Grace Enriquez's GSIF Blog

4 September, 2020

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

• • The researcher will be conducting this study in Lesotho, a small developing country
  • 10 researchers will be traveling to Lesotho to study the lifecycle of a pathogen
  • The particular pathogen is only found in Lesotho
  •  The researcher does not want to pay community members for their assistance as they themselves feel that they would help others if asked
  •  The team only has two weeks to complete the entire project 
  •  Results from this study can help make water safe for consumption which will be beneficial to the community

 

• Ethical Issue: Research team wants time and knowledge from community members without compensation

 

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

•  Researchers
  • Praise from academic community for identifying/understanding this pathogen
  • Scientific publications
  • Possible promotions in job/career due to discovery
  • Motivations to help others have safe drinking water 
• Universities 
  • Praise and recognition from other
  • More funding in the future as they build their research base
  • Potential awards
  • Recognition leading to higher ranking and more students applying 
  • Build up their brand/reputation for pathogen research
• Funding Sources 
  • Return on their investment → successful project, lead to future work in the area, improved reputation
• Community Members
  • A need to have clean drinking water which could be an outcome from the research 
  • As little interference in their daily life as possible; maximum benefit from research
  • Having clean water could attract more tourists to their country
  • They export water, so having a good reputation for having clean water can help boost exports

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

Approaches 

• Potential solution 1: Give a financial incentive to community members
  • Ethical Principle or code
    • Beneficence – our actions would result in benefits to the research community (larger understanding of the pathogen), the communities in Lesotho (knowledge of pathogen, eventually hopefully a solution to cleaner water).
    • Justice – Community members would receive compensation according to their contribution to the project.
  • Pros 
    • Covers their time if they took off work to help you 
    • Gives them a larger incentive to donate extra time 
    •  Locals feel they’re contributing to something meaningful and are being appropriately compensated for their effort
  • Cons 
    •  Need additional funds to provide the incentive
    •  May not be sustainable in the long-term if the team were to need to return to gather additional samples
    •  Moving funding to pay for incentive may cause the team to cut corners that might undermine the research results 
• Potential solution 2: Continue as planned
  • Ethical Principle or code
    • Justice – community members are not receiving equal compensation for the effort they are putting in.
  • Pros 
    • No additional planning, time, or funds are required
    • Research team is giving back to the community in the long term through information on the pathogen and is incentive enough 
    • Research team saves money 
  • Cons 
    • Community members might not be willing to provide us with the information we need  
    • There is no immediate incentive or benefit to community members
• Potential solution 3: Provide education about the pathogen and how to clean the water they use
  • Ethical Principle or code
    • Justice – Community members would receive compensation according to their contribution to the project.
  • Pros 
    • Community members gain an understanding of the pathogens that may be affecting their health and the need for clean water.  
    • Involvement of community members in the research may lead to them being more willing to participate and let you return in the future
    • May be more sustainable than a financial incentive
  • Cons 
    • Time consuming to train or educate people 
    • Community members may not see education as an incentive, it may take up too much of their time or they may not care to learn about it
    • May create panic as community members feel that they have no sources of safe drinking water and cause unrest 

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

When trying to decide if this study was ethical or not, I tried to put myself into the role of the community members. It was especially important to try and base my decision based on the fact that Lesotho is a developing country. If this study were conducted in the U.S.A, and researchers asked me to help guide them around my hometown, I would accept due to the fact that it would not be extremely costly. Yet, in the context of a developing country, it is essential to remember that many people rely on the work they do every day in order to feed themselves and their families. Therefore, I believe it is most ethical to properly compensate the community members for their time and the work they are doing. 

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. 

After careful consideration, the best course of action would be Solution 1: Give a financial incentive to community members. This course of action satisfies the highest ethical values, as it provides justice and beneficence. It brings about beneficence as it ultimately maximizes benefits. Not only do the community members get adequately compensated for their help, but also it improves relations between Lesotho and the researchers, and will allow for the study to be conducted in-country (as having community members collect and ship samples may compromise the study). This solution also embodies the principle of justice as it is treating community members equal to other workers in the labor force. It will compensate volunteers for their time that they may have otherwise spent earning money at a job. When comparing this solution to the other proposed solutions, solution number 1 will be more beneficial than solution number 2, as solution number 2 leaves the issue as it is and gives no financial compensation. This solution will not be as helpful as it will not compensate community members for their time. The impact of this solution is that community members may feel as if they are not appreciated, which may decrease relations and will make the community more hesitant to continue working with the research team. When comparing solution 1 to solution number 3, solution number 1 is preferable, as solution number 3 has significant cons. For example, community members may not see education as an incentive, especially when compared to receiving money. Furthermore, education will be very time consuming for researchers who only have two weeks to complete the study, it may also lead to panic when community members are informed of the pathogen that lives within their water sources. 

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.

It must be taken into account that solution 1 will need more funding, as it will provide financial incentives to community members. Yet, it is possible to postpone the study for a while to continue applying for grants and additional funding. Especially since this is a humanitarian issue, NGOs or other organizations that dedicate resources to these problems may be able to provide these additional resources. Additionally, since the typical salary per day is very low in many low- and middle-income countries, a large amount of additional funding will not be needed. The impact of this solution will allow the venture to continue and potentially lead to the study being able to successfully help the communities of Lesotho. It will also lead to better relations between the researchers and the communities of Lesotho. 

