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Addressing the Shame Imposed by Healthcare Providers on Individuals with HIV/AIDS – Using Change Models and the SPELIT Power Matrix to Provide Cultural Sensitivity Training to Physicians and Nurses in Belize

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by Tabia Richardson

 

Abstract

According to the literature, “the United Nations Agency for International development and the World Health Organization estimated that 33.2 million people worldwide had HIV/AIDS in 2007 with an estimated 1.6 million living in Latin America” (Andrewin & Chien, 2008, p. 897) and the rates of prevalence and incidence were increasing worldwide. In Belize the contempt associated with HIV/AIDS is great because the “acquisition [of this disease] is perceived to be a result of immoral and voluntary actions, [due to] homosexual and promiscuous sex and the sharing of infected needles among injection drug users” (Andrewin et al., 2008, p.897). More specifically, the literature asserts that for these patients, their first experience with rejection comes from healthcare providers for whom diagnose and treated them (Andrewin et al., 2008).

This proposal is being submitted to the 4th Annual Conference of the International Center for Global Leadership in Placencia, Belize. This conference highlights different phenomenon for which global leaders offer their attention. HIV/AIDS has been on the radar for global health leaders because it not only affects health care providers, but a number of industries worldwide. This proposal highlights the phenomenon of contempt that is prevalent amongst healthcare leaders for whom serve HIV/AIDS patients worldwide, but more specifically in the country of Belize. It is hoped that through offering training, the issue of contempt may be addressed and eventually eradicated as it relates to individuals afflicted with HIV/AIDS no matter the vector of contraction.

Introduction

Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome (HIV/AIDS) is a debilitating disease that can be deadly, and for some, comes with a stigma. This is a disease that is said to be an equal opportunity disease that affects people of every gender, age, race; and nationality. It can be contracted from mother to newborn, from man to man, man to woman; and can be contracted through the inappropriate handling of medical procedures.

In many countries around the world, this disease has reached pandemic levels. Due to its severity and sometimes the shame associated with it, when some people are diagnosed with this disease, they may feel as if they have the proverbial scarlet letter embossed on their person for all to see.

According to the literature, HIV/AIDS is a global health issue that causes those diagnosed with the disease to sometimes want to hide from the diagnose rather than acknowledge and confront it (Andrewin et al., 2008). In fact, “in Central America, the fear of the negative consequences of disclosing one’s HIV status – a key step in building alliances amongst patients and empowering communities living with HIV – is based on concrete instances of rejection and discrimination” (Gonzalez & Colon, 2014, p. 11). Thus, HIV/AIDS is a global health issue that needs to be better addressed by healthcare organizations. Although this disease is a well-known global health issue, interestingly it  is infamous for the silence it evokes.

In 1987, “HIV was first diagnosed in Belize” (Pope, 2012, p. 1161). It is thought that the disease came to Belize from abroad from people who migrated to the country (Pope, 2012). However, once HIV/AIDS became prevalent in the country, and its effects were fully understood by the healthcare professionals, for cultural and religious reasons, its existence was somewhat ignored as well as the people who contracted the disease (Pope, 2012). Therefore, the purpose of this paper is to discuss ways to erase the disdain associated with an HIV/AIDS diagnose for Belizeans by training healthcare professionals to treat these patients with compassion rather than contempt as they fight this disease.

Literature Review

In the article written by Andrewin et al (2008), entitled “Stigmatization of patients with HIV/AIDS among doctors and nurses in Belize”, the authors performed an observational study in 2007 of 230 healthcare providers who diagnosed and treated HIV/AIDS patients. The researchers found that the “stigmatization imposed on patients was greatest [due to] ‘attitudes of blame/judgment’ [that were] inflicted on those with the disease” (Andrewin et al., 2008, p. 900) by doctors and nurses. They also learned that, due to the healthcare professionals’ negative feelings toward the HIV/AIDS patients, the physicians and nurses who treated them were involved in such unethical practices as “sharing a patients HIV status with colleagues without the patients’ permission, testing patients for HIV/AIDS without the patients’ consent, treating patients with HIV/AIDS with disdain compared to other patients; and they found that female nurse healthcare professionals, who spend the most time with these patients, showed more differential treatment than their male physician counterparts” (Andrewin et al., 2008, p. 902). The researchers concluded that there was a need for healthcare professionals to receive training on how to better serve patients with HIV/AIDS and that future research should investigate this phenomenon.

In the article “Therapeutic imaginaries in the Caribbean: competing approaches to HIV/AIDs policy in Cuba and Belize” (2012), the author highlights the historical differences found in the care of HIV/AIDS patients in Cuba versus those in Belize (Pope, 2012). The researcher showed how initially Cuba stigmatized HIV/AIDS; however, overtime, its healthcare system decided to provide “education about sexually transmitted infections, access to primary care, and culturally appropriate disease control” (Pope, 2012) in order to reduce the incidence and prevalence of the disease. Pope stated that unlike Belize, and its handling of this disease, the Cuban constitution mandates that medical care be granted to all; thereby permitting that all “persons living with HIV are guaranteed adequate medical care” (Pope, 2012, p. 1159) and because of this mandate, Cuba “has reduced the stigma associated with HIV and therefore has reduced negative stereotypes associated with this disease” (Pope, 2012, p. 1160). Conversely, the article showed that unlike Cuba, Belize struggles with the stigma associated with this disease. According to Pope (2012), in Belize, HIV/AIDS is seen as a “moral disease that is a result of immoral acts and thus there is no education offered” (Pope, 2012, p. 1161) concerning prevention or maintenance of this disease.

