Eubios Journal of Asian andInternational Bioethics
EJAIB Vol. 28 (6) November 2018www.eubios.info
ISSN 1173-2571 (Print) ISSN 2350-3106 (Online)
Official Journal of the Asian Bioethics Association (ABA)

Copyright ©2018 Eubios Ethics Institute(All rights reserved, for commercial reproductions).

Contents

page

Editorial: Gender Equality
167- Darryl Macer
Nursing and #MeToo168- Nasreen Rafiq, Shyrose Sultan, Afsheen Hirani,
Samreen Siraj, Zainish Hajani, Neelam Rafiq
Ethical Analysis and the Situation of Teenage Pregnancy
in Irisan Baguio City, the Philippines
171- Feby Basco Lunag and Darryl Macer
Ancient Indian Gurukul System: Developing an Ethical
Human Being
179- Ketan Mor
Levels and Determinants of Complementary Feeding
Pattern Exclusive of Minimum Meal Frequency andDietary Diversity among Children of 6 to 23 Months in
Bangladesh183- Naznin Pervin, Darryl Macer & Shamima P. Lasker
Youth Volunteers in Post-Disaster Rehabilitation andReconstruction in Nepal
193- Bibek Adhikari and Darryl Macer

Editorial address, and all correspondence to:Prof. Darryl Macer, Ph.D., Hon.D.
President,
American University of Sovereign Nations(AUSN),https://ausovereignnations.org
Email: darryl@eubios.info
EJAIB adopts and complies with the Committee on
Publication Ethics (COPE) Publication ethics andmalpractice policy. All potential authors shouldhave read these guidelines and by submission of anarticle for publication you acknowledge that you
have complied with this policy. Violations will behandled in proportion to the intention andseriousness of the violation.
Registered address of EJAIB: P.O. Box 16 329,
Hornby, Christchurch 8441, New Zealand

Editorial: Gender Equality- Darryl Macer
Email: darryl@eubios.info
A world free of harmful discrimination is one which
all ethical people ascribe to. There are several papers inthis issue which examine problems created by
imbalances in the power of male and female persons,and the stereotyping of gender roles. The ways that our
expected roles have developed is complex and has
emerged through the development of our societies.
In their paper Nursing and #MeToo, a group of nurses
in Pakistan explore the issues of gender discrimination
faced by male nurses as they attempt to serve theirpatients. In some conservative societies patients are
particularly sensitive to having persons of the othergender look after them. Yet professionals are trained towork with vulnerable persons of all ages and genders.
To be a mother is one of the great human joys,
responsibilities and opportunities. The research of Feby
Basco Lunag explores the growing problem of teenage
pregnancy in the Philippines. Interviews with mothers
about their experiences should be required reading for
all teenagers who are at risk of becoming pregnant. Men
also need education, as do families.
The research of Naznin Pervin et al., found that infantmalnutrition still exists in Bangladesh, and there arerecommendations made for mothers, and the service
providers so that practical improvement can be made.
The results have implications for many countries, andeven in rich countries those living in poverty facemalnutrition.
Ketan Mor discusses the roles of Indian traditions indeveloping and defining what an ethical human being is.
Bibek Adhikari presents results of interviews and focus
group discussions among youth in Nepal regarding theirexperiences of being volunteers in Disaster Management.
One of the programmes of Eubios Ethics Institute is
Youth Looking Beyond Disaster (LBD) Training
programmes, and our key partner in Nepal is Youth’s
UNESCO Club. The LBD program enhanced theireffectiveness and more training programs should be held
when the LBD program receives the necessary support.

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Eubios Journal of Asian and International Bioethics 28 (November 2018)

Nursing and #MeToo- Nasreen Rafiq
Registered nurse at Internal Medicine ICU, Aga Khan University
Hospital, Pakistan
Email: nasreen.rafiq@aku.edu- Shyrose Sultan
Registered nurse in Gastroenterology and General Surgery, Aga
Khan University Hospital, Pakistan
Email: shyrose.sultan@aku.edu- Afsheen Hirani
Registered nurse in Gastroenterology and General Surgery, Aga
Khan University Hospital, Pakistan
Email: afsheen.hirani@aku.edu- Samreen Siraj
Clinical Nurse Instructor in Musculoskeletal and Sports
Medicine, Aga Khan University Hospital, Pakistan
Email: samreen.verasiya@aku.edu- Zainish Hajani
Clinical Nurse Coordinator in General Surgery, The Aga Khan
University Hospital, Pakistan
Email: zainish.hajani@aku.edu- Neelam Rafiq
Registered nurse in Emergency Medicine, Aga Khan University
Hospital, Pakistan
Email: neelamrafiq.nr@gmail.com

Abstract
The year 2018 revealed a number of sexual
harassment stories into public conversation as part of
the #MeToo movement. The campaign has relatively
spread across all professions and work industries.
Today, the society is already hypersensitive towards
sexual talks, and the campaigns such as #MeeToo makeit even more difficult to overlook these stories; it has
challenged the demarcation of important andsuperfluous accusations which gives rise to various
ethical dilemmas. Therefore, the #MeToo movement
becomes significant to evaluate both sides of a coin, andassess a situation from various ethical paradigms inorder to reach an ethically acceptable solution.
Key Words: #MeeToo, Sexual molestation, Psychosis,
Utilitarianism, Justice, Theory of care, Liberalism,
Kantianism, Sexual harassment
Description of the Issue
The year 2018 saw many headlines reporting the
distressing sexual molestations in under the tagline#MeToo. New revelations break regularly in answer tothese viral posts in relatively every industry. In this
#MeToo era, where everybody is hypersensitive, it has
become difficult to demarcate the necessary accusations
from unnecessary ones which ascend various ethicaldilemmas. Enduring to the bystander effects, nursing is
also facing troubles from these arising ethical allegations.
This paper discusses an ethical dilemma in line with theslogan #MeToo.
A 25 year old female patient in the immediate postextubation period complained of being sexually molested
by a senior male nurse while positioning during a night
shift. She was suffering from ICU psychosis, and also
stated that I never wanted a male nurse. The case wasinvestigated and no evidence was found against thenurse; yet, the nurse was terminated after a joint
decision made by the departmental management,
hospital ethics committee (HEC) and human resource(HR) department. A week later, a similar incident
occurred again during a night shift with consistentdecision.
The scenario ascends various questions under theumbrella of ethics.
1. Should a patient be always trusted right even if he or
she is in psychosis?
2. Is opposite gender care ethically justified in genderstereotyped countries?
3. Does simultaneous occurrence of two similar events
suggest a system or an individual error?
4. Can justice and advance directives with regards togender based care be justified by the scenario?
The paper aims to identify and reflect the case undermultiple ethical paradigms and find ethically soundjustifications for the decision.
Our Position
We believe that in the abovementioned and othersimilar dissensions the termination of the nurses is
ethically indecorous. In any circumstance, themanagement has no right to punish any individual
without evidences of the alleged offense.
Theory of Care versus Justice
The theory of care emphasizes to respect patients’dignity, practice benevolence and empathize with people
in needs (Reddy, Meyer, Shefer & Meyiwa, 2014). The
managements’ decision to terminate the nurses
safeguarded the dignity of the mentally undermined
individuals under the umbrella of ethics of care.
However, justice refers to a fair and impartial treatment
of individuals, and making a decision which is unbiased
and acceptable to everyone (Sheldon, 2016). The
termination of the staff in justification to protect a
psychotic patient’s dignity obscured justice. It is because
psychosis impairs reality; and patients may talksuspicious, unauthentic and vain phrases (Fusar-Poli etal., 2014). Hence, trusting to the statement of a mentally
undermined person, valuing his possession and making
important decisions on its basis may create questions onjustice and the strength of the decision.
Consequence of our position. If the argument of justicesuccessfully saves the case against the mentally
undermined patients, it may also risk the dignity of thesepatients and violate the theory of care. The UN
Declaration of Rights of Mentally Retarded People(1971) also claims that mentally disabled people havethe right to be protected from exploitation andundignified treatment (Flynn, 2016), and it can bedemonstrated by respecting their possessions andpersonal space (Poreddi et al., 2013).
Counter-argument for justification. It is right thatmentally incapacitated people are more prone to sexual
humiliations, and their expressions must be respected
and heard. However, if this is right then they should beheard in all decision making processes, and their words
should be legally considered capacitated every time
which appears to violate the Pakistan mental healthordinance (Tareen & Tareen, 2016).
Utilitarian versus Liberalism Theory
The utilitarian theory ropes the idea of maximal goodeven if it disappoints some individuals (Beauchamp &Eubios Journal of Asian and International Bioethics 28 (November 2018)Childress, 2013). The consecutive punishment to thenurses created examples to decrease the future risks ofsexual molestations among all mentally underminedpatients and benefit the entire mentally incapacitatedpopulation. However, the liberal theory contradicts andcombats against individual rights (Beauchamp &Childress, 2013). Every individual should get his rightand the safeguard of others’ rights should notcompromise the individual’s rights. Termination without
any evidence violated the individual nurses’ right torespect, justice, and work with dignity.
Consequence of our position. Saving the case on thebasis of liberal arguments will further increase thefuture risks of these incidences among the incapacitatedpopulation, decreasing the quality of care. Moreover,devaluing patients’ words will not only decrease thedelivery of quality care but also dwindle the hospital’s
overall rapport in the healthcare market. This willfurther reduce the hospital admissions and shrink its
business which will negatively influence the entire
organisation and its workers. What use is it to prioritize
a nurse which will only provide individualized
satisfaction?
Counter-argument for justification. The simultaneous
occurrence of two similar events does not justify theindividual error, but rather can suggest institutional
faults. If it was an individual error it would not havebeen repeated within a week, particularly after
witnessing the unpleasant consequences. Or else there
would have been some history of harassment or relatednuisances during his career. However, there was noevidence of such history too. Also, nursing is falsely
considered as a female profession, and females
outnumber males. This not only makes men a vulnerable
group; but it also decreases their interest in theprofession persistently contributing to a statistically
imbalanced male-female ratio in nursing (Holden&
Littlewood, 2015). Certainly, if the institutions will still
consider these incidents as individuals’ mistakes, theincidences of such events will continue to rise even more,
and the institutions will further lose their “men” power.
Kantianism versus Kantianism
Deontology endorses duty holding which upholds
moral obligations and affirms that characteristics ofactions rather the consequences make the actions
morally good or bad (Beauchamp & Childress, 2013).
The management gave its decision with the duty to do
justice with the patients and avoid future risks ofmaleficence in care. However, Kant also claims thatjustice is a supreme and generalized ethical compulsion
which should be received by every autonomous
individual (Burkhardt & Nathaniel, 2013). The
termination of nurses’ employment without any
evidence of delinquency does not weigh independently
in morality which violates the individuals’ negative
rights i.e., to be free from others’ wrong actions.
Consequence of our position. The code of medical
ethics sanctions that institutions are responsible touphold patients’ right to privacy and every health care
worker is obligated to respect their dignity throughout
the course of treatment (Epstein, & Turner, 2015). It thenurses violated the code; but were not punished they
will be more fearless to repeat the offense.