28 August, 2020

Step 1: Determine the facts in the situation – obtain all of the unbiased facts possible. Clearly state the ethical issue. The ethical issue in this prompt is one where the designer has to decide whether to get rid of the self-disable function, in order to reduce costs, at the expense of potentially spreading disease among the population. 

 

The facts in this situation are:

• The self-disable function prevents further use of a syringe
• If a syringe is used multiple times there is a potential for spreading the disease
• Including the self-disable function is more costly in terms of production
• Having a lower cost would make the syringe more accessible for individuals. 

 

Step 2: Define the Stakeholders – those with a vested interest in the outcome. The stakeholders in this ethical dilemma include:

• The doctors and nurses
• Hospital administrators
• Patients and their families
• The designer

 

Step 3: Assess the motivations of the Stakeholders. 

• Doctors and nurses aim to help as many people as possible and improve the health of their patients. They also aim to uphold their pledge of doing no harm to patients
• Patients want to be cured of their illness while paying a low cost so that treatment may be affordable
• Hospital administrators seek to provide healthcare services for the community while ensuring that they can continue to operate, therefore, they must make financially sound decisions
• The designer aims to make a low-cost syringe which is effective in delivering medication

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

1st Course of Action: Add the self-disable function on the syringe

• Ethical Principle: Duty-based principle. Although costly, allowing for the syringe to self-disable after use will allow for the safest administration of the medication. A very ethical course of action. 
• Pros: 
  • The safest course of action for everyone, not only the patients, but also for healthcare professionals who are handling the syringes
  • Will reduce the spread of disease
• Cons: 
  • Will be very costly for the general public
  • Hospital administrators will have to pay more to purchase the syringes
  • Not very accessible

 

2nd Course of Action: Do not include the self-disable function on the syringe

• Ethical Principle: Consequence-based thinking. Follows Utilitarian thinking of doing what will ultimately be best for the majority. 
• Pros:
  • Will help the most amount of people, as most funds will go directly to the production of the syringe
  • Allows for people with lower income to receive healthcare services
• Cons: 
  • May enable the spread of disease among the population
  • Has the potential to do more harm than good (depending on the severity of the disease and the resources required to treat it)
  • Not entirely safe for patients

 

3rd Course of Action: Do not include the self-disable function and use a portion of the funds to provide training to healthcare workers on the proper use of the syringe

• Ethical Principle: Consequence, Virtue, and Care-based thinking. This course of action follows utilitarianism as many people will have access to the medication. A virtuous healthcare worker will administer the medication safely and use knowledge taken from the training to dispose of the syringe properly. Likewise, Care-based thinking allows healthcare professionals to do what is best for the patient while providing healthcare services to many. 
• Pros: 
  • Allows for a large amount of people to receive the medication
  • Will be affordable in low and middle-income countries
  • Will curb the spread of the disease
• Cons: 
  • Resources and funds that could be allocated towards the production of the syringe will instead be allocated towards developing and providing training to healthcare workers

 

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

When thinking about this dilemma, I originally thought that the safest option should be pursued. Yet, I do understand that the context I have is very different from the reality many middle and low-income countries face. If healthcare workers do not have adequate training on the dangers of reusing syringes, many people may be put at risk. It is also important that the general population has access to these medications or else many will be denied access to a higher quality of life. I also believe that it is unethical to deny people life-saving medications due to cost. In the United States, we currently have an ongoing crisis where many diabetics are dying because they cannot afford the rising costs of insulin. 

 

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 is the third course of action: do not include the self-disable function and use a portion of the funds to provide training to healthcare workers on the proper use of the syringe. This option satisfies the highest core of ethical values because utilitarianism (consequence) will allow for the most amount of people to be helped. Virtue-based thinking and Care-based thinking will allow healthcare professionals to be virtuous and safely dispose of the syringe. Overall, this is the best approach as it is cost-effective compared to including the self-disable function, and it is more ethical compared to not including the self-disable function as healthcare workers will have the knowledge needed to be caring and virtuous when using the syringe. Assuming that the training program is effective, middle and low-income countries will be able to afford the medication while the transmission of the disease will be low. Yet, assuming the training program is not as effective it may lead to higher rates of transmission. Although on balance, this solution is still the most ethical, as it will allow for a lower rate of transmission than solution 2 while being more accessible to the general population than solution 1. Also, hospital administrators will be able to make financially effective purchases of the syringe, while the designer will have fulfilled their purpose of creating a low-cost and effective syringe. 

 

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.

The implications of my solution, economically, is that the venture will continue to expand, as since it is low-cost, hospital administrators will be willing to buy a large quantity of syringes. In terms of technological aspects, I as the designer will have successfully delivered an effective, low-cost product to many hospitals. Socially, the population will benefit as many individuals will receive the necessary medication. Environmentally, the syringe is not reusable, but parts may be recycled. Yet, this will need to be looked into further and will potentially require additional funds.

Blog Prompt:

 

1.Refine the detailed income statement for your venture for two years (at six month intervals) or a more appropriate time scale. Explicitly state the assumptions that underlie your financial model.

