“I like school. I can’t wait to go to class.”

Zeng Lei is sitting on the steps of the old classroom building. He is 15 minutes early. But, Zeng Lei is not alone. Nine of his fourth-grade classmates are crowded around the front door, unable to keep still. Eagerly they scan the schoolyard for the teacher-supervisor to come over and open the door. They can’t wait. 

Are these the school’s top, fast-track students? Are they meeting with their teacher to prepare for the Math Olympics? Are Zeng Lei and his classmates the young, motivated geniuses that are ready to lead China into the 21^st century?

Actually, these are not the best students. Only three of ten will graduate from high school. If these fourth grade students took a math test that was also given to a group of second grade students from an urban public school, the second grade city kids would outscore Zeng Lei and his friends. Easily. In fact, there are many first graders in China’s cities that would outscore these rural fourth graders in math, Chinese and English.

So what is Zeng Lei waiting for? Why are these children—who have never been especially interested in school before—so anxious to get into the classroom?

Computers, games, learning and more

Zeng Lei and his friends are in our Computer Assisted Learning program. All of the fourth graders in his school are part of the program. We call Computer Assisted Learning “CAL” for short. It is one of the most prominent initiatives of our research group, the Rural Education Action Project (or REAP).

CAL is a game-based remedial tutoring program. Each week, twice a week, all fourth graders in a CAL school attend a 45-minute session in a computer room. Some of the computer rooms are new. We set them up. Some of the computer rooms were already there. We got them into shape for the CAL program.

But CAL is more than just hardware. On each of the computers, there are two pieces of software that REAP has created to help students in poor rural schools catch up and stay caught up. The software is calibrated to the curriculum that is being taught in the classroom. The software reviews the material taught during the week and then provides—in a game format—targeted review questions. Lots of review questions. Lots of games. Music and rhymes and riddles and challenges.

So, are we talking about a complicated new technology that is technically difficult to deliver and maintain? In fact, nothing can be further from the truth. The CAL program is made up of two simple pieces of software. One of the programs cost REAP less than US$5000 to develop. A group of Tsinghua University undergraduate computer majors created the software in six weeks during the summer of 2009. It is not copyrighted. Any one can have it. It can fit on any USB drive. The other piece of software can be purchased online for around 50 yuan. It takes about 5 minutes to install. Even I can install it—and I am a 58-year-old technology caveman. Simple. Attractive. Using off-the-shelf, low-powered computers as tutors to drill students in a way that they think is fun. 

Each class has a teacher-supervisor but with only one simple job. In Zeng Lei’s school, she speaks to the math teacher before the CAL session to find out what lesson the class covered during the week and then tells the students which icon to click. And that is about it.

So how much impact does this simple program have? We conducted a little test to find out. We picked 148 schools in 3 provinces and randomly selected half of those schools to receive the CAL program (our “CAL schools”) and half to receive no intervention at all (our “control schools”). And with such a simple intervention, the results were really nothing short of amazing.

We found that after just one year of using CAL, test scores of the students in the CAL schools were significantly higher than the students in control schools (who had no CAL program). And we conducted four more studies—a total of five separate, large-scale field experiments. In all of these studies our results were the same. Test scores rose for CAL students in migrant schools in the suburbs of Beijing. Test scores rose for CAL students in rural mountainous schools in the Qingling Mountains of southern Shaanxi. Test scores rose for CAL students from minority community schools in Qinghai. In all of these environments, test scores went up in math. Test scores also went up in Chinese. Scores on scales measuring mental health (especially anxiety) improved. Students became more confident in problem solving. All of this from two 45 minute sessions per week.

Remember, the ONLY difference between the CAL treatment schools and the control schools was the CAL program. When we ran the program for a second year—we were afraid that the initial effect of CAL might be the result of short-term student excitement rather than true change in learning behavior—we found that CAL continued to improve student learning. CAL did not eliminate the gap between urban and rural students. But the CAL program did reduce the gap significantly. 

And according to the REAP studies, students in CAL schools gained something even more important. They started to like school. During the baseline, only about 25% of students said that they liked school (in both the CAL schools and the non-CAL control schools). At the end of the school year, after several months of CAL, more than 60% of the CAL students said that they “liked” school. There was no significant change in the control schools. With the addition of just two CAL classes per week!

