Part 1: Ethical Decision-Making

• Known Facts:

1. 1. 1. Gruel (maize & banana) does not provide key nutrients
      2. Mothers like them gruel
      3. There are pesticides used on the crops
      4. ~35% of children are nutritionally stunted
      5. Want to transition from breastfeeding at about 24 months
      6.  HIV/AIDS is very prevalent in this region. 
      7. The gruel is integrated into a child’s diet to complement breastfeeding until they are ~24 months of age
      8. The WHO wants women to stop breastfeeding at 6 months
      9.  Mothers in the area firmly believe that the gruel is highly beneficial for their children, but scientific research has shown that it does not provide some key nutrients
      10. The longer a child nurses when the mother is HIV+, the greater the chance that the virus will be transmitted to the child
      11. Mother to Child Transmission of HIV is common
      12. Women’s cooperative grant
      13. Women are skeptical of the porridge
      14. Pesticides used can cause adverse health defects in children

• Stakeholders

1. 1. 1. Mothers
      2. Children
      3. Women’s cooperative
      4. WHO
      5. Healthcare system
      6. Local cash crop farmers
      7. Pesticide companies
      8. Donor

• Motivations

1. 1. 1. To improve lives, children’s health, support local business
      2. To stop mother to child HIV transmission rates
      3. Improve the nutritional status of children 
      4. Prevent stunted growth
      5. Improve the livelihoods of rural households
      6. Make money off of local crops
      7. To make money
      8. Want the money to support the causes they want and be successful

• Solutions:

1. 1. Triage system to diagnose mothers with HIV before birth
      1. 1. Ethical Principle/code: Utilitarian
         2. Pros: HIV can be better monitored for women, helps to ensure that the baby does not get HIV, women who test positive can seek treatment and help stop transmission.
         3. Cons: added task to medical staff who may already be understaffed.
      2. The current solution is: Fortify the current gruel with vitamins and minerals but has a problem with pesticide use, which have potential harmful effects.
         1. Ethical Principle/code: Virtue –  process also matters too
         2. Pros: would sufficiently replace breastfeeding and meet nutrition needs.
         3. Cons: wouldn’t eliminate women’s skepticism. Would still have pesticides that are toxic to consume if not washed and treated properly.
      3. Eliminate crops in the porridge that have a higher risk of pesticide harm i.e. utilize covered crops like pumpkins, bananas for making gruel (crops that naturally have an outer shell/protection layer).
         1. Ethical Principle/code: Utilitarian – the greatest good for the greatest number 
         2. Pros:  Simple, no added cost or big change of process, just strategic utilization of crops
         3. Cons: Fewer nutrients from losing various other foods. Limits the amounts of recipes and combinations you can make.
      4. Create a protocol that people can follow to properly wash crops 
         1. Ethical Principle/code: Virtue
         2. Pros: Helps reduce amounts of pesticides left on crops, creates healthy habits, could prevent ingestion of other harmful types of bacteria left on crops. 
         3. Cons: even with the wash, there may still be pesticides present on the crops, people can get sick if the protocol isn’t followed properly
      5. Look into pesticide chemicals and decide if there are “cleaner” pesticides or more natural methods for getting rid of pests
         1. Ethical Principle/code: Duty
         2. Pros: less toxic pesticides used=not as harmful effects on the body, pests likely won’t destroy crops as much as no pesticide use=higher crop yield. 
         3. Cons: there is already a negative connotation regarding pesticides people may not believe there are “cleaner” pesticides. It could also be difficult to obtain or access clean pesticides.
      6. Recruit specific farmers that practice safer growing w/o pesticides
         1. Ethical Principle/code: Duty
         2. Pros: supports local business and keeps the economy strong in the community, it would eliminate the stigma around having food made with produce grown with pesticides. We could get a deal with a farmer for cheaper prices
         3. Cons: these farmers might not be able to handle the amount of produce required to make the gruel.

• Seek assistance, as appropriate

1. 1. 1. https://www.azurihealth.co.ke/
      2. https://www.pan-uk.org/health-effects-of-pesticides/
      3. https://wfto.com/sites/default/files/Gender%20study%20Report%202_WFTO_DEAR%20March%202019.pdf
      4. https://www.aciamericas.coop/IMG/pdf/genderissues.pdf
      5. https://www.trustedclothes.com/blog/2016/10/11/women-africa-power-co-operatives/

• The best course of action

1. 1. 1. Combination of 1 & 6 Solutions
         1. Attacks all necessary problems, educates, gives opportunities for more jobs, teaching the mothers the dangers of passing HIV + having safe, nutritious alternative to offer → progress

• Implications

1. 1. Women can protect their children.
      1. We would want to start with a small population whose health clinics have the infrastructure, time and money to screen mothers for HIV.
   2. Women will know their HIV status, minimizing the HIV transmission rates.
      1. Provides education on what steps they should take if they have been diagnosed HIV positive.
         1. Better life expectancy and livelihood of the community overall. 
   3. Supporting the local economy
      1. Creates social mobility within community.
      2. Educate farmers on how to grow top quality produce without pesticides.

