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Action to Address a Stakeholder-Identified Need: Development of a Questionnaire to Improve Resolution after Medical Injury

July 27, 2020
By 25572

Associate Professor Jennifer Moore, a former Sylff fellow at Massey University in New Zealand, implemented a research project to assess the needs of injured patients and their families after medical injury with funding from Sylff Leadership Initiatives (SLI) from January 2019 to April 2020. The survey tool she developed and refined throughout the project is expected to facilitate better and happier reconciliation processes between healthcare organizations and injured patients and families after medical injury.

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“I wish there had been a questionnaire like this that was given to me after the hospital injured me! I recently had a hip replacement, and the provider posted a survey to me. It was so bad that I didn’t complete it. I thought, ‘Do these people have common sense? What does this mean?’ I wonder if they didn’t do what you are doing and [trial] the survey with the actual patients. I think it is so important to actually trial test it on patients first.” (Injured patient from New Zealand, comments during a cognitive interview, January 2019. The word in brackets in the quotation was edited by the author).

 

Introduction

This project was the first to attempt to develop a questionnaire to assess injured patients’ and families’ needs after medical injury. We pretested a draft version of the questionnaire with injured patients and families in New Zealand and the United States. In the quotation above, the injured patient highlights the importance of pretesting questionnaires to increase the likelihood that it will be an effective tool.   

Medical injury is unexpected harm caused by medical care. After heart disease and cancer, medical injuries have been identified as the third leading cause of death in the United States; this conclusion is consistent with findings from research undertaken in other countries, such as Canada, Japan, and New Zealand, and these statistics have generated calls for “greater attention” to medical injury because of the scale of this global issue.[1] An additional well-documented issue is that healthcare institutions’ responses to medical injuries, particularly their attempts at resolution, frequently fail to meet patients’ expectations and needs.[2] The literature also highlights that poor responses from healthcare organizations exacerbate the psychological, physical, and financial effects of medical injuries.[3]

During my recent research about the resolution of medical injury, the key stakeholders and participants identified another important social problem that requires action. Most healthcare organizations are interested in doing a better job of meeting injured patients’ and families’ emotional, informational, and practical needs after medical injury but currently lack tools to evaluate how well they met those goals.

Jennifer with her daughter Rebecca and two research participants

Research Objective, Methods, and Dissemination

Therefore, this project’s key objective was to address that gap, and stakeholder-identified need, by developing a questionnaire that healthcare organizations can use to assess how well they met the needs of patients who suffered medical injuries during their care. To develop the questionnaire, we undertook the following steps.

  • We designed a draft version of what we call the Medical Injury Reconciliation Experiences Survey (MIRES). This draft was based on findings from our two previous studies of injured patients’ experiences of nonlitigation approaches to resolving medical injuries.
  • We performed a content analysis of transcripts from a stratified random sample of interviews conducted with injured patients in New Zealand and the United States in 2015–16.
  • We extracted themes describing what is important to patients following medical injury and developed a draft questionnaire with question domains and items corresponding to these themes.
  • We revised the draft questionnaire following review and feedback from expert clinicians, risk managers, and patient advocates.
  • We pilot tested the revised questionnaire on a sample of 24 injured patients and family members in the United States and New Zealand, conducting cognitive debriefing interviews focused on the comprehensibility and completeness of the questionnaire.
  • We further revised the instrument based on this feedback. Thirty-seven revisions were made in response to their suggestions.
  • We traveled to New Zealand to disseminate and implement the questionnaire to key stakeholders in New Zealand, such as district health boards' public hospitals, the Ministry of Health, the Accident Compensation Corporation, and the patient advocacy group Acclaim. I traveled around New Zealand (particularly Christchurch, Dunedin, and Wellington) to meet with representatives from the key stakeholder organizations to explain the questionnaire to them and to discuss how best to implement it in their organization.
  • We are in regular, ongoing contact with the representatives of the key stakeholder organizations in New Zealand to answer their questions about the questionnaire and to ask about their initial experiences using it.
  • We submitted a paper to an academic journal that reports the results of the survey development.
  • After the COVID-19 travel bans are lifted, we will travel to New Zealand again at the stakeholders’ request to discuss implementation progress and to undertake any further edits to the questionnaire that may be required.
  • Once the COVID-19 travel bans are lifted, I will also travel to the United States again to discuss implementation progress at the participating hospitals. The intention was to visit the United States in May 2019, but that trip was canceled because of COVID-19. (Sylff funded the New Zealand part of the project, not the US part. We are very grateful to Sylff for their support.)

Once our research paper is accepted, it will be important to disseminate the paper, because our project is the first to attempt to develop a questionnaire to assess injured patients’ needs after medical injury. Further research could use our questionnaire to undertake a full validation study.

The final version of the questionnaire included the following domains:

  • perceptions of communications with healthcare providers after the injury (11 items);
  • perceptions of remedial gestures, such as apology and compensation (12 items);
  • indicia of the patient’s overall satisfaction with the reconciliation process (3 items);
  • the nature and impacts of the injury (5 items); and
  • characteristics of the patient (5 items).

 

Conclusion

Jennifer with a patient's research participant's puppy during the cognitive debriefing interview about the draft questionnaire.

Injured patients and their families expressed the view that they appreciated the opportunity to assist with the survey design process. The survey was feasible to administer with pencil and paper, taking around 10 minutes to complete. The MIRES appears to be comprehensible and acceptable to patients and offers a practicable means by which healthcare organizations can assess how well their reconciliation processes are meeting injured patients’ needs. One of the US patients who participated in this project observed that the “questionnaire has the power to help so many other patients like me.”    

[1] Martin Makary and Michael Daniel, “Medical Error—The Third Leading Cause of Death in the US,” British Medical Journal 353 (May 2016): 2139, https://doi.org/10.1136/bmj.i2139.

[2] Frederick S. Southwick et al., “A Patient-Initiated Voluntary Online Survey of Adverse Medical Events: The Perspective of 696 Injured Patients and Families,” BMJ Quality and Safety 24, no. 10 (October 2015): 620–29.

[3] Elaine O’Connor et al., “Disclosure of Patient Safety Incidents: A Comprehensive Review,” International Journal of Quality in Health Care 22, no. 5 (October 2010): 371–79.

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Exploring Nuclear Transitions: In Quest of a Framework

July 14, 2020
By 26651

Shounak Set, a Sylff fellow from Jadavpur University, is currently pursuing his PhD at King’s College London. His SRA was conducted at Jadavpur University, which is home to the oldest and largest international relations program in India and is also distinguished by close institutional ties with the Indian defense research establishment. The field trip culminated in immeasurable value for his doctoral dissertation.

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In the second half of the twentieth century, the advent of nuclear science left an indelible imprint in the practice and study of international relations. Nuclear proliferation refers to the spread of nuclear technologies and energy for both civilian and military purposes. Given the political and technological ramifications of the nuclear sector, the nuclear policies of states are essentially a subset of their foreign policy, but they are driven by a variety of discrete considerations. With its apocalyptic potentials, nuclear energy can devastate humankind through atomic weapons, but they can also be a harbinger of prosperity if harnessed for generating electricity. That being the case, when do states use nuclear energy for cooperation, and when for confrontation?

The author meeting with Avtar Singh Bhasin, an eminent archivist of Indian diplomatic history. A one-man army, Mr. Bhasin, having retired from the Ministry of External Affairs, voluntarily collects and publishes relevant documents that are otherwise inaccessible for the benefit of researchers.

The urge to answer these questions resulted in a six-month field trip to India from mid-September 2019 to mid-March 2020, where Jadavpur University served as the host institute. India represents both a challenge and an opportunity for academic engagement on account of its scale and complexity; and it questions several prevailing tenets and assumptions of international relations. At once a rising power and an impoverished nation, both a young state and a legatee to an ancient civilization, it simultaneously confirms and contests prevailing tenets of social science and poses unique challenges of research design. The first country to call for nuclear disarmament on the global stage in 1955, India conducted a series of nuclear weapons tests in 1998 to herald a new epoch. Likewise, after decades of righteous indignation at the institutionalized arbitrariness of the global nuclear order, India was eventually accommodated there in an unprecedented manner through the India-US Civil Nuclear Agreement of 2008. In addition to the selection of India as a case, the specific focus on these historical events underscored that the area of focus was situated along several research paradigms including but not limited to international security, science and technology, global order, and political contestation.

Brass Tacks: The Exercise

The field trip—as part of a doctoral study at King’s College London that interrogates the conventional understanding on these two episodic events, namely the 1998 nuclear tests and the India-US Civilian Nuclear Agreement of 2008—was undertaken with the primary aim of data collection, which was to be supplemented by discussions with topical experts. The primary sources mostly comprised interviews and archival material, and the absence of declassified material on the thematic area of focus (nuclear decision-making and proliferation), along with the associated sensitivity of the subject area, impelled an exercise in triangulation research through an interdisciplinary prism. Accordingly, data was collected from multiple sources in tandem with elite interviews among a wide range of individuals comprising mostly retired diplomatic, security, and political functionaries who had been direct participants in the cases under study. The initial plan was to conduct 20 interviews, but 35 interviews were ultimately conducted across New Delhi, Kolkata, and Bangalore through snowball sampling; this to led to progressive uncovering of diverse aspects. In order to facilitate optimum utilization of resources, archival research in New Delhi and Kolkata was conducted concurrently with the interviews rather than following a sequential approach.

The author interviewed Dr. V. S. Arunachalam, the scientific advisor to successive Indian defense ministers from 1982 to 1992. Dr. Arunachalam has been intimately associated with the Indian missile and nuclear weapons development programs.

Along with the above, discussions and consultations with 16 topical experts were also undertaken, which contributed toward refining the project by clarifying several aspects. Requisite steps such as anonymization of certain interviewees and data security protocols were followed for storage of confidential data and protecting the identities of key personnel as per considerations of security and research ethics.

Research Redux

Essentially probing the intersection between nuclear policymaking and domestic factors in India, the study adopts process tracing to analyze policy transformations through a foreign policy change framework. In conducting in-depth case studies of major foreign policy changes in the recent past, it hypothesizes that domestic politics gain salience during points of significant transformation and leverages the findings in a theory-building exercise through Bayesian reasoning. This approach accounts for the diversity of ideational and institutional forces at play in these policy transitions of historic magnitude; these forces remain inadequately addressed by extant studies, which are circumscribed by linear approaches characteristically prioritizing global-level variables at the cost of the domestic and vice versa.
While the nuclear tests in 1998 heralded a “Second Nuclear Age” in tandem with the realities of the global shift of power from the West to the East, the India-US Civil Nuclear Agreement of 2008 epitomized a metamorphosis of the global order through an irreversible transformation of the international nonproliferation regime. These events portended global ramifications, marked a drastic reorientation of India’s external behavior, and were accompanied by salient domestic political realignments.
Cognizant of these manifested confluences of global, regional, and domestic factors, this study eschews singular explanatory frameworks and attempts to construct an integrative model that explains major policy transformations. The research identifies political parties as the salient vector of domestic politics and probes the interface between political parties and major foreign policy outcomes of the recent past. Political parties form the government, which conducts foreign policy. However, scholars of comparative politics deal with political parties but leave the study of foreign policy to their counterparts in international relations and vice versa. In the process, the interlinkage between political parties and foreign policy remains in the shadows. While studies on political parties in international relations are scarce in general, in the case of India, there is a conspicuous absence.

Relevance and Outcome
The quality and quantity of the accumulated data has contributed substantially to the structural robustness of the key argument and has convinced me to add another chapter to my dissertation. The number of chapters based on my field trip data stands at three, in contrast to my initial plan of two for the same. With the progression of the field trip, the unpacking of historical cases and their attendant complexities corroborated the initial formulations of the study, which had problematized the conventional narratives.

