Part I

 

Facts of the situation

1. Gruel is used to complement breastfeeding in children from the ages of 2-24 months. 
2. Gruel is made of cornmeal and bananas and has very little nutritional value, but the mothers think it does. 
3. I have received a grant to establish a women’s cooperative in this region of East Africa.
4. The grant will fund the creation of a nutritious porridge made of local produce that can be used to wean children off of breast milk at 6 months.
5. HIV/AIDS is prevalent in the region and can be spread through breastfeeding.
6. 500 women are interested in working on the co-op to improve their livelihoods, but they do not all believe that the porridge will work as a weaning food.  
7. Pesticides are used to grow many crops in this region, including the crops that can be used in the porridge, but the pesticides cause adverse health effects for infants. 

 

Ethical questions:

• Addressing the ethical health issues associated with prolonged breastfeeding in a area with high rates of HIV/AIDS
• Early introduction of supplemental foods in infants’ diets
• Potentially feeding infants and children pesticides through the local produce
• We want to find a balance between using pesticides and educating on the prevalence of HIV/AIDS when the main focus of the co-op is to improve nutrition levels and livelihoods of households in rural areas.

 

Stakeholders

 

1. Children 
2. Mothers
3. Manufacturers of the gruel
4. Grant recipient (myself)
5. Members of the women’s cooperative
6. Grant donor
7. Local farmers (secondary stakeholders)

 

Motivations of the stakeholders

 

1. Children 
   1. Want good tasting foods
   2. Infants/young children most likely still want to be breastfed
2. Mothers
   1. Want healthy children
   2. Mothers want to do what is socially acceptable. If many other mothers are skeptical of switching to the nutritious porridge, they may not want to as well.
   3. Don’t want to pass on HIV
   4. Child rearing
3. Manufacturers of the gruel
   1. They want to wean babies off breastfeeding, and most likely think they’re product helps nutrition to some extent.
   2. Continuing to make money off of their product (They would not want a competitor.)
4. Grant recipient (myself)
   1. Establishing a successful women’s co-op that improves the livelihoods of the women working there
   2. Help children’s nutrition and health levels with a sustainable porridge recipe 
   3. Social impact
5. Members of the women’s cooperative
   1. Making money and supporting their family
   2. Improving their own livelihoods
   3. Making a product that other mothers trust and want to buy so that the women at the co-op can make money
   4. Help children and nutrition levels
6. Grant donor
   1. Improve the nutritional status of children 
   2. Improve the livelihoods of rural households
7. Local farmers (secondary stakeholders)

 

Alternative solutions to the case study

 

1. Do not worry about the use of pesticides in ingredients or interfere with breastfeeding practices of women. Women in the co-op could ensure proper washing and peeling of the produce when preparing the porridge.
   1. Ethical principle: potentially a violation of doing what is best for all and having integrity
      1. Pros
         1. Women’s co-op can focus their attention and money on the two primary goals of the co-op, improving nutrition levels and livelihoods of rural families, which would make the grant donor satisfied with the work being done
         2. Children would still get nutritious foods if they choose to purchase this product
      2. Cons
         1. Peeling produce tends to take away many of the valuable nutrients
         2. Does not address the concerns of prolonged breastfeeding with HIV/AIDS
2. Hold mass education programs on washing or peeling nutritious foods and breastfeeding to accompany the marketing of the porridge. Workshops and mother support groups could be used to teach women the importance of using the porridge as well. 
   1. Ethical principle: beneficence/nonmaleficence- The goals of the project are being met, but steps are also being taken to prevent any adverse effects in children from the pesticides.
   2. Pros
      1. Satisfies the goals of the women’s cooperative to improve nutrient levels, as long as people buy the food, and improves the livelihoods of those that attend the workshops making the members of the women’s co-op happy.
      2. Could lead to positive behavioral changes that impact nutrition and HIV levels in children
      3. Positive press and marketing for the women’s co-op
   3. Cons
      1. Lots of effort and money is required from the co-op to implement an education and marketing program like this
      2. Would need to choose specific communities to implement this
      3. The program would have to change the minds of women who use gruel and are skeptical of the efficacy and safety of the new porridge. 
3. Using community heads or elderly women to influence the community on the porridge and proper feeding practices
   1. Ethical principle: Beneficence/nonmaleficence- Like before, the goals of the project are being met, but steps are also being taken to prevent any adverse effects in children from the pesticides.
   2. Pros
      1. Satisfies the goals of the women’s cooperative to improve nutrient levels, as long as people buy the food, and improves the livelihoods of those that attend the workshops
      2. Could lead to positive behavioral changes that impact nutrition and HIV levels in children
      3. Less money would be needed than for a large educational program
      4. Community officials and older women have lots of influence in smaller communities
   3. Cons
      1. Difficulty of convincing older women and chiefs to help with education
      2. Would need to pay them or benefit community leaders in someway, and recruiting helpers would still take time and money

