This week in class we analyzed two different case studies one focusing on ethical decision making and the other on grassroots diplomacy. The first case discusses the issues of creating a cooperative in East Africa that addresses childhood malnutrition and HIV. The second case discusses issues the cooperative faced a few months after its creation.

Part I:

 

• FACTS AND LOGIC

 

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
2. The cooperative is being created to address malnutrition among young children. However, the ethical question in discussion is:Is it ok to lower the risk of HIV/AIDS, at the risk of adding sickness to children from pesticides?
3. Stakeholders and Motivations
   • Mothers
     • Personal: better health for their children, prevent spread of HIV, prevent ingestion of pesticides
     • Professional: want to earn money for family
   • Children
     • Face the direct consequences of pesticides and spread of HIV
   • Women’s Cooperative
     • want to wean children off breast milk through the use of their porridge
     • make money
     • skeptical of pesticides and HIV
   • Local Cash Crop Farmers
     • sell their crops to be made into the porridge
   • Researchers and Board member
     • Personal: provide a healthy alternative to help wean children off breast milk, avoid pesticides, avoid HIV infection
     • Professional: Sustainable cooperative, healthy children, see an impact through the creation of the cooperative
4. Potential Solutions

• • Create a triage system to diagnose mothers with HIV before birth
    • Ethical Principle/code: Utilitarian
      • Useless to prevent against HIV if the baby gets it during the birth process
      • 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
      • Cons: added task to medical staff
  • Eliminate crops in the porridge that have a higher risk of pesticide harm i.e. utilized covered crops like pumpkins, bananas for making gruel
    • Ethical Principle/code: Utilitarian – the greatest good for the greatest number
    • Pros:  Simple, no added cost or big change of process
    • Cons: Fewer nutrients from losing various other foods
  • Create a protocol that people can follow to properly wash crops. Also, recruit specific farmers that practice safer growing without pesticides.
    • Ethical principle/code: Duty and Virtue
    • Pros: Helps reduce amounts of pesticides left on crops, creates healthy habits, could prevent ingestion of harmful bacteria left on crops,  it could support local business and keep 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
    • cons: these farmers might not be able to handle the amount of produce required, the wash method may not completely get rid of all the pesticides.
  • Proposed solution: I believe that the last solution is the best course of action. By creating a protocol for how to wash crops and also recruiting farmers who use less pesticides this reduces the risk of making the kids sick. This will give the children the proper nutrients that they need. While there is risk that the kids could still get sick from the pesticides I think keeping children from breastfeeding and possibly exposing them to HIV infection is a much higher risk. While in Sierra Leone I noticed how much families cared for their children. They would do anything they could to make them healthy. For example, I noticed several protocols around villages for Ebola awareness. So, I think a protocol would easily be accepted. If a wash protocol was developed I think many farmers would change their practice to make it healthier. Solution 2 does not decrease the risk of pesticides and may end up making the product too expensive. Solution 1 is a huge invasion of privacy and may not appeal to women. In my opinion, the ethics that arise with solution 1 cause more issues rather than reducing them.
  • Implications:
    • Technologically: The technology in this solution is our porridge product that will be distributed by the women’s cooperation. This recipe will be strategically created to address areas of malnourishment in children. This would make children healthier.
    • Socially: Socially, women would be able to make money for their family, farmers would be able to practice safer farming methods, children can participate in more activities because they are healthy.
    • Economically: Women working for the cooperation will make money, the cash crop farmers practicing clean farming methods would make money

 

Part II (6 months later):

• Facts:
  • business is thriving
  • Women work for nine hours a day and make about $3
  • Women save time traveling to market (and $)
  • Happy with the coop and the sense of identity
  • Women turn over their money to men in the family
  • Men waste the money
  • One of seven members of the leadership council
  • Have six months left on the committee
  • Committee wants things to change
  • A patriarchal society where men have say on money
  • 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.
• Principle: How can the cooperative achieve the twin social outcomes of improving the nutritional status of children and the livelihoods of rural households
• Stakeholders and motivations:
  • Mothers
    • Personal: Want the money to feed their kids
    • Professional: continue to support the venture
  • Children
    • Personal: want to be fed and healthy
    • no professional motivations
  • Women’s cooperative
    • Personal: Want to feel involved in the community
    • Professional: Want to improve the nutritional status of children
  • Local cash crop farmers
    • Personal: Want to prevent stunted growth in children
    • Professional: want to make money selling their crops to the cooperative
  • Husbands
    • Personal: Want the money the women make for their own benefit
    • No professional motivations
• Potential Solutions:
  • The women will have a choice receive a certain amount of gruel each day as payment for their work instead of receiving money or they can continue to receive their payment in the form of money.
    • 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 and may influence the women’s decisions.
    • How does it save face of those involved? 
      1. Gives mothers the option to what they want without confrontation with husbands
    • 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
      3. Short-term:  supports women and their choices as to how to spend the money they earnedImplications on the venture
      4. Long-term:  Very empowering for women and could be good publicity for the venture
  • Women receive vouchers instead of money. The vouchers can be used to buy food at the coop
    • 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) 
    • How does it save face of those involved? 
      1. Puts blame of money distribution on the co-op, not the women
    • Implications on relationships 
      1. Short-term: women are protected from unfortunate consequences
      2. Long-term: animosity and backlash 
    • 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
  • Have events where the women can bring their kids to work and pay for the kids’ lunch out of their wages, similar to daycare.
    • How does it solve the problem
      1. Pros: women will be able to pop in and see their kids, the kids will have access to nutritious food, the women will have control over some of the money to feed their kids
      2. Cons: husbands can still use the money to buy frivolous things
    • How does it save face of those involved
      1. Husbands don’t get mad at women for using money behind their back
    • Implications on relationships
      1. Short-term: Husbands will be happy with wives because they are bringing supplemental money home
      2. Long-term: Kids will get the nutrients they need from the gruel and be healthier
    • Implications on the venture
      1. Short-term: Women will enjoy working at the coop because they can be close to their children
      2. Long-term: The twin social outcomes will be achieved
  • I believe that solution 3 is the most viable decision because all stakeholders are getting what they want
    • husbands: getting supplemental money for their use
    • wives: empowered by coop and earn a wage to buy food for their children
    • children: healthier because they get to eat the gruel
    • cash crop farmers: still selling their crops to the coop and making money
    • women’s coop: achieving the twin social outcomes of improving the nutritional status of children and the livelihoods of rural households
  • The women do not mind giving their money to the husbands they just want to make their children healthy. By bringing their kids to work and feeding them the gruel for lunch, they are getting the required nutrients and the husbands are still getting money. They may still spend it on frivolous things but the women’s goals were accomplished.
  • Implications:
    • Technologically: The daycare would allow the children to be close to their mothers and have access to healthy nutrients
    • Socially: The relationships at home should be just as strong because everyone is getting what they want
    • Economically: The coop, farmers, women, and husbands are all earning more money. More women would be employed.