PTA.
The proportion of households with parental

involvement in PTAs ranges from 0 to 80 per
cent (shown in red to green on Figure E5).
For most communities, participation was less
than 20 per cent (the two tallest bars on the
histogram). It is lowest in the central west of
the Delta around Labutta.
45
Figure E6: Received education assistance

gal
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
The proportion of households with children in

surveyed communities that reported receiving
education assistance since Cyclone Nargis
ranges from 0 to 100 per cent. Assistance
was focused in the southern part of the Delta
(shown in green and yellow on Figure E6).
Coverage by donors has concentrated

efforts on the Townships most affected by
the Cyclone, rather than areas with chronic
problems. The Townships where assistance
was directed in Ayeyarwady Division are:
Bogale; Dedaye, Pyapon; Kyaiklat; Labutta;
Mawlamyinegyun and Ngapudaw Townships.
In Yangon Division, support was focused on
Kawhmu, Kungyangon, Twantay, and the
periurban areas of Shwepyithar and Hlaingtharya.
46
2.7 Livelihoods
Changes in the patterns of economic activity and livelihood have occurred as a result of Cyclone
Nargis. The sheer number of people killed has dramatically reduced the labour force. The storm
surge salinated, washed away or flooded large tracts of land. Animals, crops, trees and the equipment
needed for fishing and farming were lost. Without the capacity to produce their own food or income,
communities will remain aid-dependent.
Figure L1: Livelihoods before and after Cyclone Nargis
Bar girl / massage / &c.

Forestry
Before
Rent / lease of property
Salt production
After
Microfinance
Savings
Borrowing with collateral
Sale of assets
Charcoal
Remittance
Gifts / family
Borrowing without collateral
Pawning of assets
Aquaculture
Private sector employee
Gang labour
Government employee
Selfemployed / craftsman / artisan
Trader / shopkeeper / broker
Other
Seasonal labour
Fishing
Agriculture
Casual labour
0 5 10 15 20 25
Figure L1 shows principal livelihoods or income generating activities. Livelihoods in the surveyed
area are very diverse with most households reporting multiple sources of income (up to three could
be included). A total of 3674 sources of income were reported before, and 3584 after the Cyclone.12
These results are summarised in Figure L2.
12 In figures L1, L2 and L3, the results for other appear quite high despite the range of options available.
47
Figure L2: Principal livelihoods before and after Cyclone Nargis (grouped)
Debt (including sales of assets)

Before
Trade After
Other
Agriculture, fisheries, and forestry
Labour (all employment)
0 10 20 30 40
Since the Cyclone, there has been a shift away from fishing and agriculture and an increase in
casual labour. By comparison with the VTA, the shift to casual labour appears smaller now than
immediately after the Cyclone.13 This may indicate a return to previous livelihoods, but this is a
simple measure of what people do, and does not show how productive these activities are. For
example, a person who previously earned most of their income from fishing may have been able to
return to this profession, but if they have lost their boat, they may have to engage in less profitable
forms of fishing. Therefore, they may be spending the same amount of time doing an activity, but
it may not be as productive or profitable as prior to the Cyclone. Also, if people migrated out of the
Cyclone-affected area to seek work, that result is not captured in this household survey.
Daw Myint Theins story
From the Cyclone, the familys living conditions are not the only thing that changed - their health
and income were affected as well. When the Cyclone washed their home away, it also carried away
everything they owned, including the money which Daw Myint Thein invested to sell vegetables.
Once a very proud widow, now she has nothing left to invest and therefore her eldest son has to do
heavy work at the ricemill carrying ricebags and other heavy items. He got injured with his spinal
column getting compressed from this heavy labour. Her younger son, who is just 17, has therefore
had to quit school and do the same kind of work as his brother for the family to survive.
Figure L3: Principal activities before and after Cyclone Nargis (grouped)

48
Trade, selfemployed, skilled worker

Before
None
After
Other
Household / care for household members
Agriculture and fishing
Labouring including domestic labour
0 5 10 15 20 25 30
Percentage of persons
Figure L3 shows the principle activities carried out by people before and after the Cyclone. They
include non-income generating domestic work, more commonly done by women.
Daw Mya Seins story
After the Cyclone, people who owned ricefields were left with no money to invest and no seeds
to plant. Since the landowners do not have money to start planting, casual workers also became
jobless. They do not have any money to start other kinds of work. A lot of boats were also
destroyed. Homes that were not destroyed were only rebuilt for temporary use. Since agricultural
workers cannot get back on their feet, they cannot rebuild their homes.
Livelihoods within communities are interlinked and interdependent, reflecting complex social and
economic structures. Casual and agricultural labourers are dependant on the recovery of the
landowners for the restoration of their livelihoods. Where losses of assets and land were high,
interactions between these groups may change. Where large numbers of lives were lost, the social
structures themselves may also have changed. Not only has the labour force been reduced, but the
uneven death toll radically altered the gender balance in some areas, as many more women and
children died than men.14 Employment, trade and money-lending practices that were built on long
standing relationships between individuals and families were disrupted.
Daw Kyi Ohns story
In addition to the loss of her son, Daw Kyi Ohns hut was almost destroyed from the strong wind
and water. After the Cyclone, she only lives in a small hut. In the disaster, she also lost her savings
and belongings. Accordingly, she cannot sell vegetables like before [because she has no money to
buy them with].
2.7.1 Credit
One of the consequences of disrupted social structures is an impact on interlinked access to
employment and credit. Traditional patron/client relations, especially between farmers and day
labourers have been impacted by Cyclone Nargis. Forms of patronage and lending that function
viably under stable social conditions may become more problematic when compounded by other
factors that increase vulnerability. Day labourers reported taking high interest loans to rebuild their
damaged or destroyed homes. Interviewees from the qualitative plug-in reported interest rates up
to 60 per cent.

49
In order to plan their lives after the Cyclone, the family borrowed money from a farm-owner at
high interest, about 60 per cent. They have to pay 60,000 kyat in interest when they borrow
100,000. Her husbands yearly wage is 50 baskets of paddy, which is equivalent to 200,000 kyat.
Now they have to spend the high-interest loan and they will never be able to get out of the circle
of debt - they are always in heavy debt. At the same time, her husband cannot give up being a
day-labourer since he has better job security as a farm worker, and it is easier to borrow money
or get wages in advance. Thus people in the village prefer to be farm labourers rather than casual
labourers. Job scarcity for casual labourers has caused a lot of stress.
Different types of employment allow different access to credit. Labourers who have more secure,
but often lower-paying, positions are better able to access credit from landowners or others with
available capital. Women may also have poorer access to credit than men. From the results of the
qualitative plug-in, some people with very restricted incomes were unable to secure a loan for cash
and have accepted shelters built in exchange for a years labour.
Daw Mya Seins story
The[family] planted 20 acres of paddy before the Cyclone. They were not in debt because their
income matched their expenses, but now they can no longer plant or work on their farm... In Daw
Mya Seins village, the Cyclone destroyed most of the houses, including hers. The crops were also
ruined because they had not been harvested. The family cannot afford to plant paddy for the rainy-
season crop. All the households in the village are in trouble now.
The social structures surrounding access to credit and forms of debt are examined in greater depth
in other publications including the SIM.
2.7.2 Agriculture
The maps for the Agriculture, Livestock and Fisheries sub-chapters show the proportion of households
that suffered a loss since Cyclone Nargis and six months later have not recovered or replaced what
was lost. Households may have a portion of their previous holdings or none at all. Communities
where no surveyed households had holdings of the type being examined prior to the Cyclone, or
where there was no loss, are not reported on for that indicator. So only communities that had some
holdings and suffered a loss have been reported on.
Areas shown in red on the maps represent communities where a high proportion of households have
lost and not yet recovered their pre-Nargis holdings. The depth of loss and reasons for loss are also
discussed. For all indicators, the reasons are almost exclusively due to the Cyclone.
50
Figure A1: Paddy lost and not yet recovered

al g
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
The Ayeyarwady River Delta is the rice bowl

of Myanmar and paddy is traditionally an
important source of income for farmers and
agricultural labourers. The proportion of
households with reduced areas for cultivation
of monsoon or summer paddy is highest in
the area affected by the storm surge (shown
in red and orange on Figure A1). This includes
Bogale, Labutta, Pyapon and Mawiamyinegyun
Townships.
A total of 215 surveyed households had

owned rice paddy prior to the Cyclone. Of
the households that lost paddy, the median
productive paddy holding prior to the Cyclone
was 10 acres and six months after the Cyclone
the median holding was 3 acres. The median post-Nargis holding for this group was 33 per cent of
pre-Nargis holdings (95% C.I. 25% - 43%). A total of 26 per cent of households surveyed had lost
all of their pre-Nargis holdings.
The median, rather than the mean, of loss is reported here as, prior to the Cyclone, a few people
owned large areas of paddy and many people owned small areas. This distribution would cause the
results of the mean to be more reflective of the large land owners than of the more numerous small
holders. A similar approach is used throughout this chapter.
51
Figure A2: Reasons for loss of paddy
Other reason
Other Damage or loss
Lack of tools
Lack or fertiliser / pesticides
Lack of seeds
Shortage of labour
Damage to drainage
Salt spoilage
0 5 10 15 20
As shown in Figure A2, the three most common reasons given for loss of paddy area for cultivation
are salt spoilage, due to the storm surge, damage to drainage and shortage of labour. These are
problems that may take several years to recover from.
In vulnerable households interviewed for the qualitative plug-in, people from previously plentiful rice-
growing regions expressed their concern over the effects of crop failure. Villagers with unproductive
garden plots also expressed concern over the effects of salt contamination.
In front of the house is a big field where seedless and failed riceplants look like they are trying to
survive under a very hot sun. Daw Thet Thet Swe said, We do not know why the riceplants are like
that, this is the first time we have seen that. We think it is from the Cyclone.
52
Figure A3: Tree crops (perennial) lost and not yet recovered
f Ben
gal
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
Lost perennial crops, including orchards,

palms, fruit and nut trees, are concentrated
in the inland areas of the central delta, such
as Mawlamyinegyun, Wakema and Maubin
Townships, and southwest of the Delta in
parts of Ngapudaw and Labutta Townships
(shown in red on Figure A3).
Less than half of the communities surveyed

had perennial crops prior to the Cyclone,
a total of 51 households, as they are not
common in the low-lying delta area. Many
of these crops may take several years to re-
establish before producing fruit or nuts.
The slow recovery expected for these crops is

reflected in the depth of loss, which is greater
than for paddy. For households that suffered a loss, prior to Cyclone Nargis the median landholding
for perennials was 5 acres. The median holding at the time of the survey was 0 acres (95% C.I. 0
0). More than three quarters of households that suffered a loss, lost all their perennial crops and
replaced none of them.
The most common reason given for the loss of tree crops is that the trees were damaged or destroyed
in the Cyclone (Figure A4).
53
Figure A4: Reasons for loss of tree crops (perennial)
Lack of seeds
Lack or fertiliser / pesticides
Lack of tools
Damage to drainage
Salt spoilage
Other reason
Shortage of labour
Damaged or destroyed
0 10 20 30 40 50 60
Damaged or destroyed means that productive trees and bushes were blown down or washed
away.
U Toe Kyis story
He owns one acre of fruit garden where he grows betel and fruit. Due to the Cyclone, his garden
was destroyed and he needs money to replant. Therefore, he is facing difficulties with his familys
survival.
54
Figure A5: Home garden lost and not yet recovered

