Cyclone Komen Early Recovery Assessment: Village Administrator
Questionnaire (paper)
Informed Consent Statement
Hello, my name is ____ My role is _____ and I work for REACH Initiative, a research NGO
which is based in Geneva. We are conducting an assessment to understand how communities
in Rakhine are recovering from Cyclone Komen. This assessment is not linked to any aid for
any particular village community. Instead, its aim is to help aid agencies and the government
plan activities to help communities recover from the cyclone.
We therefore cannot offer you any direct aid or incentives as a result of this interview.
However, your opinions and experiences will make a very important contribution to our
understanding of the problems you face. This will in turn support planning and policies that aim
to benefit all cyclone-affected communities. Everything you say us will be kept confidential. We
are interested to hear all your opinions, both positive and negative. At the end of this interview
we will make a report and share it with all actors involved in disaster management planning, but
we will not mention your names, or who said what.
You can decide whether you want to take part to take the interview or not. Once my questions
have started, you have the right to refuse to answer any question, or to leave the interview at
any time. If you choose not to take part or to skip any questions, it will have no negative
impacts on your ability to access services from REACH or any other agency. Please feel free to
ask me any questions now, or at any point during the interview. Do you consent to participate
in this interview?
Module I: Demographics
1.1 Total village population (households)
1.2 Total village population (individuals)
Female:
Male:
Total:
1.3 Total population currently displaced from their
original houses (households)
1.4 Total population currently displaced from their
original houses (individuals)
Female:
Male:
Total:
Module II: Cyclone impacts
2.1 Shelter
2.1.1 Total number of houses in village before
cyclone
2.1.2 Total number of houses in village damaged
by cyclone
2.1.3 Total number of houses in village destroyed
by cyclone
2.2 Livelihoods
2.2.1 Total area of paddy fields owned by village
before cyclone (acres)
2.2.2 Total area of paddy fields owned by village
damaged by cyclone (acres)
2.2.3 Total amount of paddy embankment before
the cyclone (feet)
2.2.4 Total amount of paddy embankment
damaged by the cyclone (feet)
2.2.5 Total area of paddy fields owned by village
available for planting now (acres)
2.2.6 Total number of shops in village before
cyclone
2.2.7 Total number of shops in village damaged
by cyclone
2.2.8 Are shops in the village currently open for
business?
2.2.9 Why not?
Wash
2.3.1 Number of water storage ponds in village
before cyclone
2.3.2 Number of water storage ponds in village
damaged/destroyed by cyclone
Specify damage
2.3.3 Number of public latrines in village before
cyclone
2.3.4 Number of public latrines in village
damaged/destroyed by cyclone
Education
2.4.1 Number of schools in village before cyclone
2.4.2 Number of schools in village
damaged/destroyed by cyclone
Specify damage
2.4.3 Are children in the village currently going to
school?
2.4.4 Why not?
Yes
No
Health
2.5.1 Number of clinics in village before cyclone
2.5.2 Number of clinics in village
damaged/destroyed by cyclone
Specify damage
2.5.3 Are people in the village able to access
medical care?
Yes
No
2.5.4 Why not?
Transport/access
2.6.1 Does the main access route to the village
require repair?
2.6.2 Specify repair requirements
2.6.3 What proportion (%) of paths/roads within
the village require repair?
2.6.4 Specify repair requirements
Vulnerability
2.7.1 Are there any especially vulnerable people
(e.g. female-headed HHs, older people, people
with disabilities) who have special requirements
after the cyclone?
2.7.2 Please describe in as much detail as
possible
Yes
No
Module III: Recovery context
Aid and assistance
3.1.1 Since the cyclone, has the village received
any aid support from outside?
Yes
No
[If yes] What support, from whom?
3.1.2 Since the cyclone, have there been any
organised efforts in the village to rebuild damaged
infrastructure, paddy fields etc?
[If yes] Please describe
Yes
3.1.3 Since the cyclone, have there been any
organised efforts in the village to support badly
affected people?
[If yes] Please describe
Yes
3.1.4 Do any permanent committees or
organisations exist in your village?
Yes
For example: village committee, youth group,
women’s group, etc.
[If yes] Please describe
No
No
No
3.1.5 Since the cyclone, has this village had any
interactions with the other villages in the village
tract during the recovery effort?
[if yes] Please describe
Yes
No
Environmental context
3.2.1 Has the cyclone had any long-term damage
on the village natural environment? Please
describe:
For example: damage to forests/mangroves,
blockage of channels, greater risk of
landslides, etc.
3.2.2 Are people relying more on the natural
environment as a result of the cyclone? Please
describe:
For example: collecting more firewood,
catching more fish
Protection context
3.3.1 Have there been any safety concerns in the
community since the cyclone happened?
Yes
No
3.3.2 [If yes] please describe
Are there any concerns specific to women and
girls?
3.3.3 Have there been any problems related to
competing land ownership claims since the
cyclone?
3.3.3 [If yes] please describe
Yes
No
Needs
What are the three main short-term priority needs
for the village?
1.
2.
3.
What are the three medium-term (three month)
main priority needs for the village
1.
2.
3.
Additional information
Please record any relevant additional information in the box below:
Cyclone Komen Early Recovery Assessment: Household
Questionnaire
Informed Consent Statement
Hello, my name is ____ My role is _____ and I work for REACH Initiative, a research NGO
which is based in Geneva. We are conducting an assessment to understand how communities
in Rakhine are recovering from Cyclone Komen. This assessment is not linked to any aid for
any particular village community. Instead, its aim is to help aid agencies and the government
plan activities to help communities recover from the cyclone.
We therefore cannot offer you any direct aid or incentives as a result of this interview.
However, your opinions and experiences will make a very important contribution to our
understanding of the problems you face. This will in turn support planning and policies that aim
to benefit all cyclone-affected communities. Everything you say us will be kept confidential. We
are interested to hear all your opinions, both positive and negative. At the end of this interview
we will make a report and share it with all actors involved in disaster management planning, but
we will not mention your names, or who said what.
You can decide whether you want to take part to take the interview or not. Once my questions
have started, you have the right to refuse to answer any question, or to leave the interview at
any time. If you choose not to take part or to skip any questions, it will have no negative
impacts on your ability to access services from REACH or any other agency. Please feel free to
ask me any questions now, or at any point during the interview. Do you consent to participate
in this interview?
Section 1: Geographic information
Township
Village Tract
Village
Section 2: Demographics
2.1 Respondent sex