The author after an interview with Mr. Maharaja Krishna Rasgotra, the Indian foreign secretary from 1982 to 1985. Having joined the Indian Foreign Service in 1949, Mr. Rasgotra has been involved in several historic moments in Indian diplomacy, and his counsel has been sought by successive prime ministers of India.

While the bulk of the literature is premised on the insularity of domestic politics in the conduct of Indian diplomacy, this study finds that major foreign policy changes are not generated by exogenous factors alone; and despite its limited salience in regular times, domestic politics gain a critical dimension during these moments of transition. This is crucial, since it reflects foreign policy making in a rising power and builds on a growing body of research on rising powers in international relations. The major findings indicate a gap between existing conventional postulates and the empirical specificities, as the timing of the 1998 nuclear tests and the unprecedented reorientation of the international nuclear order through the India-US Civil Nuclear Agreement contest existing theories of international relations. These include a global-domestic dichotomy in the process of salient junctures and a limitation of path-dependency models.
Previously unexamined primary sources highlighting the need for alternate explanations of historical cases were uncovered and pose significance for potential revision of extant conceptions and assumptions. The collected data facilitates the broadening and widening of the empirical and conceptual templates of foreign policy analysis, which remains anchored in a Western setting. While the process has affirmed the major observations of the study prior to this field trip, it has also led to a reappraisal and update of some earlier formulations of this study.

Concluding Remarks

Professor Shibashis Chatterjee, the director of the Sylff Program at Jadavpur University, acted as the local supervisor and added considerable value to the project. Professor Chatterjee happens to be the director of the School of International Relations and Strategic Studies and an acknowledged expert in the specific topic as well, with acclaimed publications to his name. While our interactions in themselves proved to be intellectually enriching to the project, Professor Chatterjee also made efforts to help me access relevant institutions and provided consistent administrative support. The latter proved to be crucial as, toward the end of 2019, India was witnessing severe political upheaval, which generated grave law and order issues and adversely affected my schedule. Since the completion of the project, he has also emerged as a benevolent mentor concerned about my professional and social well-being in the true spirit of the Sylff family.
The extended Sylff community at Jadavpur University provided a friendly and welcoming milieu that made my stay in India pleasant and memorable. In retrospect, the field trip facilitated by the Sylff Research Abroad program has not only been of immeasurable value to the doctoral dissertation, but it has also been instrumental for my professional growth. In the vortex of the twenty-first century, radical trends typically overwhelm extant arrangements and generate new challenges without resolving older ones. Against this backdrop, this journey has been immensely fulfilling at both the emotional and intellectual levels and shall enable me to embark on my career as a scholar engaged in the study and promotion of international peace and human understanding.

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Multi-Dimensional Challenges, Multi-Sectoral Innovations: The Resilience of Common Forest Management in Japan

June 22, 2020
By 26719

Yance Arizona[1] is a 2011 Sylff fellow from the University of Indonesia and currently a PhD candidate at Leiden University in the Netherlands. Using an SRA award, he visited the Osaka University of Tourism in Japan and the University of New South Wales in Australia to sharpen the comparative elements of his research on customary land recognition in Indonesia. In this article, he focuses on lessons learned about the resilience of common forest management in Japan by discussing the challenges and innovations of state and nonstate actors.

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Community-based forest management has a long history in rural Japan. Since the Edo period (1603–1868), rural communities have shared their collective land and labor to maintain forest and other natural resources for self-sufficiency. This model of natural resource practice is known as common forest management. The common forest, called iriai in Japanese, became integrated into the traditional village system.[2] The membership of iriai common forest groups is embedded in that of traditional Japanese villages (mura). However, common forest management has slowly changed over time due to internal and external factors since Japan entered the industrial revolution. This article discusses several challenges concerning the current practice of common forest management in Japan. I also reveal several initiatives by the government and citizens to restore collaborative forest management and to renew interest in rural development. The analysis in this article is based on interviews, literature studies, and observations conducted in two rural areas in Japan during my Sylff Research Abroad (SRA) fellowship in November and December 2019.

 

What Is the Common Forest in Japan?

Many scholars have used the iriai forest or common forest in Japan as an illustrative example of potential community-based management as an alternative to private property ownership and an extractive model of natural resource management (Mitsumata and Murata 2007; Berge and McKean 2015). For a long time, the rural population in Japan has collectively engaged in agricultural activities in shared communal land by planting trees, especially sugi and pine, to meet their daily needs. Iriai groups have collectively cleared, planted, maintained, and harvested forest products to provide mutual benefits among the members. The membership of the common forest group was initially based on the membership of a village. Since the Japanese government installed modern development programs, primarily through the Meiji Restoration (1868), many traditional concepts, laws, and activities have slightly changed. In the following section, I will discuss five concerns about recent developments in common forest management in Japan.

Five Challenges of Common Forest Management

The common forest practice in Japan faces multidimensional challenges. Here I will briefly discuss five major challenges of the common forest in Japan, including demographic, economic, environmental, institutional, and regulatory factors.[3] Firstly, legal uncertainty leads to misrecognition and disputes among iriai rights holders (regulatory factor). During the Meiji era (1868–1912), Japan’s Civil Code began to take effect. The Civil Code is a mark that Japan began incorporating a modern legal system inspired by the German and French legal traditions (Kanamori, 1999). Regarding the property right regime, the modern Civil Code strictly divides land property into private and public properties (Suzuki, 2013: 67–86). In short, private property is in the ownership of individual citizens, whereas public property belongs to the state or other public bodies. This dichotomy leads to uncertainty regarding the legal status of iriai forests because the iriai model cannot be categorized as either private or public property. As a result, Article 263 of the Civil Code considers the common forest to be in the co-ownership of a group of citizens. By contrast, Article 294 stipulates iriai as the right of the local population to use state land or forest. Neither of these articles represents the original model of iriai forest rights, which combine communal and individual land ownership.

Misrecognition of the legal status of the common forest in the Civil Code generates ambiguity in land registration practices. Iriai rights holders have to register their common land and forest under “nominal names” on behalf of other legal entities. Gakuto Takumura (2019) demonstrates six models of how iriai rights holders register their communal land rights. These six models of adaptation to the modern land administration system appear in the registration of a common forest on behalf of other legal entities, such as (a) a leader of a village, (b) several leaders of a village, (c) all household heads in a village, (d) a shrine or temple of a village, (e) a new municipality, or (f) a district, a cooperative, or an authorized community association. Registering the iriai right under nominal names has occasionally caused legal disputes among the iriai rights holders. One case that received much attention in Japan was the Kotsunagi case, which took decades for the courts to settle (Inoue and Shivakoti 2015).

 

The author gives a guest lecture on customary forests and tourism in Japan and Indonesia at the Osaka University of Tourism. Detailed information can be found at https://www.tourism.ac.jp/news/cat3/5810.html.

The second concern is government imposition of the modernization of iriai forest management (institutional factor). Besides the legal status, another institutional challenge to the iriai forest is the modernization of the rural administrative system. In the early period of the Meiji era, the Japanese government announced a policy to modernize village governments. The modernization of village government affects iriai forest management because iriai group membership was traditionally based on membership in a traditional Japanese village. This challenge parallels the general trend in rural Japan to merge villages rather than splitting them into several smaller villages. When two or more villages are merged, a question arises regarding the ownership and membership of iriai rights, whether it still belongs to the initial village that has merged or it becomes the co-ownership of the new village union.

Another striking policy by the Japanese government to modernize iriai forest management is the Modernization of the Common Forest Act of 1966 (Takahashi and Matsushita 2015). This act intended to transform traditional common forest practices into modern forest management. However, the implementation of this act did not result in a uniform model of forest management; instead, the act has been adopted in different models of forest management depending on the social conditions of iriai rights holders. Research by Daisaku Shimada (2014) revealed how rural communities in the Yamaguni district in Kyoto adapted to the Modernization of Common Forest Act and other external influences, such as population change and the timber liberalization policy in securing common forest management. Rural communities modify their common forest institution to allow migrants to be members of new forest management boards.

The third challenge is depopulation and urbanization (demographic factor). In contemporary Japan, depopulation and urbanization are central issues in the debate on rural development. Japanese society is experiencing depopulation because of a low birthrate and an aging population. At the same time, the urbanization level is dramatically high. Many young people move away to live in urban areas, leaving the rural areas mainly inhabited by older generations. Depopulation and urbanization affect the membership and decision-making process in common forest management. The membership of iriai forest groups shrinks as some of the members move to the city or elsewhere, causing a reduction of the workforce in the management of the common forest. In the past, iriai rights holders lived permanently in a village. When someone moved to other villages, his or her rights to the iriai forest vanished. Today, some people consider their rights to remain valid even when they have moved to other villages. Another problem in terms of people’s mobility concerns the decision-making process in common forest management. Traditionally, iriai rights holders decide on common forest management through a consensual agreement among the group members (Goto 2007). If a member of the iriai group is not involved or disagrees with the majority opinion, it means that the group has not reached a consensual decision. Currently, some iriai groups apply flexible categorization to their common forest membership by including newcomers to the board and involving them in the decision-making process. The lack of a clear decision-making process and a shrinking workforce have led to the underuse of iriai forests in several places in rural Japan.

The fourth problem is the timber liberalization policy (economic factor). In the 1960s, the Japanese government introduced a timber trade liberalization policy to support industrial development. This policy increased timber import from other countries, mainly from the United States, Russia, and Southeast Asian countries. As a result, this strategy decreased the competitiveness of domestic timber production and the economic value of wood, which has been the core commodity of common forests. Before the timber liberalization policy, the common forest supplied wood for building houses, offices, castles, and temples, as well as for making furniture, and provided firewood for cooking and heating. From the 1960s onward, as the country entered a period of rapid economic growth, Japan replaced the use of wood with other resources. The use of concrete and steel is more dominant for residential buildings and offices, and the use of fossil fuels in place of firewood is increasingly widespread. In addition, to meet domestic wood demand, the Japanese government no longer relies on domestic supplies and relies instead on imported wood. This timber import policy devastated Japan’s domestic timber production and market. Consequently, the core business of iriai forests, that of meeting domestic wood demand, has gradually declined. Lack of productive activities in rural areas also became one of the drivers for rural people to move to big cities.

 

Together with a group of postgraduate students from Kyoto University, the author visits a private forest in Kawakami Mura, Nara Prefecture. This forest site is the oldest planted forest in Japan.

The final concern relates to land degradation (environmental factor). Iriai rights holders maintain the common forest by growing supporting plants around the main trees. These plants support soil fertility and provide economic benefits to farmers. However, due to the shortage of labor to maintain the common forest, conifer plantations are left unmaintained. At first glance, this condition looks good for conservation, because forests are left green and trees grow for long periods. But apparently, this is not suitable for the healthy growth of the main trees because they are in competition with the shrubbery. Moreover, unmanaged conifer plantations cause frequent landslides in rural areas. These disasters are compounded by the typhoon and earthquake catastrophes that often occur in Japan. This environmental vulnerability is not only the cause but also the result of underutilization of the common forests.

Revitalization Movements

The revitalization of common forest management in Japan corresponds with an attempt to improve rural livelihoods. The Japanese government and nongovernmental organizations engage in rural development, including the revival of common forest management. The Japanese government, through the Ministry of Internal Affairs and Communications, implements a program to increase the interest of urban residents, either Japanese citizens or immigrants, in living in rural areas. These people from different locations assist rural community members in meeting their basic needs, especially related to health and livelihood. Moreover, the Japanese government promotes a “forest volunteer program” to attract people’s interest in getting involved in forest restoration activities. Forest volunteers are individuals other than forest owners or those with a direct interest, who participate in on-site work necessary for forest management in response to the critical state of the forests. Shinji Yamamoto (2003) found that the forest volunteer program has been generating a positive impact on drawing urban people’s interest in forestry activities. This program began in the 1970s and has since spread across the country. According to Japan’s Forestry Agency, the number of citizens’ organisations that have participated in forest volunteer activities was 2,677 as of 2010 (Yamamoto 2003). 