 

Total Costs Year 1: $84, 800 Year 2-5: $33,900	Items
Staffing  (Year 1: $63,200 ) ($13,200 per year following)	V4M trainer, Ed1-2 Trainer, Project Manager, Autism Diagnosis Consultant, Measurement & Evaluation Consultant, Expert for business start-up
Travel & Transportation ($3,600 per year)	V4M budget, Ed1-2 budget, Project Manager budget
Meeting Expenses  ($4,800 per year)	V4M travel budget, ED1-2 travel budget
Partnerships  ($3,000 per year)	Building partnerships fund, Autism Service Provider Capacity Building
Equipment & Supplies (Year 1: $3,000) ($2,400 per year following)	(3) Kindles/Tablets, Certificates, Binders, Office Supplies
Communications  ($1,200 per year)	Top-Up, Internet
Messaging and Education  (Year 1: $3,000) ($2,700 per year following)	School Teacher Workshops, Posters for Schools and Clinics, Prominent Location Billboards

 

Revenues	Anticipated Value
Autism Science Foundation Grant	TBD
Autism Speaks Grant	TBD
UNICEF Grant	$1,000,000
The Simons Foundation	TBD
Lehigh University CORE Grant	$60,000
Ministry of Health in Sierra Leone	Partnership
Ministry of Education in Sierra Leone	Partnership
World Hope	Partnership

 

Reach Projections
The reach projections of this project will be measured by the number of children screened for autism in Sierra Leone. This data will be collected annually based on the total population of children aged 3-5 who live in the cities implementing the autism screener for that year.
Year 1  2022	Year 2 2023	Year 3 2024	Year 4 2025	Year 5  2026
10% of Children ages 3-5	30% of Children ages 3-5	50% of Children ages 3-5	70% of Children ages 3-5	90% of Children ages 3-5

 

 

Assumptions: 

• The majority of the funding of this venture will come from grants and investors
• Partnerships with community organizations lower the cost of the venture and increase value in the community 

 

2.Refine the Business Model for your venture based on your revenue model. You may use the Osterwalder BMC to refine your business model but prepare one or more visuals that explain how your venture will work and accomplish your BHAG.

• Once our project can reach more of a steady state, our end to end solution will focus on having the children who need services to have a pathway to access those. 
  • Our screener will be used across Sierra Leone where parents will be able to find out if their child is suspected of having autism or not. As this is not a diagnostic tool, if a yes is the result of the screener, they will have a pathway to diagnosis. 
  • After this, parents and children will have a pathway to services from partners in Sierra Leone that already exist: Sierra Leone Autistic Society and schools in the community. From our education and training that we plan to complete in the upcoming years, there will be at least one person who will be able to provide services in schools. Services and supports for children with autism differ from students without disabilities for a number of reasons. Within children diagnosed with autism, the amount of services also varies depending on severity of the disability, therefore it is not possible to detail this portion of the end to end solution as it is highly individualized. 

 

3. Develop an M&E plan for your venture.

 

• Clearly list all assumptions.

• Screener is accurate in identifying those with autism and can be used across all ethnic groups in Sierra Leone.
• People in Sierra Leone will see the value in using the screener and will continue to use the screener after our team’s fieldwork.
• Parents will act on the results of the screener to seek support services, accessible resources, training, and education

• Identify short-term and long-term success metrics.

• Short Term Successes:
  • Number of schools that have trained teachers
  • Number of clinics that have trained nurses
  • Number of children that are screened
  • Number of children who have screened positive
• Long Term Successes: 
  • Number of children that are diagnosed with autism
  • Number of children included in the schools systems that are diagnosed with autism
  • Number of children into adulthood diagnosed with autism

• Identify specific methods to measure the metrics.

• Have our on-ground supervisor relay monthly data on: 
  • Number of children screened
  • Number of children screened positive
  • Number of children screened negative
  • Number of children sent for further diagnosis/testing
• Have our Education trainer and Health Clinic trainer relay monthly data on:
  • Implementation of training in each school 
    • Successes/failures? 
    • How many kids were screened as a result?
  • Implementation of training in each hospital
    • Successes/failures?

 

1. Develop a detailed income statement for your venture for two years (at sixth month intervals). Explicit state the assumptions that underlie your financial model (at steady state)

• COGS: None
• Revenues: 
  • Grants
  • Foundations
  • Non-Profits
• Overhead: 
  • Transportation (to and from trainings (Car/Van/Bus))- Local
  • Fuel
  • Transportation (to and from trainings/base (plane))- Distance
  • Lodge
  • Food
  • Money for Trainees
  • Training Locations (Rent)
  • Workshops
  • Internet
  • Materials (handouts)
  • Materials (computers)
  • Certificates
  • Advertisements (Radio/Media)
  • Advertisements (Posters)
  • School Ambassador (specific # TBD)
  • CHW- Screening (specific # TBD)
  • CHW- Educator (specific # TBD)
  • Training devices (Kindle/Tablet (specific # TBD))
  • Cell Phone Credit
  • Consultants for evaluation and measurement
  • Money for SLAS (devices, materials, etc.)
• Profit: None

 

1. Identify two specific sources for the design phase of your project and two specific funding sources for the dissemination phase of your project. For each funding source, explain why this is a good fit  for your project, and what specific aspect of your project might the funding source support.

 

DESIGN PHASE:

• Funding Source: Autism Speaks
  • On their website, you can see which countries across the globe have received funding from them previously (see picture below). They change their topics that they call for proposals on each year, however the grants are all focused on the following mission that their organization pushes on their website (see below). Although our team cannot link to a specific name of a grant that the organization has that would fit our project, we did examine the previously funded projects and they have funded the diagnosis tool development in Tanzania (“The Development and Pilot Testing of Open Access Screening and Diagnostic Tools for Autism Spectrum”) and prevalence data studies in Bangladesh (“Scales, procedures, and intervention programs for estimating the prevalence of childhood disability and autism in Bangladesh”). Each are hyperlinked when you hover over their name and you can read more about each project. 
    • “Autism Speaks Science is committed to being a catalyst for research breakthroughs that improve lives today and deliver a spectrum of solutions in the years ahead. This work involves unraveling the biology of autism, including its varied subtypes and dimensions and translating research findings into life-enhancing solutions”

 

• Funding Source: Bill and Melinda Gates Foundation, Grand Challenges Grant
  • This foundation has many different areas of focus in their grants with the Grand Challenges grants focused on “innovation to solve key health and development problems“. They have posted previously funded grants which are mainly focused on physical health, however our grant proposal could surround how the development of the screener will lead to improved mental and emotional health. 

