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Nutrition, physical activity, smoking, and alcohol consumption are major causes of morbidity and mortality related to noncommunicable diseases (NCDs). Hypertension, diabetes type II, cancer, and chronic pulmonary diseases cause 60 percent of deaths worldwide and will likely increase by 17 percent during the next 10 years. Eighty percent of deaths caused by NCDs are registered in low- and middle-income countries in the working-age population and contribute to the growth of poverty [1,2,3].

During the last 15 years in Mongolia the leading causes of mortality have been cardiovascular disease and cancer.

This qualitative survey is one part of the Facility-Based Impact Study (FBIS) and was funded by the MCA Health Project. The overall goal of the MCA Health Project is to reduce mortality and morbidity caused by NCD and traffic accidents. Over a period of five years, the project aims to provide the population with essential knowledge about health promotion, the prevention and early detection of NCDs, and the adoption of healthy lifestyles through capacity building for the health system and, more specifically, for the preventive facilities. One main activity of the project is to improve primary health services related to NCDs through interventions for capacity building on the level of health facilities. This FBIS focuses on assessing the current situation in the facilities to enable a later comparison of the results of this baseline study and a later follow-up study to evaluate the impact of the Health Project on the performance of health staff, their knowledge, attitudes, and practice in the facilities, and the preparedness of facilities in terms of equipment and staff. The survey was carried out by a joint team of local and international consultants from the MCA Health Project, EPOS Health Management and THL Finland, and researchers from the School of Public Health.  

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Asia Health Policy Program working paper # 31
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N. Khuderchuluun
Pekka
Silke
N. Sumberzul
O. Chimedsuren
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The Asia Health Policy Program (AHPP) at Stanford’s Shorenstein Asia-Pacific Research Center (Shorenstein APARC) looks forward to welcoming its incoming 2012–13 research fellows from Mongolian Medical University, the University of Hawai’i, and Harvard. AHPP’s new fellows specialize in research topics including cervical cancer prevention, migrant remittances, and the political economy of support for the elderly.
 

Developing Asia Health Policy Fellows

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Baigalimaa Gendendarjaa

Baigalimaa Gendendarjaa will be joining AHPP from the Mongolian National Cancer Center. Her research includes a comparative study of how knowledge of cervical cancer risk factors has influenced behavior changes in Mongolia before and after the introduction of the National Cervical Cancer Program. She holds a master’s degree in medicine from Mongolian Medical University.

 

 


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Marjorie Pajaron
Marjorie Pajaron took part for five years in the National Transfer Accounts project based in Honolulu. Her research focuses on the role of migrant remittances as a risk-coping mechanism, as well as the importance of bargaining power in the intra-household allocation of remittances in the Philippines. Pajaron received a PhD in economics from the University of Hawai’i at Mānoa.

 

 

 


Asia Health Policy Postdoctoral Fellow 

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Yuki Takagi

Yuki Takagi earned her PhD in government from Harvard University and is completing a postdoctoral fellowship at Princeton. Her dissertation research focuses on the political economy of support for the elderly and intergenerational family transfers, such as nursing and childcare, focusing on Japan. Takagi holds bachelor of economics and master of law degrees from the University of Tokyo.

 

 

Throughout the academic year the AHPP fellows will present seminars, take part in individual and collaborative research projects, and participate in campus events.

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Donald K. Emmerson
Donald K. Emmerson
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Jim Castle is a friend of mine. I have known him since we were graduate students in Indonesia in the late 1960s. While I labored in academe he went on to found and grow CastleAsia into what is arguably the most highly regarded private-sector consultancy for informing and interfacing expatriate and domestic investors and managers in Indonesia. Friday mornings he hosts a breakfast gathering of business executives at his favorite hotel, the JW Marriott in the Kuningan district of Jakarta.

Or he did, until the morning of July 17, 2009. On that Friday, shortly before 8am, a man pulling a suitcase on wheels strolled into the Marriott's Lobby Lounge, where Jim and his colleagues were meeting, and detonated the contents of his luggage. We know that the bomber was at least outwardly calm from the surveillance videotape of his relaxed walk across the lobby to the restaurant.