f Ben
gal
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
In around one third of the communities

surveyed, at least one household had a
smaller area of home garden than before
Cyclone Nargis. These communities are
spread across the south of the survey area
(shown in red, orange and yellow on Figure
A5).
Home gardens provide supplementary food

and income. They are less common in
some parts of the Delta where the soil is not
suitable. 397 households had home gardens
prior to the Cyclone.
For households that lost a home garden, the

median pre-Cyclone holding was 400 square
feet and post-Cyclone it was 0 square feet (95% C.I. 0 - 0). More than two thirds of households lost
all of their home garden.
55
Figure A6: Received agricultural inputs

al g
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
Receipt of agricultural assistance, including

seeds, fertiliser and equipment, is limited with
only around 10 per cent of communities
receiving any assistance (shown in green and
yellow on Figure A6). The assistance that
was received is concentrated in the south east
of the Delta, from the western part of South
Yangon District through some of Maubin
District and most of Pyapon District.
Some interviewees reported that rice seeds

provided as part of the relief effort were of
mixed varieties with varying growth rates
that rendered traditional harvesting methods
impossible.
56
2.7.3 Livestock
Livestock play diverse roles in households affected by the Cyclone. Poultry (chickens and ducks)
are kept mainly for eggs, and cockerels are killed and sold, diversifying peoples diets and providing
income. Pigs are raised and sold for occasions such as weddings and festivals and are particularly
important for the landless. Buffalos and cattle are draft animals used to plough fields. The Figures
in this sub-chapter are constructed in the same way as Figures A1, A3 and A5, reporting a loss of
livestock since the Cyclone that is yet to be replaced
.
Figure LS1: Poultry lost and not yet replaced
al g
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
Prior to Cyclone Nargis, holdings of chickens

and ducks were widespread with 1,166
households owning poultry. Losses of these
poultry holdings occurred in almost every
community surveyed. In almost one-third
of the communities, every household had
suffered a loss (shown in red on Figures LS1
and the highest bar on the histogram).
The distribution of households that lost

chickens and waterfowl and failed to recover
those losses follows very closely the path of
the Cyclone.
For households that suffered a loss, the

median pre-Cyclone holding of poultry was 20
birds. At the time of the survey the median
holding was 1 bird (95% C.I. 1 - 2). This is a 90 per cent reduction on average. 43 per cent of
households that previously had poultry now have none.
57
Figure LS2: Reasons for loss of poultry
Other
Eaten
Sold
Lost
Died
0 20 40 60 80
The principle reason given for loss of poultry was that they died in the Cyclone (Figure LS2).
The most common reason for loss of pigs was also that they had died in the Cyclone (Figure LS3).
However, around 20 per cent were sold. Some pigs may have been sold to raise cash to pay for food,
shelter or other needs created by the disaster.
Figure LS3: Reason for loss of pigs
Eaten
Other
Lost
Sold
Died
0 10 20 30 40 50 60
58
Figure LS4: Pigs lost and not yet replaced

gal
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
Meat is a luxury in the Delta and pigs are

typically raised for sale. They are particularly
important to the landless, but also add value
to other farming activities. Prior to the
Cyclone, 449 households owned pigs.
Pig loss was more concentrated in the area of

the storm surge (shown in red on Figure LS4)
than poultry loss (Figure LS1). This includes
Bogale, Labutta, Pyapon and Mawiamyinegyun
Townships.
For households that suffered a loss, prior to

the Cyclone, the median holding of pigs was
2 and this fell to 0 (95% CI= 0 - 0). In total,
68 per cent of households that had pigs prior
to the Cyclone did not own pigs at the time of the survey.
59
Figure LS5: Buffalo and cattle lost and not yet replaced
f Ben
gal
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
The loss of buffalo and cattle is a significant

problem for the recovery of the agricultural
sector as they are draft animals used to pull
ploughs. Prior to the Cyclone, 132 households
owned at least one draft animal. There is a
correlation between the loss of paddy (Figure
A1) and the loss of buffalo and cattle (shown
in red on Figure LS5).
In around 20 communities, every household

that had buffalo or cattle has lost those
animals and they have not yet been replaced
(the second highest bar on the histogram).
For households that suffered a loss, the

median holding prior to the Cyclone was 4
draft animals, at the time of the survey it was 1 draft animal (95% C.I. 0 to 1). There was an
average loss of 75 per cent of draft animals with 44 per cent of households that previously owned
buffalo or cattle now owning no draft animals.
60
Figure LS6: Reasons for loss of buffalo and cattle
Eaten
Other
Lost
Sold
Died
0 20 40 60 80
The most common reason for the loss of water buffalo and cattle was that they died in the Cyclone.
Around 10 per cent were sold.
2.7.4 Fisheries
The people of the Delta and rivers traditionally engage in a diverse range of fisheries activities from
deep sea fishing to aquaculture in ponds. The maps in this section are constructed in the same way
as maps in the two previous sub-chapters, reporting a loss of boats and fishing equipment as a result
of the Cyclone that is yet to be replaced.
61
Figure FI1: Boats lost and not yet replaced

f Ben
gal
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
This indicator covers the loss of any type of

boat. Boats are used in fisheries, but also for
transportation around the Delta and along
rivers.
In 13 communities, every household that had

a boat has lost that boat and it has not been
replaced (shown in red on Figure FI1 and the
second highest bar on the histogram).
258 households owned at least one boat prior

to the Cyclone, very few households owned
more than one. After the Cyclone, more than
three quarters of households lost that boat
and have not yet been able to replace it.
62
Figure FI2: Reasons for loss of boats
Sold
Other
Damaged
Lost / destroyed
0 20 40 60 80
Figures FI2 and FI3 show almost identical reasons for the loss of boats and fishing nets with more
than 80 per cent destroyed by Cyclone Nargis and the next most common reason being that they
were damaged.
Figure FI3: Reasons for loss of fishing nets
Sold
Other
Damaged
Destroyed
0 20 40 60 80
63
Figure FI4: Fishing nets lost and not yet replaced

l ga
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
The loss of fishing nets is indicative of losses

of other fishing equipment such as traps, lines
and bamboo fences.
The proportion of communities where

households lost fishing nets (Figure FI4) that
are yet to be replaced is more concentrated
in the Delta than for boats (Figure FI1). The
distribution of the histogram was very close
to the histogram associated with Figure FI1.
Prior to the Cyclone, 280 households had

nets. The median pre-Cyclone net ownership
was 2 nets and at the time of the survey it
was 0 nets (95% CI= 0 - 0). 73 per cent of
households that had fishing nets prior to the
Cyclone no longer have any.
64
2.8 Cross-cutting issues
There are a number of issues that play a role across all sectors. These include vulnerability, post-
traumatic stress, wealth, receipt of aid, gender and environment. By focusing on each of these,
the needs assessed by sector in the proceeding chapters can be understood in a more nuanced and
systemic way. Issues relating to gender and environment have been integrated into the chapters.
2.8.1 Vulnerability and protection
Natural disasters stretch, disrupt, and often destroy social networks as much as they destroy lives
and property. The people that are at greatest risk are the vulnerable populations living at the edges
of fragile and often tenuous networks of social security. Using the qualitative plug-in, a particular
focus was given to vulnerable groups in the community described in Figure V1 below.
Figure V1: Estimates of the proportion of households in each category of vulnerability
Main carer is a grandparent
Adolescent girl unrelated to head of household
Main carer is male
Main carer is less than 18 years old
Malnourished child
Members of different preNargis households
Female headed with young children
Reduced utilisation of land
Schoolage child not attending school
Children living in substandard accommodation
0 10 20 30 40
According to the data collected in the household assessment, the most common type of pre-defined
vulnerable case found was children living in sub-standard accommodation (defined primarily as
overcrowding), followed by school-age children not attending school. Approximately 15 per cent of
households are female headed with young children and 10 per cent of the households had members
of different households in the one dwelling. Children whose main carer was either a grandparent,
male or under-18 years old accounted for around 8 per cent. These case-definitions are not mutually
exclusive and many households meeting multiple categories of vulnerability were found.
65
Due to the heightened risk faced by these vulnerable groups, the qualitative plug-in was conducted
to allow in-depth investigation into their needs and concerns. Households were selected as being
vulnerable and interviewed according to the set of ten criteria in Figure V1.
Although at the time of writing this report it was only possible to present preliminary findings for
the qualitative data, the qualitative plug-in clearly highlights significant immediate needs and also
identifies new problems that are knock-on effects of Cyclone Nargis. These include: fear of food
and water shortages; effects of problematic post-Nargis labour practices; outcomes of uneven aid
distribution; changes in aid availability; collapse of local systems of cooperation; and results of
differentiated intervention policies. These are the conditions of post-disaster recovery, but could
also be the early warning signals of potential future problems. Discussion of most of these issues is
integrated in the previous chapters.
After Cyclone Nargis, 23 per cent of households reported psychosocial distress within their household.15
The psychological trauma of the Cyclone itself and subsequent disruption of peoples lives, livelihoods
and social structures is ongoing and it is changing people and their communities.
U Khin Moes (a village leader) story
U Khin Moe was heartbroken when he saw that the electric poles [that he had installed through a
village project] had fallen down. He got really worried about what the community would think of
him, and what peope who had borrowed money to contribute to the project, would say. It was too
much for him when he saw that his paddy fields were destroyed. He could not sleep or eat. He was
found walking in the village at night talking gibberish to himself.
Fieldworkers for the qualitative plug-in observed two major indicators of psychological stress. Firstly,
interviewees regularly cried when answering even simple questions about their experiences. Although
the survey tool is specifically designed to avoid direct questions about trauma, such evidence is often
wilfully offered without solicitation. Secondly, fieldworkers reported inappropriate laughter, a well-
known marker for post-traumatic stress.
U Toe Kyis story
U Toe Kyi and his wife were saddened by the loss of their son and his family, and they give everything
they can to support their grandson. They even sent him to school to receive a proper education.
They try to make him happy - they buy him toys and take him to festivals. But sometimes they can
see him sitting quietly lost in his thoughts, thinking about his family.

