As people around the world look to support earthquake relief efforts in Nepal, scholars from Stanford and the London School of Economics and Political Science offer new research that can help donors make better decisions about where and how to contribute their money.

“NGO reports tend to focus on quantity in delivery, such as numbers of homes and people served—but not on quality,” write Yong Suk Lee (Stanford) and J. Vernon Henderson (LSE).

In a forthcoming paper, the coauthors evaluate reconstruction efforts in Indonesia following the 2004 earthquake and tsunami, and find two trends: aid agencies that directly execute their services—point-to-point—perform the highest quality work. And, when agencies contract their services, higher quality work is performed when a global, not domestic, implementer completes the work.

Knowing this reality, and with improved disclosure of outcomes, the coauthors hope that donors would be able to make more informed choices.

Fishing village survey 

Through fieldwork and three rounds of surveys – in 2005, 2007 and 2009 – Henderson and Lee investigated aid work in Aceh, an area of coastal villages in northern Indonesia (Figure 1).

Humanitarian efforts there focused on “hard aid” such as construction of houses and fishing boats. Total aid delivered amounted to $7.7 billion and was implemented by international and domestic aid agencies—some directly and some as contractors—as well as the Indonesian government.

First, Henderson and Lee conducted a pilot survey, and then with a cohort of surveyors from the University of Indonesia, held interviews with village leaders and fishing families. Participants were asked to rate their housing accommodation, and if applicable, how their fishing activity compared to before the disaster.

“Mostly, we sat with villagers to see how willing they were to talk about aspects of aid,” Lee said. “Since it was several years after the tsunami hit, people were pretty open throughout the process.”

Data from those surveys was combined with information from the Recovery Aceh-Nias relief project database maintained by the government and the U.N., as well as demographic information provided by participants.

Delivering aid: Global v. local

Empirical analysis revealed that aid agencies such as the Red Cross and Catholic Relief Services reflected higher quality aid delivery (at a mean quality near 3.00), while agencies such as Save the Children and Concern Worldwide reflected lower quality (at a mean quality between 1.0-1.5).

“What’s surprising is that reputation didn’t really line up with what was expected,” Lee said, citing a few renowned agencies that didn’t receive high marks.

Lee said this could be explained by the fact that aid agencies that specialize in disaster recovery are better equipped, while a learning curve might exist for agencies with wider missions.

Global aid agencies are more likely to have logistical experience given their reach across multiple disaster situations. And while all NGOs face reputational costs for their results, global aid agencies are greater exposed to criticism because, by size, they’re more visible.

Yet, while global aid agencies and implementers may have the raw skills, local implementers have the cultural know-how.

“Local implementers might not have the most experience – like how to construct a house or manufacture a fishing boat – but they will likely know what’s actually desired,” Lee said. “So, there are obvious tradeoffs at play.”

For example, villagers reported bad ventilation in houses. This was because some aid agencies used small windows and concrete instead of wood material more traditionally used in Indonesia. Some boats were impossible to use because of improper design; they sank upon first use or fell apart after a few months.

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Upper left: A house built in an aid project village shows windows retrofitted after initial construction. Upper right: Boats constructed by aid agencies for fishing activity are refashioned to taxi people and cars. Lower: Fishing boats sit unused on the side of the road many of them impossible to operate, according to villagers surveyed. (Courtesy of Yong Lee).

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Logistics and oversight

Aid delivery depends in many ways on the location and scale of the disaster. But, a few main aspects can determine if an aid agency doing its own work or operating as an implementer meets or exceeds expectations.

Henderson and Lee suggest that agencies that were highly supervisory had greater positive outcomes from their workers. In the case of Aceh, better monitoring and insistence on quality by leadership is a likely corollary between construction of better quality homes and boats.

“Rather than just give money, NGOs need to really oversee the projects. Organization and management are essential facets,” Lee said. “And that requires a lot of additional effort on their part.”

Oversight is especially relevant in disaster situations because of the often-overwhelming need for reconstruction. A flood of less-skilled workers enters the market to fill this gap, and on average the quality of work degrades.

“It’s much more difficult to impose quality control at this point,” Lee said. “So the implication that comes out of it is how does the implementer effectively utilize less-skilled workers.”

