From August 2002, just months after Timor-Leste gained independence, to April 2006, I was the World Bank’s Country Manager for Timor-Leste and thus eyewitness to an unfolding state-building process. The experience affected me profoundly as a development professional. In the short time I lived in Timor-Leste, and notwithstanding daunting circumstances, I saw some agencies, in particular the Ministry of Health and the Central Bank, grow into institutions that delivered results and broadly gained the trust of the population. When community violence erupted in 2006, the Ministry of Health responded effectively, and the Ministry of Social Solidarity repurposed itself around the drawn out displacement process that followed.
My observation of this process is what inspired Institutions Taking Root, a new report that illustrates how institutions can become effective even in the most fragile of circumstances. The report looks at some public institutions that do manage to deliver results, earn legitimacy among citizens, and forge resilience. While the specific experiences of these agencies vary from country to country, learning more about the practices and policies that contribute to their success can reveal important clues about how institutions grow stronger and take root in fragile contexts.
This summer, I made a project visit to a government clinic in northern Sierra Leone. It is a clinic pretty much in name only, being constructed as 1-bedroom living quarters for a teacher and subsequently converted into a health facility. The nurse took me on a tour, pointing out the problems: a broken scale to weigh infants, no waiting room for early stages of labor, animals grazing and
Recently, at a community meeting I attended at Robina clinic in Tonkolili district, Sierra Leone, facilitators asked a group of young women to rate the quality of health service delivery using what they coined the “mango test.” As part of this “test” community members decide how many hypothetical mangos, on a scale from 0 to 5, they would give a nurse as thanks for the quality of her care.
I spent four years co-directing a grassroots legal empowerment organization in Sierra Leone called Timap for Justice (“Timap” means “stand up” in Sierra Leonean Krio). One of our clients was a cigarette seller and sometime sex worker from the east end of Freetown—I’ll call her Kadiautu. A drunk off-duty police officer brutally beat Kadiatu after an argument one night, not far from the station.