SPELIT

A proposed way to address the matter of compassionate HIV/AIDS healthcare delivery in the Belizean healthcare system is through the SPELIT Power Matrix (Schmieder-Ramirez & Mallette, 2007). The premise of The SPELIT Power Matrix (Schmieder-Ramirez et al., 2007) is that it assists in analyzing the environment in which an organization exists before implementing change. The acronym SPELIT stands for S: Social Environment, P: Political Environment, E: Economic Environment, L: Legal Environment, I: Intercultural Environment; and T: Technological Environment. To assess the Belizean healthcare system with the proposed organizational change, evaluating the following tenets of the SPELIT is imperative:

S: Social Environment – Belize gained independence in 1981 from the United Kingdom. The population of Belize is 377, 968 people (“United Nations”, 2016). According to the United Nations Agency for International Development, there are “3,600 adults who are 15 years old or older reported to be living with HIV/AIDS: 1,700 women and 1,800 men” (“United Nations”, 2016). In Belize’s 2015 Ministry of Health report, it is documented that of those Belizeans diagnosed with HIV/AIDS, “30.8% of them have experienced discriminatory attitudes because of their disease” (“Ministry of Health”, 2015).

P: Political Environment – Belize has two major political parties: People’s United Party and the United Democratic Party. The country also is a member of such global organizations as the United Nations, the Association of Caribbean States, and the Organization of American States.

E: Economic Environment – Belize has an agricultural economy where the main crops are sugar and bananas. The countries it trades with most frequently include: United States, Mexico, Europe; and other Central American countries – all of whom have experienced the effects of HIV/AIDS (“United Nations”, 2016).

L: Legal Environment – Belize has its own Constitution and functions under the Common Law of England. It has three different branches of its judicial system: Magistrate Courts, Supreme Court, and a Court of Appeals. As of 2003, it also is a member of the Caribbean Court of Justice with other Caribbean Nations (“World Encyclopedia”, 2016). While the treatment of HIV/AIDS patients is a human rights issue, unlike Cuba, the Belizean Constitution does not include language on the expectations of treatment for these individuals (Pope, 2012).

I: Intercultural Environment – There are a number of cultural groups living in the country including Mestizos, Creoles, Mayans, Garinagus, Mennonites, East Indians and Chinese. The country’s main language is English, but Belizean Creole, Spanish, German, and other indigenous languages are spoken.

T: Technological Environment – In 2008, Belize instituted an electronic medical record system to keep track of diagnosed HIV/AIDS patients (“Ministry of Health”, 2016). The Ministry of Health introduced this system in order to “improve capacity to monitor patients and facilitate care of people with and getting tested for” (“Ministry of Health”, 2016) having this disease. Similarly, in 2010, the Ministry of Health implemented a computer-based system called the “2010 Care-Based Surveillance System” whose purpose was to gather and store demographic information on all known Belizeans who had been diagnosed with HIV/AIDS (“Ministry of Health”, 2016).

After evaluating the areas of the SPELIT (Schmieder-Ramirez et al., 2007) and the literature, perhaps Belize could benefit from an organizational change in how healthcare organizations there address the needs of HIV/AIDS patients.

Change Models

According to Andrewin and Chien (2008), “HIV/AIDS stigma discrimination compound the challenge of getting the pandemic under control” (Andrewin et al., 2008, p. 897). Surprisingly, “the healthcare setting has been identified as one of the major settings in which stigmatization urgently needs to be addressed” (Andrewin et al., 2008, p. 898) and the authors acknowledged that “little is known or documented about the attitudes and practices of healthcare workers in Belize regarding the treatment of HIV/AIDS patients” (Andrewin et al., 2008, p. 898). Therefore, because of the latter, this proposal suggests that Belize implements a community-based, health promotion intervention that can be conducted with healthcare professionals. The objective of this program would be to train physicians and nurses on how to offer competent and individualized care that would show compassion and understanding to patients who are diagnosed with HIV/AIDS — regardless of how they may have contracted the disease. This training program could also afford health care professionals a “safe place” to express and work through their biases regarding HIV/AIDS patients amongst their peers. The hope would be that, in such an environment, they would be able to acquire the tools to help to eliminate their biases. By learning new ways to render compassionate healthcare to these patients, the healthcare providers may become the non-judgmental entities these patients need to encourage and empower them to became self-efficacious as they manage their diagnosis.