 

Best solution

 

I think that in this case study, the concerns of educating on the prevalence of HIV/AIDS is out of the scope of the responsibilities of the women’s co-op. When we presented on our foods that target malnutrition levels in children, many judges were concerned with things like a small amount of sugar in our recipe or using plastic to package our products. While these are legitimate concerns, they are things that did not impact the true goal of our project with is to impact the nutrition levels of children in Sierra Leone, so they were less of a concern than other parts of the project. I do not think that the women’s co-op would be responsible for changing the breastfeeding practices of women and educating them on the prevalence of HIV. With that being said, I think the women in the co-op should be as careful as possible when using produce that contains pesticides. Pesticides affect infants and children very similarly to malnutrition. They should clean and peel what they can while still maintaining nutrient levels. Babies have a harder time removing pesticides from the body, which can damage their cognitive development or organ function. If the women’s co-op is introducing produce into many of the children’s diets, which they probably are if they are used to eating gruel which is made of just cornmeal and banana, then they would also be introducing the pesticides. They should take every precaution to avoid using pesticides and “do no harm” to the children. In this case, the benefits of treating malnutrition do not outweigh the costs of harming infants with pesticides. If the women are cautious about using pesticides, the babies health can improve from the porridge and more mothers will buy it. In turn, the women’s livelihoods will improve from a successful product. Implications of this decision could be a rise in developmental defects due to the use of pesticides in addition to the higher nutrient levels of children. If the porridge gets proper approvals by the food or health sector of the government, then hopefully these issues could be avoidable. 

 

Part II

 

Facts of the situation

1. The co-op has been successful and the women are happy with the work they are doing.
2. The livelihood of the women was not improved because the money they earn is being spent on frivolous things by their husbands. But, the women do feel empowered by the work they are doing.
3. I see it as a problem that the money that the women earn is not improving the livelihoods of their families. I am still a board member of the women’s co-op for 6 months and am loved and respected by the community.
4. The other 6 members of the board are local women who want things to change, but they are not necessarily for or against taking the money back from the men.
5. Not achieving strategic social outcomes of improving the nutritional status of children (of the women in the co-op) and the livelihoods of rural households.

 

Ethical question

• To what extent can I interfere with the personal/family lives of the women in the co-op to ensure that there is an improvement in their livelihoods?
• What is my strategy to getting the goals of the cooperative back on track?

 

Stakeholders 

1. The original donor
2. Board members
3. Women involved in the co-op
4. Children and families with improved nutrition from the porridge
5. Children and families with unimproved nutrition (co-op worker families)
6. Husbands taking the money
7. Me 

 

Motivations of the stakeholders

1. The original donor
   1. Personal 
      1. Making the desired impact that is aligned with his/her own morals and goals of the project
   2. Professional
      1. Achieve higher nutrition levels in children and better lives for women in the co-op
2. Board members
   1. Personal 
      1. Avoid stirring up drama for something that does not concern them as much as it does me.
      2. Healthy children
   2. Professional
      1. Have a fully functioning co-op
3. Women involved in the co-op
   1. Personal 
      1. Feed their children good food
      2. Make their husbands happy
   2. Professional
      1. Make money that goes towards the family
      2. Feel empowered
4. Children and families with improved nutrition from the porridge
   1. Personal 
      1. Continue purchasing this decent product
      2. Health of the children
   2. Professional
      1. none
5. Children and families with unimproved nutrition (co-op worker families)
   1. Personal
      1. Improved nutrition levels 
      2. Wanting a better livelihood
      3. Not spending too much money on things that benefit the children 
   2. Professional
      1. none
6. Husbands taking the money
   1. Personal 
      1. Enjoy their life and continue to spend money on frivolous things
   2. Professional
      1. Not look embarrassed
7. Me
   1. Personal
      1. Maintain strong relationships with the women in the co-op and board members
      2. Ensure the safety of women in the co-op if they get into an argument with their husbands
   2. Professional 
      1. Meet the twin social outcomes of the project- improving nutrition levels while also improving livelihoods in rural households
      2. Social impact

 

Alternative solutions to the case study

 