Nonprofit organizations and universities also run several programs to enhance the interest of young generations regarding rural livelihood and environmental management. A crucial example is the kikigaki program. Literally, kikigaki consists of the words kiki (“listening”) and gaki (“writing”). The kikigaki program encourages young people to take an interest in the stories of local people. Kikigaki is a learning method for understanding someone’s life story through direct dialogue. Since 2002, high schools in Japan have adopted the kikigaki method to raise students’ awareness of societal problems faced by rural communities (Effendi 2019). Due to the increase in global attention toward environmental issues, the kikigaki program also covers environmental education for children. Environmental issues allow students to get involved in the revitalization of common forest management. The kikigaki program initially developed in Japan and spread out to other countries, such as Indonesia. I interviewed Motoko Shimagami, who is developing kikigaki programs in both Japan and Indonesia. According to Shimagami, youth involvement is an essential factor in improving rural livelihood and sustainable environmental management. Several years ago, Shimagami conducted a comparative study of common forest management between Indonesia and Japan (Shimagami 2009) and found that similar methods of revitalization of the common forest through the education of high school students are pivotal in both countries.

 

Matsutake Crusaders, a voluntary group dominated by elders who gather every week to maintain a hill landscape, creating a suitable condition for matsutake mushrooms to grow.

Another initiative that I have seen in Japan is the ecovillage network. An ecovillage is an intentional, traditional, or urban community that is consciously designed through locally owned participatory processes encompassing social, cultural, ecological, and economic dimensions to regenerate social and natural environments.[4] In 2013, I visited the Konohana Family ecovillage in Shizuoka Prefecture. This ecovillage is part of a worldwide ecovillage network. The Konohana Family, though it calls itself a family, consists of 100 members who are not of the same blood. They live in rural areas and cultivate collective agricultural land. With the spirit of “togetherness” as a family, they fulfill basic needs through collective land management. During my visit to Japan with the support of the SRA fellowship program, I visited the Matsutake Crusaders in the northern part of Kyoto. This group consists of more than 30 retirees who gather once a week to engage in collaborative natural resource management. They nurture matsutake, a wild mushroom typical of Japan that has high economic and cultural values (Tsing 2015). They voluntarily cut some pine wood as a precondition to creating a suitable environment for matsutake to grow. Professor Fumihiko Yoshimura, the leader of this group, said that although this initiative is different from the iriai rights model, they called it a satoyama movement. The satoyama concept in landscape management combines forest and agricultural activities, mainly in hill areas. Currently, many rural communities in Japan are involved in satoyama movements (Satsuka 2014). In another location, a study by Haruo Saito and Gaku Mitsumata (2008) shows the integration of matsutake production with traditional iriai land use in Oka Village, Kyoto Prefecture.

This article has illustrated five major challenges of common forest management in Japan. These challenges are responded to with a variety of innovations by the government and nongovernment organizations to help the common forest practices survive in supporting rural livelihood. These innovations to revitalize community-based natural resource management have been developed with various narratives such as environmental movements, rural livelihood supports, family and community orientation projects, and voluntary civic education. Although rural communities have encountered serious challenges since Japan entered industrial development, villagers continue to maintain the common forest with some modifications. Villagers demonstrate the resilience of common forest management by taking an inclusive approach that includes migrants in the board membership of common forest management and by involving themselves in broader networks of community-based natural resource movements. Community resilience is the crucial factor in common forest management in Japan.

 

References

Berge, Erling, and Margaret Mckean. 2015. “On the Commons of Developed Industrialized Countries.” International Journal of the Commons 9, no. 2 (September 2015): 469–85.

Effendi, Tonny Dian. 2019. “Local Wisdom-based Environmental Education through Kikigaki Method: Japan Experience and Lesson for Indonesia.” IOP Conference Series: Earth and Environmental Science 239: 012038. https://doi.org/10.1088/1755-1315/239/1/012038.

Goto, Kokki. 2007. “‘Iriai Forests Have Sustained the Livelihood and Autonomy of Villagers’: Experience of Commons in Ishimushiro Hamlet in Northeastern Japan.” Working Paper Series No. 30. Afrasian Centre for Peace and Development Studies, Ryukoku University.

Inoue, Makoto, and Ganesha P. Shivakoti. 2015. Multi-level Forest Governance in Asia: Concepts, Challenges and the Way Forward. India: Sage Publication.

Kanamori, Shigenari. 1999. “German Influences on Japanese Pre-War Constitution and Civil Code.” European Journal of Law and Economics 7, no. 93–95. https://doi.org/10.1023/A:1008688209052.

Mitsumata, Gaku, and Takeshi Murata. 2007. “Overview and Current Status of the Iriai (Commons) System in the Three Regions of Japan: From the Edo Era through the Beginning of the 21st Century.” Discussion Paper No. 07-04. Kyoto: Multilevel Environmental Governance for Sustainable Development Project.

Miyanaga, Kentaro, and Daisaku Shimada. 2018. “‘The Tragedy of the Commons’ by Underuse: Toward a Conceptual Framework Based on Ecosystem Services and Satoyama Perspective.” International Journal of the Commons 12, no. 1: 332–51.

Saito, Haruo, and Gaku Mitsumata. 2008. “Bidding Customs and Habitat Improvement for Matsutake (Tricholoma matsutake) in Japan.” Economic Botany 62, no. 3: 257–68.

Satsuka, Shiho. 2014. “The Satoyama Movement: Envisioning Multispecies Commons in Postindustrial Japan.” In Asian Environments: Connections across Borders, Landscapes, and Times, RCC Perspectives, no. 3: 87–94.

Shimagami, Motoko. 2009. “An Iriai Interchange Linking Japan and Indonesia: An Experiment in Interactive Learning and Action Leading toward Community-Based Forest Management.” Working Paper Series No. 46. Afrasian Centre for Peace and Development Studies, Ryukoku University.

Suzuki, Tatsuya. 2013 “The Custom and Legal Theory of Iriai in Japan: A History of the Discourse on the Position of the Rights of Common in the Modern Legal System.” In Local Commons and Democratic Environmental Governance, edited by Takeshi Murota and Ken Takeshita. Tokyo-New York-Paris: United Nations University Press.

Takahashi, Takuya, and Koji Matsushita. 2015. “How Did Policy Intervention Work Out for Commons Forests in Japan? An Analysis of Time-Series Prefectural Data.” Paper in the IASC Conference 2015 Edmonton W23 (2015-5-27).

Takamura, Gakuto. 2019. “The Bundle of Rights Model to Explain the Underuse of Japanese Common Forest from History.” Presentation in Asian Law and Society Association (ALSA) Conference, Osaka Univesity, December 12–15, 2019.

Tsing, Anna L. 2015. The Mushroom at the End of the World: On the Possibility of Life in Capitalist Ruin. Princeton: Princeton University Press.

Yamamoto, Shinji. 2003. “Forest Volunteer Activity in Japan.” In Local Commons and Democratic Environmental Governance, edited by Takeshi Murota and Ken Takeshita. Tokyo–New York–Paris: United Nations University Press. 287–302.

 

 

 

[1] I would like to express my gratitude to Professor Sozaburo Mitamayama (Osaka University of Tourism) for his hospitality and assistance during my research visit in Japan. I am also thankful for a series of insightful discussions that I have had with Motoko Shimagami (Ehime University), Gaku Mitsumata (Hyogo University), Gakuto Takamura (Ritsumeikan University), and Mamoru Kanzaki and Daisuke Naito (Kyoto University), and for the fruitful comments by Hoko Horri (Leiden University) for this article.

[2] In this article, the terms “common forest” and “iriai forest” are used interchangeably.

[3] See also Kentaro Miyanaga and Daisaku Shimada (2018), who identify three main driving factors that lead to the underuse of common forests in Japan: demographic drivers, socioeconomic drivers, and institutional drivers.

[4] See. https://ecovillage.org/projects/what-is-an-ecovillage/

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The State and the Rights of Individuals: Pursuing Research at the Graduate Institute Geneva

April 16, 2020
By 25314

Using an SRA grant, Benedikt Behlert spent four months from September 2019 to January 2020 as a junior visiting fellow at the Graduate Institute of International and Development Studies in Geneva, Switzerland, which proved to be highly beneficial for his PhD project on the administrative procedures required to protect human rights. 

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My PhD project on “The Necessity of a Conversation between the Administration and the Individual: The Relevance of Procedure to International Human Rights” asks the question whether international human rights law requires states to have in place structured decision-making procedures for their administrative bodies. Such procedures are often perceived as a nuisance by the two sides involved—the administration and the individual confronted with it—and as an unwelcome hurdle in reaching their objectives.

The Maison de la Paix, home of the Graduate Institute Geneva.

This perception clouds the value of administrative procedure, however, which can protect individual rights against arbitrary state action. This protective potential is realized first and foremost by involving the individual in the decision-making process, such as by granting them a right to be heard and requiring reasons for a negative decision. This is the insight from which my normative analysis of international human rights law commences.

The different ways in which individuals are potentially confronted by administrative bodies are numerous. Beyond “everyday encounters,” such as when an individual applies for a permit, there are complex and sensitive human-rights issues like the ongoing “migration crisis” that highlight the relevance of this inquiry.

What does international human rights law say about the relevance of procedures for the protection of the rights of migrants and refugees? Does it require institutionalized procedures to examine whether a person’s claim for asylum is well-founded? What should such procedures look like? A thorough understanding of the general relationship between the laws governing international human rights and administrative procedures should help answer such questions about specific encounters between state administrations and individuals.

Comparison with Constitutional Rights

One chapter of my thesis draws inspiration from German constitutional law, in particular, the German doctrine of constitutional rights. The connection between administrative procedure and German constitutional rights has been discussed for more than 40 years. The ideas and arguments found in this discourse are by now well-developed, and given the striking structural and substantial similarities, they might provide valuable insights for human-rights-based arguments.

The goal of this comparative exercise was to learn something about the structure and nature of international human rights law, which will inform the subsequent part of my thesis where I try to construct an international-human-rights-law-based argument in favor of procedural rights and obligations.

However, looking for inspiration from one’s own jurisdiction carries a certain risk for the international lawyer. The outcome of research may be too heavily influenced by one’s own background and thus irrelevant to the international legal discourse. In order to avoid falling into this trap, I decided to write the part of my thesis focusing on the similarities and differences between constitutional rights and international human rights in a highly international research environment.

I had the great honor of spending four months at the Graduate Institute of International and Development Studies in Geneva as a junior visiting fellow. With its very diverse faculty and even more diverse student body, the Graduate Institute Geneva—also a Sylff institution—was just the right place for me to get the inspiration and critical feedback I needed.

The view from my workplace at the Graduate Institute Geneva.

The Benefits of an International Research Environment

I reviewed pertinent German constitutional law literature and international human rights law literature during my stay. The vast number of resources available at the Graduate Institute and its library were a great help. Most importantly, however, I had the chance to talk to researchers at various levels—PhDs, postdocs, and professors—from different disciplinary and national backgrounds, both informally and in more formal settings. Everyone at the International Law Department was extremely welcoming and helpful. In numerous talks with members of the world-renowned faculty and fellow PhD students, I received valuable input.

Furthermore, I gave a presentation in a roundtable session at the International Law Department, which was followed by an engaging and stimulating discussion. Not only did all these talks enable me to think about the German ideas more critically, but they also helped me to find more effective ways to present my findings to an international audience, which is the eventual target of my thesis.

Beyond the direct benefits for my research, my time as a junior visiting fellow at the Graduate Institute helped to broaden my horizon more generally. Almost every day, a high-level event with leading figures of international politics took place in the grand auditorium, exposing me to many interesting and informed analyses of current issues and crises. The junior visiting fellowship thus enabled me to better perceive my research within the bigger picture of international studies. Finally, the support which the International Law Department and the visiting fellows office provided was outstanding, very personal, and made my stay comfortable and easy.