When initiating organizational change in a healthcare system such as Belize, it is important to substantiate the changes by referencing theoretical change models. One change model that could be implemented to help destigmatize HIV/AIDS in Belizean medical facilities is Kurt Lewin’s Action Research Model. This model has four components to effect change: 1. Field Theory, 2. Group Dynamics, 3. Action Research; and 4. the 3-Step Model of Change (Burnes, 2004). Therefore, in keeping with Lewin’s change model, the concept of Field Theory depicts the “field” as the environment where the organizational change occurs. Thus, the field would be the Belizean medical facilities (Burnes, 2004). In endeavoring to change the perceptions physicians and nurses have toward HIV/AIDS patients, it would be necessary to also use Lewin’s Theory of Group Dynamics which states that “understanding the internal dynamics of a group is not sufficient by itself to bring about change, but that there is also the need to provide a process whereby the members could be engaged in and committed to changing their behaviour.” (Burnes, 2004, p. 983). Thus, it would be imperative that the feelings and perceptions of the Belizean physicians and nurses be regularly assessed so that the proposed organizational changes could properly take root in medical settings (Burnes, 2004). Also, to further assess the organization, an important aspect would be to determine to what extinct patients as well as healthcare professionals felt that the organizational change would benefit the organization. The latter is an example of Lewin’s principle of Action Research which “recognizes that successful action is based on analyzing the situation correctly, identifying all the possible alternative solutions and choosing the one most appropriate to the situation at hand” (Burnes, 2004, p. 983) by assessing the “felt-need” (Burnes, 2004, p. 983) of those involved is addressed. Thus, the “felt-need is an individual’s or group’s inner realization that change is necessary” (Burnes, 2004, pp. 983-984).  To summarize the literature states that “unfreezing or getting rid of the former organizational norms before wholeheartedly implementing the changes in an effort for the medical professionals to “unlearn” their old organizational behaviors” (Burnes, 2004, p. 985) is imperative and thus the main goal of change management. The literature also states that when implementing the second step of organizational change called “moving” (Burnes, 2004, p. 985), it is necessary to try not to “predict or identify a specific outcome from Planned change” (Burnes, 2004, p. 985), but instead to allow organizations to be open to whatever the results that are initiated by the change (Burnes, 2004, p. 985). Finally, the last of the three steps is “refreezing” (Burnes, 2004, p. 985), which would help the health professionals to maintain the organizational changes they make overtime (Burnes, 2004).

Another change model that could be used to help the Belize healthcare system deal with the proposed organizational changes is Woodard’s Leading and Coping with Change Model (Woodard & Hendry, 2004). According to the literature, Woodard and Hendry cautions that “when change processes require fundamental shifts in the way organizational members think and act, the consequences of change can test to the utmost the organization’s capabilities and resources” (Woodard et al., 2004, p. 156). Woodard and Hendry affirm that when implementing this theory, it is imperative to offer “support for employees to learn new competencies, through formal coaching, helps them to develop the skills to manage the new situations they are faced with” (Woodard et al., 2004, p. 168) because as the change unfolds, employees continue to evaluate what is going on, and apply various coping strategies thus the premise behind this paper.

Conclusion

HIV/AIDS is a serious global health phenomenon. It has a particularly harmful impact in countries where the disease is attached to negative societal perceptions – especially when these perceptions negatively impact the patients which is the case in Belize (Andrewin et al, 2008). Thus, in order to gain a true understanding of this phenomenon, it is imperative to research it further. The need to ascertain the true biases that some healthcare providers have toward this patient population are interesting as this is a profession that takes an oath to help all people and to do no harm while doing so. Therefore, to learn that there are some healthcare providers who contribute to the contempt that some in Belizean society may hold towards those diagnosed with HIV/AIDS is unfortunate. The objective of this proposal is to use the SPELIT Power Matrix (Schmieder-Ramirez et al., 2007) to help to identify ways that the healthcare system in Belize might implement organizational change by instituting training for its healthcare providers, as outlined in this proposal, in order to inject more compassion into the business of treating HIV/AIDS patients in Belize.

 

References

Andrewin, A., & Chien, L. (2008). Stigmatization of patients with HIV/AIDS among doctors and nurses in Belize. AIDS Patient Care and STDs, 22(11), 897-906.

Burnes, B. (2004). Kurt Lewin and the planned approach to change: a re-appraisal.

Journal of Management Studies, 41(6), 977-1002. Gonzalez, M.A., & Colon, M. (2014). Black Central Americans in the struggle against AIDS.

NACLA Report on the Americas, 11-13.

Ministry of Health, Belize (2015). Annual HIV Statistical Report 2015. Retrieved on December 3,

2016 from http://www.health.gov.bz/www/publiations/hivaids/877-hiv-annual-report.2015

Pope, C. (2012). Therapeutic imaginaries in the Caribbean: competing approaches to HIV/AIDS policy in Cuba and Belize. Annals of the Association of American Geographers, 102(5), 1157-1164.

Schmieder-Ramirez, J., & Mallette, L.A. (2007). The SPELIT Power Matrix, Untangling the Organizational Environment with the SPELIT Leadership Tool. San Bernardino, CA: BookSurge, LLC.

United Nations Development Programme in Belize (2016). Retrieved on December 7, 2016 from

http://www.bz.undp.org/content/belize/en/home/countryinfo

Woodard, S., & Hendry C. (2004). Leading and coping with change. Journal of Change Management, 4(2), 155-183.

World Encyclopedia of Nations (2016). Retrieved on December 7, 2016 from  http://www.encyclopedia.com

Growth Strategy for Belize

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by Ramzan Amiri

 

INTRODUCTION

Belize is a country in Central America bordering the Caribbean Sea. Key neighboring countries include Honduras, Guatemala, and Mexico. The geography of Belize is mainly flat with low mountains in the south. The government system is a parliamentary democracy and a Commonwealth realm; the chief of state is the queen of the United Kingdom, and the head of government is the prime minister. Belize has a mixed economic system which includes a private-enterprise system, combined with centralized economic planning and government regulation. Belize is a member of the Caribbean Community (CARICOM).