So, this is why Zeng Lei lined up early outside the CAL classroom on CAL day. He could not wait to get on the computer. He could not wait to play the CAL games and answer the questions. He could not wait to learn. And for maybe the first time in his life, he really liked going to school.

China’s digital divide: The widest in the world

In this article, we are not pushing CAL. Hey: we believe every child in rural China could benefit from CAL. But, the real reason for our column is to discuss some of the fundamental structural problems of China’s rural education system. Let’s use CAL as a lens to examine some of the problems that are plaguing rural schools today.

Why is it that such simple computer games can make such a difference? There are many reasons. First and foremost, we believe it is due in large part to the simple fact that computers are new and novel for these students. The engaging and effective way in which a computer can convey information is something most of these kids have simply never experienced. Unfortunately, most rural children still do not have access to computers or other electronic technologies.

In a paper that REAP wrote and published last year, we documented that the digital divide is wider in China than in any other country in the world. In the city, just about every student has access to computers and software and other electronic learning devices. In poor rural areas, almost no student has this access.

Here are the facts: According to data on more than 10,000 students in Beijing, Shaanxi and Qinghai, we can convincingly show that the gap in computer access between urban students and rural students in Western China ranges between 13:1 and 36:1. In China’s largest cities, 80% of children have computers at home and 73% of children have Internet. In poor areas of Western China only 6% of children have computers and only 2% have Internet at home. We can find no country in the world with such a wide digital divide.

And in schools, access to computers and Internet and educational software is even more skewed: Every child in China’s cities has access to modern ICT technology in their schools; almost no students in remote rural areas do. The digital divide in China is wide indeed.

And, this digital divide has consequences for learning. As REAP has shown with its CAL programs, if you give children access to the technologies of the 21^st century—equipped with simple, fun and relevant learning software—they learn. And they have fun doing so. If they do not have access to computers, the Internet and relevant software, they miss out on that opportunity.

Lots of hardware; an absence of learning

This is a story of opportunity lost.  It is disheartening. If incompetence and institutional failure irk you, do not read any further.

The good news: In the same REAP paper that documents the digital divide, we also demonstrate that there are easy, effective ways for rural public schools to moderate the digital divide. When schools install computers; keep them maintained; have teachers that know how to use them; and teach structured, learning-based material during computer class, the students in those schools overcome part of the disadvantage of not being able to afford a computer or Internet access at home.  

The bad news: There are almost no schools in rural areas that have invested in all of the components that are needed for a successful computing program. And, there are even fewer that use modern technologies to deliver quality, learning-based curriculum that helps students learn.

Why is this the case? Why aren’t rural schools able to deliver quality educational learning to students? The answer is complicated. Certainly it is not an absence of hardware. In the current five-year plan, billions of dollars are being spent on equipping rural schools with computer rooms. In China’s poorest areas, much of the funding is allocated by the central government. Beautiful new facilities are being equipped with new, perfectly adequate computers. Over the past five years since we have been working on CAL, we have seen rows and rows and rows—literally miles of rows—of new computers. And new desks, lots of screens and plenty of other hardware. Could this mark the end—or at least the beginning of the end—of China’s formidable digital divide?

Unfortunately not. While this hardware is important, the support from above appears to stop there. There is almost nothing else provided. The new machines may have Microsoft Office Suite installed. Students are able to learn Powerpoint, Word and Excel. There are typing programs on some machines. The third most common piece of software is one that teaches students how to program in Basic. Never mind that Basic is a computer programming language that was out of date in the 1990s. But there is almost no educational software. There are almost no learning applications. One of the most common ways that computers are used in junior high schools in Northwest China is to give students a way to watch DVDs, usually the latest movies or old reruns of popular TV series. And that’s about it.

Even if there were educational software or other learning tools loaded onto these shiny new computers, it would not necessarily help. In almost no school in rural China is there a professional, trained staff member that is charged with maintaining and managing the computers. We have collected budgets from thousands of schools in Western China. There is almost never a budget for using, maintaining or replacing computers once they break down. As we all know, computers—especially those in a busy school computer room—inevitably break down or stop working. It is natural. It happens all of the time to me. It happens all of the time to all of us. When it happens, of course, we fix it. In many rural schools, however, when computers break down, they stay broke. There is no one to fix them. There is no budget to fix them with. There is no intention to fix them. The national government pays for the initial hardware. After that, the schools are left on their own. And the local bureau of education does not have the resources (or are not willing to spend the resources) for staff or maintenance.