1. Setting up a daycare facility at the co-op that cares for and feeds children with the porridge
   1. Pros
      1. Women would enjoy seeing their children at work
      2. Children would be fed
      3. Could potentially cost less than buying food for the women each day because they are already making the porridge that would be fed to the children and they would only need to pay one or two staff members to look after the children
   2. Cons
      1. Money would be taken from women’s wages to pay for the daycare employee and a small amount of porridge each day, but the rest of the money would still be going to the husbands “frivolous” habits
   3. Saving face: The husbands could potentially keep doing what they’re doing to some extent, but the women would be able to see their children each day and provide them with more nutrients if they eat the porridge. 
   4. Implications on relationships
      1. Short term
         1. Mothers would be able to see their children at work and provide them with higher nutrient levels, which would empower them and most likely strengthen their relationship with board members for providing this solution. 
      2. Long term
         1. Trust between the board and families for providing a solution that benefits each stakeholder
   5. Implications on venture
      1. Short term
         1. Tensions between husbands and board members is possible because the women are bringing home less money
         2. Restructuring of payment system
         3. Adding or designating staff responsible for organizing the daycare
      2. Long term
         1. Long term daycare employees would be required
2. Paying women with shares in the company
   1. Pros
      1. Women are not seeing the money they earn anyway, and the families tend to spend small amounts of money they have. In this scenario, they would (hopefully) see a large return on the money that was invested.
   2. Cons
      1. Requires strong book-keeping and trust among the company
      2. The co-op must be successful long-term in order for a return on investment
      3. Women would not bring home any money for husbands which could make them angry 
      4. Women may want their money sooner and not be interested in shares in the company
      5. Would not impact children’s nutrition levels in the short term
   3. Saving face: The board members would need to communicate with husbands and families in order to save face with the husbands and protect the wives. 
   4. Implications on relationships
      1. Short term
         1. If women don’t bring home money each day, it could poorly affect their relationships with their husbands
      2. Long term
         1. Women could build a strong relationship with board members because of the trust and hard work that is required to ensure a return on their money
   5. Implications on venture
      1. Short term
         1. Company could build up quickly by reinvesting all the overheads of paying the women into the company.
      2. Long term
         1. Growth of the company could help them impact more children in other areas and countries and could help fund other projects or ideas that the women at the co-op have. 

 

Best solution

 

1. Paying the women with nutritious foods or with free porridge to feed themselves or their children. The food would need to be perishable so that mothers do not sell the food on the black market for cash.
   1. Pros
      1. Goes back to twin social outcomes of benefitting family and providing nutrients to the children
      2. The co-op does not lose any money by doing this
   2. Cons
      1. Women would bring home less or no money because of the cost of food they are being given, so their husbands could potentially get angry and harm the women- could be given a choice of what share of their income is food and which portion is actual cash
      2. Non-perishable foods could be sold on the black market by women
   3. Saving face: The board members would need to ensure that women have consent from their husbands to choose this option because the money that the board would use to pay for food would come out of each woman’s salary.
   4. Implications on relationships
      1. Short term
         1. Husbands could be bitter at first that they have less money to spend on things they enjoy, at least initially. 
         2. It would take convincing the board members, so I would have to ensure that I have their trust.
      2. Long term
         1. Even more empowerment for the women which could minimize any resentment towards husbands. 
         2. Success could result in strong relationships with each member of the women’s co-op and families because the co-op helped the families achieve a better lifestyle.
   5. Implications on venture
      1. Short term
         1. Tensions between husbands and board members is possible
         2. Restructuring of payment system
         3. Adding or designating staff responsible for coordinating food.
      2. Long term
         1. Empowered women that work at the co-op
         2. Healthier children 

The facts of the situation: 

1. Jack was an American student working on a social venture in Kenya for five months
2. International donor organization donated gifts
3. Jack lived and interacted with kids at the youth center
4. Jack handed out the gifts
5. 4 children were not given gifts ceremoniously like the rest. They were given black hats instead, and it was after the ceremony. 
6. The staff did not think there was an issue and are angry that Jack is blaming them for a “trivial” matter.
7. Jack thought it was unfair for the 4 children to not get the same treatment as the rest. 
8. Jack wants to keep a good relationship with the children and the staff members at the youth center.