Getting to know the implementers and evaluating their work in-progress would help ensure quality on behalf of the aid agency. And, better dissemination of information about aid outcomes would help assure donors that their monies are being applied in the best possible way.

Future study

Most “hard aid” delivered to Aceh’s villages had finished by 2010, but “soft aid” such as democracy promotion and women’s empowerment stayed longer.

Henderson and Lee conducted one final survey in 2011. The data has been offered as open source material for researchers along with the larger data set.

Noting this, Lee said, “We’re thrilled that people are looking into the data further. It’s exactly what we wanted.”

Research projects applying the data include the impact of the tsunami on Aceh’s local economies and health effects on the population, among other areas.

Eyes remain focused on Indonesia as votes for candidates Joko Widodo and Prabowo Subianto are counted in the country’s landmark presidential election.

On Wednesday, the polls reflected a precariously even divide between Widodo, also referred to as "Jowoki," the governor of Jakarta, and Prabowo, an ex-general and son-in-law of the country’s former dictator Suharto. Initial polls show Jowoki holds a slight lead, but the government has yet to declare an outright winner, with neither side conceding at the moment. 

Donald Emmerson, director of the Southeast Asia Forum at Shorenstein APARC, answers a few questions about the election and what it could mean for Indonesia’s fledging democracy.

This election will transfer power from incumbent president Susilo Bambang Yudhoyono, the first to lead the country since its democratic transition. Is this election a turning point for Indonesia?

It is. It is only the third direct presidential election in the history of Indonesia. The first two, in 2004 and 2009, yielded landslide victories for Susilo Bambang Yudhoyono (SBY), giving him two consecutive presidential terms as president. His large margins of victory were, in effect, incontestable. In contrast, the presidential election on 9 July is being sharply contested, based on various "quick count" estimates of who won and by how much. Some of those estimates say that Joko Widodo ("Jokowi") has won. A smaller number of estimates assign victory to his opponent, Prabowo Subianto. These estimated margins of "quick count" success by one candidate over the other are typically small: the differences run between 1 and 5 percent.

These small margins asserted on behalf of contradictory outcomes have politicized the voting-and-counting procedure and stimulated fears of fraud. Prabowo in particular appears to be challenging the legitimacy of a possible win by Jokowi when the official result is announced. That announcement is scheduled to be made by the General Elections Commission on 22 July.

If the official margin of victory is very slender, whether for Jokowi or for Prabowo, the losing campaign could request a ruling on the matter by the Constitutional Court. If the request is taken up by the court, another month could elapse before a legal judgment is issued. Under this alarming if hypothetical scenario, Indonesia's political future could remain in a prolonged limbo conducive to major unrest. 

Given that the polls reflect a tightly contested race, will the losing party accept defeat?

Who knows? It will depend on what happens. That said, there are powerful reasons to believe that the loser, whoever he is, will think twice before taking his case to the streets. The onus on such vengeance as endangering Indonesia's fledgling democracy would be great. We also need to remember that if, as many expect, the election commission (and perhaps, later, the Constitutional Court) validates Jokowi as the next president, he is likely to face a parliamentary majority that supported Prabowo. Indeed, only 37 percent of the seats in the main national legislature are occupied by members of parties that endorsed Jokowi. If Prabowo is declared the loser, and the evidence of electoral malfeasance is absent or minor, Prabowo may accept having lost if he knows he can retain substantial influence over national policy while preparing for another presidential run in 2019. 

Both candidates campaigned on widespread platforms that called for reform in many areas ­– from energy to anti-corruption. What issues are Indonesians most concerned about?

Basically, poverty and corruption. But many Indonesians allocate their votes based less on policy distinctions than on the personalities of the candidates. Prabowo's ability to catch up with Jokowi in popularity during the campaign reflects in no small measure his more charismatic and commanding personality in contrast to Jokowi's relatively lackluster performance.

What steps can the next administration take to keep Indonesia from slipping back to its authoritarian past?

The two candidates are very different in this regard. Prabowo is a former general. He has been implicated in major violations of human rights. He is linked to the autocratic regime that preceded Indonesia's current democratic experiment. One can imagine many steps that Prabowo could take as president to nudge Indonesia back onto its former authoritarian track. He has already said that direct elections are not good for Indonesia.  

