+ "Violence, Empathy, and Altruism: Evidence from the Ivoirian Refugee Crisis in Liberia" (with Alexandra Hartman). pdf

In regions plagued by reoccurring periods of war, violence, and displacement, how does past exposure to violence affect altruism toward members of different ethnic or religious groups? Drawing on theories of empathy-driven altruism in psychology, we propose that violence can increase individuals' capacity to empathize with others, and that empathy born of violence can in turn motivate helping behavior across group boundaries. We test these hypotheses using data on the hosting behavior of 1500 Liberians during the 2010-2011 Ivorian refugee crisis in eastern Liberia, a region with a long history of inter-ethnic conflict and cross-border violence. We find that individuals who directly or indirectly experienced violence during the Liberian civil war host greater numbers of refugees. We also find that violence-affected individuals host a higher proportion of non-coethnic and non-coreligious refugees, as well as higher proportions of refugees who had health problems upon arrival or had fled direct violence. Finally, using a conjoint experiment to measure the influence of refugee attributes on respondents' willingness to host, we find that while bias against outgroup refugees is strong overall, individuals who previously experienced violence exhibit less bias and have stronger preferences for refugees in distress. These findings suggest that violence does not necessarily lead to greater antagonism toward outgroups, as is often assumed, and that in some circumstances it can actually promote inter-group cooperation.

+ Building Trust in a Reformed Security Sector: Evidence from a Field Experiment with the Liberian National Police (with Robert Blair and Sabrina Karim)

How to restore citizens’ trust and compliance with the police in the wake of civil war? We report results from an experimental evaluation of the Liberian National Police’s (LNP) “Confidence patrols” program. The program deployed teams of elite, newly-retrained, betterequipped police officers on recurring patrols to rural towns and villages across three Liberian counties over a period of 14 months. The evaluation comprised a combination of original survey data, LNP crime reports, and detailed qualitative field reports from a Liberian research assistant who embedded with the police for the duration of the experiment. We find that the program improved knowledge of the police and of Liberian law; enhanced security of property rights; reduced the incidence of some types of crime, notably simple assault and domestic violence; and increased reporting of more serious crimes to the LNP. The program did not, however, increase trust in the LNP or the government more generally; indeed, if anything it appears to have reduced satisfaction with the LNP’s performance when crimes occur, possibly because exposure to elite officers raised expectations beyond the rank-and-file LNP’s capacity to meet them. We consider implications of these findings for post-conflict policing in Liberia and weak and war-torn states more generally.

+ "Patterns of demand for health services during the Ebola outbreak: panel survey evidence from Monrovia, Liberia" (with Karen Grepin, Robert Blair, and Lily Tsai), BMJ Global Health, 1.1 (2016): e000007. pdf

Introduction: The recent Ebola virus disease (EVD) outbreak was unprecedented in magnitude, duration and geographic scope. Hitherto there have been no population-based estimates of its impact on non-EVD health outcomes and health-seeking behaviour.

Methods We use data from a population-based panel survey conducted in the late-crisis period and two post-crisis periods to track trends in (1) the prevalence of adult and child illness, (2) usage of health services and (3) the determinants thereof.

Results: The prevalence of child and adult illness remained relatively steady across all periods. Usage of health services for children and adults increased by 77% and 104%, respectively, between the late-crisis period and the postcrisis periods. In the late-crisis period, (1) socioeconomic factors weakly predict usage, (2) distrust in government strongly predicts usage, (3) direct exposure to the EVD outbreak, as measured by witnessing dead bodies or knowing Ebola victims, negatively predicts trust and usage and (4) exposure to government-organised community outreach predicts higher trust and usage. These patterns do not obtain in the post-crisis period.

Interpretation: Supply-side and socioeconomic factors are insufficient to account for lower health-seeking behaviour during the crisis. Rather, it appears that distrust and negative EVD-related experiences reduced demand during the outbreak. The absence of these patterns outside the crisis period suggests that the rebound after the crisis reflects recovery of demand. Policymakers should anticipate the importance of demand-side factors, including fear and trust, on usage of health services during health crises.