Female
Male
2.2 Respondent age
2.3 Number of individuals in household
Section 3: Household productive assets pre/post-crisis
3.1 Paddy
3.1.1 Does your household own any paddy
 Yes
land?
 No
3.1.2 How many acres do you own?
3.1.3 How many acres of your crop were
destroyed during the cyclone?
3.1.4 How much of your paddy embankments
 All
were destroyed during the cyclone?
 Around three quarters
 Around half
3.1.5 Have you begun repairing your
embankments?
3.1.6 How much of your farming equipment
(tools, ploughs etc.) was damaged/destroyed
during the cyclone?
3.1.7 How many acres of your paddy fields
are available for re-planting now?
3.1.8 Do you have any paddy seed available
for re-planting?
3.1.8.1 How much? BASKETS
3.1.9 Have you begun re-planting your paddy
land?
3.2 Gardens/plantations
3.2.1 Does your household own a vegetable
garden or plantation?
3.2.2 What proportion of your
garden/plantation was damaged/destroyed
during the cyclone?
3.2.3 Have you started re-planting your
garden/plantation?
3.3 Livestock
3.3.1.1 Did you own any chickens before the
cyclone?
3.3.1.2 How many?
3.3.1.3 Did you lose any chickens during the
cyclone?
3.3.1.4 How many?
3.3.2.1 Did you own any pigs before the
cyclone?
3.3.2.2 How many?
3.3.2.3 Did you lose any pigs during the
cyclone?
3.3.2.4 How many?
3.3.3.1 Did you own any goats before the
cyclone?
3.3.3.2 How many?
3.3.3.3 Did you lose any goats before the
cyclone?
3.3.3.4 How many?
3.3.4.1 Did you own any cows/buffalo before









Around one-quarter
None
Yes
No
All
Around three quarters
Around half
Around one-quarter
None


Yes
No


Yes
No









Yes
No
All
Around three quarters
Around half
Around one-quarter
None
Yes
No


Yes
No


Yes
No


Yes
No


Yes
No


Yes
No


Yes
No

Yes
the cyclone?
3.3.4.2 How many?
3.3.4.3 Did you lose any cows/buffalo before
the cyclone?
3.3.4.4 How many?
3.4 Fisheries
3.4.1 Did your household engage in any
fishing activities before the cyclone?
3.4.2 Did your household own any boats
before the cyclone?
3.4.3 How many?
3.4.4 Were any of these boats damaged or
destroyed during the cyclone?
3.4.5 How many?
3.4.6 How much of your other fishing
equipment (apart from boats) was
damaged/destroyed during the cyclone?
3.5 Transport assets
3.5.1 Did your household own any vehicles
such as bicycles, scooters or trishaws before
the cyclone?
Does not include fishing boats
3.5.2 Specify vehicle type(s)
3.5.3 Were any of these vehicles damaged or
destroyed during the cyclone?
3.5.4 Specify vehicle type(s)
3.6 Business assets
3.6.1 Did your household own a shop or
business before the cyclone?
3.6.2 How much of your stock was
damaged/destroyed during the cyclone?
3.6.3 Was your business premises
damaged/destroyed during the cyclone?
3.7 Other productive assets
3.7.1 Apart from the things we have
discussed, were any other items used by your
household for income-generating activities
damaged/destroyed during the cyclone?
For example: tools for carpentry, materials
for tailoring