Economic reform in Belize has been uneven, institutional weaknesses and lingering policy have constrained dynamic growth in many parts of the economy. Recovery from the recent economic slowdown has been anemic due to limited entrepreneurial activities in the private sector.  Tariff and non-tariff barriers have been burdensome, and the high cost of domestic financing is significantly impacting the private-sector from investment and economic diversification.   The judicial system is influenced by the politicians and corruption has become a common practice (Heritage Foundation, 2018).

Belize has a young population with a median age of 22.7 years with an age structure of 0-14 years at 33.95%, 15-24 years at 20.55%, 25-54 years at 36.62%, and 55 and over at 8.88% (The World Factbook, 2017).  But the school system is not adequate to support the large young population which has resulted in low literacy rate as well as a dropout rate beyond 8th grade to 50% (Pathlight International, 2018).

Belize has opportunities to become a strong economic player in the region due to its small size, which gives them the agility, and its location of bordering with some of the larger Countries, i.e., e. Mexico, Honduras, and Guatemala. Potential is there for trade agreements, maquiladora model of manufacturing/assembly due to Belize’s low salary and a high unemployment rate of the population between the ages of 15-24. According to CIA factbook (The World Factbook, 2017), the unemployment rate of ages 15-24 in Belize is 18.9%, while Mexico has 7.7%, Guatemala has 4.8%, and Honduras at 14.2%. This could be a good opportunity to get some foreign direct investment in from those countries with proper tax incentives and also get young adults employed. Additionally, Belize government does not seem to have a viable long-term definitive plan or a strategy to move the country forward. A10-year economic transformation plan with the help of IMF, World Bank and some of the larger NGOs would create a purpose and meaning for the Government and the People.  Furthermore, with an effective marketing strategy, engaging Belizean and mobilizing them would be a tremendous benefit to the transformation process. This engaged approach will uplift the morale, inspire the population, as well as create a cohesive culture of ownership and pride (Sinek, 2009).

ENVIRONMENT SCAN (SPELIT)

The environmental scan using Social, Political, Economic, Legal, Intercultural, and Technological (SPELIT) framework (Schmieder, 2007) reveals several opportunities to transform Belize to a vibrant and competitive economic powerhouse in the Central American Region.

Following represents my first-hand observation using SPELIT framework as a method of analyzing the business environment. This was accomplished during my recent visit to Belize as part of Pepperdine University Business Policy analysis team and speaking with some of the local business people.

S= SOCIAL

  • Migration continues to transform Belize’s population.
  • About 16% of Belizeans live aboard, while immigrants constitute about 15%.
  • The emigration of a large share of Creoles and the influx of Central American immigrants, many Guatemalans, Salvadorans, and Hondurans, has changed Belize’s Ethnic composition.
  • Mestizos have become the largest ethnic group, and Belize now has more native Spanish speakers than English or Creole speakers, despite English being the official language.
  • All cultures appear to live in harmony

P= POLITICAL

  • Complaints of lengthy bureaucratic delays and corruption serve as disincentives to foreign investments.
  • Belize lacks political risk insurance, and as a practice rarely engages in title insurance on real estate property transactions.

E= ECONOMIC

  • Belize’s economic freedom score ranks 23rd among the 32 countries in the Americas region, and its overall score is below the regional and world averages
  • Economic reform in Belize has been uneven, and more dynamic growth is constrained by lingering policy and institutional weaknesses in many parts of the economy.
  • Burdensome tariff and nontariff barriers and the high cost of domestic financing hinder private-sector development and economic diversification.
  • Tourism is the number one foreign exchange earner in this small economy, followed by export of sugar, bananas, citrus, marine products, and crude oil.

L= LEGAL

  • Governance is weak with high levels of corruption.
  • Unreliable land title certificates have led to numerous property disputes involving foreign investors and landowners.

I= INTERCULTURAL

  • Most Belizeans are of multiracial descent. About 52.9% are Mestizo, 25.9% Creole, 11.3% Maya, 6.1. % Garifuna, 3.9% East Indian, 3.6% Mennonites, 1.2% White, 1% Asian, 1.2% Other and 0.3% Unknown.
  • In the case of Europeans, most are descendants of Spanish and British colonial settlers, whether pure-blooded or mixed with each other.
  • Most Spanish left the nation just after it was taken by the British colonists who, in the same way, left after independence. Beginning in 1958
  • German and Russian Mennonites settled in Belize, mostly in isolated areas.

T= TECHNOLOGY

  • Wi-Fi is a challenge in most parts of Belize. The speed is very slow, and connectivity is unreliable.
  • The government decided in 2016 to install fiber optics connection throughout the country. This is a three-year project and appears to be going well. The installation has taken place in a couple of the larger cities including the Capital, Belmopan.

 

PROBLEM STATEMENT

The key challenge the Belize Government appears to face is stagnant GDP growth which is impacting government from making any infrastructure investment, consequentially, impacting Foreign Direct Invest (FDI).

Some of the key infrastructures that are lacking include educated workforce, supply chain infrastructure, and facilities to support manufacturing or technology industries. The most critical challenge appears to be there is no plan in place by the Government to educate the workforce. 50% of the Belizean children do not attend high school, 40% of the Belizean live in poverty and cannot afford to send their children to school or purchase books, and worst of all 23% of the Belizeans over the age of 15 cannot read or write (Pathlight International, 2018).  One of the schools the Pepperdine Team visited had a library but was locked, and no one knew where the key was. We were told the library had not been used for years. One high school Principal we spoke to about computer class mentioned that they have a few desktop computers, but half of the computers are not working and the few that are working are being used to teach students typing. It appears there is no clear understanding of how these assets they already have should be effectively utilized.