66
2.8.2 Wealth
The wealth of households and communities impacts on their ability to fund their own recovery.
However, for many households, the wealth and income earning capacity that they held prior to
Cyclone Nargis was lost or damaged in the disaster.
The wealth index (Figure WE1) displayed here shows the relative wealth distribution across the
survey area. It was calculated using the Principal Components Analysis (PCA) method and looking
at: household ownership of durable goods; cost of schooling as a barrier to education; presence of
malnutrition; food insecurity; and consumption of luxury foods, such as meat.
Figure WE1: Wealth index

al g
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale Wealthy
Labutta
Poor
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
The results in Figure WE1 are a relative measure within the surveyed area and are not comparable
with other measures of wealth within or across countries.
67
2.8.3 Receipt of aid
Figure R1: Local organisations working in communities

gal
f Ben
PATHEIN
Bay o
YANGON
Mawlamyinegyun
Pyapon Legend
Bogale High: 100%
Labutta
Low: 0%
Gulf of Mottama

(Gulf of Martaban)
0 5 10 20
Kilometers
In nearly every community surveyed, at least

one household was aware of a local
organisation working in their community. In
around a third of communities, every
household surveyed was aware of a local
organisation (shown in green on Figure R1
and the highest bar on the histogram).
There is a discontinuity between the area

worst affected by the Cyclone, which is the
southern part of the Delta where the storm
surge struck, and the area where local
organisations are most active, which is closer
to Yangon.
Thawtar Khins story
After waiting three months, the family got some assistance from an INGO. They received a bag
of rice, a water tank, some mats, mosquito nets and some kitchenware. Thawtar Khin was very
happy that these items helped her with her familys needs. They lost their mosquito nets in the
Cyclone and so were quite happy to get new ones. Although this help did not cover all their needs,
the family was stil hapy to get it just when they needed it the most.
The types of aid needed are diverse, reflecting the diversity of the livelihoods and interdependence
of economic and social structures. In several of the qualitative interviews, people expressed a wish
for start up capital in order to re-establish their small businesses. Sources of assistance have also
been diverse, beginning with the communities themselves.
68
Daw Myint Theins story.
The family stated that the house they are living in was built with the generous help of their
village....she hopes for the day when she can get a small amount of money to reinvest to get back
on her feet.
Daw Thet Thet Swes story.
The family received aid from two INGOs and two local NGOs, who provided some support to the
family. They received tarpaulins from a local NGO, a kit of items for everyday use such as soap,
tooth paste, kitchen utensils from one INGO, and a sack of rice from another INGO. This assistance
was adequate, and they did not need to worry about their basic survival. Some of the aid was in
the form of durable goods for use over the long-term, while others, like food and rice, covered only
a certain period of time.
The complexity of relief and aid programs can have unintended consequences that exclude needy
people who do not meet the specific criteria to receive various types of assistance. People who lost
their documentation are more vulnerable than those who possess this information, as claims to
various rights and services are predicated on national registration.
Daw Mya Seins story
The family received farm assistance because they owned their own farm, though they were not
eligible to receive food aid. They rely on other people to share their food with them.
2.9 Conclusions
Looking at the findings across all sectors, and taking into account the cross-cutting issues, there are
a number of conclusions that can be drawn. While this report does not seek to evaluate in detail
the success of the assistance provided or to make policy recommendations, this chapter outlines a
number of key characteristics of the data collected and analysed for the first round of the Periodic
Review.
First priorities
A number of issues are identified in this report that need to be addressed as a high priority.
The need for food aid will continue for some time due to the extent of losses in food production
and productivity, as well as reduced purchasing power in the affected area.
The interaction of the high prevalence of diarrhoea, severe food insecurity and poor sanitation
practices in the south west of the survey area.
The high prevalence of fever and lack of medicines available in the central delta.
Poor food security in the far west, where little or no food aid has been received.
The concerns about water shortages through the dry season.
The use of unimproved water sources and inadequate water treatment south of Yangon.
The high proportion of people who are living in inadequate temporary shelters, particularly
in the southern delta.
Increasing indebtedness, to be repaid in both cash and labour. Interest rates for loans are
extremely high making repayment of debt difficult.
The need for much greater support for recovery of livelihoods in order for Cyclone-affected
populations to regain the level of self-sufficiency that they had prior to Cyclone Nargis.
The recovery of the Delta has wider significance, as it is a very important food-producing
region for Myanmar.
69
In addition to these specific priorities, three overarching conclusions can be drawn from the findings
of the first round of the Periodic Review.
1) Needs are diverse
The needs of the people and communities that were affected by Cyclone Nargis are diverse. They
vary according to the nature and extent of the damage caused by the Cyclone in different areas.
In particular, the needs of communities in the areas affected by the storm surge are often greater
than the needs of other communities. In the areas where the storm surge hit, peoples lives were
literally washed away.
There is also a diversity of needs within communities. Vulnerable members of societies are those who
are the least protected. Food and water shortages will affect these people first. However, they exist
within a social fabric and in order to sustainably assist vulnerable groups, systemic rehabilitation of
entire communities is needed.
The diversity of needs between and within communities means that ongoing relief as well as recovery
assistance is required. Some people remain dependant on emergency assistance to meet daily needs,
and continued targeted relief through vertical programming is vital. There are also groups, whose
needs are less immediate that require opportunities to re-establish and secure their livelihoods. This
requires more horizontal programming approaches to address the needs of interdependent social
and economic structures.
2) Depth and coverage of assistance is required
Some assessment of assistance provided was made in most sectors and two principal characteristics
are apparent. Firstly, it is evident that while assistance was successfully targeted to the most
affected areas in the Delta, there are considerable geographic variations. Assistance is not reaching
the western Delta, including Labutta and Ngapudaw Townships, as effectively as it is reaching the
eastern Delta. In addition, the level of need evident in some of the larger towns and periurban areas
is not matched by relief and recovery assistance received, for example in parts of Yangon Division
and Pathein Township. These may reflect chronic needs, rather than a result of Cyclone Nargis.
Secondly, the persistence of need even in areas that received substantial assistance, such as Pyapon
District, means that the depth of assistance is not yet sufficient. This is primarily a reflection of the
extent of the devastation caused by the Cyclone.
3) Need for more integrated programming
In order to address the complex, interdependent issues facing the communities affected by the
Cyclone, greater coordination and horizontal integration of programming may be required. Relief
assistance will continue to be needed even as recovery efforts are increased. However, the need for
relief will only end when communities are assisted holistically and the diversity of needs is addressed
in ways that work with existing social and economic structures to achieve sustainable recovery.
70
Summary
Ongoing relief as well as recovery assistance is required because:
some people remain dependent on emergency assistance to meet their daily needs;
while
for others what is required is an opportunity to re-establish and secure their

livelihoods.
Many of the issues facing the Cyclone-affected communities are interlinked and cut across
sectors.
It is not possible to attribute all of the results presented in this report directly or exclusively
to the Cyclone, or to subsequent relief efforts.
Some of the results suggest pre-existing and chronic needs.
Assistance that has been delivered is making an impact; however the depth and geographic
coverage is not yet sufficient to meet all needs.
Assistance should address the diversity of need in the communities.
Greater coordination and horizontal integration of programming may be required.

71
Section 3:
Annexes
3.1 Methodology of the first Periodic Review

The methodology used for the first round of the Periodic Review in the Union of Myanmar employed
several innovative approaches in order to provide useful data and analysis for decision makers. A
key innovation was the use of a mixed-methods approach that combined a quantitative probability-
sampled household survey with a qualitative purposively-sampled 'plug-in' investigation focusing on
vulnerable groups.
3.1.1 Quantitative methodology
Sample Design
The Periodic Review assessed the same sampling area as the VTA, which was defined as the worst-
affected Townships, but not the same communities. The definition of affected used to select the
Townships was the loss of life and / or property that had an impact on the livelihood of an individual,
family or a community. It did not take into consideration the ability to cope with the damage and
destruction.1 There were 30 Townships with this definition (see Annex 3.3 for the list).
The Periodic Review used a two-stage cluster sample design in which the primary sampling units were
communities sampled from the affected area and the secondary sampling units were households
within selected primary sampling units. Primary sampling units were selected using the Centric
Systematic Area Sampling (CSAS) method. This method involves dividing the survey area into
non-overlapping, equal, and contiguous areas and sampling the community located closest to the
centre of each area. The advantages of using the CSAS method is that it provides a spatially-even
sample of communities avoiding the bias towards sampling the most populous communities that is
present in sampling methods such as population proportional sampling (PPS). When combined with
a representative within-community sampling method, it allows spatial analysis and presentation of
survey data.
It is common practice to use a square grid to define the areas used in CSAS samples. This was done
in the VTA. A hexagonal grid was used in the Periodic Review because it yields a more spatially even
sample than a square grid with neighbouring primary sampling units tending to be equidistant from
each other in all directions.
To determine the location of the primary sampling units, a hexagonal grid was drawn onto a map
of the survey area. The size of the hexagonal tiles used was determined by consideration of the
need for spatial detail and a practicable number of primary sampling units. The side length of each
hexagonal tile was six nautical miles (11.11 kilometres). With this side length, the distance between
the centroids of neighbouring hexagonal tiles is 10.39 nautical miles (19.06 kilometres). 113 of
these hexagonal tiles were required to cover the Periodic Review survey area. Post-Nargis satellite
imagery was used to determine the community located closest to the centroids of the hexagonal tiles
and 113 communities were selected as primary sampling units.
Within each selected community, households were selected using a map-segment-sample technique
that is known to provide a representative sample of households from communities.2 The combination
of an even spatial sample of primary sampling units (PSUs) and the use of a representative within-
PSU sampling method allows spatial analysis techniques to be used and for results to be presented
as maps.
1 TCG (June 2008), Post-Nargis Joint Assessment, p 35.

2 A short guide to the Map-Segment-Sample community sampling method for the TCG Periodic Review.
72
Indicators and questionnaire
The assessment tools were created by identifying contributing variables for indicators identified in
consultation with the health, food, nutrition, protection of women and children, water-sanitation-
hygiene (WASH), agriculture, early recovery, education and shelter Clusters, and representatives of
the Government of the Union of Myanmar. Indicators selected were to be part of the Early Recovery
framework for the Cluster and were to monitor needs. Some indicators were used previously in well-
developed monitoring assessments, such as questions from the Core Questions on Drinking-Water
and Sanitation for the WASH Cluster. However, in some cases the questions were developed to fit
the requirement of monitoring needs after a cyclone. Where possible, indicators were selected to
be compared to the Village Tract Assessment. The tool was developed in English and translated into
Myanmar, pre-tested in English and Myanmar, and further evaluated in a pilot survey.
Sample size, data collection and data analysis
The planned overall sample size was 113 primary sampling units (PSUs) with 22 households sampled
from each PSU. Data were collected between 29 October to 14 November 2008. The survey
sampled 113 PSUs as planned, but five of these were censored due to improper recording of location
data. The achieved sample size was, therefore, 108 PSUs with 22 households sampled from each
PSU. Data were double entered and validated using a purpose written database system. Data were
analysed and mapped using ordinary kriging.
73
3.1.2 Quantitative assessment tools
MYANMAR PERIODIC REVIEW

