Executive Summary
Between December 2005 and November 2006, a team of researchers from the International Organization for Migration (IOM) and the Department of Social Medicine from Harvard Medical School, carried out a Psychosocial Needs Assessment (PNA) in high conflict sub-districts across Aceh, in two phases. Phase 2, or Psychosocial Needs Assessment 2 (PNA2) conducted research in 75 high conflict villages in 11 districts throughout Aceh. The PNA2 report is an extension of the research for Psychosocial Needs Assessment 1 (PNA1), which was conducted in high conflict sub districts in Aceh Utara, Bireuen and Pidie, Aceh in February 2006. Research for this second study was conducted in 10 districts in July 2006 with funding from the World Bank, Decentralization Support Facility (DSF), IOM, and the Harvard Medical School, and in Aceh Besar district in November 2006, funded by IOM and the Harvard Medical School. The primary focus of this report is to provide findings from the PNA2 data and to compare these data with data previously analysed and published in the first Psychosocial Needs Assessment (PNA1) report.(1) Research for PNA1 was funded by the Canadian Department of Foreign Affairs and International Trade, IOM and Harvard Medical School.
The basic goal of the overall project was to evaluate the psychosocial and mental health needs in communities which have been deeply affected by the years of conflict between armed forces of the Republic of Indonesia and the Free Aceh Movement (GAM), given the cessation of violence after the signing of the August 2005 Memorandum of Understanding. This report focuses on past traumatic experiences and current psychosocial and mental health needs in high conflict areas throughout Aceh. Although the peace agreement ended almost three decades of violence most of the traumatic experiences reported date from the early 1990's until August 2005. The report deliberately refrains from identifying groups or individuals instrumental in the violence visited upon these communities.
Project design
The project was designed to provide scientifically-derived, empirical data which can serve as a basis for developing mental health and psychosocial services to support these communities' efforts at recovery. Specifically, the two studies sought to determine the level of conflict-related traumatic experiences suffered by members of these communities, to map differences in these experiences across regions and communities, to assess levels of psychosocial and mental health problems, identify high risk subgroups in the population, to identify patterns of resilience and resources drawn on by communities in managing mental health problems, and to assess the urgency for particular forms of mental health interventions in areas affected by decades of violence. Given the findings of extraordinarily high levels of traumatic experience and mental health symptoms in the initial PNA1 study in Aceh Utara, Bireuen, and Pidie, PNA2 was designed explicitly to extend the needs assessment to all high conflict districts in Aceh, and to compare the findings in other parts of Aceh with those in the index communities studies in PNA1.
The study was designed by senior researchers from Harvard Medical School, led by Profs. Byron Good and Mary-Jo Good, and by Jesse Grayman, Ph.D. candidate at Harvard and IOM staff member. It included two components: a qualitative, key-informant study designed to explore how the conflict has affected particular communities and what community leaders feel should be the priorities for responding to the psychosocial effects of the conflict; and second, a formal survey of adult members of selected communities designed to measure levels of experience of trauma events associated with the violence, levels of psychological distress associated with these experiences, and perceived priorities for services. The field survey for PNA2 was carried out by a team of researchers hired and directed by the IOM field staff in Banda Aceh, led by Jesse Grayman. Data were analysed at Harvard Medical School by Prof. Mary-Jo Good and Matthew Lakoma. This report was authored by Mary-Jo Good, Byron Good, Jesse Grayman and Matthew Lakoma.
The sample for the quantitative survey for PNA2 consisted of 1,376 adult, aged 17 or older (and for PNA1 the sample consisted of 596 adult respondents) randomly selected from rural communities that experienced the highest conflict since the early 1990's. Sampling procedures produced a well distributed and representative sample of adult men and women in these communities. In addition, key informants, consisting of leaders in the selected communities, were interviewed in all participating villages. The present report focuses on analysis of the quantitative survey.
For purposes of analysis, the communities in the survey are divided into 6 regions, grouping districts that share geographical contiguity, cultural similarity and common conflict histories. The six regions are; the North Coast (Aceh Utara, Bireuen, Pidie) Aceh Besar, the East Coast (Aceh Tamiang, Aceh Timur) the Central Highlands (Aceh Tengah, Benar Meriah and Gayo Lues), Southeast Highlands (Aceh Tenggara) and Southwest Coast (Aceh Barat, Nagan Raya, Aceh Barat Daya and Aceh Selatan). Findings may be generalized only to high conflict communities in these six regions.
Note:
(1) Good, B., M.-J. D. Good, J. Grayman, and M. Lakoma. 2006. Psychosocial Needs Assessment of Communities Affected by the Conflict in the Districts of Pidie, Bireuen, and Aceh Utara. International Organization for Migration.