Blog Entry for Week Four

Step 1: Determine the facts in the situation – obtain all of the unbiased facts possible. Clearly state the ethical issue. 

• • Facts
    • The gruel mothers are currently using does not provide sufficient nutrients
    • Approximately 500 women have expressed interest in joining the cooperative
    • The product is designed to be introduced at 6 months of age because early weaning using the traditional porridge leads to poor nutrition
    • HIV positivity rates in the region are very high
    • A longer breastfeeding period means an increased likelihood of mother-to-child HIV transmission
    • The produce used for the porridge is made from local ingredients that are grown with pesticides
    • The pesticides are known to have developmental complications associated with them
    • The women are skeptical of the new porridge product
  • Considerations:
    • How/where the produce is grown (locally or farther away)
    • How accessible the product is
    • Equity in compensation (for marketer/salesperson vs manufacturers especially).
  • Ethical issue
    • How can child nutrition and health be balanced while providing an opportunity for women to improve their livelihoods?
• How can adverse health effects caused by pesticides be balanced with potential transmission by breastfeeding from mothers with a high rate of HIV?

Step 2 and 3: Define the Stakeholders – those with a vested interest in the outcome  

• Grant donor (secondary)
  • Personal motivations: want to feel good about helping people
  • Professional motivations: wants to have the biggest effect by making the solution as cheap as possible
• 500 women in the cooperative (primary)
  • Personal motivations: stick with traditional values; improve their livelihood
  • Professional motivations: want an income to support their family
• Children (primary)
  • Personal motivations: Avoid HIV and developmental issues; receive proper nutrition
  • Professional motivations: N/A
• Local community (fathers and family members of the women) (secondary)
  • Personal motivations: sticking with traditional values, but see their family members grow up healthy and happy
  • Professional motivations: make as much income as possible, stay employed
• Local farmers (primary)
  • Personal motivations: sticking with traditional values
  • Professional motivations: make as much income as possible, stay employed
• Local government (secondary)
  • Personal motivations: sticking with traditional values
  • Professional motivations: have community members stay employed, attract outside attention and investments
• Cooperative itself
  • Personal motivations: want to improve the livelihoods of the children and mothers in the area
  • Professional motivation: want to stay economically viable, want to succeed as a venture
• We as the team in charge of the project
  • Personal: Make an impact and help people
  • Professional: Have a success story that will boost prestige and credibility; 

Step 4: Formulate (at least three) alternative solutions – based on information available, using basic ethical core values as a guide 

• Approach: Have mothers use the new porridge at 2 months in order to reduce HIV risk

• • • Ethical Principle or code: to protect children from the risk of transmission of HIV by reducing the amount of time all mothers use breastfeeding
    • Pros: potentially having lower numbers of HIV, children get some amount of breastfeeding and a good amount of nutritional porridge
    • Cons: Still have a risk of breastfeeding, still have a high risk of pesticide caused development issues, will cost the cooperative a lot of money to feed every child the porridge from 2 months to 24 months

• Do nothing and abandon the venture—use the money to test for HIV instead

• • • Ethical principle or code: to test all women for HIV in order to reduce the transmission rate in the region
    • Pros: Respect culture, inexpensive, is a potential solution to the HIV issue
    • Cons: Maintaining a problematic status quo (HIV risk, poor nutrition, and developmental issues, economic struggles), does not help the women who want to improve the livelihood of the community

• Approach 1: Make the porridge using organically grown produce to resolve the pesticide issue after breastfeeding for six months without testing the mother

• • • Ethical Principle or code: providing the child with a clean and safe food source after having it use the most nutritional food source available 
    • Pros: eliminates potential health issues caused by pesticides in the crops, improves nutrition for children
    • Cons: will require upheaval of current planting system with pesticides, does not reduce risk of HIV transmission, likely more expensive

• Approach 2: Test women for HIV and encourage them to breastfeed as long as possible if negative (switch to porridge at 2 months as usual if positive)

• • • Ethical Principle or code: Preventing HIV spread as much as possible by testing to see if mothers are positive
    • Pros: Reduces risk of both HIV transmission and child malnutrition
    • Cons: Requires additional expenditure on testing, maybe logistically complicated to implement

• Approach 3: Following WHO guidelines and having all mothers breastfeed for 6 months before switching to porridge

• • • Ethical Principle or code: Following a respected source’s guidelines
    • Pros: Ensures good nutrition for children
    • Cons: May be difficult to get the community to adopt, increases HIV risk, have the women go against cultural norms by issuing the porridge instead of the gruel

• Approach 4: Process vegetables differently in order to eliminate pesticide risk (similar to 1 above)

• • • Ethical Principle or code:
    • Pros: Does not require upheaval of the current growing process, reduces chances of pesticide residue causing health issues
    • Cons: requires additional labor, resources, money, and water (water may bring new pathogens)

Step 5: Seek additional assistance, as appropriate – engineering codes of ethics, previous cases, peers, reliance on personal experience, inner reflection

• How much does HIV risk increase with 6 months of breastfeeding vs 2 months?
• Can vegetables be treated to reduce pesticide exposure?
• Is organic agriculture a viable option in this setting?
• How great a developmental risk do pesticides pose?

Step 6: Select the best course of action – that which satisfies the highest core ethical values. Explain reasoning and justify. Discuss your stance vis-a-vis other approaches discussed in the class. 