HOUSEHOLD QUESTIONNAIRE
This document should not be replicated or othewise used
without the advice and consent of the authors.
DIVISION:
DISTRICT:
TOWNSHIP
WARD/ VILLAGE TRACT:
PCODE:
M M R
Date of Interview: Day Month Year
Time: Beginning of Interview Hour Minute
End of Interview Hour Minute
THE INFORMATION COLLECTED WILL BE USED ONLY FOR STATISTICAL PURPOSES AND IS STRICTLY
CONFIDENTIAL
74
Name of Enumerator Code
Name of Supervisor Code
Name of Data Entry Operater 1 Code
Name of Data Entry Operator 2 Code
Verified: Verified by (name):
Yes 1
No 2
Hexagon No. Household No.
Name of Principal Respondent ID Code
Measure the length of the dwelling Measure the width of the dwelling
feet feet
Interview Outcome: Complete interview 1
Partial/incomplete interview 2
Refusal 3
Questionnaire of
mODulE 1: hOusEhOlD ROstER
(1) (2) (3) (4) (5) (6) (7)
Start with the Was this Is this person If this person is not currently living in SEX: AGE RELATIONSHIP TO HEAD:
all individuals person currently the household, where is he or she?
currently living in the living in the
living in the household household?
household. prior to
Then list Cyclone HEAD
those who Nargis? RECORD AGE HEAD 1
lived in the IN YEARS IF
SPOUSE/PARTNER 2
I household PERSON IS MORE
D prior to THAN ONE YEAR SON/DAUGHTER 3
Cyclone OLD. RECORD SON/DAUGHTER-IN-LAW 4
C Nargis who AGE IN MONTHS
FATHER/MOTHER 5
O are no IF PERSON IS
D longer in the LESS THAN ONE FATHER-IN-LAW/MOTHER-IN-LAW 6
E household. YEAR OLD. SISTER/BROTHER 7
Another household in same village 1 GRANDCHILD 8
Another village/city in Myanmar 2 GRANDPARENT 9
Country outside of Myanmar 3 NIECE/NEPHEW 10
Dead 4 OTHER RELATIVE 11
YES 1 YES >>5 1 Missing 5 MALE 1 NOT RELATED 12
NO 2 NO 2 Dont know 6 FEMALE 2 YEARS MONTHS DONT KNOW 13
NAME
1
2
3
4
5
6
7
8
9
10
11
12
13
75
14
15
(8) (9) (10) (11) (12) (13)
ASK ONLY IF PERSON IS 15 YEARS OLD OR OLDER ASK ONLY IF PERSON IS 15 YEARS OLD OR OLDER
76
What was the main activity that [NAME] did before What is the main activity that [NAME] does now?
Does the Does the What is the What is the religion
Nargis?
natural father natural ethnicity of of [NAME]?
Government employee 1 Government employee 1
of [NAME] mother of [NAME]?
live in this [NAME] Farmer 2 Farmer 2
household? live in this
Fisherman 3 Fisherman 3
household?
Shop owner 4 Shop owner 4
Myanmar 1 Group labour (boss or member) 5 Group labour (boss or member) 5
Shan 2 Salt producer 6 Salt producer 6
Chin 3 Self employed/craftsman/artisan 7 Self employed/craftsman/artisan 7
Kachin 4 Day labor/casual labour 8 Day labor/casual labour 8

IF YES, IF YES, Kayah 5 Buddhist 1 Domestic worker 9 Domestic worker 9
RECORD THE RECORD THE
Mon 6 Muslim 2 Go to school 10 Go to school 10
ID CODE ID CODE
Kayin 7 Hindu 3 Household work/care for members 11 Household work/care for members 11
Rakhine 8 Christian 4 Petty trade 12 Petty trade 12
Mixed 9 Other 5 Livestock/poultry sellers 13 Livestock/poultry sellers 13
Other 10 Dont know 6 None 14 None 14
Other 15 Other 15
ID CODE ID CODE Dont know 16 Dont know 16
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
mODulE 2: chilD mODulE
(1) (2) (3) (4) (5) (6) (7) (8) (9)
CHILDREN 6 MONTHS OLD OR CHILDREN WHO ARE SUFFICIENT HEIGHT OR LENGTH (25 to 43 INs)
Write the YOUNGER
name of any
child who is COMPARE
Is [NAME] Since yesterday, did MEASURE IS Did [NAME] How did you treat [NAMES] diarrhoea? Has [NAME]
15 years old THE HEIGHT
currently [NAME] receive any of THE CHILDS BILATERAL exerience LIST UP TO THREE METHODS had a fever
or less and (OR LENGTH)
being the following? MID UPPER PITTING diarrhoea in the last
I currently OF THE CHILD
breastfed? ARM CIRCUM- OEDEMA during the 14 days?
D living in the TO THE
FERENCE ON PRESENT? last 14
household MEASURING
THE LEFT ARM days?
C from the POLE. Increased food or drink given to child 1
AND WRITE
O Roster in the (a) (b) DETERMINE Reduced food or liquid given to child 2
DOWN THE
D corresponding IF THE
RANGE IN Gave special foods to child 3
E line with their CHILD'S
Any other Solid or WHICH THE
ID Code from HEIGHT (OR Oral rehydration therapy 4
liquids semi-solid MEASUREMENT
the Roster LENGTH) IS Other (specify) 5
(mushy) IS FOUND
BETWEEN
foods Reduce or stop breastfeeding 6
THE TWO
MARKS. RED 1 Home remedy 7
YES 1 YES 1 YES 1 YES 1 YELLOW 2 YES 1 YES 1 No treatment 8 YES 1
NO 2 NO 2 NO 2 NO>>11 2 GREEN 3 NO 2 NO 2>>9 NO 2
NAME 1st 2nd 3rd
01
02
03
04
05
06
07
08
09
10
11
12
13
77
14
15
(10) (11) (12) (13) (14) (15) (16)
CHILDREN 2 TO 4 YEARS OLD CHILDREN 5 TO 15 YEARS OLD
78
What is the main reason that What class does [NAME] Does [NAMEs] Has [NAMEs]
Has [NAME] been Does [NAME] go to a place Does [NAME] [NAME] does not attend school? attend? school have a parent or guardian
I given an injection specially for children to learn, attend school? Parent Teacher been involved in
against measles? to play, or to be taken care of? Child not interested 1 Association? the Parent Teacher
D
Parents not interested 2 Association in the
C last 6 months?
Education costs 3 WRITE DOWN THE CLASS
O
Required to work 4 THE ACCEPTABLE
D
E Child is sick/disabled 5 ANSWER WILL BE FROM
Childs looks after 6 1 TO 11
others in household
School too far away 7
No school 8
Other (specify) 9
YES 1 YES 1 YES >>14 1 YES 1 YES 1
NO 2 NO 2 NO 2 NEXT CHILD NO >> Next 2 NO >> Next 2
child child
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
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MODULE 3 :Food Security
(1) PLEASE TELL ME HOW MANY DAYS IN THE PAST 7 DAYS YOU OR ANY MEMBER OF YOUR
HOUSEHOLD ATE THE FOLLOWING FOODS
(EXCLUDE FOODS PURCHASED AND EATEN OUTSIDE OF THE HOME) Write the number of days
Food Group Examples from 0 to 7
A. CEREALS bread, noodles, biscuits, cookies or any other foods

made from millet, sorghum, maize, rice, wheat
B. VITAMIN A RICH VEGETABLES AND pumpkin, carrots, squash, sweet potato, broccoli
TUBERS
C. WHITE TUBERS AND ROOTS white potatoes, kohlrabi, arrowroot, casava (tapioca),
yams, radishes
D. DARK GREEN LEAFY VEGETABLES spinach, mustard greens, chinese kale, morning glory,
pickle tea leaves
E. OTHER VEGETABLES tomoatoes, cucumber, lettuce, onion, cabbage, green

herbs, red beet, and other vegetables including wild
ones
F. VITAMIN A RICH FRUITS watermelon, peaches, apricots, oranges, papaya,
mango
G. OTHER FRUITS AND DRIED FRUITS pomelo, mangosteen, apples, banana
H. FLESH MEATS beef, port, lamb, goat, rabbit, wild game, chicken, duck,
or other birds
I. ORGAN MEAT (IRON RICH) liver, kidney, heart or other organ meats or blood-based
foods
J. EGGS
K. FISH fresh or dried fish or shellfish, prawns, shrimp
L. LEGUMES, NUTS, SEEDS beans, peas, lentils, chickpeas, grams, cashew,

groundnuts, nuts, seeds, or foods made from these
M. MILK AND MILK PRODUCTS butter, yogurt, ice cream and other products made with
milk.
N. OILS AND FATS oils, fats, or butter added to food or used for cooking
O. SWEETS sugar, sugar cane, jaggery, honey, sweetened soda or

sugary foods such as chocolates, sweets or candies
P. SPICES, CONDIMENTS, BEVERAGES spices (black pepper, salt), condiments (soy sauce, hot
sauce), coffee, tea, soft drinks, alcoholic beverages
(2) DID ANYONE IN THE HOUSEHOLD EAT ANYTHING (MEAL OR SNACK) OUTSIDE OF THE
HOUSEHOLD IN THE LAST 7 DAYS?
YES 1
No 2
(3) In the past 7 days, on average, how many meals and snacks did your household eat each day?
(4) In the past 7 days, did you have less than enough food for your household?
YES 1
NO >>7 2
(5) How often did this happen?
(1-3 TIMES) 1
(4-6 TIMES) 2
Every day 3
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(6) How often did you do the following when your household did not have enough food during the last 7 days?
Never 0
1-3 days a week 1
4-6 days a week 2
Every day 3
CHOSE LESS EXPENSIVE FOOD
CHOSE FOOD THAT YOU USUALLY DO NOT EAT
EAT LESS IN THE MAIN MEAL THAN NORMAL
EAT FEWER MEALS PER DAY
BORROWING FOOD OR BUYING FOOD ON CREDIT
GOT SUPPORT FROM FRIENDS AND RELATIVES
SOME MEMBERS OF HOUSEHOLD WENT WITHOUT MEALS
(7) What are the 3 most important sources of food for your household during the last 7 days?
WRITE 1 FOR THE MOST IMPORTANT, 2 FOR THE

SECOND MOST IMPORTANT AND 3 FOR THE THIRD
MOST IMPORTANT
Own production
Gift from family
Purchases
Borrow/credit/advance (money)
Pre-harvest advance (food)
Exchange items for food
Exchange work for food (not food aid)
Food for work (food aid)
UN / INGO food aid
Government food aid
Local NGO / CBO (not faith based)
Faith based organization
Other
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MODULE 4: Water and Sanitation

(1) What is the main source of drinking water for your dwelling?
PIPED WATER INTO DWELLING 1 >>4
PIPED WATER TO YARD/PLOT 2 >>4
PUBLIC TAP/STANDPIPE 3
TUBEWELL/BOREHOLE 4
PROTECTED DUG WELL 5
UNPROTECTED DUG WELL 6
PROTECTED SPRING 7
UNPROTECTED SPRING 8
RAINWATER COLLECTION 9
BOTTLED WATER 10 >>4
CART WITH SMALL TANK/DRUM 11 >>4
TANKER TRUCK 12 >>4
SURFACE WATER 13
OTHER (SPECIFY ______________________ ) 14
(2) Is the drinking water source within the compound?
YES 1
NO 2
(3) How long does it take to go there, get water and come back?
Number of minutes
If do not know, write 99
(4) Do you treat your water in any way to make it safer to drink?
YES 1
NO 2 >>7
(5) Which of these methods do you use to make the water safe CHECK AL L THAT APPLY
for drinking?
YES 1 NO 2
BOIL
ADD BLEACH/CHLORINE
STRAIN IT THROUGH A CLOTH
USE WATER FILTER (CERAMIC, SAND, ETC)
SOLAR DISINFECTION
LET IT STAND AND SETTLE
OTHER (SPECIFY ________________ )
DONT KNOW
(6) When was the last time you used one of these methods to make your water safer to drink?
TODAY 1
YESTERDAY 2
THIS WEEK 3
THIS MONTH 4
SEVERAL MONTHS AGO 5
OTHER (Specify ________________ ) 6