DISSEMINATION PHASE:

• Funding Source: Autism Speaks
  • Similar to how the development phase would be able to benefit from a grant from Autism Speaks, the dissemination would also qualify. As the grants change each year, our team examined what was previously funded. They have not specifically funded education of autism in Sub-Saharan Africa, however they have funded education grants in five countries outside of the United States. For example, ARTI: The Autism Research & Training Initiative in India is one funded grant that is somewhat similar to what we would be completing in Sierra Leone. You can view this grant by hovering over the name, and it will link you to their information. 
• Funding Source: Abilis Foundation
  • This foundation funds an array of topics including “Training, material production and dissemination on Human Rights of persons with disabilities“. They currently only focus on the following countries in Africa: Ethiopia, Tanzania, Uganda. This obviously does not include Sierra Leone, however it does not say that it is limited to those. We believe that this foundation may be a good avenue for us to create a relationship with where they can spread their reach in Africa. 

 

1. Identify five specific partnerships that you need to forge to advance your project forward with the ultimate goal of positively impacting at least one million people. Describe exactly how that partnership might help you achieve scale and why that entity might be willing to work with you.

 

• World Hope International 
  • This partnership allows our team access to the resources available to World Hope as well as the workers that they already employ and are willing to help. This partnership provides invaluable workers that we cannot afford to pay ourselves at this time as well with people who are passionate to help their community like our project aims to do. The workers are already established and respected in the community which helps to bring community members in because of the pre-existing trust.
• Ministry of Education
  • This partnership will allow us access to the schools across Sierra Leone which will make the distribution of our screener faster and more wide spread. If the Ministry of Education agrees to allow the screener into every school, allow training of individuals, and require minimum standards for children with autism, this will speed up our goal’s timeline and streamline screening. This partnership is vital to screening one million children as most children attend at least one year of school. 
• University of Makeni 
  • This partnership will be vital for two reasons. First, our training for pre-service teachers in autism will impact millions of children as these teachers will go on to teach countless classes in their lifetime. The lessons they learn from our training will be long lasting. Second, we can utilize pre-service teachers to go out into the community and screen after they are sufficiently trained. This could be worked into their career preparation, provide those who are in the program additional training and expertise, and allow for more children to be screened which is our ultimate goal. This mutually beneficial partnership is a method of how our screener will reach one million children.
• Hospitals/Clinics
  • It is important that community health workers, doctors, and clinic workers are training to identify autism similarly to how they would identify someone who is deaf or blind. Bringing in disability screening in a more wide spanning nature will allow more children who need to be identified to be identified. This partnership will be built on the health of the community which is the goal of hospitals as well as our team. 
• Sierra Leone Autistic Society 
  • This partnership is vital as it is currently the leading group helping children with autism. This organization has a jump start on our team because of their connections, therefore we can leverage our relationship with them to access their network. In addition to this, we will work with them to help develop more programming, expansion, and diagnosis. This partner is already devoted to autism in Sierra Leone, therefore this partnership is a match made in heaven. 

 

 

• Refine your Business Model Canvas:

 

 

1. End-to-end solution:

 

• Once our project can reach more of a steady state, our end to end solution will focus on having the children who need services to have a pathway to access those. 
  • Our screener will be used across Sierra Leone where parents will be able to find out if their child is suspected of having autism or not. As this is not a diagnostic tool, if a yes is the result of the screener, they will have a pathway to diagnosis. 
  • After this, parents and children will have a pathway to services from partners in Sierra Leone that already exist: Sierra Leone Autistic Society and schools in the community. From our education and training that we plan to complete in the upcoming years, there will be at least one person who will be able to provide services in schools. Services and supports for children with autism differ from students without disabilities for a number of reasons. Within children diagnosed with autism, the amount of services also varies depending on severity of the disability, therefore it is not possible to detail this portion of the end to end solution as it is highly individualized. 

 

 

• Ten practical lessons from the business (revenue) models of ventures we reviewed today (or others you research) as they relate to your venture.

 

 

