Assessing Trauma Healing Methods for Volcanic Disaster Evacuees in Indonesia

Everyone must have attempted to repair a significant wound at some point, many would give up on facing the day after being shaken by difficulties. Do not be disheartened, however, for a dirty heart cannot perceive things as they truly are. For those of us who do not know the ultimate destination of certain matters, this should not make us reckless and thoughtless, or quick to criticize circumstances [4].

Communicating with children, particularly those who have experienced loss, involves preparedness and comprehension, as it is normal for psychological conditions and personal feelings to interfere with our ability to communicate with children. Before communicating, we must ascertain what people feel or desire. They typically experience profound sadness when their loved pass. It must be realized that if one can understand another person’s mind, one’s understanding of them will be enhanced, allowing one to completely appreciate the significance of each face-to-face interaction with them [5]. We may not be special enough for children. We cannot satisfy our children. Nevertheless, we have many things that we can give to our children [6].

Herbert Read argued in his 1931 article titled “The Meaning of Art” that art is merely an endeavor to create pleasing shapes. Such a pleasing form satisfies the human consciousness of beauty. Children are intimately connected to the world of play and all things that are fun. Parents may select the most suitable option in line with the child’s personality. This is a crucial aspect of understanding the child. While talking with others, more than fifty percent of the messages captured by the other person result from our body language and not our verbal skills [5]. Art and craft can support children’s growth and development. Art can be made into anything we need with the right skills. If we believe that we have provided children with adequate care in their vulnerability in these evacuation shelters, we should pay them additional attention. Participate in mentoring and enliven the environment; do not just expect the children to do it. Ask questions they will be happy to answer. Encourage them to discuss themselves, their accomplishments, and their interests [7]. Using pretend play and acting is a different kind of assistance. Via the performing arts, it will be possible, among other things, to assist individuals in comprehending their reality and seeking the meaning or purpose of life. Theatrical productions arising from human passion, creativity, and intellect can aid in forming perception [8, 9].

High preparedness has direct relationship with evacuee experiences, as they were directly affected by a natural disaster [10]. The level of youth participation is deemed necessary to be increased to develop a more comprehensive disaster management program according to regional needs. Far disaster management should be transformed into disaster awareness which is delivered through education, socialization, training, and disaster response simulations [11]. The participation of the private sector or hospitality industry and the government is needed to build a good synergy in disaster risk reduction programs both locally and nationally [12]. Through participatory analysis and research, the study of a rural village in Shaanxi Province shows that bottom-up initiatives can complement the existing system. Its current progress demonstrates the potential for using a transdisciplinary perspective to initiate Community-Based Disaster Risk Reduction (CBDR) in China, where both top-down and bottom-up approaches, come together alongside different disciplines to increase a rural community’s disaster resilience [13]. Creativity is associated with outputs that can be used as objects of study that can be enjoyed. Creativity can result in works of art, music, scientific breakthroughs, and so forth [14]. In creative thinking, acting, and playing, there is a synergy between parents and children. An honest person can share true ideas and emotions. Without being covered up, without making things up for their interests or the interests of other parties. Because being honest is done for honesty and the sake of goodness [6].

Martilla and James established the Importance Performance Analysis (IPA) method to determine the relationship between consumer perceptions and product or service quality improvement priorities [15]. IPA analysis is also referred to as quadrant analysis because one of the findings of the analysis reveals the placement of each attribute on the predefined Cartesian axis [16-18]. IPA analysis is used to map the relationship between the importance and performance of each provided attribute and to assess the disparity between the performance and importance of each [19, 20]. The primary goal of IPA is to present information regarding service aspects that customers perceive significantly impact customer or user happiness and loyalty. IPA can also identify service attributes that, according to consumers, need to be addressed since they are unsatisfactory [21, 22]. Gap Analysis is a measurement technique used to determine the gap between consumer performance and expectations and is part of IPA [23, 24].

If the performance value is larger than the importance level value, the Gap analysis will yield a positive (+) result. Conversely, if the importance score exceeds the performance score, a negative value (-) will be calculated. If the overall gap is positive, customer satisfaction with the company’s services is very high. In contrast, if the gap is negative, the consumer is unhappy with the service [25, 26]. The closer the distance, the better. Typically, a company with a good service level will have a smaller gap, as the service level matches the needs of service users [27].

Conventional importance and service level analysis (IPA) focuses solely on respondents’ opinions on the importance and service levels [15]. It excludes expert advice and service standards, such as government standards or expert advice in their respective fields, as well as other considerations. This makes the outcomes of scientific analysis dependent on the respondent’s perspective [28-30]. Every service review should include the expert opinions of authorities in their respective disciplines [31]. In addition, a Gap analysis was conducted to assess the disparity between each variable and each research attribute. Because each variable has varied strengths based on the opinions of respondents from different groups and social backgrounds, a noticeable disparity can arise.

In the meantime, researchers employed a 5-point Likert scale questionnaire to evaluate the efficacy of each trauma healing method in shelters: (1) strongly disagree, (2) disagree, (3) neutral, (4) agree, and (5) strongly agree [32].

The literature review above has a variety of approaches and logic of thought, especially in studying the perceptions of someone who is in an unusual condition, such as being affected by a natural disaster, eruption, flood or other stressful conditions. Creating levels for social conditions is not a common thing, even in create a mathematical research model. But in this research, the physical parameters used still possible be measured and understood logically.