 

Part 2: Grassroots Diplomacy

• Known Facts:

1. 1. 1. Business is thriving
      2. Women work for nine hours a day and make about $3
      3. Women save time traveling to market (and $)
      4. Happy with the coop and the sense of identity
      5. Women turn over their money to men in the family
      6. Men waste the money
      7. One of seven members of the leadership council
      8. Have six months left on the committee
      9. Committee wants things to change
      10. A patriarchal society where men have say on money
      11. Though the cooperative is thriving, it is not achieving the twin social outcomes of improving the nutritional status of children and the livelihoods of rural households. 

• Stakeholders:

1. 1. Mothers
   2. Children
   3. Women’s cooperative
   4. Local cash crop farmers
   5. Husbands

• Motivations

1. 1. Want the money to feed their kids, continue supporting venture
   2. Want to be fed
   3. Improve the nutritional status of children 
   4. Prevent stunted growth
   5. Want the money to buy personal stuff they want

• Solutions:

1. 1. 1. The choice to take a certain number of gruel products and $ per day
         1. How does it solve the problem? 
            1. Pros: controls money flow going home, gives women choice to just take food for kids if that’s what they want and is needed
            2. Cons: the husband might be angry that not as much money is coming home
         2. How does it save face of those involved? 
            1. Gives mothers the option to what they want without confrontation with husbands
         3. Implications on relationships 
            1. Short-term: confused husbands, might be frustrated
            2. Long-term: adjusted, even distribution of food for kids and money for family when needed or want it
         4. Implications on the venture 
            1. Short-term:  supports women instantly for wants
            2. Long-term:  further advertise food in local community
      2. Potential Solution: Women receive vouchers instead of money. The vouchers can be used to buy coop food 
         1. How does it solve the problem? 
            1. Pros: Money gets spent on food for the children, women in control of voucher and how it gets spent
            2. Cons: Husband mad that there isn’t any extra money coming in, the voucher can’t be put towards other goods needed (can only get food), does not support women selling food in markets (only within the co op) 
         2. How does it save face of those involved? 
            1. Puts blame of money distribution on the co-op, not the women
         3. Implications on relationships 
            1. Short-term: women are protected from unfortunate consequences
            2. Long-term: animosity and backlash 
         4. Implications on the venture 
            1. Short-term: ensuring women are getting food to feed their children
            2. Long-term: principal-agent problem and company store logic
      3. Potential Solution: Mobile money credit–women are not given cash but rather a phone credit that can only be used by them so men do not have access.
         1. How does it solve the problem? 
            1. Pros: women have full control of the money, not tangible so it can be hidden. They can spend it on food and other items the family needs
            2. Cons: How often do women have their own phone? Will the money be easily accessible to them? 
         2. How does it save face of those involved? 
            1. Lack of accessibility to men can be blamed on the co-op, not the women
         3. Implications on relationships
            1. Short-term: women are protected from unfortunate consequences
            2. Long-term: animosity and backlash
         4. Implications on the venture 
            1. Short-term: ensuring women are getting food to feed their children
            2. Long-term: women need to have cellphones which they may not have all the time depending on income levels per month.

• Seek assistance:

1. 1. 1. Classmate discussed about ways you can shame the men. For example, put a pacifier under the bill.
      2. Classmates discussed ways you can save family’s spending receipts:
         1. If you turn them in and show that you are spending responsibly, then you can get a discount or get paid more
            1. Incentives men to make responsible purchases
      3. Khanjan mentioned teaching women how to build equity
         1. Can grow and support further farming operations

• Best course of action:

1. 1. 1. I feel that solution 1 (The choice to take a certain number of gruel products and $ per day) is the best possible action because it satisfies both the woman’s desire to feed their children and the needs of the husband to have money.  Women don’t have to have an uncomfortable conversation with their husband about his spending habits because they already have food to feed their children which is all they wanted in the first place. 

• Implications:

1. 1.  When the woman turns in her produce from the cooperative, a cooperative staff member then tells her the total value of her crops. The women then gets the choice to how she will split the value of her earning–she can choose to be paid in 60% food and 40% cash or 50% 50% (whatever her needs are for that week). The cooperative then makes the exchange. The variety of produce is from all the other members of the cooperative.