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(7) What is the main source of water used by your household for other
purposes, such as coooking and hand washing?
PIPED WATER INTO DWELLING 1

PIPED WATER TO YARD/PLOT 2
PUBLIC TAP/STANDPIPE 3
TUBEWELL/BOREHOLE 4
PROTECTED DUG WELL 5
UNPROTECTED DUG WELL 6
PROTECTED SPRING 7
UNPROTECTED SPRING 8
RAINWATER COLLECTION 9
CART WITH SMALL TANK/DRUM 10
TANKER TRUCK 11
SURFACE WATER 12
OTHER (SPECIFY _______________ ) 13
(8) Who in your household has the main responsibility for fetching
the water used for your household?
Probe: Is this person under age 15 years? What sex? Circle

the code that best describes this person
Adult woman 1
Adult man 2
Female child (under 15 years) 3
Male child (under 15 years) 4
Dont know 5
(9) What kind, and how many, types of storage containers does your household have to store drinking water?
type How many How many How many How many

does the have a have a gallons
household sealable tap? does each
have? lid? one store?
Clay pots
Buckets
Jerry cans
Tin cans
Barrels (concrete)
Barrels (wood)
Barrels (others)
Other (specify)
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(10) What kind of toilet facilities are in your dwelling?
Flush/pour flush to:
Piped sewer system 1
Septic tank 2
Pit latrine 3
Elsewhere 4
Unknown place/not sure/don't know 5
Ventilated improved pit latrine (VIP) 6
Pit latrine with slab 7
Pit latrine without slab/open pit 8
Composting toilet 9
Bucket 10
Hanging toilet/hanging latrine 11
No facilities or bush or field 12 >> 13
Other (specify) 13
(11) Do you share this facility with other households?
YES 1
NO 2 >>13
(12) How many other households share this toilet?
(13) The last time your youngest child passed stools, what was
done to dispose of the stools?
CHILD USED TOILET/LATRINE 1
PUT/RINSED INTO TOILET OR LATRINE 2
PUT/RINSED INTO DRAIN OR DITCH 3
THROWN INTO GARBAGE 4
ASK ONLY IF THERE ARE CHILDREN

BURIED 5
LESS THAN 5 YEARS OLD IN THE
HOUSEHOLD
LEFT IN OPEN 6
OTHER (Specify ________________ ) 7
DON'T KNOW 8
NO CHILDREN UNDER 5 IN HOUSEHOLD 9

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(14) What methods do you use to dispose of solid waste in your

household? MULTIPLE ANSWERS ALLOWED
BURN 1
BURY IN YARD 2
COMPOST 3
SCAVENGERS COLLECT 4
NEIGHBOURHOOD WASTE 5
COLLECTION & LOCAL DISPOSAL
THROW IN OWN YARD 6
THROW IN THE STREET 7
THROW IN RIVER/STREAM 8
OTHER (Specify ________________) 9
(15) Is there a bar of soap in the household?
YES 1
NO 2 >>NEXT MODULE
(16) Does the person who cooks the meals for the household wash his/her hands before preparing the food?
YES 1
NO 2
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MODULE 5: Health
1. How long does it take you to travel to the nearest health post/clinic?
Number of minutes
If dont know, write 99
2. Do you use the nearest health post/clinic?
Yes 1 >>4
No 2
3. What is the main reason you do not use the nearest
Wait time to see personnel too long 1
Usually no medicines available 2
Facility not open every day 3
Facility not clean 4
Facility has no equipment 5
Have to pay too much for the services 6
Prefer to use traditional healer 7
Use our own remedies for health problems 8
Other (specify) 9
4. On average, how long do you wait before being seen by medical personnel?
Number of minutes
If dont know, write 99
5. How often are medicines and drugs available at the health post/clinic?
All the time 1
Most of the time 2
Some of the time 3
Never 4
6. Is there a official village health worker in this village?
Yes 1
No 2
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MODULE 6: Housing
(1) What is the major construction material of the external walls?

Sticks & thatch/bamboo and palm leaves 1
Tarpaulin/polytarp 2
Mud/ wattle and daub 3
Wood 4
Bricks/blocks/concrete 5
DIRECT OBSERVATION
Tin/Zinc 6
Mud 7
Banboo 8
Canvas, felt 9
Other (Specify) 10
(2) What is the major material of the roof?
Sticks & thatch/bamboo and palm leaves/Dhani 1
Tarpaulin/polytarp 2
Solid wood 3
Tiles 4
Shingles 5
DIRECT OBSERVATION
Metal, tin or CGI 6
Asbestos 7
Plastic sheeting 8
Other (Specify) 9
(3) What is the primary material of the floor?
Parquet 1
Wood 2
Tile 3
Concrete 4
DIRECT OBSERVATION
Clay/earthern floor 5
Other (Specify) 6
(4) Does the dwelling have any of the following features? OBSERVATION
MARK ALL THAT APPLY YES = 1 NO = 2
Dwelling built on raised ground

A wind break of trees or other plants
Shorter side of the dwelling faces windward direction
High gable roof or hip roof
Water tight roof able to harvest rainwater
87
(5) What type of dwelling is it?

Detached house 1
Multi-family house 2
Apartment 3
Several connected buildings 4
Several separate buildings 5
Other (Specify) 6
(6) Do you feel that is it safe to leave your belongings in your house when you leave?
YES 1
NO 2
(7) Is this dwelling owned by a member of your household
YES 1 >>9
NO 2
(8) Is the dwelling where this household lives:
Rented 1
Temporary shelter, paid or not paid 2
(9) Do you live in the same dwelling or compound that you lived in prior to Nargis?
YES 1
NO 2 >> 11
(10) Have you done major construction on your dwelling, or replaced the entire dwelling with a new
building since Nargis?
YES 1
NO 2
(11) Do you want to return to where you lived before Nargis?
YES 1
NO 2
(12) Was the dwelling you lived in before Nargis owned by a member of your household?
YES 1 >>14
NO 2
88
(13) Was the dwelling you lived in before Nargis:
Rented 1
Temporary shelter, paid or not paid 2
(14) Do you think the dwelling is better, the same or worse than the dwelling you lived in before Nargis?
Better 1
The same 2
Worse 3
(15) Is your current house more crowded than before Nargis?
YES 1
NO 2
(16) Is your current house hotter than before Nargis?
YES 1
NO 2
(17) Does anyone in your household have another house?
YES 1
NO 2 >> 19
(18) Is this current house the strongest house of all the houses your household has?
YES 1
NO 2
(19) How many rooms is the sleeping area of the dwelling divided into?
(20) During the rainy season was this dwelling as dry as the dwelling you lived in before Nargis?
YES 1
NO 2
(21) Is this dwelling raised far enough above the ground to avoid flooding?
YES 1
NO 2
89
(22) Will this dwelling need improvements or maintenance during the next 18 months?
YES 1
NO 2
(23) Does anyone living in your dwelling have the skills to make needed repairs to the dwelling?
YES 1
NO 2
(24) Do any members of the community have the skills to make needed repairs to the dwelling?
YES 1
NO 2
(25) Is there a safe building within 1/2 mile from your dwelling where you can go in a big storm?
YES 1
NO 2
(26) What are the three main sources of income for the household at this time?
(Do not read the list)
Fishing 1
Agriculture (includes livestock/poultry/eggs) 2
Aquaculture (shrimp, prawn, crabs, etc) 3
Rent or lease of property 4
Salt production 5
Government employee 6
Private sector employee 7
Casual labour 8
Seasonal labour 9
Group labour (boss or member) 10
Treade/shopkeeper/village broker 11
Money sent by others 12
Self-employed/craftsman/artisan 13
Bar girl/massage/karaoke/entertainment 14
Savings 15
Borrowing (not microfinance) with collateral 16
Borrowing (not microfinance) without collateral 17
Microfinance initiative 18
Charcoal (manufacture & sale)/firewood 19
Forestry 20
90
Gifts/family 21
Pawning of assets 22
Sale of assets 23
Other (specify) 24
(27) What were the three main sources of income for the household before Cyclone Nargis?
(Do not read the list)
Fishing 1
Agriculture (includes livestock/poultry/eggs) 2
Aquaculture (shrimp, prawn, crabs, etc) 3
Rent or lease of property 4
Salt production 5
Government employee 6
Private sector employee 7
Casual labour 8
Seasonal labour 9
Group labour (boss or member) 10
Treade/shopkeeper/village broker 11
Money sent by others 12
Self-employed/craftsman/artisan 13
Bar girl/massage/karaoke/entertainment 14
Savings 15
Borrowing (not microfinance) with collateral 16
Borrowing (not microfinance) without collateral 17
Microfinance initiative 18
Charcoal (manufacture & sale)/firewood 19
Forestry 20
Gifts/family 21
Pawning of assets 22
Sale of assets 23
Other (specify) 24
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MODULE 7: Relief Programs

1. Has anyone in this household received relief items since Nargis?
Yes 1
No 2 >> 3
2. What kinds of relief items has your household received?
More than one can be marked. If the household has received the item, write 1 in the box.
DO NOT READ THE LIST. LET THE RESPONDENT SAY WHAT HAS BEEN RECEIVED.
Seeds
Agricultural chemicals/fertililzer
Agricultural machinery
Agricultural equipment
Fishing equipment/boat with or without power
Livestock/poultry
Construction tools
Household items
Student kits/learning packs
Food
Water
Shelter/housing materials
Bednets
Soap/hygiene kit
Jerry can/bucket/water container of any type
Clothes
Personal items
Fuel
Medicine
Dignity Kits
Other
3. Are there any local organizations working in this community?
Yes 1
No 2
mODulE 8: AgRicultuRE/livEstOck/FishERiEs
(1) Does your household have a home gardennow or did it have one before Nargis?
92
Yes = 1 No = 2 >> 3
(2) What is the size of your current home garden?
(2a) What was the size of your home garden before Nargis? feet by feet
feet by feet
(3) Is anyone in your household able to cultivate crops now or
was anyone able to cultivate crops before Nargis? Yes = 1 No = 2 >> 7
(4) (5) (6)
If there was a reduction in acres cultivated,
what is the main reason for the reduction?
Land spoiled (salt) 1
How many acres How many acres
Damage to drainage 2
did you cultivate in did you cultivate in
[CROP] this season [CROP] this season Not enough labor 3
or do you plan to or do you plan to Lack of seeds 4
cultivate? cultivate?
Lack of fertilizer/pesticides 5
Lack of farm tools 6
Trees damaged/lost 7
ACRES ACRES Other 8
Monsoon paddy
Summer paddy
Perennial crops
(7) Do you have any fish or crab ponds now or did you have any before Nargis? Yes = 1 No = 2 >> 11
(8) (9) (10)