How bad is it? In a recent project, we ran a contest: let REAP implement CAL in one set of 30 schools (the REAP schools); let educators from local bureaus of education implement CAL in another set of 30 schools (the government schools). The schools were randomly assigned—half became REAP schools; half became government schools. And there was no other difference between these schools at the outset. We were interested to find out: Which set of students would learn more? By this point we knew that CAL worked… now the question was, would CAL still work if implementation were turned over to local government?

So who won? Well, it is safe to say that REAP won before the competition started. The reason is that when many of the computers in the government schools did not work, they made no effort to fix them (at least initially). They simply did not have any budget to do so. It is difficult to run Computer Assisted Learning programs if the computers do not work. On top of that, the teams from the government did not even bother launching the program in a number of their assigned schools.

Meanwhile, before REAP launched its CAL program in the REAP schools, we had two teams of two students spend less than a week repairing and fine-tuning the computers. That’s all it took. Some computers were beyond repair; most were not. And we fixed all we could. In the end, REAP implemented the CAL program in 28 of the 30 schools that were assigned to us. We spent only around 2000 yuan or so on repairs and about 15 days of technician time. The result? 28 working computer rooms ready to educate excited rural kids.

A call for remaking computer management in rural schools

Lots of hardware. No learning software. No maintenance funds. No trained computer staff. That is the state of China’s rural computer programs today.

This is a failure of program design from the national government. The Ministry of Education should not spend any more money on hardware without first making sure the entire package is complete—computers; software; maintenance; staff. There needs to be national curriculum set up for installing effective, fun and accessible learning software in computer classes. We have shown over and over that these programs work: simple, game-based software packages are effective in raising test scores, in improving mental health, in building confidence and in making learning fun. Otherwise, buying more hardware is little more than showmanship. And a tragically wasted opportunity.

“Ask me. I will tell you I like school”

Just ask Zeng Lei. He will tell you. Since CAL came around, he loves school.

Where can you find Zeng Lei? Where is Zeng Lei? Oh, that is easy. You do not have to look very hard. He is standing in line outside the CAL computer room squirming in anticipation. He has 15 minutes to tell you all about it. He is always 15 minutes early.

About this series:

REAP co-directors Scott Rozelle and Linxiu Zhang are writing a ten-part series for Caixin Magazine titled, "Inequality 2030: Glimmering Hope in China in a Future Facing Extreme Despair." See below for more columns in this series:

> Column 1: Why We Need to Worry About Inequality

> Column 2: China's Inequality Starts During the First 1,000 Days

> Column 3: Behind Before They Start - The Preschool Years (Part 1)

> Column 4: Behind Before They Start - The Preschool Years (Part 2) 

> Column 5: How to Cure China's Largest Epidemic

> Column 6: A Tale of Two Travesties

>Columns 7 & 8: China's Widest Divide

> Column 9: China's Most Vulnerable Children

> Column 10: Why Drop Out?

> Column 11: The Problem with Vocational Education

> Column 12: Reforming China's Vocational Schools (in Chinese)

At the May 13-15 symposium on Fisheries and Food Security in China, 27 leading scientists and scholars from around the world gathered in Beijing to share research on the role of ocean fisheries, aquaculture, and marine ecosystems for improving food security in China.

Given China’s demographic changes, evolving nutritional requirements and dominant role in global fisheries, the key question of the symposium was whether marine ecosystems can be managed adequately to support the country’s future vision for domestic food security.

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The symposium highlighted new research on the provision of wild fish for human consumption and for animal feeds. Scholars also shared insights on China’s aquaculture sector, including the tradeoffs involved in using wild fish in aquaculture feed.

The three-day meeting focused on critical questions about the future of fisheries and food security in China:

• How will China's seafood consumption evolve with a population that is growing in both size and wealth?
   
• How can China manage its seafood industry to maximize its own food security now and in the future?
   
• Can aquaculture take pressure off of wild fisheries, or does the inclusion of wild fish in aquaculture feed put more pressure on wild fish stocks?
   