He wore a business suit, presumably to deflect attention before he blew himself up. Almost simultaneously, in the Airlangga restaurant at the Ritz Carlton hotel across the street, a confederate destroyed himself, killing or wounding a second set of victims. As of this writing, the toll stands at nine dead (including the killers) and more than 50 injured.

On learning that Jim had been at the meeting in the Marriott, I became frantic to find out if he were still alive. A mere 16 hours later, to my immense relief, he answered my e-mail. He was out of hospital, having sustained what he called "trivial injuries", including a temporary loss of hearing. Of the nearly 20 people at the roundtable meeting, however, four died and others were badly hurt. Jim's number two at CastleAsia lost part of a leg.

The same Marriott had been bombed before, in 2003. That explosion killed 12 people. Eight of them were Indonesian citizens, who also made up the great majority of the roughly 150 people wounded in that attack - and most of these Indonesian victims were Muslims. This distribution undercut the claim of the country's small jihadi fringe to be defending Islam's local adherents against foreign infidels.

But if last Friday's killers hoped to gain the sympathy of Indonesians this time around by attacking Jim and his expatriate colleagues and thereby lowering the proportion of domestic casualties, they failed. Of the 37 victims whose names and nationalities were known as of Monday, 60% were Indonesians, and that figure was almost certain to rise as more bodies were identified. The selective public acceptance of slaughter to which the targeting of infidel foreigners might have catered is, of course, grotesquely inhumane.

Since Susilo Bambang Yudhoyono was first elected president in 2004, Indonesia's real gross domestic product has averaged around 6% annual growth. In 2008 only four of East Asia's 19 economies achieved rates higher than Indonesia's 6.1% (Vietnam, Mongolia, China and Macau). In the first quarter of 2009, measured year-on-year, while the recession-hit economies of Malaysia, Singapore and Thailand all shrank, Indonesia's grew 4.4%. In the first half of 2009, the Jakarta Stock Exchange soared.

The economy is hardly all roses. Poverty and corruption remain pervasive. Unemployment and underemployment persist. The country's infrastructure badly needs repair. And the economy's performance in attracting foreign direct investment (FDI) has been sub-par: The US$2 billion in FDI that went to Indonesia in 2008 was less than a third of the $7 billion inflow enjoyed by Thailand's far smaller economy, notwithstanding Indonesia's far more stable politics.

Nevertheless, all things considered, the macro-economy in Yudhoyono's first term did reasonably well. We may never know whether the killer at the Marriott aimed to maximize economic harm. According to another expat consultant in Jakarta, Kevin O'Rourke, the day's victims included 10 of the top 50 business leaders in the city. "It could have been a coincidence," he said, or the bombers could have "known just what they were doing".

Imputing rationality to savagery is tricky business. But the attackers probably did hope to damage the Indonesian economy, notably foreign tourism and investment. In that context, the American provenance and patronage of the two hotels would have heightened their appeal as targets. Although the terrorists may not have known these details, the Ritz-Carlton Hotel Company is an independently operated division of Marriott International, Inc, which owns the JW Marriott brand, and both firms are headquartered on the outskirts of Washington DC.

Second-round revenge against the Marriott may also have played a role - assaulting a place that had rebuilt and recovered so quickly after being attacked in 2003. Spiteful retribution may have influenced the decision to re-attack the Kuta tourist area in Bali in 2005 after that neighborhood's recovery from the bomb carnage of 2002. Arguable, too, is the notion that 9/11 in 2001 was meant to finish the job started with the first bombing of the Twin Towers in 1993. And in all of these instances, the economy - Indonesian or American - suffered the consequences.

Panic buttons are not being pushed, however. Indonesian stock analyst Haryajid Ramelan's expectation seems plausible: that confidence in the economy will return if those who plotted the blasts are soon found and punished, and if investors can be convinced that these were "purely terrorist attacks" unrelated to domestic politics.

Sympathy for terrorism in Indonesia is far too sparse for Friday's explosions to destabilize the country. But they occurred merely nine days after Yudhoyono's landslide re-election as president on July 8, with three months still to go before the anticipated inauguration of his new administration on October 20. That timing ensured that some would speculate that the killers wanted to deprive the president of his second five-year term.

The president himself fed this speculation at his press conference on July 18, the day after the attacks. He brandished photographs of unnamed shooters with handguns using his picture for target practice. He reported the discovery of a plan to seize the headquarters of the election commission and thereby prevent his democratic victory from being announced. "There was a statement that there would be a revolution if SBY wins," he said, referring to himself by his initials.