As for Jokowi, were he to become president, his task would be to achieve a level of probity and progress in Indonesia sufficient to convince the country that democracy can be effective not just in theory but in practice as well.

 

Emmerson also spoke about the election with Deutsche Welle on 16 July, and the Voice of America on 9 July.

Over 215 million Muslims live in the Asia-Pacific region, but despite their number and proximity to record growth and opportunity in greater Asia, their experience has been one of persistent, widespread socioeconomic and political decline. 

A new book, Modes of Engagement: Muslim Minorities in Asia, published by the Walter H. Shorenstein Asia-Pacific Research Center (APARC) and distributed through The Brookings Institution, offers leading research on this topic and places it in a geographic perspective. Edited by Rafiq Dossani, a senior researcher at the RAND Corporation and Professor at the Pardee RAND Graduate School of Public Policy, the book paves new paths to understanding the paradox of Muslim minorities in Asia. 

Dossani was at Stanford University for nearly fifteen years as a senior research scholar at Shorenstein APARC and as the executive director of the South Asia Initiative, studying the plight of Muslims and higher education in India, among other topics. The book is a result of a seminar series with the book’s contributors.

“Since the 1970s, especially in China, Asia’s growth rate has been unprecedented within Asia’s own history,” Dossani says. Mainstream Asia has seen a rise in job opportunities and income levels, and as a result, an individual ability to accumulate wealth and commit resources to long-term investments, such as education and innovation activities.

However, not all people have found benefit from this modern, economic transformation. Most notably, Muslims have seen a severe decline in their social and political space, as well as a narrowing of their identity.

Analysts find this surprising because history reflects a narrative that says Muslims should have profited along with the rest. “It wasn’t expected that Muslims would lose out in the countries in which they were minorities,” he says.

The volume investigates this puzzle through three case studies: the Philippines, India, and China. In each country, Muslims are at least 5 percent of the population, the largest number being in India. Dossani weaves together common threads that define the Muslim minority experience. Similarities include the impact of state-led ethnic nationalism and forced assimilation. He also writes that Muslims have been unable to use protest to secure any significant, long-term gains.

Given this dire reality, what prospects lie ahead for Muslim minorities? In conversation, Dossani suggests a few policy priorities gathered from the case studies featured in the volume.

Democracy is not the answer

Democracy, a form of governance that is often championed for its equal civic participation, has not facilitated a level playing field for Muslims when theory dictates it should.

“Democracy is not the answer to handling these problems,” says Dossani, emphasizing, “it is a most inadequate answer.”

This situation is evident in the case of India where Muslims have probably done the worst, compared to the Philippines, which also shares a legacy of colonial rule and transition to democracy.

Muslims in India, who have attempted to elevate their interests on the national stage, are stopped by coalition politics. Larger interests of the group can subsume their own, encroached upon further by caste issues, language barriers and other dividing factors. China’s Hui have found a significantly better experience than the Uyghurs, who were separated from mainland China early on and excluded from opportunities afforded there (the Uyghurs reside in a northwest region, Xinjiang). In the case of India, Muslims make up only ten to fifteen percent of the population in almost every state, thus their voice fails to find leverage in the political sphere, and effectively lose out.

Furthermore, democracy is not a panacea when states are vulnerable.

“When you have very weak and fragile states, where intuitions are subject to capture easily, democracy doesn’t work,” Dossani explains. Muslim minorities are unable to gain clout because the majorities, and elites attempting to fill a power vacuum, crowd them out.

Thus, collective interest and concerted efforts on the part of governmental and non-governmental organizations – a larger nexus of individuals working toward common goals – are essential to create momentum and staying power behind Muslim issues.

“You need civil society where it explicitly deals with the issues of minority populations and tries to convince the national government and state governments that improving the lots of minorities should be a national project with commitment to their improvement,” he says.

Development as a way forward

Some national projects were developed to openly address Muslim issues, but this led other internal ethnic and religious groups to ask, “Why are you appeasing the Muslims?”

Especially since 9/11, governments have increasingly come under pressure. Stigmas that narrow Muslim identity into “extremists” and “terrorists” are more progressively shared, making it near impossible for governments to explicitly offer a helping hand to Muslims without domestic backlash. 