Being a junior visiting fellow at the Graduate Institute Geneva was a splendid experience. I am certain that my thesis will reflect the inspiration and input I received during my stay. I am immensely grateful to the Sylff Association for funding my stay in Geneva with a generous SRA award, and I can only encourage other fellows who have not done so to make use of the extraordinary opportunities the Sylff Association provides!

Jonction, the place in Geneva where the Rhône and the Arve meet.

Behlert's related article "Forced Migration in Transition: Perspectives from Social Science and Law" can be read at www.sylff.org/news_voices/27466/.

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Forced Migration in Transition: Perspectives from Social Science and Law

February 6, 2020

In November 2019, we, members of the Sylff Mikrokolleg on Forced Migration at Ruhr University Bochum (RUB), hosted the conference “Forced Migration in Transition: Perspectives from Social Science and Law” at our home university in Bochum, Germany. The conference brought together researchers and practitioners from different disciplines to tackle pressing issues revolving around forced migration.

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The Sylff Mikrokolleg on Forced Migration

Our three-member organizing committee consisted of Benedikt Behlert, Corinna Land, and Robin Ramsahye. Benedikt and Robin are PhD students in international law at RUB’s Institute for International Law of Peace and Armed Conflict (IFHV). Corinna is a PhD student at the Social Science Faculty. All of us are current or former fellows of the Sylff Mikrokolleg on Forced Migration at RUB. The Mikrokolleg was established in 2017 as an interdisciplinary group of four PhD students contributing to the field of forced migration studies from different angles through their individual PhD projects and through common projects like our conference. By now, it has assembled a network of eighteen members around itself, consisting of seven professors, three current Sylff fellows, and eight associates, two of whom are former fellows. Following the aim of Sylff to “nurture leaders who will initiate action to transcend differences and address issues confronting contemporary society,” the theme for this micro assembly of young researchers at the doctoral level was quickly found: forced migration, one of the greatest challenges facing the international community today.

An Interdisciplinary Conference Bringing Together Academia and Practice

Given the contemporary dynamics of human mobility, scholarly debates on “forced migration” gained new momentum over the last year. Controversial discussions often revealed a set of highly important challenges concerning theoretical, conceptual, and methodological approaches. They also confirmed that it was impossible to truly understand this multidimensional issue without intense cooperation between various disciplines.

Against this backdrop, our conference provided a highly necessary platform to discuss recent research findings and theoretical approaches. The fruitful academic exchange was enriched by perspectives of experts from the human rights and development practice who assured the real-world relevance of the debate.

Experts from humanities and law as well as representatives from civil society met in four consecutive workshops and raised yet unanswered questions at the heart of the matter: What is forced migration after all? How do we define it? How useful is distinguishing between legal and other categories? What is the role of affected individuals in forced migration studies? How can we mitigate the pressure to migrate? And what are our possibilities and responsibilities as academics and citizens to defend public discourse from ever more xenophobic and exclusionary voices?


Transitions of Concepts, Perspectives, Law and Space

Panel 1 chaired by Corinna Land, far right, examined the concept of forced migration in the present context.

Panel 1, titled “Transition of Concepts” and chaired by Corinna Land, reflected our interdisciplinary discussions as Kolleg fellows as to what our common project should focus on. It showed that the definitional clarity that a lawyer is trained to seek cannot be conjured out of thin air when it concerns such a contentious and complex term as forced migration. The contributions of all four panelists highlighted that forced migration is conceptualized today as an integral part of global social inequalities that continuously produce forced mobility. Focusing on the African continent, Serge Palasie, a practitioner with the nongovernmental organization Eine Welt Netz, presented a macrohistorical overview of reasons for such inequalities, drawing a link from European colonialist exploitation to contemporary hegemonic practices of states underpinning the global economic order. Christopher Boyd, a doctoral candidate at the University of Glasgow’s School of Law, built on this approach with a critique of the international legal system. As “part of the problem,” international law cements hegemonic political projects as law and is thus inherently limited in providing solutions. Dr. Isabella Risini, an international law researcher at Ruhr University Bochum, equally emphasized the complexity of forced migration in a globalized world in which political, economic, and social questions are tightly interwoven and argued for a moderate role of international lawyers. Dennis Dijkzeul, professor of organization and conflict research at the IFHV, reminded the audience of the importance of gaining a wider understanding of forced migration processes through the actors involved, including states and, increasingly, networks of international organizations and NGOs.

Benedikt Behlert, right, moderates Panel 2, which provided insights for protecting individual migrants’ human rights.

Panel 2, called “Transition of Perspectives” and chaired by Benedikt Behlert, moved the focus from the broader notion of forced migration to individual forced migrants. It explored the rise of actor-oriented theories in law and social sciences transcending the longstanding image of migrants and refugees as passive beneficiaries of humanitarian assistance. The panel acted as a forum to discuss what agency these groups have in defending their interests. Legal scholars Dr. Itamar Mann from the University of Haifa and Dr. Ekaterina Yahyaoui from the University of Ireland, Galway, presented their approaches. Taking writer Behrouz Boochani’s account of life in an Australian refugee detention center on Manus Island in the Pacific as a starting point, Dr. Mann illustrated cases of judicial activism in favor of refugees’ human rights. Having himself brought a claim regarding detention practices against Australian authorities before the International Criminal Court, he provided insights on ways in which international law may be used to further migrants’ rights. Dr. Yahyaoui explored theoretical approaches to circumscribing actors in need of international support, based on the “turn to vulnerability” in refugee and forced migration studies. Criticizing this approach for its lack of nuance, she argued for increased consideration of substantive equality as part of the established human rights framework, coupled with the theory of intersectionality, which allows for engagement with individual experiences instead of schematic categorizations.

Panel 3 chaired by Robin Ramsahye, far right, discussed relations between disputes of land rights and forced migrations.


Panel 3, themed on “Transition of Law” and chaired by Robin Ramsahye, zoomed in on the specific scenario of land allocation within populations and ensuing conflicts as an important driver of forced migration. International litigator Lucy Claridge of Amnesty International provided insights into the Endorois case before the African Commission on Human and Peoples’ Rights. As counsel, she represented members of the Endorois community, who had been displaced by the Kenyan government, in their quest for restoration of their historic land and compensation. Professor Jochen von Bernstorff from the University of Tübingen assessed current efforts to recognize the right to land in international law and examined the structural implications of land rights for the broader framework of international law. Dr. Kei Otsuki of Utrecht University explored the notion of infrastructural violence, pointing to problematic aspects of progressive legal frameworks in reaction to modernization and resettlement, which ultimately contributed to legitimizing and formalizing displacement. Mariana de Martos from the Max Planck Institute for Social Anthropology in Halle concluded the panel by analyzing the discrepancies between the law and its implementation through a case study of indigenous peoples’ land rights in the Brazilian Amazon rainforest.

Panel 4 chaired by Carolin Funke, far right, looked at the issue of migrants’ integration into their host communities.

Lastly, Panel 4, “Transition of Space” chaired by Carolin Funke, a post-doctoral researcher at the IFHV, opened the conference lens to the wider societal discourse. Both the findings of academic research and practical work on the issue of migration often seem to be drowned out by highly emotional and shrill debates, increasingly dominated by adherents of extreme positions. The panel contextualized these observations from the perspectives of academia, practice, and the media. Professor Ludger Pries of Ruhr University Bochum stressed that refugees and migrants are often either maligned or paternalized. He stressed that narrow views labeling them as intruders or target groups for transnational solidarity miss the mark, since migrants are actors in their own right, shaping their destinies. Building on this, journalist Isabel Schayani provided an account of her daily work covering the fates of migrants stranded on the European outposts that many of them first arrive at, as well as the lives of migrants who make it to Germany and endeavor to create a life for themselves. Complementing these perspectives, Claudia Jerzak from the University of Applied Sciences for Social Work, Education, and Care in Dresden presented examples of the process of integrating migrants into host communities through highly structured spaces, such as integration courses, and interchangeable, prestructured spaces, such as meeting cafés and self-organized spaces where refugees act as hosts and organizers.

Invaluable Experiences and Much Gratitude

The conference has afforded us a number of lasting experiences and benefits. Securing the funds for and organizing the conference sequence enabled us to familiarize ourselves with many tasks that are of crucial importance in the academic world. Having conceptualized several panels in form and content under an overarching theme, reached out to people and secured commitments of participation, organized international travel, and coped with several last-minute cancellations, we feel we have gained insights that can only be achieved through action. The interdisciplinary character of the conference, merging social scientific and legal approaches to forced migration, was initially challenging to conceive but turned out to be very beneficial. Throughout the phase of substantial preparation, we had to transcend our own disciplinary boundaries in delimiting the panels in a way that worked from the perspectives of both law and social sciences. We were glad to see that the conference participants did the same by engaging in fruitful discussions. Beyond the immediate exchange in the panel discussions, the conference enabled us to expand our professional networks and make valuable contacts through numerous occasions for informal discussions with our guests, many of whom we have arranged to stay in touch with for future cooperation.

We are indebted and very grateful to a number of people and organizations for the conference’s success. First, we would like to express our gratitude to the Sylff Association and the Tokyo Foundation for setting up the Sylff Mikrokolleg on Forced Migration and giving us the opportunity to research and express our ideas through their generous financial and administrative support. A special thank you to Sylff director Yoko Kaburagi is in order for attending our conference and encouraging follow-up exchange.

We also very much appreciate the help of RUB’s Research School, which sponsored the conference and continuously supported us with logistics and procedures, most importantly in the person of Dr. Sarah Gemicioglu.

We would also like to warmly thank all associate fellows and researchers involved with the Sylff Mikrokolleg on Forced Migration and who made valuable contributions to the development of the conference. We are glad to see that there is a lot of interest in our Kolleg and that many promising young researchers stand ready to take over and move it forward still.


Behlert's related article "The State and the Rights of Individuals: Pursuing Research at the Graduate Institute Geneva" can be read at
www.sylff.org/news_voices/27786/.

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Developing an Inclusive Distribution Model Using 3D-Printed Prosthetic Legs

January 30, 2020
By 24612

Keio University fellow Yutaka Tokushima—who became the first recipient of a Sylff Project Grant (SPG) in 2018 for an initiative to provide affordable 3D-printed prosthetic legs—recently completed the second year of his project. The grant enabled him to form a partnership with a university hospital in the Philippines to improve the functions of the prostheses by conducting usability trials with 49 patients. In 2019, he continued to produce and provide artificial limbs while also reaching out to local governments, donors, and the national insurance commission to help expand his project. The following is Tokushima’s account of some of the difficulties he encountered and the knowledge he gained over the past two years, which have engendered new aspirations and prospects. A video introducing his activities can be viewed here (YouTube channel) or by clicking the link below

 

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I am currently advancing an ultra-low-cost, 3D-printed prostheses project in the Philippines. The 3D-CAD software and 3D printer that we developed for prostheses can create a prosthetic leg from suitable materials (filaments) using data from a 3D scanner. At present, the price of producing one leg is 20,000 pesos (about US$400), roughly a tenth the average price of a conventional prosthesis and equivalent to the starting salary for a college graduate in the Philippines—making it affordable to the local people who in the past were not able to buy one.

In the past, prosthetic limb manufacturing required the patient to visit a production facility many times over several weeks, but 3D printing takes about 24 hours from scanning to production, so the patient only needs to visit the clinic twice; once for the diagnosis and again to pick up the leg.

What initially got me involved in this project was my experience working in Bohol, a small rural village in the Philippines, as a member of the Japan Overseas Cooperation Volunteers (JOCV) between 2012 and 2014.