The issue of lack of education is further exasperated with the government policy which supports free education only up to grade 8, with 9th through 12th-grade students having to go through a government approval process for funding. The approval process lacks credibility, and generally poor children are left out.  Furthermore, K-12 schools do not have adequate qualified teachers which unfortunately impacts the entire learning and mentorship culture.

In summary, Belize is not an attractive place for any sort of commercial investments. The country lacks basic infrastructure, and the government policies add another layer of complication for local and foreign businesses.

OBJECTIVES AND ACTION STEPS

Below are four key measurable objectives with specific actions items to consider getting Belize into the global business arena. Timeline and cost will be determined once a strategic team is formed and priorities are defined. The plan would be put in place with the help of IMF and World Bank:

  • Effective Capitalization of Human Resources (measurement: enrollments in secondary school and completion, salary growth, number of skilled jobs filled vs. open)
    • Engage NGOs with specific objectives that align with Belize’s long-term transformation plan
    • Teacher training to be accelerated
    • Update education system and policies
    • Introduce trade schools with courses that align with the industry cluster plan
    • Upgrade immigration policy to attract skilled workers
  • Improve living standards of Belizean (measurement: Income per capita growth) (home ownership by Belizean)
    • Job creation in information technology and manufacturing sectors – high paying jobs generates increase tax as well as internal demand for consumer goods. This will allow Belize to move towards consumer economy leading to additional investments in manufacturing and service sectors.
  • Increase foreign direct investments (FDI) (measurement: $ investment by foreign businesses) (Real Estate development and demand)
    • Work with IMF and World Bank to develop infrastructure in the areas of broadband development to connect with the rest of the world
    • Improve trade policies to attract investment
    • Provide incentives for investment in Commercial Real Estate
  • Develop Industrial Clusters (measurement: number of businesses and employment in the targeted clusters)
    • Define two areas of Industrial clusters where Belize can be known as having skills and capability as most competitive in the region, i.e., technology, high skilled manufacturing capability

RECOMMENDED POLICY CHANGE

A nation’s competitiveness depends on the capacity of its industry to innovate and upgrade (Porter M. E., 2008). The current protectionist trade policy of tariff on products needs to be abolished to increase global competitiveness. Companies generally achieve competitive advantage through the acts of innovation. Protectionist policies hinder innovation and stagnates growth due to limited demand.

ALTERNATIVES

There are no alternatives other than rapid acceleration with the help of government intervention in increasing the money supply. Belize is running at a deficit for quite some time, and at some point, the government will start to miss debt payments which will further deteriorate the ranking of the country.

PARTNERING

  1. Taiwan seems to have a big presence in Belize and participates in student exchange program as well as given grants/loans to Belize government for economic development. In August of 2017, Taiwan gave a grant of US$20 million to Belize and additionally a loan of US$40 million(Ramos, 2017). It appears this relationship can be further solidified if some sort of incentivized long-term economic development agreement can be achieved.
  2. Pathlight International is a California based 501 c3 organization, and their focus has been teacher development as well as helping students with scholarships, transportation, nutritious meals, afterschool academic tutoring, etc. They established their organization in Belize in 2007, since then they have trained over 600 teachers and 50 principals. They also have ongoing training programs for teachers to further enhance the learning environment for students(Pathlight International, 2018). They are currently successfully working in Belize City and Belmopan which can be further expanded to some of the urban areas.
  3. A partnership that appears to be missing is a hands-on third-party economic advisory committee to help Belize government put together a solid path for growth. Belize has a significant number of assets that can be effectively utilized to transform the country into a major economic player in the central/Latin American regions. There are several economic models that can be looked at, i.e., The Bahamas, which has a similar size population and a relatively young country but has a GDP three times the size of Belize. Another, yet extreme example is Singapore, which has a significantly larger population but went through a lot of struggle since their independence in 1965, has a GDP US$ 504.9 Billion, 15 times larger than Belize and income per capita of UD$90,500 as compare to Belize with a GDP of US$ 3.23 billion and income per capita of $8,300. So, the opportunities are there for Belize to focus and make purpose driven strategic plan to become successful.

LESSON LEARNED

  • Strong leadership with a purpose and meaning is critical to engage people and drive growth.
  • People are the biggest asset in a country or an organization. Putting them first is a critical success factor for successful growth.
  • Education and continuous training are essential for a country or an organization to innovate and grow.
  • Protectionist measures are detrimental to competitiveness and drive to excel.
  • The government has a responsibility to adjust fiscal and monetary policies as the global competitive landscape changes. Productive society leads to GDP growth.

REFERENCES

Bohlander, G. a. (2010). Managing Human Resources. Mason: South-Western Cengage Learning.

Heritage Foundation. (2018). Retrieved from The Heritage Foundation: https://www.heritage.org/index/country/belize#

Mell, A. a. (2014). The Rough Guide to Economics. London: Rough Guides Ltd.

Pathlight International. (2018). Retrieved from Pathlight International: https://pathlight.org

Porter, M. E. (2008). On Competition. Boston: Harvard Business School Publishing Corporation.