"This is an intelligence report," he continued, "not rumors, nor gossip. Other statements said they wished to turn Indonesia into [a country like] Iran. And the last statement said that no matter what, SBY should not and would not be inaugurated." Barring information to the contrary, one may assume that these reports of threats were real, whether or not the threats themselves were. But why share them with the public?

Perhaps the president was defending his decision not to inspect the bomb damage in person - a gesture that would have shown sympathy for the victims while reassuring the population. He had wanted to go, he said, "But the chief of police and others suggested I should wait, since the area was not yet secure. And danger could come at any time, especially with all of the threats I have shown you. Physical threats."

Had Yudhoyono lost the election, or had he won it by only a thin and hotly contested margin, his remarks might have been read as an effort to garner sympathy and deflect attention from his unpopularity. The presidential candidates who lost to his landslide, Megawati Sukarnoputri and Jusuf Kalla, have indeed criticized how the July 8 polling was handled. And there were shortcomings. But even without them, Yudhoyono would still have won. In this context, speaking as he did from a position of personal popularity and political strength, the net effect of his comments was probably to encourage public support for stopping terrorism.

One may also note the calculated vagueness of his references to those - "they” - who wished him and the country harm. Not once in his speech did he refer to Jemaah Islamiyah, the network that is the culprit of choice for most analysts of the twin hotel attacks. Had he directly fingered that violently jihadi group, ambitious Islamist politicians such as Din Syamsuddin - head of Muhammadiyah, the country's second-largest Muslim organization - would have charged him with defaming Islam because Jemaah Islamiyah literally means "the Islamic group" or "the Islamic community".

One may hope that Din's ability to turn his Islamist supporters against jihadi terrorism and in favor of religious freedom and liberal democracy will someday catch up to his energy in policing language. Yet Yudhoyono was right not to mention Jemaah Islamiyah. Doing so would have complicated unnecessarily the president's relations with Muslim politicians whose support he may need when it comes to getting the legislature to turn his proposals into laws. Nor is it even clear that Jemaah Islamiyah is still an entity coherent enough to have, in fact, masterminded last Friday's attacks.

Peering into the future, one may reasonably conclude that the bombings' repercussions will neither annul Yudhoyono's landslide victory nor derail the inauguration of his next administration. Nor will they do more than temporary damage to the Indonesian economy. As for the personal aspect of what happened Friday, while mourning the dead, I am grateful that Jim and others, foreign and Indonesian, are still alive.

Donald K Emmerson heads the Southeast Asia Forum at Stanford University. He is a co-author of Islamism: Contested Perspectives on Political Islam (Stanford University Press, November 2009) and Hard Choices: Security, Democracy, and Regionalism in Southeast Asia (Stanford/ISEAS, 2008).

Copyright 2009 Asia Times Online (Holdings) Ltd. All rights reserved.

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After a brief description of the legacy of the past of the Mongolian political system, the lecture then considers the influence of the Socialist era and finally focuses on the post-Socialist era, dealing with both the successes and failures of the so-called Democratic Union which currently rules the country. A brief analysis of Western and U.S. policy will also be included. Morris Rossabi, born in Alexandria, Egypt, received his Ph.D. in Chinese and Central Asian History at Columbia University. Author of Khublai Khan: His Life and Times (Main Selection, History Book Club, May, 1988), China and Inner Asia, The Jurchens in the Yuan and Ming, Voyager from Xanadu and editor and contributor to China Among Equals. Has also contributed three chapters to Cambridge History of China and numerous other books on traditional China and Inner Asia. He also wrote chapters for the catalogs for the following museum exhibitions: "Mongolia: The Legacy of Chinggis Khan" (Asian Art Museum, San Francisco), "When Silk Was Gold" (Metropolitan Museum of Art), and "Ilkhanid Art" (Metropolitan Museum of Art, Los Angeles County Museum of Art). Professor Rossabi is Board member of the Project on Central Eurasia of the Soros Foundations and is currently conducting research for a book on modern Mongolia at the Asia/Pacific Research Center of Stanford University.

Reuben W. Hills Conference Room

Morris Rossabi Professor Speaker Department of History, Queens College Columbia University
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