Diabetes was prevalent among the poor there. Without the means to go to a hospital, they would not get regular medical checkups. Illnesses would get neglected, resulting in diabetic gangrene and forcing people to amputate their limbs or die from not being able to, as many actually did. Visiting the rural clinics where I was assigned as a volunteer, I discovered that about 1% of the residents had decaying legs. The major cause of this can be attributed to their eating habits. Poverty did not provide for more than a very small amount of salty fish or meat to go with a large amount of rice, resulting in an excessive intake of carbohydrates.

There are only three public facilities in the Philippines that manufacture prosthetics. During my research I asked people who had left their gangrene unattended why they did not get medical attention. I suggested that leaving the leg unattended might kill them, but most had no reply, their faces telling me that they had largely given up on life. Getting an amputation would only mean lying around at home because they could not afford prosthetics. They would just become one more mouth to feed, so they were better off dead. I was saddened and shocked when I first realized their plight.

From this experience, I decided to develop ultra-low-cost prostheses that could be made in emerging countries and purchased by anyone. I thought that this could save people all over the world who, like the diabetic gangrene patients I had met, had decaying legs but were not able to do anything about it.

Carefully measuring the dimensions of a patient’s leg.

Understanding the structure of a patient’s leg.

Scanning leg shape data.

I started by examining a wide range of possibilities regarding prosthetic limb production in emerging countries, including the use of construction waste, bamboo, and other readily available materials. I finally came to the conclusion that 3D-printer manufacturing was the best way to balance functionality and price to meet the demands of prosthetic leg production in developing countries. However, there were many problems in terms of quality and cost in designing and manufacturing prostheses similar to existing types using commercially available 3D-CAD software and 3D printers.

After I returned to Japan in 2015, as a Sylff fellow at Keio University, I started developing 3D-CAD software and 3D printers specifically for prosthetic limbs that could overcome these issues. I set out to develop 3D-CAD software and a 3D printer exclusively for prosthetic 3D printing, eliminating all extra features and applications of commercial printers—a process that took three years.

The ever-evolving 3D prosthetic leg printer today and artificial leg brace.

From fiscal 2018, thanks to the Sylff Project Grant and in cooperation with the University of Philippines, Philippines General Hospital (UP-PGH), we conducted material strength tests to secure patient safety and usability tests to obtain medical evidence while advancing preparations for local production.

In the usability tests, we asked 49 patients to wear our 3D-printed prostheses for three months while living as before. Compared to conventional prostheses for emerging countries, we were able to achieve a 128% functional improvement (based on patient evaluation using a prosthesis evaluation questionnaire).

Based on these results, in fiscal 2019, we started local production in the Philippines for the purpose of manufacturing and selling 3D-printed prosthetic legs in emerging countries. As of December 2019, we have been able to deliver approximately 20 prostheses per month to amputees in metropolitan areas in the Philippines, and 112 people now use our prostheses. We are aiming to reach annual production of 1,000 units in fiscal 2020.

Visiting a patient who has started wearing a prosthetic leg.

A patient is able to climb up and down steep steps after regaining a normal lifestyle.

Thus far, the people using our prostheses have been limited to those living in metropolitan areas who are middle- to high-income earners. As such, we can hardly say that the prosthetic problem in the Philippines has been resolved.

My next step is to deliver our prosthetic legs to amputees not only in Metropolitan Manila but also those in remote areas like Bohol, where I had previously served as a volunteer, and in the poorest areas where people cannot afford a $400 prosthesis.

This is why I established the Instalimb Foundation, a nongovernmental organization whose mission is to develop a new distribution model for prostheses delivery catering to those who live in remote areas and who cannot pay $400 for an artificial limb and to implement this model as a social business.

Through the activities of this organization, I hope to establish a sustainable system to ensure that all people who require prosthetic limbs, including the poor in developing countries, have access to them, starting with the Philippines in fiscal 2020. 

With fellow's project members and cooperators.

As for our performance in fiscal 2019, five leg amputation patients were referred to us from local governments, and contributions from local donors were enough to pay for 12 prosthetic legs. Next year, we hope to expand our cooperation with local groups throughout the Philippines.

We have also begun approaching central government agencies in the Philippines, such as the Department of Health and the Department of Trade and Industry, as well as relevant Japanese ministries, such as the Ministry of Economy, Trade, and Industry and the Ministry of Health, Labor, and Welfare, to have our prostheses distribution model incorporated in the PhilHealth government health insurance framework that is being advanced by the Philippine Insurance Commission.

We will continue to consult with stakeholders and make policy recommendations in the hopes of quickly realizing a social system capable of providing prosthetic legs to all amputees in the Philippines.

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Altered Disturbance Regimes and Novel Ecosystems: Understanding and Managing Ecosystem State Change in the Forest-Peatland Ecotone of Southwest Patagonia

January 24, 2020
By 25980

Using an SRA award, Kyla Zaret, a 2018 Sylff fellow from Portland State University, visited Southwest Patagonia in Chile to conduct fieldwork from March to May 2019. She has been continuously visiting this area since 2003, when she was enchanted by the natural beauty of the region. After learning approaches to conservation and development during her master’s program, she began building networks with local people and stakeholders. Her Sylff SRA fieldwork was based on her long-term commitment and experiences.

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Patagonia looms large in the imaginations of individuals across the world, though many people are surprised to learn that the region encompasses more than one million square kilometers and extends from Chile’s fjords in the west to Argentina’s cliff-lined coast to the east, thus traversing both the Andes Mountains and national borders. While the global mythos of Patagonia as a pristine landscape of rivers flowing freely from glaciated peaks through primeval rainforest or across windblown steppe is not entirely false, it does belie the region’s historic and current patterns of land use and landscape change, which are becoming increasingly influenced by climate change and globalization. My academic research and goals as a Sylff fellow are responses to my first-hand experiences of how the above factors affect Patagonia’s ecosystems and people and my desire to lead conservation efforts that transcend socio-political boundaries to engage a diversity of stakeholders in fostering the resilience of this critical, yet vulnerable, region of the world.

Mosaic of burned wetlands and forests along the Vargas River, which parallels the “Southern Highway” and flows into the Baker River (also shown) in the Aysén Region, Chilean Patagonia. Photo by Adam Spencer, 2017.

I first arrived in Patagonia in 2003 as a backpacker, eager to explore the region’s remote and rugged beauty; however, my perspective of people and place has since deepened, as has my commitment to generating positive social change. I began conducting scientific fieldwork in southwest Patagonia in January 2010 while completing an independent research project as part of the International Conservation and Development option of the master’s program in which I was enrolled at the University of Montana (UM). I chose to undertake my practicum in Patagonia because observations that I had made during my initial travels (e.g., the conversion of native forest to nonnative tree plantations, evidence of landscape-scale fires, and a controversial hydroelectric project that would displace families from their homesteads) inspired numerous questions about natural resource management and environmental justice—questions that catalyzed my pursuit of graduate study.

Through the interdisciplinary program at UM, I learned approaches to conservation and development that prioritize local peoples’ knowledges, needs, and perceptions while striving to promote the conservation of biodiversity and ecosystem function. Within the doctoral program at Portland State University (PSU), I have been applying those teachings and building upon my master’s research to investigate how patterns of social interaction influence whose information and knowledge about altered ecosystems becomes integrated into decision-making processes, thus determining the next trajectories of ecological and social change. This research is needed because land use practices such as burning, logging, and, more recently, peat moss harvest, continue to dramatically alter the mosaic of temperate rainforests and wetlands (i.e., the “forest-peatland ecotone”) that characterize the landscape of southwest Patagonia, calling into question the continued resilience of sensitive ecosystems and the human communities who depend upon them.

A burned forest site that was once dominated by the cedar tree Pilgerodendron uviferum (Ciprés de las Guaitecas) but is now being harvested for the peat moss Sphagnum magellanicum (pon pon or pompoñ).


Historically, poorly drained sites along river valley bottoms in southwest Patagonia were dominated by a slow-growing, rot-resistant cedar tree (Pilgerodendron uviferum), whose harvest and sale formed the cornerstone of local people’s livelihoods and cultural identities, as I learned through my master’s research (Zaret 2011). Currently, however, almost all of these sites are characterized by fire-charred snags and stumps that rise from a saturated carpet of red-orange peat moss (Sphagnum magellanicum), and the cedar tree is listed as a globally threatened species (IUCN 2010). The change in dominance from cedar tree to peat moss is reflected in a transition in the resource use of these sites: in some parts of southwest Patagonia, people have shifted from harvesting cedar to harvesting peat moss. Thus, trade-offs must be made in the socio-political-economic realm regarding which potential ecosystem services of these now nonforested sites should be encouraged through management decisions. For example, should the keystone species and culturally iconic cedar tree be restored to burned sites, or is there greater perceived value in maintaining such sites in their current state of enhanced peat moss growth (e.g., so as to allow for continued harvest and sale of the moss to the horticulture market)? Conflicts are starting to arise between managers and landowners and other resource users given the passage of a new national law (Decreto 25, August 2019) that regulates the harvest of peat moss on public and private lands. Deciding how best to manage these cedar–peat moss (or “forest-peatland”) sites is further complicated by a dearth of information: none of Chile’s state agencies have been dedicated to wetland management, and very little knowledge is held by agency personnel regarding these altered ecosystems (Fernán Silva, Agricultural Service, pers. comm.).

In response to this situation, my dissertation has two overarching goals, which pertain more to the ecological or social domain of forest-peatland resource use and management of southwest Patagonia. My first goal incorporates ideas of ecosystem resilience (e.g., Holling 1973) and ecological tipping points (e.g., Scheffer and Carpenter 2003) to investigate patterns and mechanisms of ecosystem change across waterlogged sites in southwest Patagonia due to altered climate and fire regimes. I am working on this goal using forest reconstructions, paleoecological data, and vegetation surveys at control and burned sites to compare historical and contemporary relationships between climate, fire, and vegetation. My second goal is to evaluate whether the network of stakeholders engaged in natural resource use and management is structured so as to foster “social learning” (e.g., Muro and Jeffrey 2008), which may be a prerequisite for managing the complex (and novel) multiscalar dynamics of ecosystems comprising this ecotone (Folke et al. 2005). This goal has been made possible by the Sylff Graduate Fellowship and Sylff Research Abroad (SRA) award, which have allowed me to complete the qualitative and quantitative data collection needed to apply the technique of social network analysis (e.g., Bodin and Crona 2009).

Old-growth cedar trees (Pilgerodendron uviferum) rise in the distance beyond tall bulrushes in an unburned area of the Exploradores Valley of the Aysén Region, Chilean Patagonia.

The social dimension of my dissertation research is driven by my interest in whether actors who differ in their capacities (or power) to make decisions that strongly affect their occupations or livelihoods (e.g., governmental land managers vs. resource-dependent landowners or resource harvesters) communicate their knowledge and observations of the natural world with one another. This exchange is needed not only in order to best understand rapidly changing ecological dynamics but also to assure that the perspectives and needs of all stakeholders are taken into account in the management process. Thus, my SRA project was designed to help me answer the research question: Can patterns of information and knowledge exchange within the egocentric networks of distinct socio-political actors be explained by (a) the distribution of relational ties that are constrained, voluntary, or imposed by a third party (i.e., “terms of connection”; Rocheleau and Roth 2007: 434), and/or (b) scale-related differences in perspectives regarding the value(s) of forest-peatland sites?