If there is a reduction in [ITEM], what is the
main reason for the reduction?
How many [ITEM] Pond water spoiled 1
How many [ITEM] do
did you have before
you have now? Sold 2
Nargis?
Loaned to other 3
Other 4
Fish ponds
Crab ponds
(11) Do you have any livestock now or did you have livestock before Nargis? Yes = 1 No = 2 >> 15
(12) (13) (14)
If there is a reduction in the number of
[ANIMAL], what is the main reason for the
reduction?
Animals died 1
How many [ANIMAL]
How many [ANIMAL] Animals sold 2
did you have before
do you have now?
Nargis? Animals eaten 3
Lost 4
Don't know 5
Other 6
Chickens
Ducks, geese, mun-dar-lee
Milk cows
Cattle
Buffalo
Donkeys/horses
Goats
Pigs
(15) Do you have any fishing equipment now or did you have any fishing equipment before Yes = 1 No = 2 >> next
Nargis? section
(16) (17) (18)

If there is a reduction in [ITEM], what is

the main reason for the reduction?
Destroyed 1
How many [ITEM]
How many [ITEM] Sold 2
did you have before
do you have now?
Nargis? Loaned to someone 3
Damaged/needs repair 4
Other 5
Offshore/deep water boats
Inshore boats
River boats (with or without power)
93
Other boats
Fishing nets
94
MODULE 9: Durable Goods
Does anyone in your Yes = 1 Did anyone in your Do you consider it

household own the following No = 2 household own the good necesary to obtain this item
goods? prior to Nargis? as soon as possible?
Yes = 1 Yes = 1
No = 2 >> next item No = 2
1 Bed
2 Blankets, bedding
3 Table
4 Chair
5 Fan
6 Radio
7 Television
8 Sewing machine
9 Stove
10 Refrigerator
11 Bicycle
12 Motorcycle
13 Car
14 Boat/canoe
15 Fishing net
16 Clock
17 Wheelbarrow
18 Hoe
19 Ax
20 Dishes/eating utensils
21 Cooking utensils
95
MODULE 10: Needs
What are the three most important needs that your household has today?
(Do not read out the list.)
Agricultural inputs Rank
Animal feed / fodder
Clothing
Cooking utensils
Credit / microfinance / credit unions
Dishes/eating utensils
Education
Employment
Fishery inputs
Food
Healthcare / drugs / medicine
Household items
Livestock (including fowl)
Salt industry inputs
Shelter (including materials and labour)
Sleeping mats/bednets/blankets
Veterinary inputs
Water
Other (specify)
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3.1.3 Qualitative methodology
In-depth qualitative data was collected in a directed manner using a 'plug-in' approach. This data
relates to the protection of women and children using a series of closed and open questions. The
working assumption of the vulnerability assessment instrument is that, if people are unable to
benefit from outside assistance after Cyclone Nargis, and if customary rules of cooperation are not
working, then levels of vulnerability increase. A total of 349 households were interviewed as part of
the qualitative plug-in.
The inclusion of the plug-in assessment with a quantitative household survey was a mixed-methods
approach. Although such approaches are widely used in social science research, they have not
previously been used in disaster and post-disaster relief contexts due to the significant logistical and
organisational requirements.
The purpose of the qualitative investigation was to use household survey data to understand how
internationally recognised indicators of potential vulnerability are expressed at the level of lived
experience. It also provides concrete examples or 'stories' of risk categories that were quantified
in filter sets that were measured by the day-filter and to function as a verification instrument for
day-filter sets.
A day-filter of queries was applied to the quantitative survey data at the end of each day during
the quantitative data-entry period. The queries defined the criteria for revisiting households for
further investigation. The set of case-definitions used are related to the protection of women and
children.
In addition, adaptive sampling techniques were used to identify households that were not included
in the quantitative survey. There was also some variation in the criteria for selecting communities
from the quantitative survey as some communities were selected for their remoteness.
The filter set contained standardised indicators for domains of risk, but they did not in themselves
constitute all potential, culture-specific risk categories. The filter set used is set out below.
1. Household with malnourished child.
2. Household with school-age child not attending school.
3. Household with reduced (i.e., compared to before Nargis) utilisation of land.
4. Household with children living in sub-standard accommodation.
5. Female-headed household with young children.
6. Household in which main (domestic) carer is male.
7. Household in which the main carer is less than 18 years old.
8. Household in which the main carer is a grandparent.
9. Household that consists of members of different pre-Nargis households.
10. Household with an adolescent girl who is unrelated to the head of household.
The qualitative instrument builds upon data that is both technical (e.g. definitions of malnutrition,
reduced utilisation of land, and sub-standard accommodation) and empirical (e.g. female-headed
households with young children and households in which the main carer is a grandparent). It
was therefore necessary to identify households through cooperation between the quantitative
enumerators and qualitative fieldworkers.
97
Summary of Qualitative Investigation

The qualitative investigation for the TCG Periodic Review uses information from the large-scale
household survey for the Periodic Review to identify categories of vulnerability to which closed and
open-ended interview protocols for assessing vulnerability are applied.
The focus of the intervention is primarily the protection of women and children. However, in that
women and children are made vulnerable in natural disasters by circumstances often unrelated to
age or gender, the qualitative survey focuses on the functioning of the formal aid institutions and
indigenous social networks before, during, and after Cyclone Nargis.
Information about the functioning of these aid institutions and social networks is then gathered
by employing recognised categories of vulnerability for women and children to identify informants
from the household survey. Information on vulnerable populations is also gathered by employing
new categories of vulnerability identified through additional case histories documented during the
qualitative research process.
Qualitative instrument (vulnerability survey)
The qualitative investigation for this project was carried out over approximately a two-week period
in November 2008. Insofar as possible, this qualitative investigation followed the pattern of sites
selected for the quantitative household survey, which mapped the cyclone-affected region into 113
contiguous hexagons. Household survey enumerators worked out of four 'hubs'. Each hub was
assigned a qualitative hub leader, an English-speaking translator (sometimes the same as the hub
leader), and two or three additional fieldworkers.
Prior to departure from the capital, Yangon, all fieldworkers received basic training in the use of the
questionnaire, including an extended session in which filter categories were discussed in detail, with
examples provided of each. Eighteen part-time and full-time fieldworkers were trained over a two-
day period. Emphasis was placed on recording detailed narratives, not on the quantity of interviews
completed.
Structure of inquiry
Use of the day-filter system developed specifically for the rapid identification of vulnerable households,
allowed for a speedy qualitative response to the entry of quantitative information from the household
survey. Because the day-filter allows for case-definitions of vulnerability to be run on data as it is
entered, workers in the future can employ this system to begin informed and directed qualitative
fieldwork almost immediately.
Even though the relative importance of particular case definitions cannot be quantified accurately
until all household survey data has been entered, a case definition that is strongly represented (for
post-Nargis efforts, for instance, a household with reduced utilisation of land, or a household with
children living in sub-standard accommodation) emerged within the first day or two of data entry.
This system allows for far better focused disaster response than relief efforts managed autonomously
by governmental, non-governmental, or UN organisations.
The system also allows for more efficient identification of households earmarked for revisiting, and
for the development of an integrated tactical use of human resources in the field for identifying and
responding to the needs of vulnerable populations following a natural disaster.
The approach employed in the utilisation of fieldworkers and other related post-disaster human
resources involved two primary stages of response. In Stage Ithat is, the period of a few days
immediately following the initial of entry of household survey datathe field teams focused on
gathering sample qualitative surveys for each of the 10 case filters. Focusing immediately on the
examinations of case filters serves the urgent purpose in disaster and post-disaster assessments of
understanding how general categories of vulnerability are locally expressed. Doing so also allows
for some judgement to be made regarding the nature and prevalence of diverse human needs. In
one village, for instance, where the household survey identified a dominant problem with school-
age children not attending school, the qualitative research team quickly identified households
expressing 7 of the 10 risk categories used in the household survey as filter sets. Stage I, in other
98
words, functions both as a means of addressing local, cultural expressions of need, but also as a
reconnaissance tool for gathering information about the strength of case filters and the extent of
human need in disaster and post-disaster relief efforts.
At the conclusion of Stage I as soon as all categories were sampled in the four hub locations
and their surveys were submitted for translationqualitative fieldworkers immediately shifted their
attention to Stage II. In this stage the focus of the qualitative survey turned towards identifying and
recording case histories based on the demographic distribution of human need in disaster-affected
areas. In Stage II of the qualitative vulnerability survey project, fieldworkers divided into smaller
groups of two, or worked individually. This change in research strategy allowed for fieldworkers to
visit remote villages. The focus of Stage II of the qualitative intervention was to gather detailed case
histories across the entire demographic range of cyclone-affected regions. As the severity of natural
disasters are always variably experienced, these researchers, now sensitised to the exigencies of
life in disaster-affected areas, were able to gather information from both isolated and so-called
new villages composed of resettled, post-disaster inhabitants. The combination of this two-stage
research technique allowed both for a rapid assessment of need and enough detailed accounts to
venture an educated assessment of how relief and post-disaster resources might best be utilised in
the context of the Cyclone-affected area of Myanmar.
3.1.4 Qualitative assessment tools
The qualitative vulnerability assessment instrument was composed of a series of closed and open
questions in three general domains.
The first domain of inquiry within the qualitative vulnerability assessment instrument examined
formal kinds of post-disaster assistance. Formal [F] domains of inquiry included:
[F1] Nature of assistance received (which Government agencies, UN agengies, international

NGOs, or local NGOs?)
[F2] Period (when?)
[F3] Duration of effect (temporary or long-term?)
[F4] Type (kind of assistance provided?)
[F5] Needs met?
[F5] Needs not met?
[F6] Equality of access?
Levels of vulnerability are identified by the presence or absence of formal assistance, and, where
present [F1], the details of its implementation and effects [F2-F6].
Community domains examine indigenous community structures, modes of cooperation, resilience,

and mutability. Community [C] domains of inquiry included:
[C1] Nature of community cooperation (presence or absence?)
[C2] Customary rules (Do they exist? What are they? Compliance?)
[C3] Duration of effect (Temporary or long-term?)
[C4] New forms?
[C5] Equality of access?
[C6] Sustainability (Will they grow or continue? How can we promote sustainability?)
99
Vulnerability domains examine of perceptions of vulnerability. Vulnerability [V] domains of inquiry
included:
[V1] Identifying the vulnerable (who suffered most?)
[V2] Nature of vulnerability (kind of vulnerability?)
[V3] Coping (patterns altered?)
[V4] Normal or calamity (kind of coping?)
3.1.5 Qualitative results
The results presented here are a preliminary report that, at the time of writing, is based upon
incomplete data analysis, therefore not wholly representative of its long-term findings. It attempts
to identify general domains of vulnerability that are prevalent in the evidence examined to date. In
disaster settings the presentation of such qualified evidence becomes necessary in order to make
better judgements at the level of relief aid and policy.
It is certainly the case that natural disasters by definition create circumstances where already
disadvantaged individuals or social groups suffer disproportionately more than those whose lives
are more secure. The purpose of this study is, therefore, less one of describing the worst scenarios
or cases of unimaginable individual suffering, than of enhancing our understanding of how formal
institutions and social networks respond to an unanticipated natural calamity that strains them to
their limitsoften breaking them completely, but sometimes also necessitating their reformulation
in new and unexpected ways.
The names of people and villages used in this document are fictitious. They were changed to protect
the identities of the people interviewed. Interviews were conducted in the Myanmar language and
then translated into English.
Case 1) Thawtar Khin