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Counter-argument for justification. However, theoffense was not proved. If today the nurses were
punished by the management personals based on a mere
allegations and without the offense being proven,tomorrow the management should expect and accept thesame decision for themselves in case of the unprovenliabilities of any misconduct.
Autonomy versus Paternalism
In countries with strong gender stereotyping, deliveryof care by opposite gender persons is usuallyaccompanied with ethical allegations and not preferredby patients (Holden & Littlewood, 2015). Autonomy
means self-rule (Beauchamp & Childress, 2013). Afterbeing extubated, the patient also stated that she neverwanted to be cared for by a male nurse. It is important toknow that every individual is autonomous and thisautonomy should also be respected in hospitals todeliver a culturally appropriate care. Yet, abiding topatients’ assertions and substantiating the status of theirneeds is not possible in every case which may lead to theabuse of medical power with intent to benefit patients,
such as paternalism (Cooley, 2015). Senior nurses,
regardless of their gender and due to their richexperience and clinical expertise, are intentionallyassigned on the sickest patients for patients’ benefit(Rankin, et al., 2015). Since the patient was in her
immediate post-extubation period and on risk of reintubation, she also needed to be cared for by a seniorstaff. Besides, the male nurse was assigned to the female
patient by the departmental management only.
Therefore, the management should not have terminatedhim.
Consequence of our position. Gender is a traditional,
cultural and religious construct which impacts the caring
relation between patients and health care workers(Wilson. 2017). Pakistan, being a Muslim country,
believes in pardah of women (Ali & Syed, 2018) which
restricts women’s modesty to their limited interactions
with males (Walter, 2016). This is also expected to be
applied whilst in hospital care which stereotypes therole of males in nursing female patients (Younas &Sundus, 2018), making both the nurse and the patient
apprehensive about being accused of physical touchingwhich can negatively affect the delivery of quality care
(Whiteside & Butcher, 2015). Hence, in a society like
Pakistan, patient gender preference should be valued,
particularly, if it is already declared and known.
Counter-argument for justification. The patient
gender preference was declared after the occurrence of
the incident. No such choice was avowed earlier either
by the patient or her family. Hence, the nurses should
not be made guilty. Moreover, if the choice of similar
gender staff to uphold patients’ autonomy is claimed
right then paternalistic assignment of a male senior staff
on a female patient for her beneficence should not be
dubious too. The nursing code of ethics also states that
nurses practice clinical judgments grounded on
experience, skills and knowledge and allocates care
responsibility to other nurses who exhibit theserequisite competencies regardless of gender or race
(Winland-Brown, Lachman, & Swanson, 2015).

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Eubios Journal of Asian and International Bioethics 28 (November 2018)

Recommendations
All health care providers (HCPs), particularly malecolleagues, encountering such problems should step into
the role of whistle blowers. Being directly involved inpatients’ care, all male HCPs including doctors, nurses,
nurse assistants, and so on, are at risk of these unjust
events.
Employees usually listen to the stories of ethicaltraumas and injustices and wait for some authorities toaddress these accounts. They themselves need to be achange agent to answer these “#MeToo” problems. Bothemployee and the organization expect honesty from eachother. Whistle blowing also encourages staff with theright to speak up against organisations. Organizations
should introduce and implement it in their policies andprotocols to give it a written legal base to help
employees challenge injustices and harassments.
Authorities should ensure complete and thoroughinvestigations once the event is reported, and theyshould also ensure that both the confronting parties
should get a chance to speak in order to promote safety
and prevent biases in the decision.
In addition, organizations should modify their policies
according to the patients’ gender preferences regardlessof the advance directives because the concept of advancedirectives is still vague and unclear in many countries
like Pakistan (Badruddin, 2016). If possible it will lessen
problems if a male nurse is assigned to a male patient,and a female nurse to a female patient, irrespective of
the informed gender-choice. More nurses should be
hired, and departments should ensure a better balanceof male and female nurse ratio per shift.
Hospitals’ initial assessment forms should be modified
and patient gender preference should be added to
uphold patient’s autonomy and maintain dignity of care.
Also, patients and families, in case of unconscious
patients, should be specifically asked that in case of life
threatening situations can the hospital opt for an
opposite gender staff to the patient or it is strictly
proscribed. Nonetheless, a prior consent form must be
signed by the family in case of the agreement.
Hospitals should strengthen their security andinvestigation systems in order to facilitate and justify thedecision making process. Further, different motivationaltalks should be organised by the hospitals to remindnurses’ and other HCPs about their oath of being loyal
and sincere with their patients and profession. These
reminders would motivate them to deliver care withmore compassion and discourage them from misconduct.
Likewise, all HCPs should also ensure their sincerity
towards the profession and honesty towards patientcare. They should practice self-reflection for their doings
and abstain themselves from any deleterious conduct.
Conclusion
Various ethical and legal concerns affect any
conclusion while dealing with mentally underminedpeople. At times, society becomes over-conscious
towards vulnerable groups which has increased themagnitude of the problems. Thus, it has trouble at times
in making the distinction between important andfrivolous allegations, resulting in several ethicaldilemmas. Hence, it is important to weigh theconsequences on both sides of a coin. This can be doneby looking at the picture as a whole rather just a small orincomplete part of an event. Authorities must
understand the real nature of the problem to strengthen
the environmental safety for both the employees and thepatients and combat this trending #MeToo events innursing.
References

Ali, F., & Syed, J. (2018). ‘Good Muslim women’ at work: An
Islamic and postcolonial perspective on ethnic
privilege. Journal of Management & Organization, 1-19.
Badruddin, S. (2016). Ethics of breaking sad news to patient byhealth care professionals: Pakistan perspective. Journal of
Clinical Research and Bioethics, 7(261), 2.
Burkhardt, M. A., & Nathaniel, A. (2013). Ethics and Issues inContemporary Nursing, (4th ed.). Delmar, Austrailia: Nelson
Education.
Cooley, D. R. (2015). Elder abuse and vulnerability: Avoiding
illicit paternalism in healthcare, medical research, andlife. Ethics, Medicine and Public Health, 1(1), 102-112.
Epstein, B., & Turner, M. (2015). The nursing code of ethics: Itsvalue, its history. OJIN: The Online Journal of Issues in
Nursing, 20(2), 1-10.
Flynn, E. (2016). Disabled Justice?: Access to Justice and the UN
Convention on the Rights of Persons with Disabilities.
Routledge.
Fusar-Poli, P., Carpenter, W. T., Woods, S. W., & McGlashan, T. H.
(2014). Attenuated psychosis syndrome: Ready for DSM5.1?. Annual Review of Clinical Psychology, 10, 155-192.
Holden, P., & Littlewood, J. (Eds.). (2015). Anthropology andNursing. Routledge.
Poreddi, V., Reddemma, K., Ramachandra, & Math, S. (2013).
People with mental illness and human rights: A developing
countries perspective. Indian Journal of Psychiatry, 55(2),117. doi: 10.4103/0019-5545.111447
Rankin, J., McGuire, C., Matthews, L., Russell, M., & Ray, D.
(2015). Facilitators and barriers to the increased
supervisory role of senior charge nurses: A qualitative
study. Journal of Nursing Management, 24(3), 366-375. doi:
10.1111/jonm.12330
Reddy, V., Meyer, S., Shefer, T., & Meyiwa, T. (2014). Towards a
critical theory of care.
Sheldon, R. (2016). Introduction: Unsettling subjects of justiceand ethics. In Tragic Encounters and Ordinary Ethics.
Manchester University Press.
Tareen, A., & Tareen, K. I. (2016). Mental health law inPakistan. British Journal of Psychiatry International, 13(3),67-69.
Walter, A. M. (2016). Between “pardah” and sexuality: Double
embodiment of “sharm” in Gilgit-Baltistan. Rural
Society, 25(2), 170-183.
Whiteside, J., & Butcher, D. (2015). ‘Not a job for a man’:
Factors in the use of touch by male nursing staff. British
Journal of Nursing, 24(6), 335-341.
Wilson, F. M. (2017). Organizational Behaviour and Gender.
Routledge.
Winland-Brown, J., Lachman, V. D., & Swanson, E. O. C. (2015).
The new'Code of ethics for nurses with interpretive
statements'(2015): Practical clinical application, Part
I. Medical-Surgical Nursing, 24(4), 268.
Younas, A., & Sundus, A. (2018). Experiences of and satisfaction
with care provided by male nurses: A convergent mixedmethod study of patients in medical surgical units. Journalof Advanced Nursing.

Eubios Journal of Asian and International Bioethics 28 (November 2018)

Ethical Analysis and the Situationof Teenage Pregnancy in Irisan
Baguio City, the Philippines- Feby Basco Lunag, MBGPH
Kankanaey Tribe from Sagada and Besao Mountain Province;
AUSN Sovereign Nations Doctoral Scholar, The Philippines
Email: febylunag88@gmail.com- Darryl Macer, Ph.D., Hon.D., MPH
President, American University of Sovereign Nations
Email: darryl@eubios.info

Abstract
The Philippines has a young population with anestimated median age of 22.9 years in 2010. About 19.8
million or (21% of the total population of 95.8 million
Filipinos) are 15–24 years old. About 48 % of theseyoung people are adolescents aged 15–19. Studies inlocal settings provide varied information on theprevalence of adolescent pregnancy in the Philippines,
depending on source and time of survey as well as age of
respondents. The Cordillera Administrative Region has
the highest teen pregnancy rate based on the 2013
Young Adult Fertility and Sexuality (YAFS) Study. In the
YAFS survey, the region registered 18.4% for teen
fertility, making the Cordillera top all other regions.
Likewise, a dramatic increase of teenage pregnancy isalso evident in Barangay Irisan, Baguio City. Barangay
Irisan is the biggest and most populated barangay in
Baguio City. It had a population of 28,357 as of the 2010
Census, which accounts for about seven percent of thecity's total populace. The barangay is located at thenorthwestern tip of the city, and is primarily accessible
via the Naguilian Road. It is widely known for thedumpsite in the area.
The Philippines is a signatory to numerous
international agreements related to women in general,with implications for teenage pregnancy. These include
the International Conference on Population andDevelopment (ICPD) Programme of Action signed in
Cairo, Egypt, in 1994; the Beijing Declaration andPlatform for Action, developed during the Fourth World
Conference on Women in Beijing, China, in September
1995; the Fourth World Summit on Social Development(WSSD), the World Conference on Human Rights
Programme of Action; and the Convention on the
Elimination of all forms of Discrimination Against
Women (CEDAW). The country is not lacking in laws nor
policies and programs that could protect and empower
women of all ages. Political bickering, religious
interference, and the population’s ambivalent attitudes
toward sex and reproductive health have, however,negatively affected the effective implementation ofadolescent reproductive health programs in thePhilippines.
Adolescentshavingunprotected
heterosexual intercourse are at risk of both HIV infection
and unwanted pregnancy.
1. Teenage Pregnancy is a Public Health Concern
Teenage pregnancy is not only a health issue but
is related to development. It is deeply rooted inpoverty, violence, child and forced marriage, power
imbalances between adolescent girls and their male

171

partners, lack of education, and the failure ofsystems and institutions to protect their rights.1
Cases of live births among teenage mothers in thePhilippines increased by more than 60% according to
the records of the National Statistics Office (NSO)
between the year 2000 to 2010. With this trend, it isnoted that Philippines has the third highest teenage
pregnancy rate in the ASEAN region and is actually
the only country in the ASEAN region where the rate
is significantly increasing, as admitted by the
National Youth Commission office.
Complications from pregnancy and childbirth cancause grave disabilities, and are the leading causeof death for young women.2 Adolescent girls also
face high levels of illness, injury and death due tounsafe abortions that are conducted because of aprohibitive policy against providing regularabortion services. Apart from the immediate physicalrisks, early pregnancy also jeopardizes the rights,
health, education and potential of many adolescent
girls, robbing them of a better future.3
Teen pregnancy also contributes to the country’s
high population growth rate and more young people
needing more resources for health, education andfood. A high rate of teen pregnancy also means ahigh risk for maternal deaths among our young girls.
The latest data from the NSO also noted the increasein maternal deaths among female teenagers.
One of the current rising issues in the Philippine
government is the debate on the Reproductive
Health Bill that has been ratified in 2012. There is an
emergent trend to pay paramount attention to
government, communities and individuals to work
together to provide the girls with age-appropriatecomprehensive education on sexuality and morality
to develop the knowledge and skills they need toprotect their health. This is especially important fpr
empowering young women to decide when and ifthey wish to become mothers.
2. Premarital Sex is a Global Issue
Premarital sex is a crucial issue that does not only
affect the developing countries but in developed
countries as well. There is a need to revisit the past andexamine recent data to update our knowledge andimprove our understanding of the marriage institution in
the Philippines and of the way it is influenced bysocioeconomic and ideational changes (Abalos, 2014).
Unwanted early pregnancies are likely to impact
more upon females than males, causing life-longproblems such as poverty, limited employment andeducation, and even physical or developmental problems
for mother and their children. When young females givebirth to children out of wedlock, they are not only more
likely than older, married females to have children withhealth problems. They are also more likely to unable tohttp://www.unfpa.org/press/world-population-day-2013focuses-adolescent-pregnancy
2
http://unama.unmissions.org/world-population-day-unchief-draws-global-attention-adolescent-pregnancy
13

http://beta.philstar.com/headlines/2013/07/12/964481/16m-teens-give-birth-every-year-un

