Pregnancy Outcomes of Sinabung Evacuees

In 2010, I was in Kabanjahe, the capital of the Karo regency of North Sumatra, Indonesia, studying marriage and baptism records at the area’s longest standing Catholic church. I sought data on the decline of impal marriage amongst the local Karo people. This was not my first trip to Taneh Karo. I had conducted a 12-month research project in two Karo villages for my PhD project.

There are two volcanoes jutting up from the plateau. The larger one, Gunung Sinabung, which I climbed on one of my earlier trips, had been dormant for 400 years. I rode my motorbike past one of the best vantage points when I noticed smoke issuing from the top of the mountain. I stopped in a village and the people there had noticed too. The place was buzzing with talk of the mountain and the ominous white cloud emanating from the puncak (peak).

Afternoon before first eruption of Sinabung (2010)

Just after midnight that evening, we felt a jarring of the earth, much like the frequent earthquakes I experienced growing up in the Los Angeles area. From the balcony of our rental home, we could see lava emitting from the Gunung Sinabung. Evacuees from near-by villages in the backs of pickup trucks and on motorbikes came flooding in. The next morning there were more eruptions that we could see clearly from Kabanjahe (see below). The eruptions have been occurring on-and-off continuously since that time.

View from my home in Kabanjahe on morning after first eruption (2010)

Evacuating the Volcano

The volcanic eruptions of Gunung Sinabung led to the evacuation of up to 17,000 people. By and large, these people are Karo farmers who are tied to the land on which they make their living. The land is equally important for Karo reproduction as it is for production. Some were able to return to their villages. Others lived in evacuation centres for extended periods. Others evacuated, returned, and re-evacuated. Some villages in the ‘red zone’ have been abandoned permanently and the people relocated to a new village called Siosar.

In 2014 I was awarded a Fulbright Scholars grant to continue my work on the decline of cousin marriage. During that five-month trip, interested in the living conditions of displaced Karo people, I visited evacuees that were staying in various evacuation centres. I was inspired to conduct research on the health of Gunung Sinabung evacuees.

To protect the identities of the participants of our study, we borrowed images of the volcano and its evacuees from the Getty collection (see below).

Embed from Getty Images

New Paper

In 2017-18, I teamed up with a colleague at The Australian National University, Prof Alison Behie, who is an expert at the effects of natural disasters on maternal and child health, and the Chair of the Department of Anthropology at University of North Sumatra, Dr Fikarwin Zuska, who provided logistical support. We received generous funding from the ANU College of Arts and Social Sciences to support a round of fieldwork during which I would track down women who were pregnant during their evacuation. We wanted to compare their pregnancy outcomes with those of women who were pregnant at the same time but lived far enough away from the volcano to not have been evacuated.

The results of this study have been published in the American Journal of Human Biology. We found that the 97 women who were pregnant during their evacuation had an almost five-fold increase in the adjusted odds of having an early or preterm birth compared to the matching sample of 97 non-evacuee women. We also found that births to evacuee women were 1 cm shorter, when controlling for potential confounding factors, than births to non-evacuees.

Our study is important because it adds to the growing evidence that natural disasters lead to poor maternal/child health outcomes. It is one of the first to show early births and shorter, but not underweight, newborns. It is also the first to address evacuation from volcanoes. This is important because we are rapidly approaching a climate change tipping point for volcanic eruptions to become more common, and because volcanoes are location-specific and, thus, lead to increased vulnerability for those already vulnerable.

Kushnick G, Behie A, Zuska F (2021) Pregnancy outcomes among evacuees of the Sinabung volcano, 2010-2018 (North Sumatra, Indonesia): a matched cohort study. Am J Hum Biol, e23628. Link *

* The paper is behind a paywall, which means it is not viewable outside a subscribing library or without purchase. The publisher allows us to post a pre-peer review version of the paper on our personal website, so we have done this. Peer review added to the quality of the paper but the overall conclusions remained unchanged. Click here to see the free pre-peer review PDF.

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