To begin answering the above question, I conducted fieldwork in the Aysén Region of southern Chile from March to May 2019. (Aysén is where I completed my master’s research and where I have been building my own social network since 2010.) There, I traveled from the capital city of Coyhaique to rural towns and homesteads, engaging in participant observation, meeting with key informants, identifying stakeholders and potential research participants, and conducting semistructured interviews. To find and recruit interview participants, I used purposive snowball sampling to locate individuals representing opposite ends of the socio-political scale ranging from high-interest, low-power individuals to high-interest, high-power individuals. Ultimately, I conducted participant observation with 26 individuals from the land management, commercial, natural resource harvest, and nonprofit science, education, and conservation sectors, and I conducted 12 semistructured interviews (8 with individuals on the high-interest, high-power side of the socio-political scale and 4 with individuals of high interest but low power). This small sample size, especially of low-power individuals, reflects (1) the limited numbers of individuals who are currently regularly engaged in forest-peatland resource use in Aysén[1] and (2) the degree of distrust characterizing landowners’ and resource users’ relations with land managers. That is, a recent campaign by land managers to inform stakeholders of the new rules to be instituted under Decreto 25 resulted in feelings of frustration, and even persecution, on the part of landowners and resource users. Thus, when I arrived at people’s homesteads to discuss the subject of peat moss harvest, many individuals and families were still aggravated over their interactions with land managers. While some people were still open to talking with me—perhaps given my perceived neutral role as a foreign researcher—I felt it inappropriate to request a formal, recorded interview unless I had some prior history and establishment of trust with the research participant.

A view from within a stand of old-growth cedar (Pilgerodendron uviferum) in the Exploradores Valley of the Aysén Region, Chilean Patagonia.


My SRA fieldwork was most productive in terms of connecting me with land managers from the Agricultural Service who will be responsible for implementing the new regulations under Decreto 25. They are actively engaged in building their capacity to understand and monitor the dynamics of forest-peatland sites and to conduct effective education and outreach campaigns. Given my prior work with Round River Conservation Studies (RRCS), a conservation organization that leads study abroad programs for undergraduates and that has been partnering with land management agencies in Aysén since 2012, I was able to participate in several meetings with the Agricultural Service in which I advocated for the recognition of landowners’ and resource harvesters’ knowledge and perspectives. During one of those meetings, a commitment was formed between RRCS and land managers to jointly host a series of workshops for landowners and resource harvesters in which a primary objective would be creating an opportunity to share their experiences and knowledge of forest-peatland sites and to offer feedback on land managers’ activities and regulatory tools.

Back in the United States, I am currently in the process of coding interview data in preparation for conducting the social network analysis (SNA). Following the methods of Knoke and Yang (2008) and Prell (2012), I will map, analyze, and compare the egocentric networks of my research participants in terms of the proportion and quality of information- and knowledge-exchange ties that occur between individuals of the same versus different socio-political scales. These egocentric network maps will display social actors as nodes of different shapes (depending on their socio-political scale) that are connected by arrows, whose direction will indicate whether the exchanges are unidirectional or mutual and whose thickness will represent the quality of the exchange (e.g., whether voluntary or imposed; Rocheleau and Roth 2007). I will use content analysis of the interviews to qualitatively interpret patterns of information and knowledge exchange in the maps in light of people’s own perceptions of their socio-political scales and the value/importance they attribute to forest-peatland sites and their own observations of the natural world.

My preliminary findings, from participant observation and informal conversations, suggest that despite land managers’ new imperatives to identify and communicate with stakeholders, the flow of knowledge and information within and across socio-political scales is currently impaired due to the following: (1) landowners’ frustrations with past interactions with land managers; (2) landowners’ and resource harvesters’ lack of awareness of or appreciation for their own knowledge of the natural history of forest-peatland sites; (3) land managers’ lack of recognition of landowners and resource users as legitimate knowledge holders; and (4) structural aspects of regional institutions that limit communication between land managers, even within a single agency. Ultimately, I hope that the network maps—the visual products emerging from this research—can be used to pinpoint and convey where efforts to enhance communication and collaboration between stakeholders have the best chance to ensure that all perspectives and insights are brought into play to guide the wise use and continuing availability of natural resources in southwest Patagonia. I also intend to use the outcomes of my research to draw attention to other understudied nonboreal forest-peatland ecotones of the world. These areas have received scant attention from the global scientific community despite their vulnerability to climate change and their potential to contribute significantly to greenhouse gas emissions if burned (Davies et al. 2013), thus threatening the resilience of local and nonlocal ecosystems and actors.

The Sylff fellow, so excited to have finally located an old-growth stand of cedar trees (Pilgerodendron uviferum) in the Exploradores Valley of the Aysén Region, Chilean Patagonia.

As a Sylff fellow and SRA awardee, I am thankful to have been able to expand my dissertation to include a social line of inquiry that (1) will generate new conceptual and methodological links between governance, scale, and social network theory that pertain to knowledge and information exchange regarding the use and management of altered ecosystems and (2) has an applied goal of active “network weaving” (Vance-Borland and Holley 2011). In this way, I feel that I am becoming a conservation scientist and practitioner who works to transform environmental governance into a process that is equitable and inclusive for all natural resource stakeholders.

References

Bodin, Ö., and B.I. Crona. 2009. The role of social networks in natural resource governance: What relational patterns make a difference? Global Environmental Change 19 (3): 366–74. https://doi.org/10.1016/j.gloenvcha.2009.05.002.

Davies, G.M., A. Gray, G. Rein, and C.J. Legg. 2013. Peat consumption and carbon loss due to smouldering wildfire in a temperate peatland. Forest Ecology and Management 308 (November): 169–77.https://doi.org/10.1016/j.foreco.2013.07.051.

Folke, C., T. Hahn, P. Olsson, and J. Norberg. 2005. Adaptive governance of social-ecological systems. Annual Review of Environmental Resources, 30: 441–73. https://doi.org/10.1146/annurev.energy.30.050504.144511

Holling, C.S. 1973. Resilience and stability of ecological systems. Annual Review of Ecology and Systematics 4: 1–23.

Knoke, D., and S. Yang. 2008. Social Network Analysis. Thousand Oaks, California: SAGE Publications, Inc. http://methods.sagepub.com/book/social-network-analysis.

Muro, M., and P. Jeffrey. 2008. A critical review of the theory and application of social learning in participatory natural resource management processes. Journal of Environmental Planning and Management 51 (3): 325–44. https://doi.org/10.1080/09640560801977190.

Prell, C. 2012. Social Network Analysis: History, Theory and Methodology. Los Angeles: SAGE Publishing.

Rocheleau, D., and R. Roth. 2007. Rooted networks, relational webs and powers of connection: Rethinking human and political ecologies. Geoforum 38 (3): 433–37. https://doi.org/10.1016/j.geoforum.2006.10.003.

Scheffer, M. and S.R. Carpenter. 2003. Catastrophic regime shifts in ecosystems: Linking theory to observation. Trends in Ecology and Evolution 18 (12): 648–656.

Vance-Borland, K. and J. Holley. 2011. Conservation stakeholder network mapping, analysis, and weaving: Conservation stakeholder networks. Conservation Letters 4 (4): 278–88. https://doi.org/10.1111/j.1755-263X.2011.00176.x.

Zaret., K. 2011. Distribution, use and cultural meanings of ciprés de las Guaitecas in the vicinity of Caleta Tortel, Chile. Unpublished master’s thesis, University of Montana.

 

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Gender-Based Violence: Rethinking Social, Legal, and Healthcare Services in Jordan

November 1, 2019
By 25271

In Jordan, legal reforms have been promoted to achieve gender equality, which have led to improvements in female participation in education. However, there is still a big gap to achieving women’s empowerment in a practical sense, as cultural and religious norms encouraging gender inequality prevail in the society. The norms prevent women from social and political participation and even justify gender-based violence toward women. Dr. Tayseer Abu Odeh, a 2007 Sylff fellow at the University of Jordan, held a conference on July 16, 2019, at the University of Jordan to tackle the social issue by rethinking social, legal, and healthcare services. The conference was funded by Sylff Leadership Initiatives (SLI).

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Background and Objectives

It is my great pleasure to say that this conference was the first one organized in the Middle East by Sylff Leadership Initiatives, as one of the substantial and key conferences that seek to point to future directions in the field of gender studies and gender-based violence in Jordan. The conference is intended to address and examine the very implications of the term gender-based violence, which is defined in Guidelines for Integrating Gender-Based Violence Interventions in Humanitarian Actions (Inter Agency Standing Committee, 2015) as follows: “any harmful act that is perpetrated against a person’s will and that is based on socially ascribed (i.e. gender) differences between males and females. It includes acts that inflict physical, sexual or mental harm or suffering, threats of such acts, coercion, and other deprivations of liberty. These acts occur in public and in private.” With that in mind, this conference aims at addressing gender-based violence by assessing and rethinking social, legal, and healthcare services in Jordan.

The conference was held on July 16, 2019, at the University of Jordan.


According to a study conducted in 2015 and published in 2016 by United Nations Women titled “Strengthening the Jordanian Justice Sector’s Response to Cases of Violence against Women,” only 3% of victims of gender-based violence in Jordan seek official support from the police after being traumatized by any act of violence. Similarly, National Council for Family Affairs conducted an important report titled “Status of Violence against Women in Jordan” in 2008. It indicates that National Forensic Medicine Center in Jordan “deals with an average of 700 cases of sexual assault against women annually” and that “the number of murdered women recorded was 120 in 2006, including 18 cases classified as crimes of honor.” Ironically, the actual cases of physical and emotional abuse outnumber these statistics for many sociopolitical and cultural reasons. As a tribal and conservative society, many Jordanian families do not report these cases to protect their superego and collective image at the expense of the victim’s individual trauma.

 

The audience consisted of people from all walks of life.


Opening Remarks

Dr. Abeer Dababneh, director of the Center for Women’s Studies at the University of Jordan, opened the conference by stressing the significance of the event in raising the bar of social and gender consciousness in Jordan in terms of the available services offered by the three major sectors in Jordan: law, justice, and social development.

The president of the University of Jordan, Dr. Abdul-Karim Al Qudah, delivered a speech on how the University of Jordan plays a crucial role in empowering women and giving them a space for sociopolitical representation. He argued that the university is meant to be a feminist and intellectual hub for women’s equality, justice, and creativity, where many female students and teachers have a local and global reach and outshine their counterparts in every field of knowledge.

Moreover, Justice Minister Bassam Talhouni placed an emphasis on the significant role being played by the Ministry of Justice to fight a number of structural obstacles that confine and hinder gender equality. Although Jordan has witnessed some degree of local progress on gender issues, gender-based violence in Jordan is still a serious issue that should be resisted by national institutions at all levels.

Opening remarks.


Conference

The conference held on July 16, 2019, at the University of Jordan sought to develop and implement a more dynamic and practical strategy and method to protect Jordanian survivors who have been repeatedly traumatized by gender-based violence. Accordingly, the conference consisted of four panels:
Panel 1. Legal and Justice Services in Jordan
Panel 2. The Role of National, International, and Civil Society in Jordan
Panel 3. Gender-Based Violence in the Healthcare Sector
Panel 4. Gender-Based Violence in the Social Development Sector

In the first panel, all panelists stressed the way in which the sociocultural and legal contexts impact the whole process of gender-based prosecution in Jordan. The panelists also addressed how the Family Protection Program and other government institutions facilitate legal services for gender-based violence survivors. Meanwhile, they also underscored the limitations of these institutions and how such limitations should be treated locally.

The second panel was premised on the role of national, international, and civil society in Jordan. The panelists highlighted the significant role played by the National Council for Family Affairs and other government and nongovernment institutions vis-à-vis the multiple family protection projects in Jordan. They also emphasized the urgent need to revise the legal system and the alternative ways that this could be carried out to strengthen cooperation between these institutions toward fighting gender-based-violence in Jordan. In a similar vein, the third panel examined the multiple healthcare services offered by the Ministry of Health for victimized women in Jordan. Furthermore, the panelists concretely addressed the cultural and institutional flaws that hinder the process of fighting violence against women in Jordan. The panelists of the last session attempted to explore the way in which the social development sector engages in several rehabilitative counseling programs by training legal employees who are in charge of gender-based violence cases in Jordan. The panelists shed light on the psychological and professional competence of public employees.

 

The second panel, “The Role of National, International, and Civil Society in Jordan Legal and Justice Services in Jordan.”