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Eubios Journal of Asian and International Bioethics 28 (November 2018)

achieve academically to the degree desirable, or to move
forward in a career or work role due to family
responsibilities. They are likely to be poor and to beunable to provide adequately for their children. There,
early pregnancies due to premarital sexual activity areassociated with multiple negative consequences formothers and their offspring.
Teen pregnancy is an adult problem, linked to how
sexuality is dealt with in our culture. We tend to think ofteen pregnancy as an individual responsibility, that if
teenagers would just not have sex or use birth control,then we wouldn't have teen pregnancy. This isn't enough.
We need to provide a whole society of support in whichyoung people make and are supported for making gooddecisions and don't get mixed messages from adults
about sex (Abalos, 2014),
When young females give birth to children out of
wedlock, they are not only more likely than older,married females to have children with health problems.
They are also more likely to unable to achieve
academically to the degree desirable, or to move forward
in a career or work role due to family responsibilities.
They are likely to be poor and to be unable to provide
adequately for their children. There, early pregnancies
due to premarital sexual activity are associated withmultiple negative consequences for mothers and theiroffspring.
3. Sexuality Education
In spite of interest by feminist scholars, actual
discourse around sexual desire and bodily pleasureassociated with female sexuality appears to be lacking
for the majority of adolescent girls. In Filipino culture
females are the objects of male desire, hence the focus on
attractiveness. Little attention has been paid to theirembodiment, the inner sense of their own sexual desire.
Sexual desire has traditionally been accepted as part ofmale sexual development and is associated with positive
sexual identity for men. Researchers stress theimportance of increasing sex-positive attitudes towards
female sexual desire, in order to counter much of theshame and confusion experienced by females, especiallyduring adolescence. The double standard is still being
conveyed to young women through popular culture,parents, peers, and schools.
Sex education primarily emphasizes the dangers ofsex. The media stresses the importance of attractivenessand women as sex objects rather than as agents of theirown sexual desires. Researchers suggest that a young
woman's ability to be conscientious about and fully
present in her sexual experiences is correlated with her
ability to act as an agent. The ability to make responsible
and self-affirming sexual decisions is a crucial act ofagency. Taken together, studies suggest the need toreduce teens’ exposure to sexual content on televisionand to explore greater use of entertainment shows to
inform teens about risk. Reducing the amount of sexual
talk and behavior on television, or the amount of timethat adolescents are exposed to them, could appreciably
delay the onset of sexual activity. At the same time,increasing the percentage of portrayals of sexual risk
and safety relative to other sexual content might also
inhibit early sexual activity, increase knowledge ofsexual risks and how to be safe, and stimulate dialogue
with parents.
Studies report that men involved in teenage
pregnancies typically have lower levels of education,
have a greater age difference between themselves andthe adolescent mother, have higher rates of
unemployment, are more financially dependent, lower insocioeconomic status, have more behavioral problems
such as smoking, drinking, and illicit drug use, have more
simultaneous sexual partners and sexual transmitted
infections, engage in more aggressive behavior, andadopt poorer attitudes toward their partner‘s pregnancy
by being less involved in the postpartum care of themother and infant (Dunkle, et al., 2006; Gavin, et al.,
2002; Singh & Darroch, 1999; Wang & Chou, 2001).
There is little research that has investigated whether
violence perpetration by a male partner is associatedwith fathering an unintended pregnancy, but
documented association between perpetration ofviolence and high risk sexual behavior suggest than an
association is likely.
4. Sex as a Restricted Topic (Taboo) among Families
Sex is something that parents don’t talk about in
Filipino families. The lack of awareness is partly due to areluctance to vocalize problems (Magat, 2001). Open
communication with children with topics related to sex
should start during the early years of a child so thatwhen she reach adolescents, they can still openly discuss
their feelings in relation to sex.
Reducing teens’ exposure to portrayals of sex on
television poses challenges. An alternative approach thathas worked with violent content may also work withsexual content: having parents view programs with theirchildren and discuss their own beliefs regarding the
behavior depicted. Doing so can reinforce the benefits ofaccurate risk information and positive messages andmay help to limit the negative effects of sexual portrayalsthat do not contain risk information.4
Sister Teresa Dagdag in her book entitled, “May
Nangyari Na” reports that important individuals plays acrucial role in the lives of young girls. She shares thefollowing: “Wisdom guides who accompany an adolescentand help her need understand critical events in her life areher most powerful allies in decision making. These are theadolescent’s parents, teachers, mentors, agency counselors,
religious educators or others who offer a way for theadolescent to reflect on her options in life. They enable thefemale adolescent to recognize the power in herself tomake life giving decisions. These wisdom figures help pave
the way for her to acquire a broader and freer perspectivethat would help her develop a viable and sustainable value
system. This value system would no longer be based on
kaugalian. Instead, reflection can empower a female
adolescent to recognize the value of a strong sense of
taking a life direction or agency in life. The female
adolescent acquires clarity and becomes a better
integrated person.”
The importance of marriage as an institution both forthe individual and for the society at large cannot be
overemphasized. For the individual, it is an important

4 https://www.slideshare.net/guestd5f3a9/se-xand-media

Eubios Journal of Asian and International Bioethics 28 (November 2018)
event characterized by a flurry of multiple transitions—from child to adult, from mere member of a natal family
to main actor in the formation of a new family (Durbrow,
et al, 2001).
5. Teenage Pregnancy and HIV
Having unprotected heterosexual intercourse riskboth HIV infection and unwanted pregnancy, and nearly
one-third of women have a teenage pregnancy.
Understanding the interface of gender inequity andviolence, HIV and unplanned and unwanted adolescentpregnancies is important.
Much has been written about the adverse, short-term
health outcomes of teenage pregnancy for women andtheir infants. Teenage mothers have been found to be atincreased risk for anemia, urinary tract infection andpregnancy-induced hypertension. Infants are more
likely to suffer infant and neonatal death, accidents,
infections and sudden infant death syndrome
There is also a body of literature that has exploredthe longer term social and mental health consequencesof teenage pregnancy. These consequences include
depression and substance use, increased sexual risk
behavior, as well as lower educational attainment andsocio-economic status.
Most of this literature emanates from developed
countries in North America, Europe, and Australia.
Studies from South Africa have described therelationship between teen pregnancies and poorer
educational outcomes.
Adolescents having unprotected heterosexualintercourse are not only at risk of unintended pregnancy
but also HIV infection. Several observational studies
from South Africa have reported that the incidence of
HIV is higher among pregnant women than among thegeneral population.
Few studies investigating the risk factors for teenage
pregnancies differentiate between desired, unwanted
and unplanned pregnancies. In the South African context,
some teenage pregnancies are desired, but most are
unplanned or unwanted. The adverse consequences forunwanted pregnancies tend to be more severe thanthose for unplanned pregnancies.
Some studies that differentiate between unplanned
and unwanted pregnancies has focused on women of all
age groups and not on teenage girls in particular.
Differentiating between unplanned and unwanted
pregnancies may allow for a more nuanced
understanding of the risk factors of teenage pregnancy,and may allow for the development of more closely
targeted and more effective prevention strategies.
6. Objectives and Methodology
The issue of teenage pregnancy is recently evident in
Irisan Barangay. It is observed that a number of young
girls aged 13 and above are becoming pregnant in thecommunity, and this paper examines the situation. The
objectives of this research were:
1) To describe the occurrence of teenage pregnancy in
Irisan, Baguio City.
a) To identify the social norms of the teenage mothers
and their familiesb) To describe the effect of teenage pregnancy to themother, partner/spouse, family, and society.

173

7. Respondents and Interviews
Using purposive sampling, the following respondents
participated in this study. Ten teen age mothers aged
between 13 and 20 years of age. Ten family members ofteenage mothers
The study was approved by the AUSN Institutional
Review Board. Verbal informed consent was granted by
the respondents, who employed a case-study method byutilizing interviews, focus group meetings andobservations to explore the issues raised in the literature
review.
Guide questions were used in the interview so as not
to limit the data flow and process itself; follow-up
questions were given by the researcher and withconsideration for additional inputs of the respondents.
Observations included non-verbal communication
during the interview such as body and facial expressions
and projective sentences and statements. It also included
social and environmental environments. A focus group
discussion was held with twelve women and someinfants present, to further explore the issues.
The interviews were transcribed. From the data
gathered from the interviews, we used key word analysis,
and formed clusters or types to give classification of thedifferent cases.
This study is limited to a small number of
respondents of teen age mothers from Purok 14 B, Irisan,Baguio City, in order to help design a morecomprehensive research method and interview
instruments for further research (See Table).
Name
(Not
real)

NumberofChildrenAge ofChild

StatusKaren

Age /Ageatthetime ofgiving
birth
17/16

1

1 yearRoselle
Grace

25/16
17/13

2
1

4 and 2
5

Fiona

18/16

2

Jenny

17/16

1

Nalyn

19/15

1

1 yearold and1monthold
1 yearold
5SingleMotherMarriedSingleMotherLive-in

Maria
Britanny
Amy

15/13
18/16
18/17

1
1
1

2
2
1

Dina

24/16

1

8

SinglemotherSinglemotherLive-inLive-inSinglemotherSinglemother

8. Results
The stories of the 10 young mothers and theirfamilies discussed in this research is a common scenario
in many villages and rural communities in thePhilippines. Several factors have led to teenage

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Eubios Journal of Asian and International Bioethics 28 (November 2018)

pregnancies, such as poverty and lack of awareness on
the impact of early marriage.
The recent Young Adult Fertility and Sexuality Study(YAFS) reports that in the Philippines, the number ofteenage girls who have become pregnant across thenation has more than doubled in ten years. Around 14%
of girls aged 15 to 19 are either pregnant for the firsttime or are already mothers. That is up from about 6%
recorded by an earlier YAFS study in 2002. Furthermore,
the study revealed that one in three young teenagers
between the ages of 15 and 24 are sexually active.
The YAFS study coordinator and director of the
University of the Philippines Population Institute,
Josefina Natividad says that a lack of awareness of theconsequences of risky sexual behavior is contributing to
the rising rates of teenage pregnancies.5 The study titled,“Predictions and Timing of Early Childbearing in the
Cordillera”, reveals that the Cordillera Administrative
Region in the Philippines has the highest proportion ofyoung women aged 15-19 who had begun child bearing
at 18.4%, higher than the national rate of 13.6%. Childbearing is defined as having given birth before reaching
the age of 20. Results of the study indicate that the
proportion that had a birth before the age of 24 years ishigher among non-Cordillerans, rural residents andyoung women who were not raised by both parents
compared with their respective counterparts.6
Furthermore,the
National
EconomicandDevelopment
Authority-Cordillera
Administrative
Region elaborates in their article entitled, “Clear Set
Standards at Home Reduces Early Teenage Pregnancy
Risks” that in terms of exposure to the risk associatedwith early childbearing before 20 is higher among non
Cordillerans with a sudden increase at age 19 and it ismostly accounted for by births at ages 18 and 19.
However, in terms of exposure to the risk associatedwith early childbearing, the Cordillera women may be
more at risk because they started childbearing earlier
having recorded the youngest to be 13 years old. The
study summarized that among 20-24 year old women in
Cordillera Administrative Region, 25% or one in four hada birth before the age 20 or were teenage mothers. The
risk of early childbearing is not affected by urban-rural
residence, poverty status, ethnicity or being raised byboth parents. All are equally at risk. Having a college
education significantly decreases the risk of earlychildbearing. The timing of early childbearing shows thatmost teenage births happen in the late teen years at agesof 17, 18 and 19. The research also recommended thatinterventions should be age and gender specific notingthat the reaction of a 13 years old varies from thereaction of a 19 years old.
There are significant circumstances that affect young
women’s decision to engage to teenage sex. How they
respond to various issues in their lives are usually basedon their acquired and learned behaviors from theirparents, and the community where they are raised. With
the alarming increase of young women becoming
mothers at an early age, it is crucial to discuss factors
and influences for premarital/teen age sex as these may
5 abc.net.au6
http://car.neda.gov.ph/clear-set-standards-home-reducesearly-teenage-pregnancy-risks-study/