 

The stakeholders

1. Jack 
2. Staff at the youth center
3. 4 kids that received black hats
4. Kids that received other gifts (secondary stakeholders- their motivations do not affect the situation or best course of action)

 

Motivations (personal and professional) of the stakeholders

1. Jack
   1. Personal:
      1. Wants the kids to like him and the staff to like him since he will be working there for 5 months
   2. Professional:
      1. Good relationships with the children and staff could build trust and help him do better work
2. Youth center staff
   1. Personal:
      1. May see Jack as an outsider that is looking down on the work they’ve done
      2. Probably have a passion for children and social work if they work in a youth center
   2. Professional:
      1. In this situation, they wanted to distribute the gifts they were donated by the national organization.
      2. Want a strong relationship with the children to succeed at their job
      3. Keep a good relationship with Jack to preserve the relationship with his institution 
      4. Don’t want trivial things to get in the way of the good work they are doing at the youth center
3. Kids that didn’t receive gifts
   1. Personal: 
      1. Wanted to get a gift
      2. Possibly more importantly, they wanted to get a gift ceremoniously and feel as important as the other kids.
   2. Professional: 
      1. N/A

 

Ethical Questions:

1. Should Jack dwell on a situation that could make his relationship with the youth center and the children even worse?
2. Should Jack have a say in how the youth center approaches situations, especially as a newcomer?

 

Alternative solutions for this case study

1. Drop the situation and do nothing
   1. Pros:
      1. The issue is not repeatedly brought up.
      2. The staff does not think of Jack as a “children’s rights activist”
      3. Jack maintains a good relationship with the staff who thought the matter was “trivial.”
   2. Cons:
      1. The four children may stay upset and may continue to blame things on Jack because he was the one distributing gifts.
      2. The other children could make fun of the four children that only got black hats
      3. Jack could continue to feel bad for the children and may have a strained relationship with them.
2. Jack could continue to talk about the situation and explain to the staff where he was coming from. 
   1. Pros:
      1. Jack could potentially save face from the staff thinking poorly of him and build trust and friendship with the kids or the employee at the center.
      2. The kids could possibly get more sympathy from the youth center staff after they have a conversation with Jack.
         1. It may result in gifts for the children that were originally overlooked.
   2. Cons:
      1. The staff could be angry with Jack for continuing to dwell on the situation. They may continue to think of him as a “children’s rights activist.”
         1. The staff may also be angry at Jack for knocking the good work they’ve done. 
         2. The conversation could also result in the children getting better gifts, but the youth center would need to purchase them with money from their own pocket. 
      2. The children who didn’t get gifts could feel worse because the situation continues to be brought up. 

 

Best approach

1. Jack wears a black hat and does not bring the situation up to the youth center staff again. 
   1. Pros:
      1. Jack looks good in the eyes of the youth center staff because he does not come to them about the situation again. He also maintains his relationship with the children because they will feel better that Jack has the same gift as them.
      2. The children could feel better about not getting a gift during the ceremony if Jack has the same thing as them. They would have a better appreciation for the gift they did receive and possibly forget about not getting them ceremoniously.
      3. The youth center staff can move past the situation and focus on other events and issues at hand.
   2. Cons:
      1. The children who did receive gifts could feel bad that they can’t dress like Jack, but they will most likely get over it and be happy with the gifts they already got.
   3. Consequences and shortcomings
      1. The kids will only feel better from the hat if they think Jack is cool and want to dress like him. 
      2. The youth center staff most likely won’t care if Jack wears a hat like the one the kids received. They will probably happy that Jack did not continue to try to talk to them about the situation and solved it on his own. 
      3. Jack maintains a good relationship with the staff and the four children that didn’t get gifts, but now the other children may be jealous. If that were the case, Jack could play with them more and remind them of how grateful they should be for their gifts. 

 

Impact of the decision on the venture

• This solution would hardly impact the goal of the youth center/ Jack’s venture. It would preserve Jack’s relationships with both the youth center staff and the children who did not receive any gifts. He would not be seen as an outsider that is looking down on the work that the youth center has already done, and the kids will most likely feel better about the fact that they each got black hats unceremoniously because they get to keep the gifts they got and look like Jack. In Sierra Leone, children loved getting to talk to us and would even run home to tell their friends if one of us just gave them a fist bump. The decision could also maintain the youth center’s relationships with Jack’s institution. Economic implications of the decision could be that the youth center does not have to spend any of their money to replace the children’s presents or hold any other events. 