Open Discussion

Each panel had an open discussion, in which many members of the audience gave compelling and engaging questions and remarks on gender-based violence in Jordan. For instance, an Egyptian activist attempted to challenge the dominant cultural paradigms of gender duties and roles that have been dogmatized and maintained by religion, government, and culture in Jordan. Another graduate student of gender studies was curious to understand the cultural and institutional circumstances that have shaped gender trouble in Jordan. Dr. Tayseer Abu Odeh, the organizer of the conference, responded to this question by arguing that gender trouble emanates from the cultural and social dogma of stereotypes and some religious misinterpretations that deem gender roles as being fixed and unchangeable. Thus, these dogmatic gender roles should be dismantled and challenged by reforming educational pedagogy, incorporating the most up-to-date research findings on gender studies into educational curricula in terms of the cultural and political context of gender-based violence in Jordan, gender equality, and statistical cases.


Final Recommendations Suggested by Participants

The participants agreed on a set of feasible and compelling recommendations that meet the most pressing issues of gender-based violence in Jordan. The media, for instance, should play a crucial role in sustaining and disseminating a profound discourse that offers a counternarrative to gender-based violence that should include updated statistics on all acts of gender-based violence in Jordan, hosting influential feminists to discuss major issues of gender-based violence, and evaluating the kinds of services offered by the three sectors of healthcare, justice and police, and social development. Similarly, the Ministry of Higher Education should be obliged to incorporate a new course on gender-based violence through which university students will be exposed to a wealth of legal, cultural, and epistemological knowledge on gender-based violence in Jordan regarding the discursive quantitative and qualitative circumstances that motivate any act of violence against women in Jordan. Moreover, the panelists stressed the significance of creating a professional national monitoring system through which the risk of gender-based violence in Jordan could be identified and assessed. Several panelists suggested a vibrant institutional and legal collaboration among all government and nongovernmental organizations that are in charge of survivors and victimizers of gender-based violence.

Dr. Tayseer Abu Odeh also stressed the importance of establishing a research database that would function as a professional research platform encompassing all reports, documents, and stories that address and document gender-based violence and assess national services in Jordan. A number of panelists argued that founding a national counseling office for gender-based violence at all universities should be a national priority. Drawing on the agenda of this conference, some of the scholars recommended outlining and endorsing a national manifesto agreed upon by all governmental and nongovernmental institutions that are in charge of fighting gender-based violence in Jordan. It would be a national and academic manifesto that legislates and outlines the national and humanitarian roles, duties, authorities, and agendas among various national partners that are concerned with gender-based violence.


Conclusion

It has been noticed that the vision of gender-based violence held by the government and bureaucracy in Jordan is somewhat limited and dogmatic. Several participants standing for government institutions were obsessed with a discourse of denial in which their findings seemed to underestimate the serious risk of gender-based violence in Jordan. Conversely, independent scholars and gender activists and leaders expressed an opposing view that challenges the one suggested by government representatives. With that in mind, a number of panelists suggested putting forward and organizing another forum in the near future that would reexamine gender-based violence in Jordan from a radical sociopolitical perspective. Drawing on Lila Abu-Lughod’s feminist paradigm, our anticipated conference would be mainly premised on the intersections between globalism, gender politics, and the political economy.

The conference caught the attention of many international and national feminists, scholars, lawyers, activists, senators, officials, policy makers, and academics. It also drew considerable interest from the media in Jordan. The conference was covered by the most influential and popular Jordanian media outlets that include, but are not limited to, the Jordan Times, Petra News Agency, Alrai, Addustour, Alghad, and the University of Jordan’s website. All media reports released on the conference noted the significance of the conference in fighting all forms of gender-based violence in Jordan.

Taking the major proceedings and recommendations of the conference into account, I would argue that gender-based violence in Jordan is still a serious sociopolitical and cultural problem that should be faced and resisted by all levels of the private and public sectors. In a nutshell, there should be a substantial strategic collaboration between all government and nongovernmental institutions. With that in mind, in my capacity as a Jordanian writer, activist, and intellectual, I am determined to keep fighting this crisis in every possible way and exert tremendous efforts to raise cultural and social consciousness about gender-based violence in Jordan. 

 

Dr. Tayseer Abu Odeh, an organizer of the conference.


References

“Strengthening the Jordanian Justice Sector’s Response to Cases of Violence against Women,” United Nations Women, 2016.


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Detailed arguments made in the panels are summarized below.

Panel 1: Legal and Justice Services in Jordan

The first panel of the conference was titled “Legal and Justice Services in Jordan.” Asma Khader, a leading human rights lawyer and former minister of culture, addressed the way in which gender-based prosecution is carried out in Jordan. Khader shed light on the social, cultural, and legal contexts of juridical prosecution in Jordan. Khader argued that many prosecutors who are in charge of gender-based violence cases and the implementation of the legal system lack sufficient legal, sociopolitical, and cultural literacy and professional training.

The second speaker, Reem Abu Hassan, a leading human rights lawyer and former minister of social development, discussed gender violence from a legal perspective. Drawing on her perspective, Abu Hassan also contended that cultural and social stereotypes are considered to be one of the most pressing issues that have shaped the various structures of gender trouble in Jordan.

The third speaker of this panel was Fakhri al Qatarneh, director of the Family Protection Program. Qatarneh examined the role of the program in facilitating the multiple services that are offered for gender-based violence survivors in Jordan. Unlike Khader and Abu Hassan, Qatarneh argued that the increasing number of complaints that have been recently reported to the Family Protection Program is an indicator of people’s awareness of gender-based violence in Jordan. Qatarneh’s argument sounded somewhat contradictory, as it confirmed an ideological discourse of denial that has been sustained by government officials whenever they address gender-based violence in Jordan.

Panel 2: The Role of National, International, and Civil Society in Jordan

The second panel addressed the role of national, international, and civil society in reinforcing sufficient and effective services that have to do with gender-based violence in Jordan. The first speaker was Yara Al Deer, a researcher at the Arab State Regional Office of the United Nations Population Fund. Al Deer pointed out that national and local institutions of healthcare, justice, and social development sectors should collaborate and cooperate more effectively to implement a range of feasible procedures of social, psychological, and legal support for survivors.

The second speaker, Dr. Mohammad Fakhri Meqdady, secretary general of the National Council for Family Affairs in Amman, highlighted the role of the NCFA in fighting gender-based violence in Jordan in light of various social and political transformations. Meqdady noted that a family protection project was initiated to protect a large number of survivors in Jordan. He also stressed the importance of collaboration among government and nongovernmental institutions that fight gender-based violence in Jordan from statistical, procedural, and legal perspectives.

Dr. Salma Nims was the third speaker of this panel. She is secretary general of the Jordanian National Commission for Women in Jordan. She addressed the dynamic and vital way in which the political and social roles of the Jordanian National Commission for Women are played. According to Al Nims, the commission is in charge of the following responsibilities: ensuring a convenient and applicable environment, revising the legal system, opening up a powerful and face-to-face dialogue with the government, building up an effective dialogue with the civil society in order to agree on specific legal amendments and revisions, and enforcing an active form of cooperation among all government and nongovernmental institutions to fight gender violence in Jordan. Such a dynamic role, however, is diminishing due to lack of institutionalism and bureaucracy.  

Dr. Ibrhim Aqil, director of the Noor Al Hussein Center for Family Health Care, was the last speaker of this panel. Aqil explored how civil society can imagine and offer alternative and feasible services for survivors of gender-based violence in Jordan. Aqil juxtaposed the interplay between data of gender-based violence, getting access to these data, and the right to get adequate and efficient services. He also placed an emphasis on the indispensable nature of multiple services that should be offered for survivors. These services include protective, educational, legal, administrative, social, and psychological procedures.

Panel 3: Gender-Based Violence in the Healthcare Sector

The third panel was titled “Gender-Based Violence in the Healthcare Sector.” Dr. Malak Al Ouri, director of Women’s Healthcare in the Ministry of Health, examined the role of the Ministry of Health in the reinforcement of health services for traumatized women in Jordan. Al Ouri discussed how the family violence department plays a vital role in handling gender-based violence issues in Jordan. In addition, a number of professional committees have been initiated by the ministry to follow up on all cases of gender violence in Jordan and make sure that each case is reported and documented immediately and rigorously. However, there is a built-in flaw in the institutionalized and scholarly documentation of such kind of cases arising from governmental bureaucracy, cultural stigmatization, and lack of cooperation between government and nongovernmental institutions regarding gender-based violence.

Dr. Maha Darwish, an expert on gender-based violence with the United States Agency for International Development, also addressed alternative and feasible services to rehabilitate gender-based victimizers from a psychosocial perspective. Darwish suggested psychological procedures to rehabilitate victimizers and ensure a professional training program designated by the Ministry of Health and other local institutions. 

Panel 4: Gender-Based Violence in the Social Development Sector

Panel four was concerned with gender-based violence in the social development sector. Amer Hiasat, director of the Social Development Program in Amman, discussed the multiple ways in which social protection for gender-based victims is maintained and carried out by the Ministry of Social Development. Hiasat asserted that the ministry has a crucial role in offering beneficial services for survivors of gender-based violence in Jordan. Nevertheless, this role is still flawed due to multiple bureaucratic and institutional inconsistencies.

Meanwhile, Eva Abu Halawa, director of Mizan Organization for Women’s Rights, put forward a number of suggested methods that civil society should use to protect survivors of gender-based violence. She contended that raising gender consciousness among people is a national priority that should be taken into account in fighting gender-based violence in Jordan. She also suggested creating more specialized counseling departments for training legal prosecutors and employees who handle cases of gender-based violence.

The last speaker of this panel was Dr. Amal Al Awawdeh, a professor of gender studies at the Center for Women’s Studies, University of Jordan. She interrogated the professional and technical competence of government social specialists who are in charge of handling gender-based violence in Jordan. Her findings are premised on the lack of effective professionalism among government social specialists and how such a flaw impacts social and counseling intervention and protective programs that have been employed by the Ministry of Social Development.

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[Report] Fall Session of Sylff Leaders Workshop 2018–19

November 16, 2018

Introduction

An inaugural group of 20 Sylff fellows participated in the fall session of the newly launched Sylff Leaders Workshop from September 16 to 23, 2018. The fellows, who were selected from among 114 applicants, were a highly diverse group in terms of nationality, Sylff institution, field of specialization, and current occupation.

Sylff fellows and secretariat members in Sasayama.

Sylff fellows and secretariat members in Sasayama.

The main objective of the workshop was to provide graduated Sylff fellows an opportunity to experience diverse cultures through intensive discussions with people from different backgrounds and with varying viewpoints. Fellows were also able to deepen their ties to the Sylff community and gain new insights into Japan—not just the well-known aspects of the host country but also traditional and local areas off the beaten track.

About Sasayama

All participants had been scheduled to reach Sasayama via Osaka, but some were forced to switch routes, as Kansai International Airport was heavily damaged in the catastrophic typhoon just prior to the workshop. From Osaka, fellows traveled an hour and a half by bus to Sasayama in Hyogo Prefecture, where most of the sessions were held.

Sasayama is a scenic farming community of low-lying hills famous for such products as kuromame (black soybeans), mountain yams, chestnuts, and tea. It is also a former castle town, and the castle originally built in the seventeenth century has been partly reconstructed. Some buildings and neighborhoods retain the style and structure of the castle town.

Fields of harvest-ready rice in Sasayama.

Fields of harvest-ready rice in Sasayama.

A reconstructed section of Sasayama Castle.

A reconstructed section of Sasayama Castle.

Welcome remarks by Sanae Oda.

Welcome remarks by Sanae Oda.

Sanae Oda, executive director of the Tokyo Foundation for Policy Research, welcomed the fellows on behalf of the Sylff Association secretariat. “One major aim in developing this program was to enable fellows to renew their understanding of the kind of leadership qualities we’re looking for,” she said in her remarks. “Society today has become very divisive. We need leaders who will bridge differences and promote understanding between people of diverse cultures and values. The message I hope you’ll take home from this workshop is that this is a role Sylff fellows should play in working for the common good.