lead us to answers on the increasing rate of teen age
motherhood.
9. Relationship of Parents with Adolescent Children
The way that parents relate or connect to theirdaughters plays a huge role to young girls. It is evident inthis research that there is lack of parental openness to
topics related to sex.
It is observed among Cordilleran parents that they
are not comfortable in discussing about sexualintercourse, masturbation, STD, pubic hair, and so on.
For example, when a child asks his/her parents about
sexual intercourse, the common response among parents
is to tell the child that she/he will understand it when
she comes to that age. For some parents, they scold theirchildren for asking a question which they believe is
promiscuous. Sol Gordon discussed in his book titled,“Raising a Child Responsible in a Sexually Permissive
World” says that parents need to provide moral
guidelines. Given the fact that many adolescents engage
in sex without their parents’ consent, adults can try toensure that these encounters are not disastrous.
Standards of behavior are good for adolescents, as well
as for adults. Adolescents want and need sensible
guidelines from their parents. Hence, it is important forparents to learn to develop healthy attitudes about sex.
Well informed and confident parents who openly discuss
this topic to their children, may lead to sexually healthy
lives of their daughters and may even help in preventing
teenage sex.
The values, ethics and principles of a child aredeveloped in the family. Parental connectivity isimportant because the parents are the main actors inevery family, the guardian and enforcers of family values.
The parent’s role in guiding and advising female
adolescents in making important decisions may be astrong influence for either teenage marriage or anotheralternative. The adolescent also needs to anchor her lifeon her family, particularly her parents (Sr. Teresa
Dagdag, 2012).
The mother-daughter relationship in the family plays
a key role for the daughter in making crucial decisions in
her sexual life. It is therefore important for mothers tocommunicate significant feelings and thoughts about
teenage sex.
Karen shares that her father is a small scale miner
who is frequently away from home. When she
introduced her boyfriend to her family, her father invited
her boyfriend to drink. Jean claims she never knew what
they talked about until today.
Maria, on the other hand describes her dad asirresponsible and a womanizer. While her mother isworking in Singapore as a domestic helper, her father isalso busy having an affair with another woman. This had
pushed Maria to run away from home and stay with her
friends instead. Maria’s mother decided to take them out
from their family home and let her live with her aunt andgrandmother when her father brought home his mistress.
Parents have different ways of bringing up children.
Too little discipline is not desirable, and neither is toomuch. Karen describes her parents as supportive, hindi
namamalo (they never hit), hindi naninigaw (they don’t
shout) and they did their best to give her everything she
wanted in spite of not having enough money. Her motherEubios Journal of Asian and International Bioethics 28 (November 2018)is a Barangay Health Volunteer while her dad is a small
scale miner.
Fiona also describes her mother as super strict while
her dad as walang paki-alam (he doesn’t care at all).
Grace, being the second child from among 8 children
says that her parents are very loving and caring. Theynever failed to give her advice and they pushed her to go
to school. However, Grace admits that she is really hard
headed. She just followed her own desires. Poverty isalso one of the main reasons why Grace was not serious
on her schooling as she claims she goes to school without
pocket money and cannot submit school projects due tolack of money.
10. Sexuality as Taboo among Cordilleran Families
Parent-adolescent sharing about sexual mattersremains a taboo for most and to talk about it is an
exception at best. Adolescents tend to feel more
comfortable about sharing their sexual relationships
with their peer group and close friends rather than with
their parents. While a good number of mothers are able
to listen to the young female adolescents, most of theyoung women do not even attempt to share intimate
concerns about woman-man relationships with theirparents (Dagdag, 2012). In the Cordillera Culture, there
is an awkwardness in revealing and discussing sexuality
with parents.
Karen reveals that she has a close relationship withher mother while Fiona describes her mother as strict
and someone who would hit you instantly for your small
mistakes. Fiona shares that she did not really have aclose relationship with either her mother or father.
Furthermore, Karen claims that her mother is loving,supportive and lenient. Although she gives advice
regularly when it comes to education, they never really
discussed about premarital sex or sexual relationships.
When she introduced her boyfriend to her parents,
Karen was given abundant advice about theconsequences of marrying early but they did not discuss
anything about sex.
When Karen got pregnant, she did not have thecourage to tell her parents. She hid the pregnancy forthree months. However, since she was graduating fromhigh school already, she decided to disclose thepregnancy at her high school graduation. Karen claims
that at least she could compensate the shock ofpregnancy with her high school diploma. When her
mother learned about the pregnancy, she just cried andcommitted to support her all the way. Her mother eventold her that she would adopt her baby like her own
child so that Karen could still live a normal life.
It is evident from the stories of the young mothers
that some of them may have close relationship with theirmothers however the issue on sexuality remains a taboo.
The parents appears to be embarrassed in discussing
sexual life of their teenage daughters.
While examining the profile of the respondents, there
are also home situations that affects the motherdaughter relationship. For example, Maria’s mother isworking abroad and it is her aunt who served as her
guardian. Grace on the other hand shares that her
mother is preoccupied with her work and in taking goodcare of her other seven younger siblings.

175

The lack of quality time or complete absence ofmothers while they are growing up has a negative effectas children needs guidance and monitoring.
11. Sexual Culture
Today’s television portrays heavy doses of sexual
content, ranging from touching, kissing, andconversations about sexual activity to portrayals of
sexual intercourse. Sex is often presented as a casual
activity without risk or consequences. Conventional
wisdom holds that the messages young viewers absorb
from television promote sexual activity in this group. Yet,despite the prevalence of this view, there has been little
empirical study to date of how watching sex on
television influences teenagers’ sexual behavior (Collins,
et al 2004).
“No influence in your teenager’s life is as powerful as
peer pressure” says Neil Bernstein in his article entitled
Sex and Peer Pressure. Truly, peers can mobilize ateenager’s energy, motivate him or her to strive forsuccess, and encourage him or her to conform to ahealthy group norm. For young people, having peers
helps in founding their identity. However, peer pressure
can impair good judgment and fuel risk-taking behavior,
drawing a child away from the family and positive
influences and luring them into dangerous activities suchas premarital sex.
Karen shares that when she entered into premaritalsex for the first time, her friends congratulated her forthe new milestone. Losing one’s virginity is a wellcelebrated event among her peers. However this was not
mentioned by other persons.
Likewise, Mina was highly advised by her single
mother about the difficulties of being a single mother.
She experienced the difficulties of teenage marriage
herself as she is an illegitimate child raised by a single
mom. However, because of peers she still got pregnant
and repeated the past mistake of her mother.
Young people are likely to have unprotected sex when
drunk. Karen shares that she was drunk during her firstsexual intercourse. Alcohol is associated with having sex
at a young age, having unplanned sex and having
unprotected sex. Certainly, when drinking gets out ofhand, inhibitions are lowered and anything can happen-and that includes an unplanned sex and unwanted
pregnancy.
The birth of social media has also opened doors tolimitless access to sex culture. Music videos, movies,
reality shows, beer ads, and online pornography. Sex iseverywhere. The more sexual content kids watch andlisten to, the earlier they’re likely to have sex themselves.
Certainly, it is alarming that social media has a freesource of information about sex, dating and sexual health.
12. Young Women’s Reproductive Health as a
Development Issue
Women's reproductive choices include the number ofchildren they want, and when they want them. It is not
only a women's right but is also empowering, helping
women out of the cycle of poverty and hunger. Having
fewer children (or smaller families) has many benefits. It
makes it easier for women to participate in economic
and political work. Life can become less of a struggle
amid the soaring prices of food, high costs of social

176

Eubios Journal of Asian and International Bioethics 28 (November 2018)services and continued erosion in the real value ofmoney. The inability to make these critical life choices isa major obstacle for poverty reduction, food security andwellbeing for all, and especially for women.
Nevertheless, it is critical to see that women's
reproductive choices are not happening in isolation.
Discriminatory laws continue to limit women's rights toland and other productive resources; they suffer higher
unemployment than men and are relegated to jobs thatare lowly paid, exploitative and leave them vulnerable tovarious forms of sexual violence; and they continue to beeased out of participation in public and political life.
Neoliberal reforms, such as the removal of pricecontrols and subsidies on food and basic commodities,
and the withdrawal of public spending on healthcare(including reproductive healthcare services), child careand education, have increased the burden on poor
women to put food on the table and take care of theirchildren.
The importance of a study of adolescent sexuality isseen in light of the youth bulge that we experience in thePhilippines today. We are in the midst of a youth bulge
wherein the youth population ages 15-24 years oldreached 15.1 million in 2000 and is projected to be 30
million in 2030. According to Corazon Raymundo, thefigures for prevalence of premarital sex, being 1 out of 5,
having had sexual intercourse before marriage is high bycomparison with other Asian Countries (YAFS 3:93). This
study also responds to the recommendation of the
Economic and Social Commission for Asia and the Pacific(ESCAP) on the need to examine the socio-culturalcontext (including social structure, behavior, andgender) to develop active advocacy programs with aview to promoting positive societal attitudes towards
adolescent issues (ESCAP, 1997:4).
Furthermore, in the interests of national economic
development, Gilda Salvacion Diaz highlights theimplications of high adolescent fertility for national
economy, “The consequence of high adolescent fertility
not only threatens the health of young girls but also thecountry and its economy as well.” (Diaz, 1999:1).
Given the importance of the study on adolescentsexuality for our nation, there is a need for new
understandings of sexuality by our youth today so thatthey are not drawn helplessly into situations for which
they are not unprepared. Reexamining values such associal acceptance, hiya “shame”, pakikisama (getting
along) as well as learning perspectives on other values
named by Filipino psychologist Virgilio Enriquez basedon the Philippine Context are helpful in understanding
the decisions for present day teenage marriages.
Furthermore, developing a keen sense of agency in theadolescent would be a significant contribution towards
deepening awareness of what strengthening their active
participation in these decisions would mean in terms of
their future roles as parents guiding their own
adolescent children.
13. Discussion
There are several research findings on adolescentsexuality based on the stories gathered in the research(See also respondents’ comments in the Appendix).
These findings suggest the influences that drives womento teen age sex and the impact of teenage motherhoodand teenage marriage.
Poverty is a reality in the lives of the young women
respondents in the study. Baguio City is a highly
urbanized community that makes them more vulnerable
to community pressure. One of the respondents said that
she was discouraged to go to school due to lack of daily
pocket money and failure to submit projects in school
due to lack of enough resources to sustain her education.
The respondents are lured into the idea that marriage isthe answer to escape poverty at home, however, thesituation led them more into the vicious cycle of poverty.
Two of the respondents are on their own building theirown family and rearing their children without support
from their parents.
To save the young woman’s honor, marriage offers away out of the “kahihiyan” (embarrassment) of being a
non-wed pregnant young woman. Two of the
respondents were married by their parents following a
traditional practice although they were not of their legal
age yet. Marriage law in the Philippines is governed by
Executive Order 209, The Family Code of the Philippines.
Legal capacity of the contracting parties who must be amale and a female, aged 18 years or above. However, thetraditional practice which was agreed by both families ofthe young couple has become their permit to live
together as husband and wife. Culture prescribes thepractice when certain values become so deeply
entrenched becoming the basis for a community
response. The community pressure to act in a certain
way may be expressed as an approval or censure ofteenage and pregnancy.
Today’s modern age has opened limitless access to sex
culture. Everyone (young and old) has access to theinternet which provide a rich source of information.
Music videos, movies, reality shows, beer ads, and online
pornography. Sex is everywhere. The more sexual
content kids watch and listen to, the earlier they’re likely
to have sex themselves.
Young people are likely to have unprotected sex when
drunk. Alcohol is associated with having sex at a youngage, having unplanned sex and having unprotected sex.
Certainly, when drinking gets out of hand, inhibitions arelowered and anything can happen--and that includes anunplanned sex and unwanted pregnancy.
14. Recommendations
With the surging hormones and emotional changes
that frame adolescence can feel like a roller coaster ride.
There should be an improvement on sexuality education
for young people and providing them with the services
that they need in order to protect themselves fromunwanted consequences of sexual behavior
From the results gathered from this study, thefollowing are the recommendations:
1) Strengthening their morality/Spiritual Upliftment
This concern is both appropriate to the single
members and the teen mothers. Since the singles arealso vulnerable to bad influences or temptation, andthe teen mothers for further pregnancy, they need tobe reminded of making moral decisions, selfrestraint, self-preservation and other good manners
and conduct.