4.1 Importance Performance Analysis

In contrast to conventional of Importance Performance Analysis (IPA), four parameters were evaluated in the 4D Importance Performance Analysis, including the level of importance, performance, government support, and expert advisory. As with conventional IPA analysis, the respondents’ opinions determine the importance and performance metrics. In the 4D IPA analysis, government support refers to official actions in evacuation shelters, such as supplying tents, mattresses, restrooms, electricity, logistics, etc. The expert advisory is utilized to determine its comparability with the government’s actions and services and the level of importance communicated by evacuees as respondents. As stated in the table below, each attribute has four values, such as the value for attribute C. (toilet). Experts placed a high value of 4.25 on proper toilets in evacuation shelters. Respondents rated the importance of toilets in evacuation shelters as 3.86. However, support from the government is only 1.85; this score is equal to the opinion of respondents, who gave a value of only 1.55 for toilet performance.

The Table 1 is the result of data collection from respondents for the importance and performance level variables, the value of government support for each attribute, and expert advisory. Certain attributes reflect a poor value in yellow and red, while others demonstrate that the service is good or excellent. Toilets, clean water, and electricity are a few of the services provided to evacuees with poor service. Services deemed average include tents and air circulation or ventilation in tents and evacuation camps. The provision of food for the evacuees was deemed good, while the activities at the evacuation locations were so diversified that they received excellent grades from responders; this was consistent with the level of importance and direction from disaster specialists.

Table 1. Analysis of 4D IPA

The results of the conventional Importance Performance Analysis (IPA) and the quadrant location for each attribute are displayed in Table 2. Based on evacuees’ comments, two attributes are included in quadrant 1, including the provision of food supply, and activities in shelters. Tents, toilets, clean, and water, are the attribute values that require improvement. Compared to the gap analysis, Table 2’s results resemble Figure 3, particularly for government support factors and expert opinion (advisory).

The image in Figure 4 is the outcome of the Gap analysis. In evacuation shelters, the most significant gap is in providing essentials such as potable water, toilets, and power. This may be closely related to the widespread use of smartphones as a means of communication with close family, whether to ask for help, give news, or communicate intensively with the closest and most trusted people, in addition to other activities that can only be performed on a smartphone device, such as accessing social media, watching YouTube videos, and more. Electricity is not available in all refugee tents, so the value given by respondents is quite low for the service of providing electricity to refugees.

Regarding the value of government support for each attribute, it is challenging to increase it. For instance, the BNPB standard for evacuation shelters has very large dimensions but does not meet some basic needs for evacuees, such as the need for lighting, sufficient ventilation, and maximum user capacity, which directly impacts the evacuees’ comfort. A BNPB tent and other available emergency tents are depicted in Figure 5.

Some parts of comfort are undoubtedly difficult to achieve, particularly those relating to the privacy of evacuee groups with distinct categories requiring unique management, such as breastfeeding moms, the elderly, evacuees with restricted access to clean water, etc. This discomfort can be alleviated if each individual realizes that the situation is an emergency and calls for the cooperation of fellow evacuees.

Table 2. IPA and quadrant result

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Figure 3. Result of IPA quadrant. Q1: Keep up the good work. Q2: Concentrate here. Q3: Low priority. Q4: Possible overkill

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Figure 4. Result of GAP analysis

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Figure 5. Several sizes of refugee tents

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Figure 6. Public kitchen for refugees (A) and personal kitchen by refugees (B)

Based on the 4D IPA analysis results presented in Table 1 and Figure 4, the evacuees’ food needs may be adequately met. Nevertheless, some evacuees constructed private kitchens, as depicted in figure 6B. Figure 6A is a photograph of the public kitchen for refugees in the evacuation shelter [34]. There must be a persuasive communication strategy for the government further to improve services in refugee camps following evacuees’ needs.

4.2 Trauma healing methods

The opinions of evacuees regarding the trauma-healing method are outlined in Table 3. According to the red, yellow, and green hues in the table, some procedures are appropriate for particular age groups but not others. Similar to the motivational or religious talks approach, this method is less appealing to toddlers and children up to productive age, but it is favoured by the working age group, as well as the retirement and old age groups. Still referring to the opinions of evacuees’ regarding the trauma-healing method at the shelter, learning through singing was liked by all age groups, while learning through arts and crafts, such as drawing and colouring, was only accepted and liked by children up to the age of adolescence.

Table 3. Trauma healing methods and respondent class ages

Based on the data in Table 3, the researchers determined that evacuees of working age, unproductive age, and old age required assistance, even motivational and religious talks. Evacuees of working and productive age who could not access jobs in an evacuation shelter, such as farming, animal husbandry, and others, felt a crushing blow. Several of them lost agricultural products owing to heated clouds and volcanic ash, as well as livestock that perished from exposure to volcanic materials. Moreover, evacuation shelters are not conducive to activity, particularly for those of student age, productive age, working age, and even retirement age and old age. Diverse activities can give a fresh, pleasant environment so that evacuees can continue to live and minimize their feelings of grief caused by natural disasters.

In real life, families will gather in the same tent and they will behave as if refugee tent is their temporary home. Meanwhile, if we refer to Table 3 above, mental trauma recovery activities are very ineffective. This is due to the different ages of refugees need require different psychiatric treatment. In this study, no correlation analysis was carried out which should have revealed a close relationship between shelter facilities and the mental health conditions of the refugees. In future research, it would be more interesting if the variables in the Importance Performance Analysis could be used as parameters to measure the mental health of refugees and not only measuring the comfort level of refugees in shelters.