• The facts of the situation:
  1. There is a disease-causing pathogen in the research area, and community members are already aware that it is there.
  2. We want to test the water with the goal of understanding the lifecycle and characteristics of the disease-causing pathogen.
  3. We would need help finding the different water sources and learning how and where the water is stored but paying community members is optional.
  4. There are 75 families and 500 people in the community of focus.
  5. We are sending 11 academic researchers that will be in Lesotho for 2 weeks.
  6. There is an expectation by researchers that the research could result in publications and potentially a treatment for the water.
• The stakeholders
  1. 11 researchers
  2. Community members
     1. Those drinking the water
     2. Those that are helping us find the sources of water
  3. Lestho government
  4. Funders for the researchers
  5. The researcher’s academic institution
  6. Agency that would sponsor the invention and application of treatment
• Motivations of the stakeholders
  1. 11 researchers
     1. The 11 researchers’ goal of the project is to better understand the disease-causing pathogen. Their motivation in doing the research is publication. We can also assume that they are interested in some sort of social impact because they chose this location and study to conduct their research.
  2. Community members
     1. Those drinking the water
        1. The community members that are consuming the water are motivated by the possibility of a clean source of water for their safety and quality of life. This implies that they hope or expect that the research will result in treatment of the water.
     2. Those that are helping the researchers find the sources of water
        1. These community members would also be motivated by the potential of clean sources of water. They could also be motivated by some sort of perk (i.e. free food) in exchange for their help. Moreover, they could be seeking compensation for their help for things like transport or their time.
     3. Lesotho government
        1. The Lesotho has a stake in the research because the disease-causing pathogen affects many of their water sources and citizens. Hopefully, their primary motivation of research is to protect the health and safety for their people. The research could also result in political capital/votes, and economic growth, and stronger relationships with foreign institutions.
     4. Funders for the researchers
        1. Organizations that fund the research/researchers are motivated by a return on investment. In this case, social ROI could be
     5. The researcher’s academic institution
        1. The academic institution’s motivations for research are return on investment and recognition for the research done.
     6. Agency that would sponsor the invention and application of treatment
        1. Motivations for this agency would be that researchers achieve their goal of characterizing the disease-causing pathogen so that they can create a viable treatment

• Alternative solutions for this case study
  1. First, we decided on the ethical questions that are relevant to the current situation. The first and most important being, is it ethical to conduct this study? This is not a study on human subjects as the researchers are only collecting data from the water sources. Additionally, community members have something to gain from the research without ethical questions in the way. Similar to what the class decided, we could not think of any reasons the research was unethical (connect to the 3 basic principles of ethics). One question that we did consider was: Are the researchers exploiting people for their time and knowledge for their own gain in publication, notoriety, and potential impact? We attempt to answer this question in our alternative solutions, as the current situation is providing nothing to the community members that assist in research.
     1. One potential solution could be providing workers with compensation for their time spent away from their main source of income. The researchers could pay community members for their time lost in the form of an hourly or daily rate. Paying helpers a fair compensation follows the ethical principle of beneficence. Pros of this approach are that people may be more willing to participate if they know they can get something from us, and the researchers could get all the data more efficiently if they are paying people to help get the job done. Cons of the research are that more funding would be required to pay community members each day, and a fair payment structure would need to be developed for individuals helping us.
     2. Another approach could be not paying the individuals who are helping at all but compensating them in other ways like paying for their gas or helping them carry things. Researchers could even tag along with women or community members that are already going to the water sources each day. This approach allows community members to still have some incentive, but the researchers would not have to dish out as much money. With a smaller incentive, helpers may have less motivation to get the data done quickly and efficiently.
     3. The last potential approach is to partner with an NGO or community organization to let them make the decisions and payments. Researchers could still want to compensate the workers, but because the researchers know less about the community and its members, they could let someone else handle the task of choosing who is best to help find watering sources. In this case, the individuals could still get compensated, and the community/NGO could pick the best candidates for the job by having a knowledge of the community. On the other hand, the NGO or community would have to be responsible for paying the employees. While the research could benefit them in the end, they may not have the resources for payment, it is not fair for them to pay employees that they are not directly using.

• Additional assistance- The team used our experiences in Sierra Leone and the Phillippines to make an informed decision.
• In this case study, I would choose an approach similar to solution one. In two weeks, it is difficult to get organized, find data sources, and collect data without knowledge of the place you’re in. In order to get data most efficiently, I think that it’s important to pay individuals that help so that they are motivated to spend their time with the researchers. Additionally, if the same individuals are paid each day, they can build a rapport with the researchers. This approach worked really well for us in Sierra Leone. Our team had three translators that we paid a daily rate. By the end of our trip, we had gotten extremely close with them, and we could tell that they were really invested in our research. They didn’t even have to ask us questions for the mothers by the end- they knew the answers themselves. Working with an NGO was also very useful not just for our translators to see the weight behind what we were doing but also for the community members we were helping, so I would recommend that this study also partners with an organization on the ground. The researcher’s goal is to collect data on the data on the life and characteristics of this disease-causing pathogen, and this approach could easily get them that data in the most efficient way.