Ramos, A. (2017, August 09). Taiwan Gives Guatemala over $600 Million in Funding. Amandala, p. 1.

Schmieder, J. a. (2007). The SPELIT Power Matrix. June Schmieder-Ramirez and Leo A. Mallette.

Sinek, S. (2009). Start with Why. New York: Penguin Group.

The World Factbook. (2017, July 01). Retrieved from The World Factbook: http:// www.cia.gov/library/publications/the-world-factbook

 

 

 

 

Global Leadership Reflection of Belize: Ya Da Fu We (Belizean Independence)

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by Ed Eng

 

1. Introduction/background

Belize is home to a very functional democracy, with great emphasis on order, education, and the inclusion of all social classes in one democratic process.  The country is a good example to its regional neighbors, able to carry out peaceful, cooperative elections, with a strong emphasis on participation.  This political stability has contributed greatly to the country’s positive relationships with regional neighbors and with countries around the world.  The stable and cooperative nature of Belize and its economy make for a healthy cooperative environment.  However, in order to attract high-growth startups and investments to the country, the Belize government should consider adopting alternative approaches to bring in new investment, develop a robust pipeline of skilled workers, and grow the middle class.  This paper will begin with an environmental scan to assess strengths and opportunities in Belize, followed by a discussion of the main leadership challenge facing the government, and finally, a set of proposed recommendations for policy changes and action plan to strategically grow the economy.

2. Environment of the issue (SPELIT)

In this section, I will be using the SPELIT Power Matrix as the framework for my environmental analysis to assess the strengths and opportunities for change.  This methodology was chosen over other tools because it includes a focus on the human dimension as well as other strategic factors (Schmieder-Ramirez & Mallette, 2007).

Social

There are distinct degrees of socioeconomic inequality based on wealth, power, and status.  This unequal standing is further stratified according to skin color and ethnicity. At the top echelon, there are lighter-skinned Creoles, mestizos, and newly arrived North Americans, East Indians, and Middle Easterners.  These higher-level groups retain control of the two political parties and the retail trade sector.  At the lower levels, there are darker-skinned Creoles and Garifuna who are largely unemployed.  The Maya and Garifuna display the enduring character traits of the indigenous people.  The Maya are subdivided into the Mopan and Ketchi peoples.  Both groups have exorbitantly high levels of poverty and participate insignificantly in the political and socioeconomic realms.  The violent crimes that happen most often are murder, manslaughter, and rape.  The most widespread property crimes are robbery, burglary, and theft (“Culture of Belize – history, people, women, beliefs, food, customs, family, social, marriage,” n.d.).

Belizeans in urban areas expect the government to assist them in raising their children and support early education.  In contrast, child rearing in rural communities is aided by family and relatives.  By statue, a child has to attend primary school up to age fourteen.  However, only 40 percent of primary school students progress on to secondary schools because of poor test performance in the national school examination and for lack funds for tuition fees and textbooks.  Overall, less than 1 percent of the population qualifies for higher education.  A national university that was commenced in 1987 only offers a limited number of programs and has fewer than 500 students (“Belize School System – Flags, Maps, Economy, History, Climate, Natural Resources, Current Issues, International Agreements, Population, Social Statistics, Political System,” n.d.).

Belizeans use the healthcare systems in Guatemala and Mexico for medical services because of the insufficiency of health facilities and inadequacy of trained professions to deliver quality services.  Many locals also turned to old-fashioned remedies like plants and other and inherited rituals (“Healthcare in Belize – International Living Countries,” n.d.).

Political

The government is ratified by a parliamentary democracy and exercises the executive, legislature, and judiciary branches of authority.   However, the political parties have essentially eliminated the power of the legislature in preference for a cabinet of ministers.  The two main parties are the Peoples United Party and the United Democratic Party and both draw support across all ethnic groups and social classes.  All members of the government foster openness to the public and encourage their constituents to engage with them (“Belize POLITICAL DYNAMICS – Flags, Maps, Economy, History, Climate, Natural Resources, Current Issues, International Agreements, Population, Social Statistics, Political System,” n.d.).

The national army supplies protection against Guatemala, which in the past, has threatened to invade the country and claim its stake of Belizean territory.  The army also provides drug prohibition efforts and aids in disaster endeavors.  The police force is the first line of defense against all crime. However, the police are perceived to be only active in urban communities and the limited number of villages with police stations (“Culture of Belize – history, people, women, beliefs, food, customs, family, social, marriage,” n.d.).

Economical

The services industry is the largest sector in the country, contributing a total of $718 million in 1996, equivalent to 57 percent of the gross domestic product (GDP).  The dominant industry in the private sector remains agriculture, with fishing and logging in a distant second and third respectively.  The government promotes international trade and encourages export of food production in the country.  The main food items of sugar, citrus and bananas accounted for 86 percent of exports in 1996 and made up almost 80 percent of foreign exchange earnings (“Culture of Belize – history, people, women, beliefs, food, customs, family, social, marriage,” n.d.).

However, the prevalent heritage of colonialism in the modern economy is displayed in the large holdings of land owned by foreigners for real estate speculation.  This near-monopoly resulted in only 15 percent of the land left are available for agriculture purposes.  The government has never had a comprehensive land development and reallocation policies (“Belize GROWTH AND STRUCTURE OF THE ECONOMY – Flags, Maps, Economy, History, Climate, Natural Resources, Current Issues, International Agreements, Population, Social Statistics, Political System,” n.d.).