But even with the odds against them, Muslim minorities still have a way forward.

In the three countries studied, Muslims have found traces of success, and in other Asian nations such as Sri Lanka and Nepal, there has been considerable accommodation of Muslims. Across all circumstances, “Muslims have done best in countries where the state has focused on education for all,” Dossani says.

Instead of providing ethnic-based aid, governments should focus on resource availability as a main qualifier for assistance. State-sponsored education and health care initiatives that capture the poorest populations help Muslims who inherently fall into this category. 

“Any wise government would say ‘look we want to connect education to development and focus on the poorest, no matter who they are.’ If they do that, Muslims will automatically get their fair share,” he says. The Philippines has already recognized this reality, and begun to implement development projects that naturally include Muslims.

Regime change can also motivate Muslim accommodation, either directly or indirectly, as is likely in the case of India.

Newly appointed Prime Minister Narendra Modi, although said to have an anti-Islamic stance in the past with the Bharatiya Janata Party, may in fact create policies that favor Muslims because it fits in with a grander vision of national growth. 

Referring to Prime Minister Modi, Dossani says, “It’s not clear that he cares about Muslims, but in some ways, he cares about development.

“At some point, any development-conscious person will realize that no country can progress if 15 percent of the country hangs behind.”

Diaspora matters

The swell of migration in the globalized era has made the formation of diaspora communities, dispersed populations outside of country of origin, a common phenomenon. Muslim minorities are a large part of this movement, seeking opportunity and using their ethnic or religious connections to establish a new life elsewhere.

Muslims of Asian origin are located beyond Asia – in the Middle East, North Africa and Southern Europe, among other areas. But despite being removed from their native soil, an allegiance and interest in the homeland typically remains.

“Diaspora exists in a very big way,” Dossani explains. Their influence should not be underestimated, both financially and politically. The Muslim diaspora provides an important channel of support that helps struggling Muslim populations.

Remittances from relatives overseas can bring in substantial transfers of money and support to populations that may not otherwise have enough resources, or be supported by the government. For several years now, one of the single largest inflows of money into the Philippines has been from these outside sources. India’s Muslim diaspora has a strong diasporan foundation with codified institutions set-up to organize relations. China’s experience is less documented, Dossani says, although he conjectures that some diasporan support exists, whether formally or informally.

Diaspora organizations, often led and supported by expatriates, appear to be growing worldwide, and can play a crucial role in the formation of Muslims’ global identity and network of support. Neighboring countries with Muslim majorities, such as Malaysia and Indonesia, have also offered themselves as diplomatic partners in resolving conflicts over Muslims’ conditions, given their own long histories of addressing them internally.

Nearly forty-four percent of Indonesia’s population is living on less than $2 a day, making it near impossible for some to seek proper health treatment. One way to improve this situation is through Indonesia’s conditional cash transfer (CCT) programs, Margaret Triyana says.

The CCT program, first piloted by the World Bank in 2007 and expanded from 2009–10, encourages Indonesia’s most destitute to pursue health-seeking behaviors by reducing barriers to health care through cash incentives. Payment is given for receiving treatments at a local clinic. Essentially, the poor are reimbursed simply for “showing up” for health services.

Triyana, a Jakarta native and postdoctoral fellow in the Asia Health Policy Program, has been in residence at the Shorenstein Asia-Pacific Research Center in the Freeman Spogli Institute for International Studies studying the effects of the CCT program on Indonesia’s poor. She has been evaluating the household CCT program’s two-year implementation, focusing on the maternal and child health initiatives.

She plans to produce multiple papers that focus on issues related to CCT interventions and its impact on mothers and children. Triyana will continue this research after leaving Shorenstein APARC this July, accepting an academic teaching position at Nanyang Technological University in Singapore. 

Recently, Triyana discussed her research with Shorenstein APARC. 

What types of health initiatives does the CCT program sponsor, and for whom?