• It was interesting to hear about grants and university supported funding was not considered part of steady state. I know that it should be phased out eventually, however I work very closely with many long term non-profits who do not rely on those grants but use them for many vital aspects. We did not have this funding as part of our steady state, but it did make me start to think about all of the places that do use it as steady state. 
• Khanjan’s comments about who will buy our materials made me start to think about other people who may want to purchase these materials. Teachers Pay Teachers, TPT, in America is a huge platform where anyone can sign up, upload teaching materials with any price they choose, and other teachers can purchase and receive the immediate download. Now in Africa, the website and technology are not as advanced, however I think we may one day be able to create ABA materials for children with ASD and we could sell them on this for anyone to purchase. Most items on TPT are under $10, with most of the items between $3-6. This is not a platform to get rich off of, however it is a great way to make money on materials you were already making. 
• I liked the concept of Greyston bakery and their hiring process to make the brownies for Ben and Jerry’s. Greyston’s bakery hired people regardless of their history and backgrounds. I think this is an important takeaway when we think about who we will be “hiring”, and more so training, to screen the children for autism. With a small number of psychiatrists available to screen, we need to think about who will be trained to screen the potential high volume of children displaying stereotypic behaviors. In Sierra Leone it will be important to hire people not based on their backgrounds, but based on their ability to understand and screen the children with validity. 
• The other project that I liked, for similar reasons, was the Barefoot college. They were able to train multiple women, in different countries, and have them go back to their village and make the solar lights. This is an important concept when we think about our screeners being accessible to other countries and other organizations. It will be important to have a type of person in mind (ex. Grandmothers in the BC video) to train and share that knowledge within the village and universities/companies using our educational training and implementing our autism screener. 
• In the video about Barefoot college, the presenter talked about how it’s the community that certifies you, a piece of paper that just hangs on the wall isn’t what is important. It was interesting to see how this applied later in the talk when he discussed how all the men weren’t interested in the Barefoot college because they just want to get the certificate and leave their village. But when they sought out the Grandmothers they ended up being people who were very passionate about the work and who wanted to use the knowledge they gained to help their village and to share it with others. This highlights the importance in identifying the right people to help with your venture because you want to find those who are also passionate about your venture and making a change, rather than gaining the information (or certificates) and leaving to use that information elsewhere. 
• It was interesting to see how much the Greyston’s bakery was able to provide to their workers and their bakery, particularly for a company that seemed to be on the smaller side, especially compared to larger companies like Ben & Jerrys. It shows that even the smaller companies, with the right business model, can have a large impact on the community around them. 
• I personally enjoyed hearing the feedback for the other teams. Although our project is completely different from some of the others, it was helpful to hear how their portions of their business model are not that far from ours. It also helped us think in a more steady state as it can always be difficult when we are starting this year and now is more pertinent. However, five years from now maybe even more important.
•  I found the story about the Reel Gardening to hit home for me specifically. It is a very good idea for those who do not have the knowledge on a large scale. However I also did not enjoy the example for a personal reason. My significant other runs a nonprofit who teaches citizens in urban areas that are nicknamed as “food deserts” how to grow their own food from community gardens, the type of seeds, and the entire process that is eliminated with Reel Gardening because it is pre-packaged. I think the large scale in other countries will greatly benefit from this venture, however it takes away a part of learning that I have seen first hand to be so genuine when watching kids learn how to prepare seeds for soil. With that being said, I think it is important for ventures to make processes more simple how Reel Gardening does as not everyone has organizations like my significant others who provides that education and training. 
•  I enjoyed examining the website for the envirofit. That website was a great example of how to take your model and make is visibly for all consumers and pushing what matters. 
• On the last slide of the PowerPoint for the week, there were some additional links to follow. I spent some time exploring these websites. One of the social ventures mentioned in the one website talked about the donation of books. I remember we talked through an example similar to this when we still were taking classes face to face. This made me start to think that we could ask organization to donate products that they are no longer using as students with autism often use many manipulatives and products in schools. They also outgrow them often and may sit unused in closets for a long time. This may be an interesting option for our team to look into. 
• I found a really important takeaway in learning about Greyston’s Bakery. I found their hiring process really interesting. It made me think about our own project and how we will need to be able to include individuals who are willing to work. This means that aside from qualifications, we must be able to give everyone who is willing to advance the dream forward a chance.
• I thought that the process behind Reel Gardening was particularly interesting. I also liked how they ensured that their project was self-sustaining. They did this by visiting African countries to train farmers, who in turn, trained other individuals. They also donated seeds after every purchase.This allowed for their project to reach a wider audience and to sustain itself.

Business Model: 

 

1. Value Proposition
   1. Offering an opportunity for a more fulfilling life, for the children and their caregivers
   2. For parents who have children that are displaying signs of autism, our autism screener is an assessment tool that allows children to be screened for autism, so that they will be provided with the opportunities to live a life of quality that typically developing children have
2. Customer Segment
   1. The disabled and their families
   2. hospitals/clinics
   3. schools
3. Channels
   1. Training programs
   2. Community health workers
   3. Primary schools, universities – its teachers and faculty
   4. Religious centers
   5. Radio, media outlets 
4. Customer Relations
   1. Personal Assistance 
      1. Someone in the community who is trained delivers the screener of education training 
5. Revenue Streams
   1. Other countries purchasing our screening tool 
   2. Other countries purchasing our teacher preparation materials 
   3. Other countries purchasing our health care worker educational materials
6. Key Resources
   1. Community Health Workers
   2. Teachers 
   3. Clinicians/ Health care workers 
   4. University professors
   5. Money/Funding
7. Partnerships
   1. World Hope Organization
   2. Sierra Leone Autistic Society
   3. University of Makeni 
   4. Sierra Leone Ministry of Education
8. Activities
   1. Production of tool 
   2. Production of education materials for teachers and health care workers 
9. Cost Structure
   1. Fixed costs:
      1. Cost of producing/printing the screener and educational materials/trainings
   2. Economies of scope:
      1. Leveraging existing channels and systems

 

List ten lessons from the Business and Operations model of the Aravind Eye Hospital