No


Yes
No


Yes
No


Yes
No





All
Around three quarters
Around half
Around one-quarter
None


Yes
No


Yes
No










Yes
No
All
Around three quarters
Around half
Around one-quarter
None
Destroyed
Damaged
No damage


Yes
No
3.7.2 Specify
4. Shelter/WASH/NFIs
4.1 Shelter
4.1.1 Was your house damaged/destroyed
during the cyclone?
4.1.2 Have you begun repairing your house
yet?
4.2 WASH
4.2.1 What was your primary source of
drinking water before the cyclone?
4.2.2 What is your current source of drinking
water?
4.2.3 What type of toilet facilities did your
household have access to before the
cyclone?
4.2.4 Did these belong to your own
household, or were they shared?
4.2.4.1 [If shared] How many families did you
share it with?
4.2.5 Were these toilets damaged/destroyed
by the cyclone?
4.2.6 Have you begun repairing this damage?
4.2.7 What type of toilet facilities do you have
access to now?






Destroyed
Heavily damaged
Lightly damaged
Not damaged
Yes
No



















Public tap/standpipe
Tube well or borehole
Protected dug well
Protected spring
Rainwater
Unprotected dug well
Unprotected spring
Bottled water
Collected from outside village
Other
Public tap/standpipe
Tube well or borehole
Protected dug well
Protected spring
Rainwater
Unprotected dug well
Unprotected spring
Bottled water
Collected from outside village
Other








None
Pit latrine with open pit
Pit latrine with concrete slab
Latrine with septic tank
Other
Shared
Own household




Destroyed
Heavily damaged
Lightly damaged
Not damaged




None
Pit latrine with open pit
Pit latrine with concrete slab
Latrine with septic tank
4.2.8 Do these belong to your own household,
or are they shared?
4.2.9 [If shared] How many families do you
share it with?
4.3 Non-food items
4.3.1 What proportion of your household items
were damaged or destroyed during the
cyclone?
For example: furniture, cooking
equipment, clothing
4.3.2 Did your household lose any identity
papers or other important documents during
the cyclone?
4.3.3 Specify
Section 5: Education
5.1.1 Did you have any children attending
primary school before the cyclone?
5.1.2 Are they currently attending school?
5.1.3 If not, why not?
5.1.3.1 Specify other
5.2.1 Did you have any children attending
middle school before the cyclone?
5.2.2 Are they currently attending school?
5.2.3 If not, why not?
5.2.3.1 Specify other
5.3.1 Did you have any children attending
secondary school before the cyclone?
5.3.2 Are they currently attending school?
5.3.3 If not, why not?



Other
Shared
Own household





All
Around three quarters
Around half
Around one-quarter
None


Yes
No










Yes
No
Yes
No
School damaged
No teachers
Unable to physically access
Economic reasons
Safety reasons
Other

Yes
No
Yes
No
School damaged
No teachers
Unable to physically access
Economic reasons
Safety reasons
Other













Yes
No
Yes
No
School damaged
No teachers
Unable to physically access
Economic reasons
Safety reasons
Other
5.3.3.1 Specify other
Section 6: Income, savings and debts
6.1 Income generating activities
6.1.1 Before the cyclone, what was your
household’s main source of income