• Can marine ecosystems be managed to protect both ocean health and food security?
   
• How does the global fish trade, including demand for luxury and medicinal seafood products, shape China's fish production industry, and vice versa?

Among the 26 participants were researchers and policy experts from Stanford University, Ocean University of China, University of Stirling, Shanghai Ocean University, University of Maine, South China Sea Fisheries Research Institute (CAFS), Yellow Sea Fisheries Research Institute (CAFS), Sustainable Fisheries Partnership, Stony Brook University, Xiamen University, Hainan University, Shandong University, Asia Pacific Fish Watch, Hong Kong University, International Institute of Sustainable Development, James Cook University, China Policy, Shanghai Jiao Tong University, and University of British Columbia Fisheries Centre.
 

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In between meetings held at the Stanford Center at Peking University, participants traveled to Beijing's largest fish market, where they observed local offerings and discussed trends in the global seafood trade with fish vendors. 

The symposium, funded by the Lenfest Ocean Program and chaired by FSE director Rosamond Naylor, kicks off a multi-year series of research papers and international meetings aimed at advancing the science around Chinese fisheries and food security. This ongoing international project will be coordinated by Professor Naylor and by Dr. Ling Cao, a postdoctoral fellow at FSE.

Sociologist Xueguang Zhou is no stranger to Stanford. He studied here as a doctoral student and returned to campus in 2006. He is now the Kwoh-Ting Li Professor in Economic Development and a senior fellow at the Freeman Spogli Institute for International Studies.

Zhou says it is a joy to be teaching in the very place he himself was intellectually trained. Recently, he spoke with the Shorenstein Asia-Pacific Research Center about his route to the Farm and his research focus on China’s urbanization and bureaucracy. 

How did you come to Stanford and the Center?

I completed my PhD in sociology at Stanford so it was a very easy and natural decision to come back as a professor. After graduating, I went to Cornell University and Duke University as well as spending two years in Hong Kong University of Science and Technology, but I always missed the exciting intellectual environment at Stanford. I have a lot of admiration for the faculty and research that takes place here. In 2006, the sociology department and Shorenstein APARC recruited me. I began to focus on China as a major research area after I had completed my Ph.D. My dissertation was actually centered on American universities. My joint appointment as a professor and as a senior fellow at Shorenstein APARC has been very complimentary. I teach in my trained area of sociology and explore my substantive interests in Chinese bureaucracy. I combine my teaching and research nicely to bridge the two sides. Additionally, this year, I will teach a summer graduate seminar at Stanford Center at Peking University.

What are the most pressing issues of China’s urbanization?

Urbanization processes in China have been underway for the last 10-20 years, in particular, the government is pushing very hard to accelerate this process. Suddenly, people have been pushed from rural to urban areas. Many are being forced to abandon their land and assume a new life away from their farming activities. This process raises many important questions, and is a main area of what I study. Chinese culture (way of life, organization, problem solving) is heavily drawn from rural tradition. Inherently urbanization has created tensions between tradition and the modern idea of Chinese society. Now we see a lot of contentious politics in China. Resistance, revolt and social movements are in part caused by this disruption of the social norms and tradition that had historically held the Chinese society together. Patterns of interaction between social groups have changed. So, what does this mean for society? And further to that, what is the new governance structure that emerges out of this? In rural China, governance in the past was based on kinship and local institutions, but the future is unclear. We need to research and understand the emergent governance structure in China. 

What impact has recent bureaucratic restructuring had on Chinese society? 

Right now, it is hard to say what effects the recent changes put forth at the Third Plenum will have on society. It is too soon to see any major effects on the long-term trend. My research focuses on the fundamental basis of Chinese structures and bureaucracies. Over the past two years, I have pursued analyzing Chinese bureaucracy through a historical lens. If we take a step back and observe these recent policy shifts in a greater timeline, we can see that local-level fluctuations are only temporary phenomena. For example, China’s new leadership recently launched a huge anti-corruption campaign. As a result, people in local-level bureaucracies have suddenly become much more careful about their behavior. But, how long will this behavior last? It is unlikely to last for very long. If we look at it from a longer perspective, we can see clear policy rhythms between centralization and decentralization over time. There may be short-term policy efforts to strengthen the central authority, but systematic institutional shifts are less likely.