1. 1. Solution must be affordable and sustainable within the limitations of the country to be effective – “you can’t run a public health program on leftovers”
   2. The screening area and entire screening process must be organized, efficient and convenient to maximize productivity and customer volume, satisfaction, and thus, return 
      1. Important for our project as we could perhaps consider propping up a center specific to screening children for Autism in the long term
   3. When Ravilla made the statement that eye is an eye in America or Africa and that it should be treated the same way with the same treatment, it made me think about our project. Our project is not trying to reinvent the wheel and we need to use similar methods and alter to match the culture and continue working effectively with what we already have available to us 
   4. When Ravilla talked about the paperless offices that worked for medical files, this is exactly what would work for our project with managing the data of who is screened and what their results would be. This method has been used across organizations and could be a legitimate way for our project to move forward. 
   5. One of the innovations Ravilla talked about was creating ownership in the community to the problem. I think this might be easier to do with something like eyesight/vision where there’s a clear solution to it and likely won’t be too much pushback from the surrounding community. This is hopefully something we’ll be able to achieve with our project, but I think it will take some time due to the existing cultural beliefs about autism and the lack of visibility in the community. 
   6. Ravilla talked about how many problems that are large and cut across all economic strata could likely be addressed by using a similar process that’s focused on productivity, quality, and patient-centered care. These are things we should make sure we focus on since autism is something that affects a lot of people across all economic levels. 
   7. The video discussed the importance of delivering services efficiently and compared that method to McDonalds. McDonalds is able to train people all over the world despite their differences in culture/religion, to produce and deliver a product in the same way in hundreds of places. Hopefully, once our product has been created, and validated, we will be able to set up a system similarly to McDonalds where people are trained in low-income countries to implement this screener around the world. 
   8. The video discusses the challenges of seeing all the patients with such few opthamologists available. The video showed their process of how they complete many surgeries in an efficient way. The video also described how they targeted certain women to support the opthamologists and how they trained them to be the backbone of the organizations. I think this is going to be a challenge we face as well when it comes to screening the children for autism. There are very few psychologists and clinicians available for screening. We need to develop an efficient plan to screen as many people as possible in a short amount of time. I think it is important that we hire and train many assistants, possibly community health workers, that can support the very few psychologists and clinicians. This will ensure that we are able to see as many children as possible in an efficient manner.  
   9. It is important to make sure to provide all the needed services. After the final exam, if patients need glasses, they can pick up frames near them. Patients can receive their glasses in around twenty minutes, and afterwards if they require surgery or further care, counseling and a bus service is provided to help get them to the hospital. Taking these steps to ensure people will receive full treatment will make sure problems in their vision are addressed, and that people are more likely to want to receive exams.
   10. Village girls in the community were involved in order to increase productivity, quality, and decrease cost. This allowed not only for the community to be engaged but for there to be a stable backbone to the organization. This is a great way to involve the local community and support your project, also this helps lead to sustainability.

 

•  List five compelling take-aways from the Art of the Start

 

• Mission statements must be short and to the point. The mission statements, and/or mantras, should be direct and state what our product’s overall goal is. 
• 10/20/30 rule will allow you to prove you are knowledgeable about your topic. 
• keep it simple: parents are busy, especially caregivers who struggle with children with disabilities. the easier it is, the more people that will get their kids screened for our project 
• Ask women: our entire project is focused around caregivers and children. We must work with them collaboratively.
• You have to have people of different skills sets and backgrounds on your team. Some will be more focused on the details, some will be able to see the larger picture, and others can help with the organization of the project. A successful project/team will incorporate people of different skill sets and make sure that all people are heard.

 

 

• Articulate your value propositions for your diverse customer segments.

 

 

For parents who have children that are displaying signs of autism, our autism screener is an assessment tool that allows children to be screened for autism, so that they will be provided with the opportunities to live a life of quality that typically developing children have.

 

For educators who have children that are displaying behavioral difficulties, our autism screener is an assessment tool that allows children to be screened for autism, so that you can identify their areas of need and provide services to enhance their educational experience.

 

For healthcare personnel, who have patients that are displaying developmental abnormalities, our autism screener is an assessment tool that allows children to be screened for autism, so that you can provide assistance for families and recommend support services for their child. 

 

 

• Discuss your Total Available Market and Total Addressable Market. List all your assumptions and hypothesis. 

 

 

Total Available Market:

Our market encompasses a large range of customers. Schools will want to use our screener for students they may suspect have Autism as well as hospitals and clinics. Individually, caregivers of children who suspect their child is different will want their child to be screened. Caregivers are usually female, however not exclusively, and the age range is open ended.

There are approximately 80 hospitals across Sierra Leone that are public or privately owned, with 17 of them being government owned. Currently, there are 3,660,818 women living in Sierra Leone who on average have 4.359 children. Additionally, there are over 500 schools in Sierra Leone with varying enrollment.  This is a massive population that could possibly use this screener. 

 

Total Addressable Market:

As this is our initial trip to Sierra Leone for our venture, we will be heavily relying on the few connections that we have created. During this trip, we plan to create more relationships so that in the future a more solidified total addressable market plan could be created. Our current connections with World Health Organization and Sierra Leone Autistic Society are part of our initial reach, however the sky’s the limit as once citizens are trained to use the screener, they will be able to reach many more children than we could. 

 

Resources:

https://dhsprogram.com/pubs/pdf/SR215/SR215.pdf

http://www.commonwealthofnations.org/sectors-sierra_leone/business/health_and_medical/

https://countrymeters.info/en/Sierra_Leone

https://tradingeconomics.com/sierra-leone/fertility-rate-total-births-per-woman-wb-data.html

1. Summarize and report out on the results of the SKS exercise:

 

Below is the chart illustrating the results of the SKS exercise, which we completed by having all members individually insert items in each category and then discussing which item we would like to emphasize and elaborate on. Approaching the exercise this way allowed us to share our exact perspectives on the status of our collaborative work, with a focus on group dynamic rather than specific goals related to our project itself. It allowed each of us to pinpoint strengths and weaknesses we may not have otherwise known (and made salient) as a group.