Legal

The judiciary system is a leftover of the British system, and appeals can still proceed as far as the Privy Council in London.  Locally, the formal functioning of the system is at risk due to a lack of judges, law administrators, and prosecutors, resulting in a logjam of cases (“Culture of Belize – history, people, women, beliefs, food, customs, family, social, marriage,” n.d.).

Intercultural

Christianity is the main religion in Belize.  Most of the people are Roman Catholics or Baptists.  There are also some Moslems and Hindus.  The authority of churches comes from State laws, which allows for the legal incorporation of churches, thus freeing them from paying taxes.  Ministers are state-sanctioned marriage officers, and the state anoints them to co-manage the majority of primary schools (Gregory, 1975).

Artists make a living by selling their works at exhibitions supported by wealthy Belizeans who display art for their private pleasure. The National Arts Council also promotes training and the display of various forms of art.  Foreign scientists from North America do almost all the scientific research in the country.  Studies in the fields of Maya archaeology and natural history are major contributors to understanding the significance of Belize within the subregion.  There is a potentially rich source of oral literature, but very few are preserved in writing. The best graphic arts are painting and sculpture that build on a rich practice of the use of wood.  International plays are performed in schools and sporadically for the public (“Culture of Belize – history, people, women, beliefs, food, customs, family, social, marriage,” n.d.).

Technological

Belize Telemedia Limited (BTL) monopolized telecommunication services at excessive rates in the eighties and nineties.  To encourage competition, the government assisted Speednet in getting its licenses to operate in Belize as an alternative provider in 2005.  In a relatively short time, Speednet became the choice of Belizean professionals with its lower rates, better service, and less bureaucratic structure.  In 2009, the Belize government nationalized BTL, which is now the main competitor of Speednet.  Both companies now offer a full range of telecommunication services including dial-up and high-speed internet access, cellular roaming, and other basic telephone services (Breaking Belize News, 2015).

3. Leadership Problem Statement

To compete in a global economy, investing in higher education and equipping citizens with training to compete for jobs in emerging sectors are essential to a nation’s prosperity.  However, the lack of reliable broadband infrastructure and limited social mobility has left Belize vulnerable, with unrealized potential.  Belize’s lack of readiness for the digital economy is further crippled by their lack of higher educational system, resulting in a lack of skilled workforce.  While the government of Belize has committed to raising the standard of living for locals and attracting foreign investments, they have not been able to draw the growth sectors that have spurred jobs and transformed economies.  The problem statement then becomes what can the Belize government do to attract the growth sectors that have spurred jobs and transformed economies in other emerging countries?  In the following sections, I will be recommending a growth strategy using Uber as an economic partner guided by relevant economic theories and conclude with an action plan for implementation.

4. Recommendations for Policy Changes

The Belize government should consider adopting the following policy changes to develop a robust pipeline of skilled workers, attract foreign investments, and grow the middle class to enhance the overall quality of life for the citizens of Belize.

Adopt a new labor law for foreign investors.

Pass a law that requires foreign investors to hire 20 percent of workers locally in an apprentice program.  This is similar to the United States’ “First Source” program, based on the principle that private companies that receive public dollars should help local residents find work.  This policy would create an ecosystem that would expand the labor force and strengthen its culture through a more productive workforce.

Attract strategic partnerships.

Belize needs a strategic partner who is willing to invest in developing countries.  Uber, with all the well-publicized toxic culture of sexual harassment that ultimately led to the ouster of its Chief Executive Officer (CEO), is also famously known for its appetite for risk-taking, even at the expense of taking a loss just to be the first to market in areas of high growth (Dickey, 2017).  This propensity to accept a risk to be the pioneer in a country fits in well with the Belizean economy and hard-working citizens of Belize.  Being the pioneer and leader in a new strategic location is considered a competitive advantage to Uber and Belize should take advantage of this risk-taking culture.

Reconceptualize the Belizean education system.

From a long-term perspective, Belize must adopt the worldview toward education that a degree from a four-year university is considered higher education.  The current educational system In Belize regards a high school education a successful gateway to the workforce.  While this might be the norm in Belize, it is not creating a work-ready workforce to compete globally, or access opportunities to advance.  The middle class already values education; the government needs to invest more in education and to build the human capital infrastructure to redefine the middle class and take advantage of new investments coming into Belize.

Private-Public Partnerships (PPP). 

To attract these high-growth sectors to Belize, the Belize government must intervene and provide the necessary incentives for these companies to invest in Belize.  This view is consistent with the Keynesian Economic Model which supports the view that government is in a better position than market forces when it comes to creating a robust economy.  Government spending would increase consumer demand in the economy, leading to added business activity and even more spending, which would, in turn, increase the overall economic activity, the natural result of which would be deflation and a reduction in unemployment (Mell & Walker, 2014).

Building large scalable sectors in Belize require a strong strategic partner who is willing to invest in developing countries.  This perspective is compatible with the Endogenous Growth Theory, which postulates that that improvements in productivity can be tied directly to faster innovation and more investments in human capital.  As such, they advocate for government and private sector institutions to nurture innovation initiatives while offering incentives for individuals and businesses to be more creative.  Under this theory, knowledge-based industries play a particularly important role — especially telecommunications, software and other high-tech industries as they are becoming ever more influential in developed and emerging economies.  A key tenet to the endogenous growth theory is that there are increasing returns to scale from capital investment especially in infrastructure and investment in education and health and telecommunications (Mell & Walker, 2014).