Can you tell us about your methods and approach to your research on Chinese personnel structures?

I analyze archival data and conduct fieldwork in China to understand changes in bureaucracy. A primary way I conduct my fieldwork is participatory observations in a township-level government in China. When I visit this township government, I stay in a guestroom in the government building, and interact with local officials on a daily basis, observe their work and eat meals with them. Basically, I get to know them, their views and way of life. I also go to the nearby villages to interact with locals to gather their opinions about bureaucracy and the policy implementation processes. I also meet with other Chinese colleagues who conduct research on government behaviors, and we share and discuss our observations. Often times, they take me to different localities to visit government bureaus and to chat with local officials. All of these interactions give me great opportunities to learn about the Chinese bureaucracy. Close observations are key for me to identifying current issues in governance and bureaucratic structures, which I then compare to the historical legacy. This line of research is also connected to a project in collaboration with graduate students, analyzing the flow of bureaucrats in an entire province using public data. 

Tell us something we don’t know about you.

One aspect of my personal experience that I cherish is that, like many in my generation, I was sent to work in rural China after high school during the Cultural Revolution.  There I became a “team leader” in a village, responsible for organizing collective activities of over 200 villagers (about 50 households) and several hundreds “mu” of farming land, when I was only 17. This experience gave me a much deeper understanding of rural life in China.

The Faculty Spotlight Q&A series highlights a different faculty member at Shorenstein APARC each month giving a personal look at his or her scholarly approaches and outlook on related topics and upcoming activities.

Rod Ewing, chairman of the federal Nuclear Waste Technical Review Board, recently led a delegation of five board members and staff to China to learn about Beijing’s efforts to develop a deep-mined geologic repository for high-level radioactive waste.

During the visit to Beijing, the delegation met with officials at the China Atomic Energy Authority (CAEA) and the Ministry of Environmental Protection (MoEP). They also met with scientist and engineers at four scientific organizations and research institutes: the Chinese National Nuclear Organization (CNNC), Beijing Research Institute for Uranium Geology (BRIUG), the China National Nuclear Engineering Company (CNPE), and the Chinese Institute for Atomic Energy (CIAE).

“We had very complete summary presentations of the Chinese approach to nuclear waste management and the status of their present research and siting program for a geologic repository for high-level nuclear waste,” said Ewing, who is a senior fellow at FSI and CISAC’s Frank Stanton Professor in Nuclear Security.

Ewing was appointed by President Barack Obama in 2012 to serve as the chair of the Nuclear Waste Technical Review Board, which is responsible for the technical review of Department of Energy activities related to transporting, packaging, storing and disposing of spent nuclear fuel and high-level radioactive waste.

The delegation had an extended discussion with Xu Dazhe, Ewing’s counterpart as chairman of the CAEA. The visit in Beijing ended with a full-day technical exchange between scientists and engineers from both countries, as well as participants from institutes outside of Beijing and members of the NWTRB

The U.S. delegation visited a museum of uranium mineral, including a specimen of the first uranium ore discovered in Guangxi in 1954. The specimen had been presented to Chairman Mao Zedong and Zhou Enlai – marking the beginning of China’s nuclear industry.

The delegation heads to the remote northwestern region of Beishan to see China's proposed site for a nuclear waste repository. Photo Credit: Rod Ewing

The delegation then traveled to Beishan to examine the granite host rock in the remote northwestern Gansu Province, which is a potential site for an underground research laboratory and geologic repository for nuclear waste.

“Both countries can learn from one another, saving time and money for each country,” said Ewing, a professor of Geological and Environmental Sciences in the School of Earth Sciences at Stanford. “Nuclear waste management is an international effort in which cooperation is essential.”

China is pursing an aggressive campaign to expand its nuclear energy capacity and as part of an effort to meet growing energy demands, as well as to reduce air pollution from coal-fired plants. There are some 20 nuclear power reactors in China and another 28 under construction, according to the World Nuclear Association.

China has a policy of reprocessing its nuclear fuel and will be disposing of vitrified, high-level radioactive waste. The U.S. delegation was particularly interested in work on the properties of the vitrified waste in a disposal environment and understanding the Chinese strategy for disposal of HLW in a granitic host rock.