 

Keep	Start	Stop
Communicating Collaborating Asking for help Being positive Being supportive  Having defined goals and next steps for each week More “working” meetings Our team spirit Continue the rate in which we are working How we will make it happen: Continue with setting goals for each week and setting goals for next week. If we continue to be organized and on the same page weekly, we will continue.	More working sessions where we focus on a specific topic, rather than just meetings where we report on the work we’ve done individually Asking how we can help someone else with their assigned tasks More honest/direct communication about progress/ feedback Communication throughout the week of updates and barriers we may encounter so we can brainstorm ideas immediately and help each other out instead of only updating once a week How we will make it happen: Set up additional times where we meet with each other  outside of our Wednesday meetings if need be Talk with our faculty advisor in order to have more working meetings	Working ineffectively  Holding back thoughts for fear of being wrong (lol mostly just me) Being afraid to ask for help How we will make it happen: Ensure we are openly communicating with one another in order to receive feedback and improve our project Ask for feedback and provide feedback at the end of each meeting/presentation

 

2. Develop a detailed Collaboration Plan for your team clearly articulating your Goals (Small g and Big G), Roles,Procedures, and Relationships:

 

What are my personal goals (small g) on this team? Pull those goals from the dreams on your individual profiles. Capture them by person in your collaborative plan. e.g., get an A, learn laser cutting, start something I can continue after the semester

 

• Grace: My personal goals which motivated me to participate in this project are centered around growing and learning. As a student of International Relations, participating in this project will allow me to delve and immerse myself into a foreign country. Furthermore, I will be able to apply skills I have learned in my courses to tackle and contribute to a field completely outside of my major and expertise. I want to be able to push myself out of my comfort zone and work on developing skills outside of my current skill set. I also have an interest in helping others and working to create impact in the lives of others. This project will allow me to achieve my personal goals as it will allow me to immerse myself in a new field and contribute to progress and impact within Sierra Leone.

 

 

What is the Project GOAL (big G) we’re all committed to achieving together?

 

The project GOAL for our team is to develop a culturally appropriate, highly effective Autism diagnostic screener. Throughout this process, we must also be committed to finding a way to disseminate the screener, bring awareness and education on the nature of Autism, as well as providing training for community health workers throughout Sierra Leone.

 

Establish Roles – How will you leverage the assets each member brings to the team? How will you leverage the experiences each member brings to the team? How will you ensure that the team’s work gets done on time and with high quality?

 

 

• Qualitative Expert (Emily):  Responsible for the study design & approach. For example, which approach (e.g., case study, ethnography, etc), what types of data should we collect, develop a protocol, how to synthesize and write up the data, develop focus group and interview questions/format.

 

• • • Experience in working on psychological/sociological research–both quantitative and qualitative.
  • IRB Expert (Alyssa): Responsible for anything & everything related to the IRB. She is the point of contact with the University, she will write, submit, revise, and resubmit IRB,  develop consents (verbal only), and work with the qualitative expert to create data collection forms, etc.

 

• Assessment Expert (Kathleen): Responsible for main analyses on current Western assessments and screeners and will work with SPED & cultural experts to decide what questions/tasks our assessment should have, learn how to validate the assessment.

 

• • • Knowledge of available western screeners and experience using, scoring, and reporting these tools. Previous experience developing and validating a new measure. Psychometric expertise. 

 

• SPED/ASD/Education/Healthcare Expert (Lindsey): Responsible for understanding these facets in order to inform the team on how best to approach our goal. Will seek to answer questions like: how did we get from where we started in the US in terms of the level of knowledge, awareness, and services, to where we are now? What can we do in SL to make progress in this area? What is the education structure of SL? What trainings do teachers need to be qualified to teach? What is the healthcare system like?

• Cultural Expert (Grace): Responsible for thoroughly understanding the culture of Sierra Leone: its history, language, values, beliefs, geography, different districts, etc., the strengths and challenges of the people and country, and will report on current events weekly which are impacting and shaping the country.

 

By assigning roles in this format, we can ensure that every facet of our broad and ambitious project goal is covered in depth so that we can gather data as comprehensively as possible–to form a firm foundation for our screener and education dissemination.

 

Establish Team Procedures Decision Making – What process shall we use: consensus, majority rules, deference to expert, default to the loudest, or? Effective Meetings – Focus on key, timely decisions together vs. status/update (offline); meeting roles: scribe, facilitator, time keeper Communication – FTF: frequency, time, location; type of technology: (Googledocs, Hangout, etc.); expectations for responsiveness; ‘best time to work’ (AM, PM, weekends?)

 

So far, we have not had an issue with disagreements and finding a consensus on important decisions. Thus, we will continue with our usual approach where someone proposes a question or suggestion on a problem and all are given a chance to input their own thoughts, stance, and comments so that we may discuss the most viable decision based on all the cards put forth on the table. If there is still a strong disagreement, we may consult our various experts (both team members and professional contacts) depending on the area of which the disagreement stands. We are currently meeting via Zoom at our regular meeting times, and conduct individual zoom meetings between team members collaborating on a certain project within the larger goal. During the regular meetings, we share updates on our progress within our various roles as well as bring up questions and concerns we had come across during the week in hopes of a resolution through team-wide discussion. 