Risk Category: 2 Household with school-age child not attending school
Risk Category: 4 Household with children living in sub-standard accommodation
Thawtar Khin, a 22 year-old woman, and her two children moved to her parents house after she
separated from her husband just before the Cyclone. Her father is U Ko Gyi, a 55 year-old day
worker who has to work every day in order to maintain the familys income while her mother is sick
and bed-ridden. Before the Cyclone, the family got water and sold it to other people. Sometimes
they made money by doing odd jobs. After the Cyclone, no one bought their water anymore and
there were no offers for any odd jobs. Their lives have become very challenging.
Before the Cyclone, the familys house was enough for the whole family to live in. But after the wind
blew down the house, they did not have enough money to rebuild it. So instead they built a small
tent in which all the members live. Since the tent is small it is quite crowded. Currently, Thawtar
Khins mother is sick and the family does not have enough money to send her to a clinic. There is no
doctor in the village and the nearest one is very far away, so they cannot send her. They could not
afford to buy more food after the Cyclone destroyed their food stock in their house. Thawtar Khin
has lost a lot of weight since she is also breast-feeding her two year old daughter.
Thawtar Khins 16 year-old brother helps the family by selling water around their community. Her 11
year-old sister just stays at home and helps her with the housework since they do not have money to
send her to school. She said that when her sister grows up, she will ask her to get a job to support
the family.
After waiting three months, the family got some assistance from an INGO. They received a bag of
rice, a water tank, some mats, mosquito nets and some kitchenware. Thawtar Khin was very happy
that these items helped her with her familys needs. They lost their mosquito nets in the Cyclone
and so were quite happy to get new ones. Although this help did not cover all their needs, the family
was still happy to get it just when they needed it the most.
100
Thawtar Khin also said, We want to rebuild our home. The tent we built is not in good shape. The
whole family is living in it and it may collapse. Theres a very big puddle with a bad smell nearby that
makes the tent unliveable. Im looking forward to the day when my children can attend a school.
Right now food is our greatest need.
Case 2) Daw Mya Sein

Risk Category: 3 Household with reduced utilisation of land
When the Cyclone struck, most of the rice fields were ripe and about to be harvested. The fields
were destroyed and people who owned many acres suffered a great loss. After the Cyclone, people
who owned rice fields were left with no money to invest and no seeds to plant. Since landowners do
not have money to start planting, casual workers also became jobless. They do not have any money
to start other kinds of work. A lot of boats were also destroyed. Homes that were destroyed were
only rebuilt for temporary use. Since agricultural workers cannot get back on their feet, they cannot
rebuild their homes.
Daw Mya Sein lives in a village with her family of six, who work on a farm. She is 55 years old. All
of her children have only primary-school education, though one of her grandsons is attending middle
school. The family can only send one child to school. All the other family members work on the
farm.
They planted 20 acres of paddy before the Cyclone. They were not in debt because their income
matched their expenses, but now they can no longer plant or work on their farm after the Cyclone.
In Daw Mya Seins village, the Cyclone destroyed most of the houses including hers. The crops were
also ruined because they had not been harvested. The family cannot afford to plant paddy for the
rainy-season crop. All the households in the village are in trouble now.
Daw Mya Seins family have received seeds and other assistance from an INGO to plant for the rainy-
season crop, but it is not enough to cover all of the farm. They have had to borrow money from
other people and pay the interest from their profit, meaning that they will not be able to get out of
this debt easily. It will not be easy for them to go back to the way things were before the Cyclone.
The family is always worried that things will never be as good as they were before the Cyclone.
One of Daw Mya Seins sisters has lent her money and the family has used the loan to plant betel.
They will have to give half of their profits to the sister, meaning that the family business has become
less profitable. They have not been able to repair their home yet, but only make some temporary
repairs.
The family received farm assistance because they owned their own farm, though they were not
eligible to receive food aid. They rely on other people to share their food with them. Their loss is
substantial because of the size of the farm land they own. All the farming families have troubles.
Day labourers are in trouble because farm owners have no work to give them.
The betel plants are now being attacked by insects. The family planted 1,500 plants a month ago
and are worried everyday about them being infested. They used to be a happy family free of debt
and worry. Even though Daw Mya Seins grandson is attending school, it is very difficult to support
him. The family needs more help to stabilise their livelihood and return their lives to normal, as it
was before the Cyclone.
Case 3) Daw Thet Thet Swe

Risk Category: 2 - Household with school-aged child not attending school
Daw Thet Thet Swe, a 41 year old woman has five children with a husband, who is a farm labourer.
Her husband lives in a hut on the farm where he works and so was not available at the time of
survey. He lives quite far away from the family home.
In front of the house is a big field where seedless and failed riceplants look like they are trying to
survive under a very hot sun. Daw Thet Thet Swe said, We do not know why the riceplants are like
that, this is the first time weve seen that. We think it is from the Cyclone
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Her husband, who works the farm, has four main tasks that follow the four seasons. From April to
July, he ploughs the fields and grows the rice. From July to November, he plants rice for the rainy
season. From November to January, he harvests the riceplants, winnows it, and stores it in the
barn. After that, he ploughs the field again for summer paddy during January to April. He can come
back home only for a short while during these four periods. Hes living there, working for them, and
cannot come back here. We do not get to go to him either - we have not seen each other for quite
a long time. Only when the Cyclone hit could he come back, Daw Thet Thet Swe said with a faint
smile.
When she was asked why the family did not join him in the field, she said, Who will feed us? They
feed only my husband, so I have to stay here with my five children, pointing to her eldest son of 18,
another of 15, two daughters of 13 and 8, and the youngest son of 4. She also added, Just to feed
them every day is so difficult, how can we send them to school? Before the Cyclone, we could still
send two of them to school. After the Cyclone, we had to drop the middle daughter out of the school
and made her help me make and sell food. Now we only have one child attending school.
Daw Thet Thet Swe meets the familys needs by selling traditional and seasonal foods. Her eldest
son used to work in a rice mill in the village as a day labourer. He lost his job for three months after
the Cyclone knocked out the mill. Being a labourer, he has to carry rice from the field to the mill,
winnow it, and clean it.
In order to plan their lives after the Cyclone, the family has borrowed money from a farm owner
at high interest, about 60 per cent. They have to pay 60,000 kyat in interest when they borrow
100, 000. Her husbands yearly wage is 50 baskets of paddy, which is equivalent to 200,000 kyat.
Now they have to spend the high-interest loan and they will never be able to get out of the circle of
debt they are always in heavy debt. At the same time, her husband cannot give up being a day-
labourer since he has better job security as a farm worker, and it is easier to borrow money or get
wages in advance. Thus people in villages prefer to be farm labourers rather than casual labourers.
Job scarcity for casual labourers has caused a lot of stress.
The family has received aid from two INGOs and two local NGOs, who provided some support to the
family. They received tarpaulins from a local NGO, a kit of items for everyday use such as soap,
tooth paste, kitchen utensils from one INGO, and a sack of rice from another INGO. This assistance
was adequate, and they did not need to worry about their basic survival. Some of the aid was in
the form of durable goods for use over the long-term, while others, like food and rice, covered only
a certain period of time.
In Daw Thet Thet Swes opinion, the most vulnerable groups who suffered the most after the Cyclone,
are the poorest in the village. Even though they have received support with materials to rebuild
their homes, these people cannot finish because they cannot afford it. Since her husband is a farm
labourer, Daw Thet Thet Swes family was able to borrow money from a land owner at high interest,
but the family still cannot afford the cost of rebuilding the house. Without her husband, she is trying
to solve her familys everyday problems and trying to relieve their suffering while her husband is
working away from home.
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Case 4) Daw Myint Thein

Risk Category: 5 Female-headed household with young children
A widow named Daw Myint Thein and her two sons of 24 and 17 live at the centre of a village near
the bank of a canal. Their hut is built of bamboo and they use palm leaves for the roof. The height
is too low for a grown person to stand up in and the hut is near foul-smelling mud and polluted water.
The family stated that the house they are living in was built with the generous help of their village.
Daw Myint Theins husband died two years before the Cyclone, when her family lived in a house her
husband had built made of wood and bamboo. During the Cyclone, the whole house was washed
away and they had to run for their lives and take shelter at a monastery. The place where they had
lived their lives full of pride and joy had turned into a devastated hovel overnight.
From the Cyclone, the familys living conditions is not the only thing that has changed - their health
and income was affected as well. When the Cyclone washed their home away, it also carried away
everything they ever owned, including the money which Daw Myint Thein invested to sell vegetables.
Once a very proud widow, now she has nothing left to invest and therefore her eldest son has to do
heavy work at the ricemill carrying ricebags and other heavy items. He got injured, with his spinal
column getting compressed from this hard work. Her younger son, who is just 17, therefore had to
quit school and do the same kind of work as his brother for the family to survive.
The family got support from the Government and from INGOs. Two months after the Cyclone they
received some donations, but these were not enough for the long run. Nevertheless, the family is
very grateful for these items, such as tarpaulin sheets to cover the roof, pots, longyis (a womans
garment) and mats from an INGO, as well as rice and cooking oil from the Government. They hope
they can get more of these items so they can get back on their feet again soon.
Daw Myint Thein stated that while the Cyclone may have destroyed their home and changed her
familys conditions, it cannot destroy their spirits. She hopes she gets a chance to get back to the
way things were before the Cyclone, when she was selling things. To do that she hopes for the day
when she can get a small amount of money to reinvest to get back on her feet.
Case 5) U Khin Moe