The Chinese are investigating a number of sites in granite in the Beishan region, located along the ancient Silk Road. Once a suitable site is located, the first step would be to establish an underground research laboratory for detailed scientific and engineering studies that will be required for a final geologic repository.

Mary Lou Zoback, a seismologist and consulting professor in the Geophysics Department at Stanford, was one of five board members on the trip. She was impressed that China intends to take five years to build an underground research laboratory and then conduct 20 years of testing before opening a repository.

The United States has been stalled for years in its proposed plan to build a similar deep geological repository for spent nuclear reactor fuel and radioactive waste at Yucca Mountain, adjacent to the Nevada Test Site. Environmentalists and local residents have opposed the project – factors that China routinely ignores.

“I think the most valuable thing in making the visit to China and visiting the site is really to gain an understanding of their program and also their general philosophy toward siting what, in this country, has been an extremely controversial project,” Zoback said. “They chose a remote area and they really haven’t even consulted with any of the surrounding towns – and that’s not what we do here. But I was extremely impressed that they recognized the need for this lab and would allow 20 years for all the scientific investigation that would be carried out to make sure it was safe.”

The Beishan region has five granitic sites that are being investigated as potential host rocks for the underground laboratory and possible repository. Board members discussed the geology and characteristics of the site with Chinese scientists and examined rock core and data that have been generated by their research program.

In addition to detailed investigations of granite, the Chinese also consider clay as a medium for a geologic repository and very deep borehole disposal, reaching proposed depths of up to 3 miles. One of the important issues is the methodology for the comparison of sites within a single type of geology or across different types of geology. The U.S. has a wide variety of geologies that may be suitable for disposal, including granite, clay, salt and volcanic tuff.

“The U.S. approach can be informed by the Chinese strategy,” Ewing said.

You can see more photos on the CNNC website.

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

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

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

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

Publications released in recent months include: 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

In regions of rural China where health education is limited, parents know more about the nutritional needs of their pigs than of their own children. And while piglets are raised to be robust and ready to command high market prices, infants in this part of the world suffer from high rates of anemia and cognitive delays that put them – and the country’s economy – at risk, according to Stanford researchers.

Those researchers are now experimenting with ways to encourage parents to feed their children more nutritious food. And they’re hoping their results will push the Chinese government to implement policies to curb malnutrition, especially anemia.

“Anemia acts like an invisible drag on the Chinese economy,” says Scott Rozelle, director of the Rural Education Action Program (REAP) at Stanford’s Freeman Spogli Institute for International Studies (FSI). REAP is a part of FSI's Center on Food Security and the Environment.

Rozelle and his colleagues spearheaded a survey of 1,800 babies in Shaanxi province that shows the scope and impact of malnutrition throughout the region. Their findings will soon be published.

A map of Shaanxi province, where the REAP survey was carried out. Photo Credit: Wikipedia

Despite China’s rapid economic growth in recent decades, anemia among rural populations remains widespread. Left untreated, anemia decreases oxygen to the brain and can hurt cognitive and physical development. The World Health Organization estimates that effective treatment of anemia can improve national economic productivity by up to 20 percent. Other research has shown that the long-term effects can be even greater.

But poor nutrition is only partially to blame for the high rates of cognitive delays that the researchers discovered. Rozelle and his team also found that most parents don’t spend enough time playing and talking with their babies. In general, parenting practices in the region do not involve providing babies with mental stimulation, which is also an important part of cognitive development.

Testing and treating 1,800 babies

Rozelle and his colleagues first set out to understand the scope of the problem by measuring anemia rates among rural Chinese babies. Between April and October, 2013, REAP administered the largest survey of rural baby nutrition ever conducted in China. Over the course of four weeks, a team of around 120 surveyors tested 1,824 babies in 351 poor, rural villages across Shaanxi Province.

The researchers found that in the region, where pig farming is one of the main industries, more than three times as many parents had accurate information about pig nutrition than about baby nutrition. When asked whether micronutrients are necessary for the healthy growth of baby pigs, over 70 percent of caretakers responded “yes”. But only 21 percent of caretakers believed that micronutrients are also important for human babies.

The researchers also found that 49 percent of the children in the survey had anemia, an additional 28 percent were "near-anemic" and 40 percent showed significant cognitive or motor delays. These rates exceed the global average for children and indicate widespread deficiencies in child nutrition in the region.