+ "Public Health and Public Trust: Survey Evidence from the Ebola Epidemic in Liberia" with Robert Blair and Lily Tsai, Social Science and Medicine, 2016. pdf

Trust in government has long been viewed as an important determinant of citizens’ compliance with public health policies, especially in times of crisis. Yet evidence on this relationship remains scarce, particularly in the developing world. We use results from a representative survey conducted during the 2014-15 Ebola Virus Disease (EVD) epidemic in Monrovia, Liberia to assess the relationship between trust in government and compliance with EVD control interventions. We find that respondents who expressed low trust in government were much less likely to take precautions against EVD in their homes, or to abide by government-mandated social distancing mechanisms designed to contain the spread of the virus. They were also much less likely to support potentially contentious control policies, such as “safe burial” of EVD-infected bodies. Contrary to stereotypes, we find no evidence that respondents who distrusted government were any more or less likely to understand EVD’s symptoms and transmission pathways. While only correlational, these results suggest that respondents who refused to comply may have done so not because they failed to understand how EVD is transmitted, but rather because they did not trust the capacity or integrity of government institutions to recommend precautions and implement policies to slow EVD’s spread. We also find that respondents who experienced hardships during the epidemic expressed less trust in government than those who did not, suggesting the possibility of a vicious cycle between distrust, non-compliance, hardships and further distrust. Finally, we find that respondents who trusted international non-governmental organizations (INGOs) were no more or less likely to support or comply with EVD control policies, suggesting that while INGOs can contribute in indispensable ways to crisis response, they cannot substitute for government institutions in the eyes of citizens. We conclude by discussing the implications of our findings for future public health crises.


+ Patterns of Trust and Cooperation in the Fight Against Ebola. pdf

(with Lily Tsai and Rob Blair)

Between December 2014 and January 2015, the we conducted a survey of over 1,500 residents of Monrovia, Liberia’s capital city. We first focus on understanding the correlates of compliance with control policies that have been essential to halting Ebola’s spread. Our results reveal a robust link between trust in government and compliance: Individuals who are less trusting of government are less likely to support control policies and less likely to adopt preventative measures. These differences persist even after accounting for key demographic and socio-political characteristics and knowledge about EVD.

Our analysis also shows that experiences of hardship and trauma during the epidemic are negatively associated with trust in government and compliance with control measures. These traumatic experiences include losing a job, forgoing healthcare for serious illness, knowing Ebola victims, and witnessing dead bodies in the streets. A follow-up survey in March 2015 shows that these effects do not persist. This may be the result of emotive mechanisms operative during conflict that reduce trust and cooperation.

We also identify an important and underreported success story in the effort to win citizens’ confidence and cooperation in the fight against Ebola. Throughout the crisis, government and NGO workers conducted community-level outreach to build trust and increase compliance with control measures. We find that government and NGO outreach efforts are associated with greater trust in government, support for control policies, and uptake of preventative measures. Follow-up qualitative research suggests that outreach was especially effective when it deliberately incorporated pre-existing community networks and institutions. Outreach involving government was considerably more effective than NGO outreach, especially in building trust in government.

+ Building trust in a reformed security sector: A field experiment in Liberia. pdf

In brief:

Researchers from Brown University, Emory University and the Massachusetts Institute of Technology collaborated with the Ministry of Justice and the Liberian National Police (LNP) to conduct a rigorous impact evaluation of the LNP’s “Confidence Patrol” community policing programme. Designed to build trust in the police and raise awareness about institutional reforms in the justice and security sectors, the programme involved repeated visits from teams of 10-15 Police Support Unit (PSU) officers to 36 communities in Bong, Lofa and Nimba counties over a period of 14 months.

The study finds that the programme increased knowledge of the police and of Liberian law; increased security of property rights; reduced the incidence of some crimes, notably assault and domestic violence; and increased reporting of crimes to the LNP.

The programme did not, however, improve trust in the LNP in general. In addition, the programme appears to have reduced satisfaction with the LNP’s handling of reported crimes, possibly because exposure to elite, newly-trained PSU officers raised expectations beyond the ordinary LNP’s capacity to meet them.

Overall, the findings provide encouraging evidence about the efficacy of the Confidence Patrols programme, while also emphasising the need for continued improvements to the capacity of the regular LNP.