Uber, with all the well-publicized toxic culture of sexual harassment that ultimately led to the ouster of its Chief Executive Officer (CEO), is also famously known for its appetite for risk-taking, even at the expense of shareholder profits just to be the first to market in areas of high growth.  This propensity to accept a risk to be the pioneer in an emerging country fits in well with the hard-working citizens of Belize.  Being the pioneer and leader in a new strategic location is considered a competitive advantage to Uber and Belize should take advantage of this risk-taking culture.  This is similar to the Ricardian Model of Comparative Advantage, used to explain why countries engage in international trade even when one country’s workers are more efficient at producing every single good than workers in other countries (Mell & Walker, 2014).  In Uber’s strategic plan, being first to a market means having a comparative advantage in that country.  With its innovative culture and willingness to invest in emerging countries even in money-losing situations, Uber also has the cash and technology to uplift and transform the Belize economy by expanding this middle class.  An industry cannot grow without an active and skilled workforce.  The government must work in unison with Uber to welcome, support and promote its entry into Belize.

This private-public partnership is supported by the Linear Stages of Growth Model, which posits that an injection of capital, creating superior technology, and growing the labor force lead to economic development and industrialization (Mell & Walker, 2014).

5. Action Steps

The Belize government can first create the incentives to attract Uber by outsourcing its fleet of public buses.  Most of the middle class rely on public transportation to get around in the city.  It is the cheapest form of transportation to go from point A to point B in the quickest time.  The buses current used for public transportation are old, converted school buses.  The Belize government can allow Uber to be the exclusive operator of the buses in exchange for Uber’s investment to replace all the buses with state-of-the-art new ones and a sum of cash to be used for loans to support nascent small businesses, and train workers in specialized jobs in emerging sectors.

Step two of the implementation is a two-step phase process focus on growing a robust pipeline of skilled workers.  To tap into one of the most important growth sectors in the country-tourism, the government can allow Uber to convert all taxi-drivers to Uber contract drivers as long as that on an hourly basis; the Uber drivers will be making more than what they were earning previously as a taxi driver.  With Uber’s GPS and on-demand technology, more taxi drivers will be mobilized, saving on gas, and total earnings will be higher, resulting in higher output.  Currently, the taxi association was formed by the taxi drivers to give them a form of structure and rights; Uber can help them create their own management structure and teach them about maintenance and other skilled trades in the public transportation arena using Uber’s technology.

Finally, the working class of Belize is large, diverse and included the traditional middle class made up of civil servants, skilled manual workers, taxi drivers, and other commercial employees unified by a belief system that emphasized cultural uprightness, upward social mobility, and the importance of education.   Uber can rebrand its name in Belize to “Uber Ya Da Fu We” (We the People), to rally the Belizeans around the partnership, and show off the Belizean pride to the rest of the world.

For Uber, once the brand is accepted by Belize, they can expand their product lines such as Uber X for the wealthy, VIPs and dignitaries, and lock out any future competitors coming in and replicate the model in other emerging countries.

6. Conclusion

While the goal is to help every emerging country compete on a world stage, I want to begin by helping Belize adopt economic policies that could potentially transform their economy and improve the quality of life of its citizens.  By doing research on Belize, gathering information by talking to various Belizeans, and reflecting on my international experience, I felt in love with the Belizean culture especially the pride they have for their country.  This international policy class has enriched my life through an experiential, hands-on approach.  The cultural interaction with the Belizeans has given me meaning for what it means to serve and affect a community.

Nation building is a community project.  I hope to come back to Belize in the near future and contribute by donating my time and expertise to improve the quality of life for its people.

 

REFERENCES

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Dickey, M. R. (2017, November 7).  These are Uber’s new cultural norms.  Retrieved from https://techcrunch.com/2017/11/07/these-are-ubers-new-cultural-norms/

Fowler, S. (2017, February 19). Reflecting on one very, very strange year at Uber.  Retrieved from https://www.susanjfowler.com/blog/2017/2/19/

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Healthcare in Belize – International Living Countries. (n.d.). Retrieved from https://internationalliving.com/countries/belize/health-care-in-belize/

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Levitt, S. D., Dubner, S. J., & Harper Audio (Firm), OneClick Digital (Firm). (2012). Freakonomics: [a rogue economist explores the hidden side of everything]. New York, NY: HarperCollins.

Levitt, S. D., & Dubner, S. J. (2010). Superfreakonomics: Global cooling, patriotic prostitutes, and why suicide bombers should buy life insurance. New York, NY: William Morrow.

Marshall, A. (2018, February 9). Uber and Waymo abruptly settled for $245 Million.

Retrieved from https://www.wired.com/story/uber-waymo-lawsuit-settlement/

Mehrotra, K. (2017, May 10). Uber Greyball investigation expands to multiple U.S. cities.

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Two Million Slaves

/in /by

By Matthew T. Lambro

The FBI reports that sex trafficking is “the most overlooked and under investigated form of child sex abuse facing American society today” (2010). Sexually exploited children do not specifically rank as a priority. The FBI’s number one national security requirement is protecting America from a terror attack (FBI, 2015). Read more