A REAP surveyor tests how a baby reacts to his own reflection. Photo Credit: REAP

The REAP team then set up an experiment. One third of households were given a free daily supply of nutritional supplements for their children. Another third were given the same free supplements, and were enrolled in a text message reminder program. A final third of households served as a control group. The study is ongoing through April, 2015, but 12 months into the program, the researchers have found that the supplements have reduced anemia rates by 28 percent, although cognitive delays have persisted.

Anemia linked to poor diets

In contrast with their children, the parents who participated in the survey seemed to be well-fed and showed relatively low levels of anemia (19 percent). Many also reported purchasing expensive baby formula for their children, indicating a willingness to spend financial resources on child nutrition. The problem therefore seems to be not one of poverty, but rather one of information: parents are unknowingly feeding their children food that is lacking in iron and other micronutrients.

The nutrients missing from the babies’ diets are plentiful in solid foods such as fruits, vegetables, and lean meat. International standards for child nutrition advise that complementary foods be introduced to infants at around six months of age. By one year of age, solids should make up more than half of a child’s diet.

Parents in the REAP study, however, waited until between one year and 18 months to introduce solid foods. Many mothers stopped breastfeeding at six months, switching their babies to diets consisting mostly of rice porridge or wheat-flour based soups.

Many parents said early childhood diets were unimportant for healthy development.

“I don’t think the foods he eats matter since he doesn’t eat that much,” one parent told the researchers.  Another insisted, “Formula and porridge are good enough for my baby. He is always happy after mealtime.”

The “Hidden Hungry”

Sometimes described as “hidden hunger,” micronutrient deficiencies like anemia can go undetected because those afflicted often look healthy. Young children can appear to be well fed or even overweight, but still lack critical nutrients for normal development. In remote places where blood tests are unavailable, it can be impossible to tell that a child is anemic.

A nurse tests a child's blood for signs of anemia. Photo Credit: REAP

But about 25 percent of the world’s population is anemic, making the condition the most common form of malnutrition. About 25 percent of people are anemic worldwide, including half of pregnant women and 40 percent of children under the age of five.

The effects of anemia, however, are most severe among infants and toddlers. The damage it causes is difficult to reverse after the first several years of life.

Nutritional Myths

Rozelle’s team found several misconceptions about infant health and nutrition. One myth was especially common: that babies cannot digest solid food until they can walk.

“I wouldn’t dare give her anything before that,” said one parent. “Soft, clean foods are good for my baby. Hard foods are not healthy.”

Some parents even assumed that soft foods were better for their child’s cognitive development. “A good way to make him smarter is to feed him starches and rice. You can’t feed him hard food,” explained a mother about her young son.

The interviews also highlighted a lack of knowledge about malnutrition, and about the links between nutrition and health. “Genes cause malnutrition,” said one mother. “You’ll know if your skin turns pale and you become really thirsty.”

Another answered, “[Anemia] is caused by not eating enough.” When asked how anemia is treated, answers included drinking sugary water, adding red sauce to food, eating peanuts, getting a blood transfusion at the hospital, and taking traditional Chinese medicine.

In reality, anemia can be treated at home with a daily low-cost iron supplement (like the one being distributed as part of the REAP study), or simply by adding more iron-rich foods to a child’s diet.

 “No one ever told me how to feed my baby”

The pervasiveness of misinformation about baby nutrition stems from a lack of access to health and nutrition education. As one mother explained, “No one ever told me how to feed my baby.” The majority of interviewees reported relying on older family members for guidance on how to feed and care for children.

Local doctors do little to encourage proper child health care. Many prescribe medicines to treat immediate symptoms of malnutrition, such as colds or diarrhea, without addressing underlying issues.

One parent whose baby was found to be anemic reported, “The doctor never said anything to help me understand my child. He just told me to buy some rice powder and medicine.”

A mother participating in the REAP study answers questions about her baby's diet. Photo Credit: REAP

Other parents refuse to see a doctor at all. An interviewee with two young sons admitted to having never taken her children for a check-up for fear that her fertility would be monitored under China’s one-child policy.  Some mothers said they relied on traditional Chinese medicine to treat health problems rather than visit doctors.