Risk Category: 3 Household with reduced utilisation of land
U Khin Moe is a community leader who lives in the eastern part of Kun Chan Village. He has a big
wooden house with a galvanised-iron roof. He and his wife have 7 sons, though 4 of the elder sons
are married and live separately.
Ten years ago, U Khin Moe was only a daily-wage worker and did not own any land. Through hard
work and good management, he bought one paddy field after another. He now owns 40 acres of
paddy fields. His sons show their father respect since he has raised them very well. Before the
Cyclone, U Khin Moes business was going well and everyone in the village respected him.
The villagers therefore asked him to be the Chairman of the Committee for Providing Electricity to
the Village. Through his efforts, the village was able to set up electric poles for electricity to be
brought to their village. People who owned farm land donated 300,000 - 500,000 kyats. Some even
borrowed money at interest in order to pay their share. It was only a matter of days - 10 to be
precise - until the village would get electricity when the Cyclone struck and destroyed everything in
its path, including the electric poles and cables. It also destroyed U Khin Moes farm lands. Now he
can only manage to cultivate 28 of his 40 acres. The remaining 12 acres are infertile.
U Khin Moe shared his experiences about the night when the Cyclone struck his village. He was not
worried since his house was big and strong. As the night grew darker, the water level reached 3 feet.
Right then a house nearby was about to collapse and so the family of 5 living there came rushing into
his home seeking shelter. Waiting for the wind to calm down and the water to subside, the whole
family and the neighbours taking refuge with them stayed up the whole night. The next day, they
all found many huts that had collapsed. U Khin Moes house only suffered damage to a small part of
the roof, where some of the galvanised iron sheets were torn.
103
He was heartbroken when he saw that the electric poles had fallen down. He got really worried
about what the community would think of him, and what people who had borrowed money to
contribute to the project would say. It was too much for him when he saw that his paddy fields were
destroyed. He could not sleep or eat. He was found walking in the village at night talking gibberish
to himself. When the village became aware of his situation, they were really worried and arranged
medical treatment for him. They took him to see psychiatric specialists in Yangon 3 months ago.
Through the support the community gave him and the treatment he has received for the last 3
months, he was able to recover. He is now recovered and slowly talked about his experiences during
the Cyclone.
The Cyclone caused 43 causalities in this village. Relief assistance such as paddy seeds, fertilizers,
machines, and household goods provided by the Government and INGOs, were helpful to the
villagers.
Case 6) U Hla Soe

U Hla Soe and his family lost their home in a Township in Yangon Division during the Cyclone.
They could not afford to rebuild in the same place and so moved in to share with relatives in his
grandmothers house in the same Township. Now nine family members have to survive together in
this tiny hut.
The main income-earner of this household is his daughter, Daw Chit, who works as a cook for a
soccer team near their house. She earns 500 kyats per day and gets extra rice and food items,
which she usually brings home to share with other members of the family. U Hla Soe and his wife
sometimes provide money for the family if they have any. They also ask for money from U Hla Soe
when they need it.
U Hla Soe said, Water leaks terribly when it rains and there is nowhere to hide in the house. Nobody
came and helped us after the storm. We only got a bag of rice from an INGO and another from a
ward [government] authority, but we received no money to repair the house or buy new thatch for
the roof. We find it difficult just to find food every day, how can we repair our house or support our
children?
He also added, Everyone is gone, everything we have, the roof, walls, clothes, everything. We went
two days without eating and we had nowhere to live. We just had to live in the railway station. I
cannot describe the trouble we had. People in the same ward were not able to come and help us,
they were even worse off than us. My daughters husband is a carpenter and if there is any work,
hell go to work for several days. When he comes back we get a little money for the things we
need.
Case 7) U Toe Kyi

Risk Category: 8 Household in which the main carer is a grandparent
A six year-old boy named Maung Nay Lwin was visiting his grandparents, who lived in the middle of
Kun Chan Village, when the Cyclone struck. He lost both of his parents as well as a sister, who were
living on the bank of a stream where his father earned a living as a fisherman. His whole family
drowned, but he was spared because he was at his grandparents house.
The boys grandfather, U Toe Kyi, lives in the centre of the village. He owns a one-acre fruit garden
where he used to grew betel and fruit. His garden was destroyed by the Cyclone and he needs
money to replant. He is now having a hard time helping his family survive.
Although the grandparents are in a very difficult position, they are trying their best to meet their
grandsons needs as much as they can. U Toe Kyi and his wife were saddened by the loss of their son
and his family, and they give everything they can to support their grandson. They have even sent
him to school to receive a proper education. They try everything to make him happy - they buy him
104
toys and take him to festivals. But sometimes they can see him sitting quietly lost in his thoughts,
thinking about his family. They are very worried and concerned for his future as well as his mental
health. They hope there will be a day when they can get help to replant their garden.
U Toe Kyi told us that their house collapsed and all the fruits and vegetables which they were growing
for their income were destroyed. The Albizzia lebbek tree in front of their house has fallen and
blocked the path to his house. Their income has been devastated ever since the Cyclone destroyed
their garden. Hence he had to seek help from his daughter, who is married and living separately.
U Toe Kyi wants to grow his garden back to the same way it was prior to the Cyclone and so would
like to have money to invest. If he can get back to the way things were before, he could help send
his grandson to school. He would also like to get help from the Government for his grandson, such
as for school fees, meals and the overall costs of sending him to school to get a university degree.
Case 8) U Maw Thane

Risk Category: 8 Household in which the main carer is a grandparent
U Maw Thane, the 60 year-old head of a household, has a wife and a granddaughter. He and his
wife are farmers. Their family is poor. Six months before Cyclone Nargis, a tornado hit their village.
During the tornado, his house and two neighbouring houses were destroyed. The tornado was so
strong that his bullock cart and other agricultural equipment went up in the air. His granddaughter
who was playing around his neighbours house was sucked up into the air and then fell onto the bank
of a canal in the field. She was hurt but luckily survived, though she was left with a scar.
The granddaughters parents were day workers. Just before the Cyclone, they took her and her
three brothers and sisters to a place near the sea to find firewood. When the Cyclone occurred,
the parents put all the children into a container and pushed them into the sea to escape the tidal
waves. Her brother and sisters died in the sea. She survived with the help of a rescue group, but
received a severe head injury. She came back to the village and is now being looked after by her
grandparents.
Despite their financial difficulties, her grandparents have sent her to school. But because of her
head injury, she has not been able to learn like other children and her memory is bad. She has been
downgraded from Grade I to Kindergarten. Sometimes the doctors come to the village and treat her.
Whenever the sky gets dark with heavy rainclouds, she stares vacantly in dejection. Sometimes she
asks for her parents to come back to live with her. Her mental suffering continues.
Case 9) Daw Kyi Ohn

Risk Category: 1 Household with malnourished child
Risk Category: 2 Household with school-age child not attending school
Risk Category: 5 Female-headed household with young children
Daw Kyi Ohn, a widow as well as head of the household, has a family of four including two sons
and one daughter. During the night when the Cyclone came, a strong gust of wind nearly knocked
over their house. She and her children were sitting on a mat inside the hut and they quickly ran
out and away. Her eldest son was in front running, and she saw an electric pole fall on him. He died
instantly.
When she saw her son lying on the road under the electric pole, Daw Kyi Ohn shouted and asked for
help. No one could hear her over the wind and she felt helpless. She tried to lift up the electric pole
on her own but could not because of the weight. Touching her sons body, she found that he was
already dead. While she was crying with her two children, the water quickly rushed onto the road
and she had to run to a big house on the other side of the road, where she took shelter. The water
reached 3 feet and flooded the whole village. The next day when the winds calmed down, she asked
for help from her community to bury her dead sons body.
105
In addition to the loss of her son, her hut was almost destroyed from the strong wind and water.
After the Cyclone, she only lives in a small hut. In the disaster, she also lost her savings and
belongings. Accordingly, she cannot sell vegetables like before. For the family to survive, her son
had to drop out of the 6th grade and work on a duck farm, where he gets 700 kyat per day. Since
she does not have any money to buy vegetables to sell, she has to find odd jobs or daily work. She
told us that finding this type of work is difficult and so she has to rely on her sons salary to survive.
She cannot continue sending her daughter to school, who was attending the 5th grade.
The family received rice, cooking oil, clothing and other things they needed from the Government,
INGOs and local NGOs. They were were so happy to receive them because they met the needs of
their family. Daw Kyi Ohn told us that before the Cyclone, the money she got from selling vegetables
in the village could send all of her children to school. Now she has to rely on her sons salary and
both of her children have had to drop out of school. She felt she would go mad when the Cyclone
took her eldest son, their hut, their belongings and all the money she could have used to invest. She
told us the children face malnutrition problems. She also said that she really wants to send them
back to school and for that she is going to be strong and will never give up. She just needs some
investment money to restart her life.
106
3.2 List of Townships in assessment area
Bogale
Dedaye
Kyaiklat
Labutta
Maubin
Ayeyarwady Division Mawlamyinegyun
Myaungmya
Ngapudaw
Pathein
Pyapon
Wakema
Dagon Myothit (North)
Dagon Myothit (Seikkan)
Dagon Myothit (South)
Dala
Hlaingtharya
Htantabin
Insein
Kawhmu
Kayan
Yangon Division Kungyangon
Kyauktan
North Okkalapa
Seikgyikanaungto
Shwepyithar
Thaketa
Thanlyin
Thingangkuun
Thongwa
Twantay
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3.3 Contributing agencies

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Post-Nargis Periodic Review I

On behalf of the Tripartite Core Group,

Table of Contents ............................................... iii

List of Abbreviations and Acronyms ............................................... vi

Section 1: Introduction ............................................... 3

Section 2: Findings ............................................... 9

Section 3: Annexes ............................................... 71

List of Abbreviations and Acronyms

ASEAN Association of Southeast Asian Nations

1 Pyi = 2.13 kgs of milled rice (approximately 2 litres)

1.1 Impact of Cyclone Nargis

killed or missing.2 The lives and livelihoods of survivors were

The destruction caused by Cyclone Nargis resulted from two Thailand

1.2 Periodic Review process

1 TCG (June 2008) Post-Nargis Joint Assessment, p 1.

The Tripartite Core Group (TCG)

Figure 2: Cyclone Path and Tidal Surge affected area

Ayeyarwady Division Yangon (North)

1.3 Other post-Nargis reports

1.4 Methodology of the Review

3 TCG (June 2008) Post-Nargis Joint Assessment, p 35.

Figure 3: Periodic Review survey area with hexagon overlay

Ayeyarwady Division Yangon (North)

A multi-sectoral questionnaire and indicator set was used

1.5 Data interpretation and usage

These are combined using the following logic:

What is spatial sampling?

How do I read the maps and histograms?

What is in the text boxes?

1.6 Next steps

Thawtar Khins story

Figure H1: PHC facilities are within 1 hour travel time

Time to nearest PHC is <= 60 minutes

For access to health care indicators, high

The percentage of households in surveyed

In more than half of the communities surveyed,

1 TCG (June 2008) Post-Nargis Joint Assessment, pp 7-8.

Figure H2: Waiting time at PHC facilities is less than 1 hour

When people arrive at PHC facilities, the

The percentage of households reporting

Thawtar Khins story

Figure H3: Health workers in the community

Community Health Care Workers (HCWs) are

The percentage of households reporting the

Figure H4: Coverage of Measles vaccination

The coverage of Measles vaccination directly

The range of coverage is from 44 to 100 per

Availability of medicines is a proxy indicator

In only one third of communities did all

There is also a discontinuity between access

Figure H6: Prevalence of diarrhoea

For indicators of disease prevalence, a low

The prevalence of diarrhoea in children

The most common results are between 0 to 20

Figure H7: Prevalence of fever

The distribution of the prevalence of fever by

As reported by maternal recall during the 14

Taken together, the indicators of fever,

Figure H8: Received medical assistance since Cyclone Nargis

In around one third of communities, at least

The assistance given is geographically

Figure N1: Global acute under nutrition

The proportion of households where children

In most communities the proportion of