The CCT program targets Indonesia’s most poverty-stricken by selecting approximately the bottom 30 percent of the poorest households, with preference toward households with pregnant women or school-aged children. Eligibility depends on socioeconomic factors per district such as expenditure, education and asset ownership. The program stretches the rural-urban divide, covering people in and off Java (this is the main island where 60 percent of the population resides). Many initiatives in the household CCT program are focused on child and maternal health. For mothers, they include a series of prenatal care visits, an iron tablet prescription, childbirth assistance and postnatal care. For children, they cover vaccinations, monthly height and weight measurements at the clinic and vitamin A pills. Overall the CCT program is a combination of poverty reduction and human capital investments, attempting to induce good behavior that instills long-term health in low resource settings.

Who is the typical primary care provider in Indonesia?

The primary care provider is often a midwife. This is because Indonesia doesn’t have enough trained doctors to support the growing demand. Clinics operate at the sub-district level, which comprise of 10-15 villages each. Every village is assigned one midwife. Midwives can perform most procedures just short of surgery. For example, midwives offer typical delivery services but refer patients to a district-level hospital for a Caesarean section. This system, for the most part, functions well, but midwives do have an expanded scope of care that can be unsettling. Children have their cuts taken care of by midwives; adults can get antibiotics through them. This diffused system is perhaps more efficient, but it can call into question the legitimacy of their authority. Midwives receive only three years of training for their certification. This is something the Indonesian government intends to inspect and will likely restructure.

What behavior changes do you see as a result of the CCT program?

My initial findings show there is increased utilization of health care programs. The CCT program incentivizes certain behaviors – attending the clinic for a test or retrieving medication – which then, in theory, leads to better health. “Showing up” doesn’t automatically correlate with improved health, but if we think about the population at hand, it would in most cases. People who weren’t using health services before now are. Everyone that was offered the program signed up. Monthly attendance to CCT-linked programs is reported at a rate of 85 percent. In particular to maternal health, I noted a 10 percent increase in delivery fees. This trend follows what we would expect to see – because of increased utilization, there is a natural rise in price for the service. On the demand-side, I found a 40 percent increase in the use of midwives, and a rise in fees paid to providers for maternal and child services. These factors indicate with a high level of certainty that the CCT program lowers barriers to health care. 

Since health is effectively its own market, will increased demand for services cause a rise in price?

Yes, health care is its own market so the supply-demand relationship is relevant. My research looks at the local market because it depends upon the price being offered at the local clinic. Indonesia’s health care system is a public-private mixture, therefore public fees are regulated while private fees are less so. Indonesia now offers universal care, but people can pay a few for services beyond basic coverage. I saw a change in the private domain in terms of demand for services. The “demand shock” caused a bit of a higher price for services. It costs about $80 to meet all of the program requirements. Payment to midwives increased, while a slight decrease occurred for traditional birth attendants. I find no significant change in birth outcomes, and the quality provided by midwives does not appear to be affected by the program. These outcomes are exactly what we’d expect to see; it is consistent with the puzzle in the literature and economics, showing more women and children in the CCT program are seeking care from health care providers, but no change in health outcomes.

Can we expect increased utilization of health services in the long-run?

I anticipate there will be long-term increased utilization. The CCT program seeks to create habit formation by focusing on youth and pregnant mothers. For example, we can see this when expectant mothers attended the clinic for prenatal care, delivery assistance and postnatal care. With cost and travel barriers eliminated or reduced, participants should find it easier to initially come and then return. I did see repeat visits in my research as a positive outcome of the CCT program. A technique used to encourage commitment is a public education program as part of the program. Participants get a group briefing on how the program works, so that they are fully introduced to the incentives and guarantees of the program. 

Does Indonesia plan to extend this into a national program?

Yes, the CCT program is planned to go national later this year. The research shows that the benchmark of high attendance was met, program participants did “show up.” Next steps are to analyze health outcomes in maternal and child health, and then look at policy implications. Indeed, the Indonesian government is seeking ways to better target and deliver health services; it will be interesting to see the long-term effects of this program.

Shorenstein Asia-Pacific Research Center faculty and scholars have published a variety of publications in early 2014, covering topics from the Japanese fiscal condition to disability policy in North Korea. 

Publications are often products of long-standing research projects led by Center affiliates. New Challenges for Maturing Democracies in Korea and Taiwan, coedited by Shorenstein APARC Director Gi-Wook Shin and Center on Democracy, Development and Rule of Law Director Larry Diamond, emerged from the Stanford Korea Democracy Project, which seeks to understand social movements in South Korea.