Parents also frequently relied on information from local baby formula sales representatives. When asked how she makes decisions about her baby’s health, one mother reported, “I read the booklets at the formula store for information.” Perhaps unsurprisingly, this same mother was late in introducing solid foods to her child, and during the interview fed her 15-month-old child a type of formula that stated clearly on the label that it was suitable only for babies up to 12 months of age.

“The formula salesperson said to ignore that,” she explained.

Nourishing the Future

The REAP team designed an experiment to tackle both problems: infants’ poor diets and parents’ lack of nutritional knowledge. The project, called Nourishing the Future, was funded by the International Initiative for Impact Evaluation, UBS Optimus Foundation, China Medical Board and others.

A NurtureMate nutritional supplement packet, made by Heinz. Photo Credit: REAP

Each household in the study, with the exception of a control group, received a one-year supply of daily supplement packets called NurtureMate, manufactured by Heinz, another partner in the project. The powdered mix of iron, zinc, folic acid, and vitamins can be added to milk or formula, or sprinkled on porridge.

In addition to supplements, the treatment group received instruction in the basics of childhood nutrition. At 8:00 every morning, half of the treatment group also received a daily text message reminder to administer the packets: “Have you taken your NurtureMate today? Your baby needs the nutrients to grown strong and stay healthy!”

Text message reminders appear to have been modestly effective in improving program compliance. Caregivers who received the reminders gave their baby the micronutrient supplements, on average, 10 percent more often over the course of the first six months of the study. So far, however, this improved compliance has not led to a corresponding fall in anemia rates.

Other factors influence infant development

Although anemia rates fell among the two treatment groups, Rozelle’s team found no cognitive improvements.

“It’s still early, but it’s becoming clear that nutrition is not the only piece of the puzzle,” says Alexis Medina, the project manager of Nourishing the Future. “Several things affect brain development in young kids. One is nutrition. Another is the mental stimulation that children get through games, toys and face-to-face interaction with adults.”

The babies Medina and her team evaluated had very few toys or books at home, and received minimal attention from their caretakers in terms of playing, singing and talking.

“A lot of parents we talked to didn’t think much about whether they were playing with their kids enough,” Medina said. “But some actually thought it was a waste of time. We had several mothers tell us, ‘Babies don’t remember much when they’re young, so I don’t bother talking or reading to [my baby]. They can’t understand me yet anyway, so what’s the point?’”

Changing policy

With its first high-quality data sets in hand, REAP is now looking for long-term answers to the child malnutrition epidemic in China.

“Sure, we can help the 1,800 babies who are participating in our study now, but what about the other 10 million babies just like them?” asks Rozelle. “To reach all of China’s at-risk babies – that’s our ultimate objective. And to do that, we need an effective government program.”

In fact, the Chinese government has already unveiled a new pilot program that aims to provide every rural baby living in poverty with a free daily nutrient packet. But instead of delivering the packets directly to households, families have to travel several hours to the local county seat to pick up their packets. To date, the pilot has been rolled out in about 350 poor rural counties, with another 300 scheduled for 2014. But the government pilot doesn’t include any baseline research, and thus lacks important data on the health impacts and cost-effectiveness of this type of nutritional intervention.

The scant data available suggests that only a small share of eligible families are actually making the effort to pick up their packets. This is the gap REAP is looking to fill with its studies. Rozelle hopes that REAP’s new data on baby nutrition will help shape the government’s pilot program as it grows.

REAP has a long history of pioneering research and impacting national policy around rural education and health in China. Between 2008 and 2012, REAP surveyed 60,000 rural Chinese school-aged children and found that 30 percent were anemic. That study helped influence the government’s decision to launch a ten-year, nationwide school lunch program funded at more than $20 billion.

“The Chinese government has identified early childhood nutrition as a key policy priority in the coming years,” Rozelle says. “However, we believe they will need help figuring out the best way to implement their policy ideas. This is where REAP can help, by providing evidence-based solutions.”

Updates about the Nourishing the Future program, along with results of the baseline survey, are available on REAP’s website.

Laura Seaman is the Communications and External Relations Manager at Stanford’s Center on Food Security and the Environment. She can be reached at lseaman@stanford.edu

 Research contact: Alexis Medina: amedina5@stanford.edu