Better Rebuilding In Aceh

When the Indian Ocean tsunami slammed into Aceh one year ago today, it fouled the coast of the Indonesian province, strewing its land with detritus and mud. Recently, I returned there to find it green with grass and bursting with yellow and purple wildflowers. Near the miraculously surviving palm trees, men are mixing concrete and forming bricks and lumber into new villages.

The greatest transformation, though, is that Aceh is at peace. On Aug. 15, the Indonesian government and leaders of the rebel Free Aceh Movement signed an agreement ending nearly three decades of conflict. The peace is visible, with far fewer troops patrolling Aceh's streets.

The opportunity to assist families in former conflict areas would seem, on the surface, immense. Abundant funding and extensive aid delivery systems now exist in the province. International donors, nongovernmental organizations and the Indonesian government have pledged more than $7.5 billion to assist Aceh and Nias Island.

But leaders of aid agencies say they are unsure whether they may use tsunami recovery donations to implement programs in areas that are primarily affected by the conflict. Even the U.S. Agency for International Development is constrained by a restrictive interpretation of how the $656 million Congress designated for tsunami-hit countries in the 2005 budget supplemental can be spent.

Improved security has given aid workers a chance to venture away from the tsunami-ravaged coasts into hillside villages previously isolated by the conflict. There they are finding children with swollen bellies and stick-like arms. Rates of acute malnutrition appear to be higher than in coastal Aceh, where the rate already exceeds the emergency level. Many children are sick with malaria. Measures of development in some of these areas lag far behind those of the tsunami-hit regions. Seeing the effects of the war makes it clear that Aceh suffered not one but two great disasters.

Unfortunately, geography rather than need has governed the targeting of most tsunami assistance. Disparities in the provision of aid to coastal vs. inland areas is heightening tensions among residents of some of Aceh's conflict-affected districts. The World Bank and others have emphasized the threat this poses to peace and redevelopment.

The humanitarian principle of impartiality demands that aid be allotted without any standard other than need. It is immoral, with billions of dollars on the table, to be serving food to children along the coasts while allowing children in the mountains above to die of malnutrition. Likewise, what justification can there be for rebuilding only tsunami-wrecked health centers but not the war-damaged health centers serving sicker children a few miles inland?

Extending tsunami aid to people and places that are primarily affected by the conflict might sound like "mission creep," but those overseeing the tsunami recovery effort acknowledge that it is a necessity. Supporting these regions, along with laudable ongoing efforts to reintegrate decommissioned soldiers, is a way of helping cement Aceh's peace. This benefits tsunami survivors, because they, along with the entire population of the province, suffered from firefights, kidnappings, torture, extortion and isolation during Aceh's decades of conflict.

Moreover, the "building back better" vision of the tsunami recovery effort can be accomplished only if a functioning infrastructure exists throughout the province, not just along the coastline. Failing to repair the war's destroyed bridges and burned houses, schools and health centers would reduce the payoff from the world's enormous investment in Aceh.

A realistic case can be made for defining all of Aceh province as "earthquake and tsunami-affected." While conflict-torn mountainous areas were not directly hit by the tsunami, they felt a secondary impact: Displaced survivors sought refuge there. The earthquake that spawned the tsunami also destroyed water wells and damaged buildings in these inland areas.

Some agencies have gingerly taken steps to extend tsunami aid to upland conflict zones, but these have often been small-scale, sub rosa efforts. It is time for this to change and for the activities to become an integral part of rebuilding plans. Similar calls for equity have been made in tsunami- and conflict-affected parts of Sri Lanka and in earthquake- and conflict-affected Kashmir.

The lesson for the future is that the United States and other international donors, along with aid agencies, must make sure their generosity benefits the widest possible population in need in societies affected by disaster. Thoughtful, community-driven approaches to assistance have the greatest hope of paying dividends.

The writer is a visiting scientist at the Harvard School of Public Health and author of "War Hospital: A True Story of Surgery and Survival." She worked as a consultant for international aid agencies in Aceh.