 

3. If fieldwork were canceled, how would we advance the dream forward? 

• Work with our contacts in the Sierra Leone Autistic Society to have them review the questions we identified for our screener and talk through phrasing and cultural appropriateness.
• See if they would be willing to and able to have some families complete the screener so we can use some initial pilot data to further refine the screener
• We will be able to continue our work and submit at least one manuscript for publication regarding an older paper we are working on and one on the process of how we created a screener. 
• We would be able to continue refining our screener and focus group questions in order to make sure they are ready to be implemented for future fieldwork trips

1. Our IRB Strategy 

 

Our team has been working over the last several weeks to prepare to begin the writing of our IRB as it goes hand in hand with our research. Our team has delegated tasks into smaller teams and individuals while keeping some tasks as a group initiative. Below is our bulleted breakdown. 

 

Person Responsible	Task
Everyone	Develop research questions Develop a hypothesis  Determine our systematic method on how we will protect and safeguard privacy.  Develop a coding technique and determine how data will be stored.  Examine other diagnostic tools and develop our possible screener questions
Dr. Morin	obtain the letters of support that show we are welcome and allowed to be there Sierra Leone Autistic Society
Alyssa	Primarily writing the IRB Write the basis for why our team needs to be approved for a waiver of written consent based on culture and tradition  We will shape it as a “pilot study” per Matt from IRB
Kathleen	Collect psychometrics from other screeners Collect reliability data for the questions that are very similar to one from another screener to help show that we are not starting from complete scratch and show we did the legwork to create the questions We need to submit all possible questions
Emily	Develop questions for focus groups Develop questions for interviews
Grace	Help with verbal consent forms and all questions to check for cultural appropriateness Help with building the basis for why written consent is not feasible
Lindsey	Help with creating our teacher training with her background on Sierra Leone’s structure of health care and education system

 

1. Develop an outline for your mid-semester presentations. What supporting evidence will you provide for each point? How will you boost your credibility every step of the way?

 

We have continued to delegate our tasks for the presentation so that we can work effectively. We plan to only have 2 people from our team present during the 5 minutes and then the rest of us will help answer questions during the Q&A. Our main presenters during the 5-minute portion of our presentation will be Emily and Grace. 

 

• Logo
• Goal: All children in Sierra Leone screened by the age of 4
• Macro:
  • Amount of research done in US/western worlds
    • Part of the literature and needs section of the presentation
  • Level of knowledge about autism in general community (if we can find literature that speaks to this)
  • In comparison, research in sub-saharan Africa and specifically Sierra Leone
  • Lack of available culturally appropriate screeners/diagnostic tools
• Mirco:
  • How does this impact the children and families?
  • Cultural beliefs of causes of autism
  • Shunning
  • Giving the child back to god
  • Possible loss of income
• Evidence of people wanting our help
  • Sierra Leone Autistic Society
  • Dedicated to outreach → AAC device donation
  • Psychiatrists and teachers asking for help when Dr. Morin visited in January
• We plan to talk about how our project is credible because of the support of the Sierra Leone Autistic Society and the other schools who have already written letters of support for us, along with helping us to review our screener and questions.

• We didn’t inherit anything as this is a new project so we will not have to address this portion. 
• We will discuss our approach and mixed methods approach to complete our project
• We will make sure to emphasize our approach for making a systemic change rather than simply introducing our product and leaving things there – incl. plans to train both community health workers, religious leaders, and ordinary citizens
• We will address our competition/ challenges by explaining cultural beliefs and divides, and how they can cause disturbances along the path towards realizing our goal
• We will compile work we have done throughout the semester across various topics, in order to support our project’s progress

10 Things That Make Me Feel Human:

1. Collaboration
2. Anthropomorphic Climate Change
3. Death
4. Singing
5. Swimming In the Ocean
6. Heartbreak
7. Collaboration
8. Pregnancy
9. Watching the Sunrise
10.  Being on a Plane at Night

 

Articulate your philosophy of engagement as it pertains to your work with the GSIF / LVSIF. Specifically discuss:

1. Why should I engage?

To help build cross-cultural relationships that will lead to learning for both our team and the people of Sierra Leone. Also, to build self- sustaining systems which will lead to the improvement of living conditions across Sierra Leone, Africa, and the rest of the world. I believe it is important to find value in one’s own work but to also realize that our work is based on collaboration. We are working together in order to learn and grow as a species. If we have this kind of mindset, we can realize that our project is more than developing a screener and diagnosing tool, it will help create a system which can contribute to the whole. 

2. How must I engage?

I must engage by using the knowledge I have accumulated over the years to contribute my best efforts to our project. More specifically, as an International Relations major, I can use the skills I have acquired to learn about the culture of Sierra Leone in order to help us all engage.

3. With whom must I engage? 

I must engage with everyone I can. Not only with the people of Sierra Leone who I will be directing with, but also my teammates. We must have a great team environment in order to work as cohesively as possible. Furthermore, I must engage with my peers, family, and friends in order to share and spread knowledge and help solidify the system through awareness.

4. What kinds of challenges, opportunities, and approaches should I care about? 

I should care about issues that might impede our work or alienate us away from Sierra Leoneans. By this, I mean cultural issues that may arise. Our work is going against local culture, as we are providing an alternative to spiritual traditions. We must be aware of these cultural barriers going in so that our work will not offend others. 

5. What might my epitaph read? 

Each day is a page and I really liked the book.