Postdoctoral fellows who reside at Shorenstein APARC for a year of vigorous study and engagement in Center activities also support research publications. Former visiting scholar Dominik Müller, now at Goethe-University Frankfurt, published Islam, Politics and Youth in Malaysia: The Pop-Islamist Reinvention of PAS. Müller examined the religious bureaucracy of Malaysia at Shorenstein APARC in 2013.

Shorenstein APARC manages an active publishing program with Stanford University Press and the Brookings Institution Press. Center affiliates also publish extensively in external peer-reviewed academic journals and books, as well as in a working paper series led by the Asia Health Policy Program.

Publications released in recent months include: 

Comparative Institutional Analysis: Theory, Corporations and East Asia. Selected Papers of Masahiko Aoki, Masahiko Aoki, Edward Elgar Publishing, 2014

The volume is a collection of 22 articles that span the course of Aoki’s 45-year academic career. The essays cover a wide range of topics from the comparative perspective including corporate governance, institutional change and mechanism design in Japan, China and South Korea. The articles suggest policy responses for industry and governments.

 

Confronting Memories of World War II: European and Asian Legacies, Eds. Daniel Chirot, Gi-Wook Shin, Daniel C. Sneider, University of Washington Press, 2014

Comparing the European and Asian legacies, the book provides insight into the influence that World War II continues to have on contemporary politics and attitudes. The collection gathers a variety of perspectives that compare how Europe and Asia handle memories and reflections of guilt, and how wartime experiences are reinterpreted and used for domestic and international purposes.

 

“Defying Gravity: How Long Will Japanese Government Bond Prices Remain High?” Takeo Hoshi, Takatoshi Ito, Economic Policy, January 2014

The article examines the fiscal regime of Japan and considers if the country can withstand its high debt to GDP ratio. The paper shows that Japan’s fiscal situation is unsustainable through various simulations, and suggests that sufficiently large tax increases and/or expenditure cuts would put government debt on a sustainable path.

 

“Facts, Minds, and Formats: Scholarship and Political Change in Indonesia,” Donald K. Emmerson, Cornell University Press, March 2014

Indonesia has changed dramatically in recent decades, and a wealth of literature highlights divergent interpretations and perspectives surrounding those dynamics. The article considers the demise of liberal democracy, the rise of President Sukarno in 1959, and the latter’s replacement by General Suharto in 1965. The essay is part of the larger volume, Producing Indonesia: The State of the Field of Indonesian Studies.

 

“The Fukushima Nuclear Disaster and the DPJ: Leadership, Structures, and Information Challenges During the Crisis,” Kenji E. Kushida, Japanese Political Economy, Spring 2014

The Fukushima nuclear disaster was a critical event that shook Japan’s political economy, society and national psyche, as well as the world’s perspectives on nuclear energy policy. The article examines how the nuclear disaster unfolded and analyzes the response undertaken by the Democratic Party of Japan under Prime Minister Naoto Kan. Kushida is the Takahashi Research Associate at Shorenstein APARC.

  

“Japan-Korea Relations: Time for U.S. Intervention?” Daniel C. Sneider, National Bureau of Asian Research, January 2014

The paper describes current relations between South Korea and Japan, recognizing that their relationship has noticeably deteriorated in recent months. While the United States has attempted to promote dialogue, its hesitant intervention is unlikely to change the overall dynamic of the Japan-Korea relationship. Sneider suggests that a more active U.S. mediation role could encourage reconciliation and normalization of relations.

 

“People with Disabilities in a Changing North Korea,” Katharina Zellweger, Shorenstein APARC, 2014 

The working paper details the environment that people with disabilities face in the Democratic People’s Republic of North Korea. Despite its reputation as a repressive, closed society where human rights are routinely abused, there are in fact a number of institutions that work to address the needs of the disabled. Zellweger writes from a perspective of a senior aid worker with over thirty years of experience in Asia; she was the Pantech Fellow at Shorenstein APARC from 2011­–13.

 

To view the full listing of publications, as well as reviews and purchasing information, please consult the Publications page on Shorenstein APARC's website.