• The best course of action would be to test all women in the region so that they know if they have HIV or not and after testing them educate them about how HIV is spread and what they should do to prevent getting HIV and what to do if they have HIV to prevent the spread. If the mother does have HIV we would recommend she only breastfeeds for the shortest amount of time of two months before switching to the porridge. We would recommend to the women who test negative to breastfeed for the entirety of the 24 months in order for their child to get the most benefits from them. We would also educate the breastfeeding on how HIV can be transmitted while they are breastfeeding in order to prevent the mother from getting it during those 24 months and giving it to the child then. This solution is also the best for both the nutrition issue and the HIV issue because it is testing and educating women in order to prevent them from spreading HIV or getting it. And for nutrition, it keeps the children with HIV positive mothers weaned into a safer option and the children with no HIV risk with the most nutrition option. It also makes economic sense because once a mother tests negative there is no more money needed to help her or her child and then more women and children can be helped overall. 

Step 7: (If applicable) What are the implications of your solution on the venture. Explain the impact of your proposed solution on the venture’s technology, economic, social, and environmental aspects.

• Technology would be using testing to get ahead with health 
• Economic would be saving money by testing and then saving money on feeding the child
• Socially it would educate the women and not disrespect their culture by not letting them do what they want once they know they’re HIV free
• Environmentally it would benefit the children by keeping them away from developmental  complications if not necessary

Part 2:

Step 4: Formulate (at least three) alternative solutions – based on information available, to have a win-win situation for your relationship and your venture.

• Approach 1: Instead of paying the women with money, pay them with food tickets that can only be exchanged for food (not alcohol, gambling, or frivolous things)
  • Potential Solution
    • Prevent the men from being able to take the money for frivolous things 
  • How does it solve the problem?
    • Pros: food tickets are limited to purchases of food rather than other things
    • Cons: it provides fewer opportunities to save money for purposes other than food. Also hard to build and manage this system.
  • How does it save the face of those involved?
    • It makes it so that the women don’t have the choice of choosing to tell the men to not take the money 
  • Implications on relationships
    • Short-term: helps the women not get into issues with the men of their families but also lets them get the food they want but men will be frustrated about it. 
    • Long-term: men will eventually learn other ways to get money for the things they want instead of taking the women’s money. 
  • Implications on the venture
    • Short-term: will go back to getting women earning money and helping them improve their livelihood. 
    • Long-term: will help the entire community by maybe getting men to stop doing frivolous activities because they will not be able to afford it without women’s money. 

• Approach 2: Providing food available for purchase by the money-crop exchange of the cooperative so that the women can purchase the food immediately themselves
  • Potential Solution
    • make it so the women won’t have to face the men and ask them for money for the food by giving them the power to spend the money immediately after it is acquired.
  • How does it solve the problem?
    • Pros: they get to keep the customer influx they get from the money-crop exchange and continue supporting the cooperative, the money does not go home to households and potentially get used for frivolous purposes
    • Cons: would draw business away from local sellers in the city center, prices could potentially climb and overcharge
  • How does it save the face of those involved?
    • it makes it so that the women don’t have to go home with the money and fight with the men about having to give it to them and instead can go out and buy the food immediately.
  • Implications on relationships
    • Short-term: This can result in arguments with the men when they find out the money has already been spent without their approval
    • Long-term: responsibility shifts from men to women, possibly making men feel less valued
  • Implications on the venture
    • Short-term: women will be unhappy as they liked how they didn’t have to take another trip to the market during the week
    • Long-term: will require management of sellers at the cooperative location

• Approach 3: Modify the behavior of the men so that they spend money on feeding their children. 
  • Potential Solution
    • Measure family nutrition outcomes and create a monthly public recognition program 
  • How does it solve the problem?
    • Pros: makes it so the issue is dealt with at the source and the women dint have to find ways to keep the money from the men, benefits the entire community by making money go to the right resources
    • Cons: will be very difficult as the men do not want to make these changes and will fight it
  • How does it save the face of those involved?
    • save face for the women who will not have to prevent the men from getting ahold of the money and also when the men do use the money for food and child nutrition they save face by having nourished children
  • Implications on relationships
    • Short-term: men will be very upset to have to give up their frivolous activities
    • Long-term: women and children will benefit as men care about what the community thinks of them by making sure their children are thought of as nourished by the community as a whole
  • Implications on the venture
    • Short-term: will be very difficult in the beginning because of how the men will not want to make the changes off the bat but will make the men so embarrassed they will want to make the changes immediately. 
    • Long-term: children will be nourished and men will stop spending money on gambling and other things

Step 5: Seek additional assistance, as appropriate – previous cases, peers, reliance on personal experience, inner reflection

• See if neighboring communities have had any luck in trying to reduce rates of gambling and alcohol
• Talk to community members to see how many people in the community actually care about saving face or not
• See if the women even want a solution, see if the men actually taking their money even bothers them or not

Step 6: Select the best course of action – that solves the problem, saves face and has the best short-term and long-term implications for your relationship and venture. Explain reasoning and discuss your solution vis-a-vis other approaches discussed in class.

• The best course of action for this issue would be to offer vouchers for 2/3 of the money the women make and then 1/3 of the profit as cash. this way the women have 2/3 of their money going towards food and items necessary for them and their children while also giving them 1/3 to use in any way they deem necessary; including letting them give this money to their husbands if they feel like they want to do to in order to stay in line with cultural responsibilities. the short-term benefits of this would be the women get to get money and get to get items for them without having to fight with the men for it because it is in vouchers only capable of buying those. the long term would be having a solid amount of money for them to use if they want

Step 7: List the sequence of actions you will take to implement your solution.

• begin the process of getting 1/3 of money given as cash and 2/3 given as food vouchers
• have a system of collection for the food vouchers up and running
• watch as children get food and see if because there is less cash coming in, it gets saved for used by the men