“Our second aim is to help you enjoy your stay in Japan and gain a better understanding of the country,” she continued. “Through your two visits, I hope you’ll not only get to know each other better but also come to appreciate the many faces of Japan.

Activities in Sasayama

Being a community with a vibrant agricultural sector, Sasayama was an excellent setting for the workshop, whose topic was “The Future of Food Production in 2030.” When considered in terms of the “food system,” the issue is of overriding concern across the globe, as it encompasses not only agricultural production but also transport, manufacturing, retailing, consumption, and food waste. There are impacts on nutrition, health and well-being, the environment and ultimately, global food security.

Keynote speech by associate professor Yoshikawa.

Keynote speech by associate professor Yoshikawa.

The keynote speech for the three-day program in Sasayama was delivered by associate professor Narumi Yoshikawa of the Prefectural University of Hiroshima, an expert on the agricultural economy, who described Japanese initiatives in organic agriculture and grassroots efforts to strengthen ties between consumers and producers.

The workshop was facilitated by methodology experts from German-based Foresight Intelligence, which supports strategic foresight and planning processes in various organizations. After the plenary session, fellows broke out into smaller groups to discuss the topic under a subleader, delving into such issues as “food security through efficiency and resilience,” “ethical attitudes and awareness raising,” and “responsible and open innovation.” Fellows also conducted an online discussion with Philipp Grunewald of Oxford University’s Environmental Change Institute, who, in addition to running a mushroom farm, has expertise in such fields as the global food production system and organic farming. The three days in Sasayama formed the foundation for the presentations by fellows on September 21 in Tokyo.

Plenary session.

Plenary session.

Breakout session 1.

Breakout session 1.

Breakout session 2.

Breakout session 2.

A majority of fellows stayed at Nipponia, a traditional wooden mansion that has been renovated into a ryokan, or Japanese guesthouse. On September 17, workshop participants were joined at dinner by Sasayama Mayor Takaaki Sakai, who introduced the city and welcomed the guests from overseas. On the following day, fellows got a taste of Japanese culture, choosing to participate in either the tea ceremony or a visit to a local sake brewery. In the evening, fellows enjoyed a Japanese style barbeque, sitting on small cushions on the wooden floor. 

Welcome dinner at Nipponia on September 17.

Welcome dinner at Nipponia on September 17.

Dinner at a robatayaki (Japanese-style barbeque) restaurant on September 18.

Dinner at a robatayaki (Japanese-style barbeque) restaurant on September 18.

Fellows participate in the tea ceremony.

Fellows participate in the tea ceremony.

Visit to a brewery for a sake tasting.

Visit to a brewery for a sake tasting.

Kyoto Trip

Before moving to Tokyo, fellows spent a night in Kyoto, visiting the Gion district, where they were entertained by maiko (female performers-in-training between 15 and 19 years old) and geiko (trained performers over 20). Maiko and geiko are part of a social tradition in going back to the eleventh century, performing for members of the upper class.

A geiko (left) and maiko (right) play games with fellows.

A geiko (left) and maiko (right) play games with fellows.

Tokyo Session

On September 20, fellows visited the Tokyo Foundation for Policy Research, located on the 34th floor of a high-rise in the Roppongi area, for a session introducing the activities of Japanese think tanks and the current state of the Japanese economy. Foundation researchers later joined fellows for dinner on a yakatabune boat cruise in Tokyo Bay.

A session with policy experts in Tokyo on September 20.

A session with policy experts in Tokyo on September 20.

The following day, fellows presented the conclusions of their workshop discussions. They used a methodology called “visioning and road mapping” developed by Foresight Intelligence calling on fellows to start with a target year—in this case 2030—and to work backwards from potential scenarios. In thinking about the status of food production in 2030, fellows first discussed bad scenarios and then considered more desirable outcomes. They identified specific problems, developed the means to resolve such problems, and presented their visions of the future. These tasks were considered in reverse chronological order (using the “backcasting” approach), rather than by envisioning a future based on the current situation. Visioning and road mapping are tools enabling the normative construction of the future and are designed to remove current biases and to think about ethics and the values needed to build a desirable future.

Fellows divided into four groups to make their final presentations, expressing clearly how a desired future could be created.

Final presentation (1) on September 21 at the Tokyo Foundation for Policy Research.

Final presentation (1) on September 21 at the Tokyo Foundation for Policy Research.

Final presentation (2) by Rosangela Malachias (left of screen) and Stefan Buchholz (right).

Final presentation (2) by Rosangela Malachias (left of screen) and Stefan Buchholz (right).

Final presentation (3) by Kabira Namit (left) and Evgeniy Kandilarov (right).

Final presentation (3) by Kabira Namit (left) and Evgeniy Kandilarov (right).

Final presentation (4) by Andrew Prosser.

Final presentation (4) by Andrew Prosser.

The workshop ended with a lunch reception with Nippon Foundation President Takeju Ogata, who recounted how the first Sylff institution, the Fletcher School of Law and Diplomacy at Tufts University, came to receive a Sylff endowment and how Sylff as a program has developed thereafter.

The same 20 fellows will meet again in April 2019 in Beppu, renowned for its natural hot springs, located in Oita Prefecture. The workshop will be hosted by Ritsumeikan Asia Pacific University, a Sylff institution located in the city. Fellows will wrap up their discussions and make their final presentations.

The workshop was launched to facilitate networking and to give fellows a fuller appreciation of the rich diversity of the Sylff community. The Sylff Association secretariat intends to offer this program biennially and is already planning ahead to the next round.

A group photo at the Tokyo Foundation for Policy Research on September 20.

A group photo at the Tokyo Foundation for Policy Research on September 20.

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Delivering 3D-Printed Prosthetic Solutions in the Philippines: An Interview with Keio Fellow Yutaka Tokushima

May 9, 2018

Sylff Project Grant (SPG) is a new support program launched in September 2017. The program awards grants of up to $100,000 to support projects led by Sylff fellows with the aim of contributing to the resolution of a social issue. Selection criteria favor projects that take an innovative, sustainable approach and have high potential for social impact. Grantees must personify the Sylff mission and demonstrate the kind of leadership and commitment needed to spearhead social change.

In March 2018, the first grant was awarded to Yutaka Tokushima, recipient of a 2016–17 Sylff fellowship at Keio University’s Shonan Fujisawa Campus. In the following overview and interview, we profile the project’s leader, his previous accomplishments as a Sylff fellow, and his plans for translating those achievements into an enterprise with sustained social impact.

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Overview

Yutaka Tokushima is a doctoral student at Keio University specializing in fabrication design. Hoping to use his expertise for the good of society, Tokushima initiated a project aimed at leveraging digital technology to provide affordable prosthetic legs to low-income individuals in the Philippines.

Owing to dietary issues, diabetes is a growing problem among the poor in many developing countries, and when patients are poorly informed about their condition and its control, the complications can lead to amputation of the lower extremities. Unable to work, amputees typically sink deeper into poverty. A conventional artificial limb, which must be assembled by highly skilled artisans from multiple parts and a variety of materials, can cost anywhere between $3,000 and $9,000 in the Philippines. For someone subsisting on less than $400 a year, such a purchase is unthinkable. Yet an artificial limb would allow many of these amputees to find work and support themselves.

A 3D-printed prosthetic leg prototype and 3D printer (right).

In an effort to surmount these critical cost obstacles, Tokushima developed a system that uses 3D printing and machine learning to fabricate prosthetic legs entirely from plastic. The process yields dramatic savings, first of all, by eliminating the need for expensive materials. In addition, the application of a 3D printing system using software with machine-learning capabilities greatly reduces the need for advanced professional skills in the fabrication process. As a result, artificial legs can be created at a small fraction of the cost of conventional prostheses, putting them within reach of low-income amputees in developing countries.

Next, Tokushima set up a company, Instalimb, which is currently conducting clinical trials of 3D-printed prosthetic legs in Metro Manila. If all goes well, he plans to launch a social business in the form of a joint venture and begin providing 3D-printed prosthetic solutions on a commercial basis in Manila sometime in 2019. The next step will be to explore ways of expanding that business model to sparsely populated areas and outlying islands, where cost and accessibility hurdles are particularly high.

Tokushima believes he has a mission to apply his expertise in fabrication design to help better the lives of people in the developing world. He also believes that, in order to ensure lasting social impact, assistance from the developed world must focus on giving local citizens the means to tackle their communities’ issues themselves.

Interview

In the following interview, Yutaka Tokushima spoke with me about his goals and aspirations for the project recently awarded an SPG. (Interview conducted by Keita Sugai on March 26, 2018, at the offices of the Tokyo Foundation for Policy Research.)

Yutaka Tokushima, left, with program officer Keita Sugai.

— What made you decide you to undertake the development of a 3D-printed prosthetic solution?

YUTAKA TOKUSHIMA: It all started when I was working in Bohol, in the Philippines, with the Japan Overseas Cooperation Volunteers [JOCV] under the Japan International Cooperation Agency.

The digital fabrication technology already existed. I was wondering if that technology could be used to help people in Bohol help themselves. I realized that 3D printing was a groundbreaking technology that could give low-income individuals access to powerful fabrication tools even on a tiny island like Bohol. 

 

— Why did you choose Metro Manila as your market? 

TOKUSHIMA: I’ve always thought that I’d like to do something to contribute to development in Southeast Asia, and when I joined the JOCV, I was sent to Bohol. As an outgrowth of my work there, I had the idea of leveraging digital fabrication technology to help the poor via social entrepreneurship. I chose Metro Manila because it’s a big city with a lot of poverty and inadequate access to urban services, and because there’s a widespread feeling that something needs to be done about its social problems. In other words, it was the place that offered the best opportunities for this kind of social enterprise. For me, a key challenge is striking a balance between philanthropy and business viability, and Metro Manila seemed like the best location from that viewpoint.

 

— We know that you’ve already conducted some trials on a limited basis. What’s been the response from your subjects?

TOKUSHIMA: We’ve had a great response. I remember particularly an elderly man whose leg had been amputated seven years earlier. He couldn’t wait to get back to his job as a cabinetmaker, and his wife was so happy she was crying. It was truly gratifying.

 

— So, what are your short-term, medium-term, and long-term objectives?

TOKUSHIMA: This year I’m going to continue usability testing to perfect the product, while establishing a business model that can be applied to most third-world cities. I’m also going to make preparations for the launch of my venture business. And I’m going to conduct a feasibility study to gauge the possibility of developing a separate business model geared to remote areas and islands. Medium term, I want to begin offering prosthetic solutions throughout the Philippines within the next three years. Beyond that, I hope to use what I’ve learned in the Philippines to expand to other developing and semi-industrialized countries.

 

— Do you have any ideas about what you might do next?

TOKUSHIMA: I know that I want to pursue this approach of using new technology to empower developing nations. The traditional model of development assistance was based on a vertical relationship. The donor countries brought in their own materials, equipment, and know-how, and when something broke down or wore out, it was often difficult to fix it. The trend in international cooperation nowadays is toward a horizontal relationship between donor and recipient. There’s a growing emphasis on providing technology that empowers people in the developing world to solve their own problems. I’d like to be a part of that.

 

— Is there any message you’d like to convey to other Sylff Association members reading this interview?

TOKUSHIMA: Sylff's goals are very consistent with the trend toward horizontal cooperation that I was talking about. The Sylff mission centers on transcending differences and joining together to address the issues confronting society. It’s an honor to be selected for a Sylff Project Grant. For others around the world who are eager to pursue similar projects, I want to say that we’re lucky to be living in a time when there are people who will give us a chance. I want to make the most of that opportunity and provide an example for others by strengthening cooperative ties and making a real difference in the world.