6.1.1.1 Specify other
6.1.2 Before the cyclone, what was your
household’s second source of income?









6.1.2.1 Specify other
6.1.3 Before the cyclone, what was your
household’s third source of income?










6.1.3.1 Specify other
6.1.4 How many male members of your
household were engaged in incomegenerating activities before the cyclone?
6.1.5 How many female members of your
household were engaged in income
generating activities before the cyclone?
6.2 Income and savings
6.2.1 In the 6 months before the cyclone, what
Paddy farming
Fishing
Livestock rearing
Casual labour
Vegetable garden/plantation
Shop/business
Remittances
Salaried job (teacher, office worker
etc.)
None
Other
Paddy farming
Fishing
Livestock rearing
Casual labour
Vegetable garden/plantation
Shop/business
Remittances
Salaried job (teacher, office worker
etc.)
None
Other
Paddy farming
Fishing
Livestock rearing
Casual labour
Vegetable garden/plantation
Shop/business
Remittances
Salaried job (teacher, office worker
etc.)
None
Other
was your household’s average monthly
income? (Myanmar Kyat)
6.2.2 In the 6 months before the cyclone, what
was your household’s average monthly
expenditure (Myanmar Kyat)
6.2.3 Before the cyclone, what proportion (%)
of your household’s food did you have to buy
(instead of growing)?
6.2.4 Does your household currently have any
savings?
6.2.5 Approximately how much? (Myanmar
Kyat)
6.2.6 Did your household lose any of its
savings during the cyclone (destroyed, stolen
etc.)?
6.2.7 Does your household currently have any
food stored?
6.2.8 How long do you expect this food will
last?
6.3 Debt
6.3.1 Does your household currently have any
debts?
6.3.2 Approximately how much? (Myanmar
Kyat)
6.3.3 Who is the main lender for these debts?
6.3.4 Specify other
Section 7: Coping strategies
7.1 Is your household currently using any of
the following strategies to deal with the effects
of the storm?


Yes
No














All
Around three quarters
Around half
Around one-quarter
None
Yes
No
Less than 1 week
1-2 weeks
3-4 weeks
more than 4 weeks





Friends/relatives
Local shops/businesses
Local money lenders
Government banks
Other

Reducing spending on food or other
essential items
Buying food on credit
Spending from savings
Taking loans
Selling livestock
Selling or mortgaging land
Removing children from school for
economic reasons
Migration of family members to look
for work
Engaging in dangerous or demeaning
work








Yes
No
7.2 Specify other
7.3 If your household receives no support in
the next three months, do you anticipate that
you will have to use any of these coping
strategies?



Cutting more firewood to sell
Other
None

Reducing spending on food or other
essential items
Buying food on credit
Spending from savings
Taking loans
Selling livestock
Selling or mortgaging land
Removing children from school for
economic reasons
Migration of family members to look
for work
Engaging in dangerous or demeaning
work
Cutting more firewood to sell
Other
None











7.4 Specify other
Section 8: Protection
8.1 Since the start of the cyclone, has your
feeling of safety changed?
8.2 [If got worse] what are the reasons for
this?








Improved
Stayed the same
Got worse
Increased crime/violence
More safety incidents when looking
for firewood/food/
More safety incidents when travelling
to private places for hygiene
Less privacy
Food prices increasing (unable to
feed family)
Disputes over land ownership
Don’t know
Other











At emergency shelter points
At water collection points
At bathing spaces
At health facilities
At school
At home
Collecting firewood
At latrines (if applicable?)
None
Don’t know
Other



8.2.1 Specify other
8.3 Since the cyclone, are there any areas
where women and children are at greater risk
of violence?
8.3.1 Specify other
Section 9: Needs
9.1.1 Apart from cash, what is your
household’s main priority need right now?











9.1.1.1 Specify other
9.1.2 Apart from cash, what is your
household’s second priority need right now?











9.1.2.1 Specify other
9.1.3 Apart from cash, what is your
household’s third priority need right now?
9.1.3.1 Specify other
9.2.1 Apart from cash, what is your
household’s main priority need in the medium
term (next three months?)








Food
Water
Sanitation and hygiene
Shelter
Health
Education
Repair of damaged farmland
Replacement of lost productive
assets
Replacement of lost household items
Vocational training
Other
Food
Water
Sanitation and hygiene
Shelter
Health
Education
Repair of damaged farmland
Replacement of lost productive
assets
Replacement of lost household items
Vocational training
Other



Food
Water
Sanitation and hygiene
Shelter
Health
Education
Repair of damaged farmland
Replacement of lost productive
assets
Replacement of lost household items
Vocational training
Other






Food
Water
Sanitation and hygiene
Shelter
Health
Education





9.2.1.1 Specify other
9.2.2 Apart from cash, what is your
household’s second priority need in the
medium term (next three months?)











9.2.2.1 Specify other
9.2.3 Apart from cash, what is your
household’s third priority need in the medium
term (next three months?)











9.2.3.1 Specify other
Repair of damaged farmland
Replacement of lost productive
assets
Replacement of lost household items
Vocational training
Other
Food
Water
Sanitation and hygiene
Shelter
Health
Education
Repair of damaged farmland
Replacement of lost productive
assets
Replacement of lost household items
Vocational training
Other
Food
Water
Sanitation and hygiene
Shelter
Health
Education
Repair of damaged farmland
Replacement of lost productive
assets
Replacement of lost household items
Vocational training
Other