Eubios Journal of Asian and International Bioethics 28 (November 2018)
2) Teenage Motherhood
Young as they are, the teen mothers are not yet
fully capable of mothering a child. They haveconcerns on how they should take care of, and rear
their, children. Of course, they get help from theirmothers, but eventually, they need to stand on theirown.
3) Acceptance of their fate and ability to move on
Some are still bitter and low-spirited about theirfate and failed to move on. Some had stopped
dreaming of going back to school. Some are regretfulof the decisions they made. With these, they need a“little push/boosting” to accept whatever situation
they are in and lead life as normal as possible.
4) Family planning
Since some of the teen mothers are alreadycohabiting with their boyfriends, most likely they
will get pregnant again. Thus, they need to listen tolectures on family planning to space out theirpregnancy for their welfare.
5) Research on men and boys
Most studies of unintended pregnancy havefocused on women rather than men. Given genderroles and norms, especially around sexual decisionmaking, where men may have more power andcontrol over initiating sexual encounters, it makes
sense that men should also be a focus of research andpotential intervention.
6) Instill a strong sense of self.
Talk about activities your children can do that
don't involve alcohol. Engage them in sports,
volunteer activities, etc., and talk about the inevitablepeer pressures that will crop up in the teen years andhow to handle them, say no, and still feel selfconfident.
7) Sex education should start at home.
Parents should not depend on school healthprograms to do all the educating. True, they offer sex
education classes, but it's ultimately up to you to give
your teen the education he or she deserves. And theone you want them to have.
8) Discuss alcohol use and abuse.
Talk about the effects alcohol has on the body andthe mind, both long-term and short-term.
9) Talk openly about sex.
Let your teen know that no topic they want tobring to the table with you is too embarrassing or offlimits. The only way to know what they're thinking is
to talk to them.
10) Get stats
Numbers are scary. The number of teen
pregnancies alone is scary. You may also offer thestatistics listed above regarding pregnancies that
occur while drinking. Here is a good breakdown of
the cost of having a child. The cost alone of raising achild is, in some cases, enough to deter a teen fromhaving unprotected sex or from putting themselvesin a situation where their inhibitions may be lowered.
No single or simple approach has successfully
reduced the teen pregnancy rate sufficently; much
more study and efforts are required. Other
industrialized countries have much lower teen
pregnancy and abortion rates than some other177

countries such as the USA. This social problem has agreat impact on us. It will take the involvement andefforts on the part of families, society andgovernment to negotiate a change in the right
direction.
15. References

St. Dagdag, Teresa (2012). May Nangyari Na
Chendraui, P., Van Ardenne R., Wendte J.F, Quintero J.C, Hidalgo,
L. Knowledge and practice of family planning and HIVprevention behaviour among just delivered adolescents in
Ecuador: the problem of adolescent pregnancies
Sedziafa A., Tenkorang E. Correlates of Forced First Sexual
Intercourse Among Women in the Philippines
Christofince N. Adolescent pregnancy: risk factors andconsequences – a longitudinal study in the Eastern Cape,South Africa.
Eric H. Durbrow et al 2001. Mothers’ conceptions of childcompetence in contexts of poverty: The Philippines, St
Vincent, and the United States
Jeofrey B Abalos Journal of Family Issues 2014 Vol 35(12) 16241641. Trends and Determinants of Age at Union of Men and
Women in the PhilippinesMagat, Margaret. a_Magazine (Mar 31, 2001): 55. Teenage andPregnant.
Eric H. Durbrow et al 2001. Mothers’ conceptions of childcompetence in contexts of poverty: The Philippines, St
Vincent, and the United States

Websites

http://www.abc.net.au/news/2014-03-24/an-number-ofteenage-pregnancies-doubled-in-philippines-in-last/5341334
http://car.neda.gov.ph/clear-set-standards-home-reducesearly-teenage-pregnancy-risks-study/
http://www.advocatesforyouth.org/parents/166?task=view
http://www.rand.org/pubs/research_briefs/RB9068.html
http://www.nbcnews.com/id/6867362/t/sex-peerpressure/#.WB4HQ49OLIU
http://www.unfpa.org/press/world-population-day-2013focuses-adolescent-pregnancy
http://unama.unmissions.org/world-population-day-un-chiefdraws-global-attention-adolescent-pregnancy
http://beta.philstar.com/headlines/2013/07/12/964481/16m-teens-give-birth-every-year-un

16. Appendixa) Structured Interview Guide
1. How old are you?
2. When did you give birth to your first child?
3. Do you have more children?
4. Who do you live with?
5. How are you coping?
6. Who is supporting you financially?
7. How much emotion, moral and other support did yourmother and father give you?
8. What happened with your school, and schooling?
9. Do other family members or friends support you?
10. What is the relationship with the father of your child?
11. What plans do you have for the future?
12. What advice can you give to other young girls?
13. When you look back would you have done anything
different?
14. What is your ethnic background?
b) Interview Results: Grace 17/13

1. How old are you? 17
2. Age of your partner 27
2. When did you give birth to your first child? 13

178

Eubios Journal of Asian and International Bioethics 28 (November 2018)

3. Do you have more children? none
4. Who do you live with? parents
5. How are you coping? Okay lang
6. Who is supporting you financially?
Parents, siblings, in-laws
7. How much emotion, moral and other support did yourmother and father give you?
Full support
8. What happened with your school, and schooling?
I got pregnant when I was in Second year high school (Grade 8).
After giving birth, I continued my studies through the Alternative
Learning System. I had graduated high school through thisprogram.
9. Do other family members or friends support you?
Yes, the sister of the father of my child.
10. What is the relationship with the father of your child?
Separated. When I got pregnant, our parents decided to get us
married following our ethic tradition. “Namanhikan” ungboyfriend ko. Our parents decided our wedding day. We had asimple celebration at home, after that I went to my boyfriend’s
home where we lived as husband and wife for two years.
Living with him was difficult. He would come home drunk and hitme. He would slap me and accuse me of having an affair. If I talkto any man, he would hit me because he was jealous.
I sacrificed for two years and had faith that someday he wouldchange. However, he continued to verbally and physically abuseme.
I was 15 when I decided to go back home and live with myparents again.
Because we were culturally married, my parents and his parents
talked again to discuss our separation. They had asked for mydecision but I was already firm to that I would break up with thefather of my daughter.
Our parents respected my decision and agreed that we separate.
With regards to my daughter, we have agreed that we would
take turns in taking good care of her. There are times that mydaughter lives with her father in a week, and then, I take her fora week. We take turns.
To date, we have been separated for five years already. I heard
he is dating somebody else. We are civil to each other for the sakeof our daughter.
I don’t have any plans to enter into another relationship now. My
priority is my daughter and I want to give her the best.
I work as a “kasambay” and I earn five thousand monthly. It isdifficult but I have to do it.
11. What plans do you have for the future?
I still look forward to going back to school.
12. What advice can you give to other young girls?
Listen to your parents.
13. When you look back would you have done anything
different?
Yes but I don’t regret anything about my daughter. I regret that I
did not listen to my parents.
14. What is your ethnic background?
Ifugao15. What is the ethnic background of the father of your child?
Mountain Provinceb) Interview Results: Fiona 18/16

1. How old are you? 18
2. Age of your partner 18
2. When did you give birth to your first child? 16
3. Do you have more children? Yes, 1 month old
4. Who do you live with? parents
5. How are you coping? Narigat
6. Who is supporting you financially?
Parents, in-laws
7. How much emotion, moral and other support did yourmother and father give you?
I am on my own

8. What happened with your school, and schooling?
I got pregnant when I was in Third year high school (Grade 9).
After giving birth, I continued my studies through the Alternative
Learning System. I had graduated high school through thisprogram.
9. Do other family members or friends support you?
Friends who are young mothers like myself
10. What is the relationship with the father of your child?
Cohabiting (Live-in)
Our parents agreed that we live together as husband and wife
although we cannot get out marriage license yet because we areboth 16 years old at the time I got pregnant.
My husband’s family provided us with a separate room so we canstart on our own. My husband works on various jobs such as
construction work and other odd jobs. For me I just stay at home
and take good care of our children.
11. What plans do you have for the future?
I want to continue my college education.
12. What advice can you give to other young girls?
Young girls should take as a mirror. They should look at oursituation. They don’t need to experience that we experience now.
Their only job now is to study hard, hence they should reallywork hard on it.
13. When you look back would you have done anything
different?
I should have studied very hard.
14. What is your ethnic background?
Mountain Province
15. What is the ethnic background of the father of your child?
Kalinga Provinceb) Interview Results: Karen 16/15

1. How old are you? 18
2. Age of your partner 18
2. When did you give birth to your first child? 16
3. Do you have more children? Yes, 1 month old
4. Who do you live with? parents
5. How are you coping? Narigat
6. Who is supporting you financially?
Parents, in-laws
7. How much emotion, moral and other support did yourmother and father give you?
I am on my own
8. What happened with your school, and schooling?
I got pregnant when I was in Third year high school (Grade 9).
After giving birth, I continued my studies through the Alternative
Learning System. I had graduated high school through thisprogram.
9. Do other family members or friends support you?
Friends who are young mothers like myself
10. What is the relationship with the father of your child?
Cohabiting (Live-in)
Our parents agreed that we live together as husband and wife
although we cannot get out marriage license yet because we areboth 16 years old at the time I got pregnant.
My husband’s family provided us with a separate room so we canstart on our own. My husband works on various jobs such as
construction work and other odd jobs. For me I just stay at home
and take good care of our children.
11. What plans do you have for the future?
I want to continue my college education.
12. What advice can you give to other young girls?
Young girls should take as a mirror. They should look at oursituation. They don’t need to experience that we experience now.
Their only job now is to study hard, hence they should reallywork hard on it.
13. When you look back would you have done anything
different?
I should have studied very hard.

Eubios Journal of Asian and International Bioethics 28 (November 2018)
14. What is your ethnic background?
Mountain Province
15. What is the ethnic background of the father of your child?
Kalinga Provinceb) Interview Results: Maria 15/13

1. How old are you? 15
2. Age of your partner/father of your child 15
2. When did you give birth to your first child? 13
3. Do you have more children? none
4. Who do you live with? Parents of my live-in parnter
5. How are you coping? Difficult
6. Who is supporting you financially?
Parents
7. How much emotion, moral and other support did yourmother and father give you?
little8. What happened with your school, and schooling?
9. Do other family members or friends support you?
Grandmother and aunt
10. What is the relationship with the father of your child?
good
11. What plans do you have for the future?
I want to continue my high school through Alternative Learning
System.
12. What advice can you give to other young girls?
Do not do what we did.
13. When you look back would you have done anything
different?
I should have taken my broken family as a challenge to make mylife better.
14. What is your ethnic background?
Mountain Province
15. What is the ethnic background of the father of your child?
Kalinga Pangasinan

Ancient Indian Gurukul System:
Developing an Ethical Human Being- Ketan Mor
Faculty of Law, University of Delhi, India
Email: Ketanmor.Mor94@gmail.com
What is Indigenous Knowledge?
As Harvard University defined traditional knowledge(TK) is generally understood to encompass four types ofcreative works: verbal expressions (stories, epics,
legends, folk tales, poetry, riddles, etc.), musicalexpressions (folk
songs
and
instrumental
music), expressions by action (dances, plays, ceremonies,
ritualsand
other
performances)and tangible
expressions that must be fixed on a permanent material(drawings, designs, paintings (including body-paintings),
carvings, sculptures, pottery, mosaics, jewellery, basket
work, textiles, carpets, costumes, musical instruments,and so on. Creative works are integral to the cultural andsocial identities of indigenous and local communities.
They embody knowledge and skills, and they transmit
core values and beliefs.
The Oxford Dictionary defines Indigenous Knowledge(IK) by describing its most usual traditional
characteristics, such as experiential knowledge of livingon a particular land or the holistic nature of muchindigenous knowledge, such that dividing science,
religion, and the arts into separate areas. But when we

179

understand IK in an Indian context then first we have tounderstand, “What is Knowledge?” Knowledge is not justknowing something. It is beyond knowing, namely it isfrom knowing to understanding. The distance which wetravel from knowing to understanding is called
Indigenous Knowledge. IK is devoid of anything which isinversely proportional to sustainable development.
Knowledge in the current scenario may be such which
can damage the current sustainable goals as direct
example is global warming. But when we speak of IK webelieve in a cosmic balance in every perspective.
Indigenous knowledge with respect to India inparticular
The main purpose of education is to achieve three
things and those are Knowledge, Skills and Behaviour.
All three are interrelated and helping each other toachieve an ideal Human being which is devoted to thesociety. Humans should have sensitivity to three things –first, his emotion should be wide. He should haveavailability to express himself freely through his senses.
Second is respect for his hard work. From growing thecrops in cultivation and finally consuming it as a food.
We must have respect for it. The last one is Collectivism.
All our activities should have participation of people. Our
works is for the community. In India there is little place
for individuality in one’s life. Every country has one
Destiny, one message and one mission. Education should
makes clear all these things in country’s population andespecially youth and children. Education system should
teach them to work under the principle of धमर् (Duty),अथर् (Money), काम (Pleasure), मोक्ष (emancipation) –these are four pillar of Indian indigenous knowledge.
Arth and Kaam should be according to Dharma for finallyachieving the Moksh. Our system should teach thesevalues to our children and youth. Moksh in a spiritual
sense may seem to be a concept out of order of day to
day routine but when that blissfulness and that feeling ofsatisfaction is observed in every sphere of life it becomes
the solace to oneself, and resultantly to the people
around you at large. Anything that is earned fromrightful means necessarily will go into rightful deeds andshall benefit the society at large and not only to anindividual aspiration.
To understand an Indian perspective of knowledge
what is required is understanding the word “DHARMA”,
which has no real English equivalent. The understanding
is required since in every aspect of human life and not
only humans, every aspect of life which has an elementof nature in it, India believes in an aspect of Dharma
working.
The root of the word dharma is "dhri", which means"to support, hold, or bear". Like Dharma of Fire is to
ignite and when it is moved in the right direction it may
propel a rocket and advance a human from the earth tothe moon and when it acts against the Dharma it may act
as a nuclear bomb explosion resulting in mass deaths. So
anything which is to support, hold or bear and is for
upliftment of a person or nature is Dharma.
One of our great leaders, Shri Golvarkar said about
Dharma in day to day life. He explained Dharma as
without the interference of external punishment system,
controlling the selfishness, lighting of moral ethical

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values among us, and accepting the diversity in natureincluding the way of living. Dharma is above god. Even
gods are regulated by it. So this is above religion, andabove all guiding principle of once life. The Hindu way oflife is not just to see black or white - it looks between thelarge grey area of both. We have accepted everything as
true. We say a person always moves from minimum
truth to maximum truth.
While the root of indigenous knowledge was toliberate a soul for the larger interest of society andmother earth the present education system is making
people dependent on state. People ask the government
for jobs. The present system makes people surrender infront of you. You can rule for centuries. An example is theworld recession in 2008, but India remains generally
safe due to its non-dependence on government andbecause of its personal saving values. Thus ourknowledge system is eternal in nature.
The main idea behind life is that a person comes andgoes from this world with an empty hand, but still in thepresent time people are fighting for land, property,
money and so on. But India’s knowledge system taught
us to sacrifice material things for the community. Whowill sacrifice more contrary to the present day world
where everybody is fighting for their own share? Nobody
wishes to give up their share for larger goods. We are
told stories of our leader’s sacrifices from childhood.
That is why, Ambani a big industrialist is not aninspiration for us but Swami Vivekananda, Netaji
Subhash Chandra Bose, Veer Savarkar, Sardar Patel, andat the present time our Hon’ble Prime Minister is a herofor us because they have made sacrifices in their life forthe welfare of communities.
The present education system is creating an illusion in
front of our Indigenous knowledge system. The system
is trying to change the very basic definition of enjoyment,
affecting the types of sacrifices which people had been
told they should make in the indigenous knowledge
system. This very illusion forces our families to focus
more on individual goods rather than the extended
family and society at large. If they succeed in making thisillusion then we will laugh at those who will talk about
duties, responsibilities, love and emotion. Their soul will
be dead and thus will always remain subordinate to theirboss.
Differences between the Present system and Our
Indigenous System
The present system looks at the world as a market.
Philosophies like Globalization, Liberalization andPrivatization have led to the destruction of our families.
Individuals are separated from the Family. Everything isa market and people became commodities for themarkets. The meaning of “development” and ways forprosperity are totally different for them. They want tosell more TVs and build more houses, for example. But
our indigenous knowledge never taught this.
We believe in the principle of Vashudev Kutumbkam
thereby the world is our family. We used to live together,eat together, watch TV together, and sleep together inthat same house. No matter how big your family is, youwill find community more important than individuals
even in today’s life. The present system changed the very
definition of rich and poor, development and growth.

Present definitions are entirely contrary to ourindigenous knowledge systems (IKS). One who spends
more, or lives a luxury life is not a rich person according
to our IKS. We are taught to live with bare minimum
needs. Mahatma Gandhi had lived his life with minimum
needs. He is the great example before us. Gandhi said weare stewards of nature or managers of this wealth.
Every knowledge system has its own roots andsources from where it derives its force. Indian
Indigenous knowledge systems find its roots from below
systems. Therefore, there are many aspect of India’s
Indigenous Knowledge system such as
A) Vedas, Purana and Upanishad Texts, Other Reference
books such as Ramayama, Mahabharat, Bhagavat Gita
etc. These all are reservoirs of our Knowledge system.
B) Ancient Gurukul System for Education and LearningC) System for Democracy and Governance - Famous
Book by Chanakya: Arthashastra.
D) System for Nature and Health- Yoga is accepted
worldwide in International Yoga Day on 21st June.
From basic moves to attaining spirituality, Yoga has
different forms. Maharishi Patanjali greatest
promoter of Yoga in this world.
E) System for Medicine- Ayurveda, is accepted by manyas an alternative for Western Medicine. Sushruta is
known as Father of Surgery in our Vedas.
F) Vedic Mathematics and Sanskrit is scientificknowledge for the world. Aryabhata, Indian founded
Zero on this earth. Bhaskarachaarya was a profoundleader of Vedic Mathematics.
But I will focus only on the Ancient Indian Gurukul
system.
Ancient Gurukul System
I am the product of the current education system. I thinkthat the current system is entirely contrary to‘Indianness” and we need to develop a system anchoredin the ancient philosophical and culture traditions of ourcountry. This system is the Gurukul Education systemand this system worked for centuries in India and still
hasn’t lost its value.
Human life in ancient India was scientifically divided
into four Ashrams. The very first ashram has a life spanup to the age of 25 years, and is known as ब्रह्मचयर् आश्रम, aperiod of learning, acquiring knowledge and skills invaried fields developing moral and ethical values related
to not only one’s personal development but also withconcern for the development of all humans. In addition
they had respect for nature and lived in harmony with all
creations of God. The emphasis was not on the individual
but developing the individual as per once capabilities forthe benefit of whole society.
The other ashrams were the ग्रहस्त आश्रम, up to the ageof 50 years where one would perform duties towards thefamily and society followed by वानप्रस्थ आश्रम, up to theage of 75 years where one prepares to withdraw fromthe worldly life and ultimately the सन्यास आश्रम, up to theage of 100 years where one aims for attaining
spirituality and serving the people.
For developing a holistic human being the process
started with Gurukul meaning a teacher and his family.
Gurukul itself means a home of a teacher who is calledEubios Journal of Asian and International Bioethics 28 (November 2018)गुरु (Guru). The word guru is made of Gu and Ru. Gumeans metal of darkness and Ru means light. Thatmeans a teacher who helps you or brings you out fromdarkness to light. The teacher’s relationship with people
was that to be of a family rather than the commercialized
education which we enter today where education istreated as a commodity for sale.
The Guru was one who had mastered different form
sof knowledge, skill and ethical values. The students
came from all classes of life, i.e.. from the royal children
and children of common persons. All were termed asिशष्या (disciples). Generally the Gurukul was establishedoutside the urban centres away from a life of luxury.
Both the guru and shishya led a life of atrocities in spiteof their different social and economic categories in orderto understand and grasp the harassed reality andmysteries of life which they were trained to master. Takefor example, social relationships which master theshishyas for their relationships, duties, obligations andresponsibility to their parents, brothers and sisters,
relatives, neighbours and so on. Thus, this individual wastrained from the childhood that he is for the society as awhole and that is why concepts like िपतृ धमर् (duty offather), पत्नी धमर् (duty of wife), पुत्र धमर् (duty of child), राजधमर् (duty of king), were developed and preached defining
individual rule in terms of social position, andresponsibility which the individual holds towards other.
Thus if the individual shishya was learning weaponry
and art of war, he was not only supposed to master thoseskills but also to understand the ethical aspects linked tothat. For example, there will be no war after sunset,
unarmed persons will not be attacked, one should fightfor right, and hence learnt what is described as Dharma
Udhya (धमर् युद्ध). The art of governance was learnt
through concept of Raj Dharma, which determined not
only the duty of king but also the morality related to theposition like being just to all, and working for the welfareof citizen.
Shishyas are taught about nature, for example, what is
the minimum uses of resources for the life. We aretrustkeepers or managers of this mother earth. We
should leave this earth in a better form to our new
generation than the one we were born into. Shishya aretaught to worship nature. They were asked not to cut
those plants which are essential for the existence of bothhumans and animals. The same things were taught aboutanimals. As a cow is treated as a mother in our country.
Not only plants but even rivers are treated as a motherin India. That’s why for us Ganga is not just a river, it’s amother. We worship rivers. And with these values we try
to respect and conserve nature.
Many times people argue from the West, that Indians
worship everything. They laugh at us. But now they are
realising the hard effects on nature due to exploitation.
Due to global warming our glaciers are melting. Now
some people have woken up, and try to teach us thephilosophy to conserve nature. For them, we just want to
say that this country has conserved nature for centuries
and still we do. We don’t need lectures from the so-called“developed” nations who are responsible for more than
80% of the carbon emissions in the name ofdevelopment. We have formed the International Solar

181

Alliance and acted together with the Paris Climate
Change Agreement
More than 80 countries are geographicallysurrounded purely or half of are in immediate danger
due to rising sea level. At that moment we need to act asa team, as a family work for the betterment of this world.
This earth is not the property of any one person or
country but we all equal trustees and managers of thisbeautiful creation of god. वसु धैव कुटु म्बकम all the world isa family and when we look at this broad perspective, ourchildren and youth start respecting it.
Today we talk of bioethics. These are the values whicha child gets from his home. If we have to teach ourchildren and youth about ethics and values, then in somesense it is a failure of our education system. Gurukul
teachings from beginning to end is taught over Dharmathat you can even call ethics. From discipline, to goingout in search of food, even the children of royal family go
out to search and gather food. From doing war togovernance to business they are taught ethical values
and their activity is valued on the scale of what we called
Dharma or ethics.
Also there is a system of punishment. If someone
violated it at an earlier time there is no such systemcalled Police. But persons have the fear of punishment.
For example if I put water to तुलसी Ocimum sanctum
plant in night. Nobody will punish me for doing that but I
will never do it because there is a stick of Dharma whichconstantly checks my action. As scientifically we know
we should not pour water at night as it is harmful forsome plants. Looking at the level of ethics this society
has in their life style can be disturbing. That why we say
India has shown the way to the world with itself livingthat life.
This present system led us to such conditions where
we have taught our generation about these ethical values
because the Western system left no stone unturned to
debunk ancient system as orthodox and even the KarlMarx called the Indian society as stagnant, oppressive
and one who worshipped donkey and cow (Marx, 1853).
For almost last three centuries, the world has facedcolonialism, imperialism, industrial revolution, IT
revolution and today we stand in a knowledge society.
Two things are particularly important here, one is that IT
is a tool, is information, is data but not Knowledge.
Secondly, why have ancient Indian practices, be it Yoga,
Ayurvedas or even Sanskrit. the mother of languages, arebeen looked upon by the whole world not only forknowledge but also for the wellbeing and continuity ofhuman values. One should remember here that theconcept of वसु धै व कु टु म्ब कम- the whole world, a family
emerged and thought of the ancient Indian philosophy
taught through Gurukul. Even then there was no UN.
Reasons behind our present condition
The main reason behind it s thats we started looking
at the West. In everything we started following themblindly. Each person may say, “My system is best. You
must follow it.” This propaganda is seen throughout thepresent system. Our indigenous system did not teach this.
Every country and within country every region can haveits own model to be adoptive for their development, but

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Eubios Journal of Asian and International Bioethics 28 (November 2018)

the purpose of all systems is the same to have moral
ethical values in our life.
Conflicts
Due to conflicts between their system and ourindigenous system, this system of Gurukul came underattack through the earlier Muslim invasion, and yet it
could not be uprooted. Though disruptions were there it
could not be disrupted. Even the invent of British rule inIndia in spite of the introduction of the Westerneducation system created to develop loyal citizens of theempire, and the missionaries zealous efforts of
conversion and for here what they faced was deeprooted in culture, and tradition in the form of a living
culture that had been there for thousands of years.
There have been long series of attacks over our IK
systems which have spread knowledge acrossboundaries and are world famous by invaders. These
include, for example,
1. Vikramashila University established in 730 AD
destroyed in 12th century;
2. Somapura University established in 8th century
destroyed in 11th century;
3. Odantapuri University established in 8th century anddestroyed in 12th century;
4. Nalanda university established in 5th century anddestroyed in 11th century. The most horrific episode
was the destruction of the gigantic library of Nalanda
which housed more than 9 million invaluable
collections of scripts, literary works of great scholars
collected for over seven centuries.
5. Takshashila University established in 5th century BCE
and destroyed in 499 AD
Lord Macaulay in his speech to British Parliament 1835
said, I have travelled across the length and breadth ofIndia and I have not seen one person who is a beggar,
who is a thief. Such wealth I have seen in the country,
such high moral values, people of such calibre, that I do
not think we would conquer this country, unless webreak the very backbone of this nation, which is her
spiritual and cultural heritage.
All their theories and efforts failed. Earlier theories
focused on IQ, which says when you are in danger saveyourself first, but now they talk about EQ, called
emotional quotient because when a car with a father,mother, and disabled daughter falls in water what makes
the father to save his daughter, and later he died due tosaving her.
There are differences between humans and animals.
Animal live to eat, sleep and give birth. I think nothing
more is their purpose of life. One of the great scholars ofwestern thought, Aristotle said, “Man is a social animal”.
He has compared humans with animals, but humans
should think beyond simply eating and giving birth to achild. He has a mind which must be used for establishing
the power of Dharma in whole universe.
Education for accepting diversity
Samuel Huntington, an American scholar, wrote in his
book “Who are We”, that with this coming of immigrants
in America, America has lost its identity. Samuel P.
Huntington writing about who we are in this word, said
that “we” has to be understood clearly. Here “We”
signifies IK, for sustainable development.

IK totally opposes to the present day focus onIntellectual Property Rights (IPRs). We are not opposing
to those people who got so many patents to their namebecause of honest inventions. But what we really have tothink about is the process which makes that person able
to register a patent in his name. When a child grew fromtheir beginning to the final achievement in theor life, that
doesn’t belong to them totally. There are many factors bywhich that person becomes capable to attain thatsuccess. From your home to your office, so many persons
help your life to make you successful. Every single
person should be complimented with your success. But
we have seen every concept of IPR makes every successstory be confined to individuals. He didn’t realized his
responsibility towards the society which contributed tohis success. Thus IK is always against such concepts, inmy opinion.
Multiculturalism has been seen as a bone in the neckin western world. It looks like it promotes separatism
but if this will not be there then how will a free market,
and liberal politics work? Multiculturalism has also
created difficulty in front of UN about its identity. The
Theory of Hedonism says people do everything forpleasure, is being rejected by our IK system. The
Utilitarian theory given by Jeremy Bentham argued that
we should focus on the greatest happiness for greatest
number of people, but it is rejected by most IKSs. The
Survival of the fittest theory has also been rejected.
We can accept multiculturalism when we can think weare one. This earth should not be a war zone. Withknowledge and wisdom this world can resolve all its
issues and lead a sacrificial life. Gandhian theory canguide us in our life. The Indian theory of
Antyodaya(अन्त्योदय) given by Pandit Deen Dyal
Upadhyay which talks about the welfare and wellbeingof last man in the row is being accepted by this nation.
Our Vedas, Isha-Upnishad can show us the way to livewith diversity.
There is a phenomena and trend generally among
students to identify and belong to some fraternity. Theintermixing of people in Colleges can break down
barriers.
Importance of Mother tongue in Education
New research has shown that chanting of Sanskrit
mantra increases the size of mind and is helpful inmemorising more information. Language is just a
medium to communicate. We must learn as many
languages as we can. India has recognised 22 official
languages despite the fact that more than 70% people
speak Hindi. There are almost 150 similar languages
prevalent in our society. We have accepted the beauty oflanguages. We are taught to dream in our own languages.
I don’t speak good English. When I asked my professor
to correct my language he told me that if I want to speak
good English then start thinking in English. But when I
started thinking in English all my thoughts and all mycreativity ended. Because as I said about the nation it is
the same as about one person. Every person on thisplanet is unique. He has his own ways of learning
reading, writing and it is our duty to promote it. Onceyou accept that language is just a way of communication,

Eubios Journal of Asian and International Bioethics 28 (November 2018)
and focus on your indigenous way of thinking andlearning, you can do wonders in this world.
How India can guide the world
These principles which originate in India centuries
ago, can be given to the world. They are universal innature and can be applied in any place, time and space.
Ultimately first to our youth and children we areremembering our glorious past and then I believe theseyouth and children from India will go across theboundaries and spread them in the world with the helpof others. Some key phrases are:
Truth Alone Triumphs
Non-violence is the topmost Dharma
God seen even in Plants
Let good thoughts come from everywhere - from all theworld
All Spiritual Paths are treated Equally
The whole World is one single Family
May all be prosperous and happy
May all be free from illness
May we all be protected
May we all be nourished
May we work together with great energy
May our intellect be sharpened - and not give rise to
Hostility
Happiness lies not in the desire for state, or material,
nor the desire for Heaven, nor reincarnation
Happiness lies in dousing the pain and suffering of allliving beings
One who is a true devotee of God - Feels the pain ofothersService of the poor is equivalent in importance and piety
to the service of God
If a human being Acts – He can become god
Woman you are a veritable Goddess
Where Women are honoured - There Divinity blossoms
Where They Are dishonoured - All Action Remains
Unfruitful
Mother and Motherland are superior to Heaven
Conclusion
In conclusion of the above discussion I may say inhumbleness by borrowing again the words from ever
eternal Vedas and ancient Indian text and those are “(नेितनेित)” which stands for “neither this, nor that”. It stands
in my opinion that all education systems, knowledge
courses, discourses are made with an intention pure andhonest to serve humankind.
The only thing that indigenous knowledge can beadapted for is that none is wrong and all paths are forthe betterment of human life by balancing it with mothernature and following the fundamental principle of the“greatest good of all”, and negating the path of “greater
good of greater number”, so as to make obsolete the very
thought of exploitation of even one soul on this earth.
The very idea of Indian ancient knowledge system is“माता भूिम: पुत्रोहं पृिथव्या:”, I am son of this mother earth.
The very thought of humans and live relationships withnature makes you aware of your surroundings, be it
nature or its dwellers. It makes you kind, receptive,
humble and adaptive towards the other existences ofmother nature and you tend to have a sense of belonging,183

and when that better sense prevails one may consume as
per our need, but never exploit, be it for natural
resources, animal kingdom or the ever evolving humanlife.

Levels and Determinants ofComplementary Feeding Pattern
Exclusive of Minimum Meal
Frequency and Dietary Diversity
among Children of 6 to 23 Months
in Bangladesh- Naznin Pervin BDS, MSc, MHE, MPH
Consultant Dental Surgeon, Salauddin Specialized Hospital Ltd,
Dhaka, Bangladesh
Email: nazneenmowshumy@gmail.com- Darryl Macer MPH, Ph.D., Hon.D.,
President, American University of Sovereign Nations
Email: provost@ausn.info- Shamima P. Lasker, PhD (USA), MPH (USA), EMMB (Europe),
MPhil (BD), MSc (BD);
Professor & Head of Anatomy, MH Samorita Medical College,
Dhaka, Bangladesh; AUSN Visiting Professor of ClinicalAnatomy & Bioethics, USA
Email: splasker04@yahoo.com

Abstract
Objective: To estimate the level of complementary
feeding pattern (CFP) among children aged between 6 to
23 months and to identify the determinants in individual,
household and community level in Bangladesh.
Methods: From secondary data of Bangladesh
Demographic Health Survey (BDHS) 2011 was used inthis study. A total of 2,373 children aged between 6 to 23
months were selected. To estimate the level of CFP“dimension index” was used and the score of the index
was used as dependent variables. Statistical analyses andtests were guided by the nature of the variables.
Multivariable logistic regression analyses were
performed to identify the significant determinants of
CFP.
Results: The overall level of CFP among children aged
between 6 to 23 months was low.
More than 95% of the children experienced either no(2.9%) or inadequate CFP (92.7%). The mean levels of
CFP as well as percentages of no or inadequate CFP weresignificantly lower among children of the youngest age
group, uneducated parents, unemployed/laborer fathers,socio-economically poor families, food insecure families
and rural areas. No weekly exposure to mass media also
revealed significant associations with CFP. However,
only few variables remained significant for adequate CFP
in the multivariable logistic regression analysis.
Adequate CFP was significantly lower among thechildren aged between 6 to 23 months (OR: 0.22, 95%
CI: 0.10-0.47), children of illiterate fathers (OR: 0.32,
95% CI: 0.11-0.95) and socio-economically middle-classfamilies (OR: 0.28, 95% CI: 0.09-0.86) as compared totheir reference categories.
Conclusion: Inappropriate and inadequate CFP may
cause serious health hazards among children of 6 to 23

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Eubios Journal of Asian and International Bioethics 28 (November 2018)

months in Bangladesh. It is ethical to take effective
interventions and strategies by the government andother concerned stakeholders to improve the overallsituation of CFP in Bangladesh.
Key words: CFP, children, individual, household,community, Bangladesh, Complementary Feeding,
Minimum Meal Frequency, Dietary Diversity.
1. Infant Malnutrition
Malnutrition is the largest risk factor in the world fordisability and premature mortality among young
children, especially in developing countries (1, 2)(Muller and Krawinkel 2005, FAO/WHO 1992). Although
the condition is entirely preventable, malnutrition is asignificant underlying factor in more than half of thedeaths of young children in these countries (Muller andKrawinkel 2005, Pelletier 1994). Recent analyses havefound a decrease in child deaths under 5 years of age
worldwide to 8.795 million in 2008 (Black et al. 2010)
and 7.7 million in 2010 (Rajaratnam et al. 2010), yetmalnutrition remains one of the key factors associatedwith global loss of life in young children (Black et al.
2003, 2010; Jones et al. 2003; UNICEF 2009; Rajaratnam
et al. 2010).
The objective of millennium development goals (MDGs)of United Nations (UN) focused on reducing poverty, andextreme hunger, and improving education by 2015 (UN2000). An objective of the ﬁrst MDG was to decrease theprevalence of underweight children under 5 years of age(under-5 children) as the primary measure ofmalnutrition by 2015 (UN 2000).
In Ethiopia, 47%, 11% and 38% of children under five
years of age were stunted, wasted and underweight,
respectively (Central Statistical Authority 2006). An
Ethiopian child is 30 times more likely to die by his or
her fifth birthday than a child in Western Europe and themost common cause of child death is the interacting
combination of malnutrition and infection (Joan andMesfin 2008).
Proper feeding practices during infancy and earlychildhood are fundamental for normal growth,development, and survival of infants and children,
particularly in developing countries (Senarath andDibley 2012, Saha et al. 2008, Srivastava and Sandhu
2007). South Asian countries including Bangladesh
reveal the highest burden of childhood undernutrition
due to unimproved feeding of children that causes
faltered growth and development, and illness, such as,
respiratory infections, diarrheal diseases and so on(Senarath and Dibley 2012, Menon 2012). According to
the various studies, 6-23 months of age of a child is a“critical window” for the transition of body and cognitive
development (Senarath and Dibley 2012, WHO 2008).
After 6 months of age, children need complementary
food because breast milk or infant formula alone is nolonger sufficient to maintain the child’s growth(Senarath and Dibley 2012, WHO 2008). At this stage,
children should be fed small quantities of nutritional
solid and semisolid foods in addition to breast-feeding(WHO 2008). The World Health Organization (WHO) andthe United Nations International Children’s Emergency
Fund (UNICEF) have articulated a global strategy andformulated guidelines for complementary feeding of thebreastfed child (Pan American Health Organization

2001). Although appropriate complementary feeding
pattern (CFP) among children aged between 6 to 23
months brings numerous health benefits (Senarath andDibley 2012), inappropriate and inadequate introductionof CFP may increase the risk of malnutrition among
under-five children (Inayati et al. 2012, Central
Statistical Agency 2011, Kumar et al. 2006). The levels of
CFP are affected by numerous individual, household andcommunity level factors (Central Statistical Agency 2011,
Kumar et al. 2006). The undernourished children are
more likely to develop severe health hazards that
impede body’s metabolism and retard utilization of
immunity resulting from deficiencies in immune
competence (Mengistu et al. 2013, UNICEF 2010).
Although Bangladesh has made magnificent progress inhealth and human development since its independence
in 1971 (Khan et al. 2011, de Onis et al. 2011), thiscountry shows limited success in beating the odds ofchild malnutrition. For instance, the prevalence of underfive child malnutrition in Bangladesh is nearly 40%,
which causes nearly 60% of under-five deaths (Islam etal. 2013). Inappropriate feeding practice could be one ofthe profound causes of high under-five mortality in thiscountry (Mancharia et al. 2004).
Considering the limited number of studies in
Bangladesh, this study aimed to estimate the levels of
CFP among children of 6 to 23 months using composite
dimension index and then to identify the determinants of
CFP focusing on individual, household and community
level factors. To our knowledge, none of the previous
studies used composite dimension index to measure thelevels of CFP in Bangladesh. Although dimension index isoriginally developed and used to calculate Human
Development Index by the United Nations Development
Programme (UNDP), it is also applied to address otherissues (Mondal et al. 2014, Haque et al. 2011).
2. Ethical Implications and Objectives of the Study
Since studies based on Dimension index to interpret
CFP are still scarce, further reports to provide
universally accepted cut off points to define different
groups of CFP would be immensely useful for the
purposes of comparison, monitoring, evaluation andadvocacy.
The primary causes of malnutrition include a lack ofquality food, poor infant and child feeding and carepractices such as suboptimal breastfeeding, deficiency of
micronutrients such as vitamin A or zinc, and recurrent
attack of infections, often intensiﬁed by intestinal
parasites (A life free from hunger 2015, Franz 2012). In
this perspective, this research is very important in thisarea to address the child feeding practice.
The objectives include:1) To find out the levels of CFP among children aged 6 to
23 months.
2) To find out the prevalence of practice of CFP based on
multilevel factors.
3) To identify the determinants of CFP
3. Data and Methodology
This retrospective study was performed by analysis ofsurveys conducted by Bangladesh Demographic and
Health Survey (BDHS) in 2011 which was a nationally
representative cross-sectional survey, during August toEubios Journal of Asian and International Bioethics 28 (November 2018)
November, 2015. A total of 8,761 under-five children(unweighted) born after January 2006 or later, wereconsidered for anthropometric measurements, of whichdata (anthropometric and age) were completed for 7,647
children (around 88%). Among them 2,373 children
aged between 6 to 23 months were considered as final
sample.
To measure the level of CFP among children, 20
frequently asked questions (indicators) had been
included for eligible mothers of households (Figure 2).
For each question, responses were coded binary as 1=
yes (practice) and 0 = no (not practice). Thereafter, theformula of “dimension index” (given below) was used inaccordance with the construction method of the Human
Development Index (HDI) to estimate the level of CFP(UNDP 2005). Firstly, Cronbach’s alpha coefficient wasused to evaluate the internal reliability of the 20
indicators. According to our analysis, the Cronbach’s
alpha estimate was 0.701, suggesting a high internalconsistency. The index was then constructed using thesums of weighted binary input variables where
maximum and minimum values were also chosen forunderlying dimension. Performance of the dimension
index was expressed into a unit-free index between 0
and 1 (UNDP 2005). The index is defined as:
Dimension Index =Actual value − Minimum value
Maximum value − Minimum value

The actual value here indicates the sum score of 20
binary indicators for each respondent and the maximum
and minimum values were 20 and 0, respectively. The
individual score of CFP (based on dimension index) wasconverted into percentage by multiplying 100. Thesescores were then divided into two categories, whereindividuals with dimension score of exactly 0 %belonged to the “no CFP” group and individuals withother scores ranging from 1-100 % belonged to the “CFP”
group (20). The CFP scores were again divided into three
categories: no CFP (0 %), inadequate CFP (1-49%) andadequate CFP ( ³ 50.0%). Both variables with two andthree categories were used as dependent variables in
multivariable analyses.
Covariates were classified into three level
characteristics: individual, household, and community
characteristics. Individual level characteristics were: ageof child (6-11 months, 12-17 months, 18-23 months); sexof child (male, female); mother’s education (illiterate,
literate); father’s education (illiterate, literate); father’s
employment status (currently unemployed composed ofunemployed persons and students, laborers composed offarmer, agricultural worker, fisherman and rickshaw
etc.; service holders composed of doctor, lawyer,
accountant, teacher and so on; businessman). Householdsocio-economic status based on wealth index (poor,
middle, rich), mass media exposure through television,
radio and newspaper/magazine (yes: all medias exposed
to at least once a week, no); food insecurity (yes, no)were considered as the household level characteristics.
The wealth index was constructed using household asset
data via principal components analysis (BDHS 2011).
Household socio-economic status was considered as
thehousehold-level
characteristics.
Household185

socioeconomic status, namely the wealth index wasconstructed from data on household assets, including
ownership of durable goods (such as televisions andbicycles) and dwelling characteristics (such as source ofdrinking water, sanitation facilities, and construction
materials). Principal components analyses were used toassign individual household wealth scores. These
weighted values were then summed and rescaled torange from 0-1, and each household was assigned into
quintiles: the ﬁrst quintile: poorest, the second quintile:
poorer, the third quintile: middle class, the fourth
quintile: richer and the ﬁfth quintile: richest (BDHS
2011). Five household food security indicators wereselected using the Household Food Insecurity Access
Scale.
The continuous score of CFP based on dimension
index were tested using ANOVA-test and t-test. These
tests tested the differences of CFP among various
categories of each independent variable. Contingency
analysis was used to test the bivariable associations
between the CFP (with three categories) and selectedfactors by applying the Chi-square ( c 2) test.
Multivariable binary/multinomial logistic regressions(binary for CFP scores with two categories andmultinomial for CFP scores with three categories) wereused to examine the associations of selected factors with
CFP. Statistical significance was accepted at P < 0.05.
Statistical analyses were carried out using SPSS software(version 20.0).
This study is not free from limitations. Due tounavailability of recent data, BDHS 2011 data was usedin this study that does not present the current
nutritional status. The cross-sectional nature of thestudy limits us to assess the cause and effectrelationships between selected factors and CFP. Most of
the food items were given to the children in last 24hours preceding the survey time, however, the children
could occasionally receive some other foods but simply
did not the previous day. All food items were treatedequally may limit this study. Another limitation could be
information bias, which may result from collecting
information of self-reporting age, education, occupation,
household assets as well as nutritional indicators.
T test is used to compare two different set of values. It
is generally applied to normal distribution which has asmall set of values. This test compares the mean of two
samples. T test uses means and standard deviations of
two samples to make a comparison.
Anova is a statistical test which analyzes variance. It is
helpful in making comparison of two or more means
which enables a researcher to draw various results andpredictions about two or more sets of data. Anova test
includes one-way anova, two-way anova or multiple
anova depending upon the type and arrangement of thedata.
Chi-square is an important non-parametric test andas such no rigid assumptions are necessary in respect of
the type of population. It is simply a technique to test
either as a test of goodness of fit or to judge thesignificance of association between attributes (Kothari,
2003-04).

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Eubios Journal of Asian and International Bioethics 28 (November 2018)

A total of 8,550 children under 5 years of age were
eligible for anthropometric measurements

Height and weight data are missing for 115 children

8,435 Children have complete and credible
anthropometric data

Age data are missing for 790 children

7,647 Children have complete and credible
anthropometric and age data

5,242 children age less than 6 months and greater than
23 months were excluded

2,405 Children have complete and credible
anthropometric, nutrition and age data

Mothers of 32 children who respond “Do not know”
for CFP were excluded

2,373 children deemed eligible for the present study(Final data)

The logistic regression model is one of the important
methods for the successful application not only indemography but also all discipline of knowledge. Logistic
regression can be used to predict a binary dependent
variable from a set independent variables and that does
not require any distributional assumptions concerning
explanatory variables are normally distributed withequal variances.
4. Analyis of CFP Data
4.1. Level of Complimentary Feeding Pattern Based on
Dimension Index
The level of CFP has been estimated using a dimension
index. Although this dimension index is originallydeveloped and used to calculate Human Development
Index by the United Nations Development Program(UNDP), it is also applied to address other issues(Mondal et al. 2014, Haque et al. 2011).
The mean level of CFP was 24.2, which wassignificantly lower among the children aged 6-11 months(19.1%), illiterate mother (18.8%), illiterate father(19.8%) and children of currently unemployed families(22.6%) (Table 4.1). Children belonging to the poorest
socio-economic group (19.6%), no exposure to television(20.7%) and newspapers (22.9%), food insecurity(22.2%) and rural area (20.70%) also revealed
significantly lower scores of CFP. Moreover, the meanlevel of CFP varied significantly among various
geographical regions with the lowest level insoutheastern region.
The overall level of CFP experienced by children aged
between 6 to 23 months in Bangladesh could be
described as a catastrophe. Poor level of CFP wasmeasured significantly using multilevel factors, such as,age, parental education, father’s employment status,
socio-economic status, mass media exposure, foodinsecurity, pace of residence and region of residence.

Figure 1: Sample size selection
4.2. Univariate association of CFP with multilevel
independent variables
The interclass variations of the percentages, based on
multilevel factors (e. g. individual, household andcommunity levels), of the children among the various
level of CFP (e.g. no CFP, inadequate CFP and adequate
CFP) were observed using Chi-square test. According to
the categories of dimension index, more than 90%
children received inadequate complementary food.
Children age, mother’s education, father’s education,
father’s employment status, socio-economic status, mass
media exposures (television and newspaper/magazine),food insecurity and place of residence were significantly
associated with CFP categories (Table 4.2). For instance,
the percentage of adequate CFP was significantly lower
among younger group of children (2.5%), amongchildren of illiterate mother (1.8%), illiterate father(1.0%). Similarly, the percentage of adequate CFP was
significantly lower among the children of those families,
who belonged to the groups of socio-economically poor
(1.6%), no mass media exposure (2.0% for televisionand 3.0% newspaper/magazine), food insecurity (2.6%)
and rural area (3.0%).
In contrast, the percentage of inadequate CFP was
significantly higher among younger the children aged
12-17 months (94.1%), among children of illiterate
mother (95.3%), illiterate father (95.9%), the children of
those families, who belonged to the groups of socioeconomically poor (95.4%), no mass media exposure(94.6% for television and 94.0% newspaper/magazine),food insecurity (94.7%) and rural area (93.7%).
Only 4.4% children were found to receive adequate CFP.
All multilevel factors other than sex of child, listening toradio and region of residence were significantly
associated with CFP.
4.3. Multivariable association of CFP with multilevel
independent variablesMultivariablelogistic
regression(binary/multinomial) analysis have been performed to
identify the determinants of CFP or to observe the effects

Eubios Journal of Asian and International Bioethics 28 (November 2018)of several socio-demographic factors based on individual,
household and community level factors. The results ofbinary logistic regression were presented first under the
dichotomous dependent variable “any CFP”. According tothese results (Table 4.3.), children aged between 6 to 23
of age were less likely to receive any CFP (OR: 0.55, 95%
CI: 0.32-0.96) as compared to the group of 18-23 months.
In contrast, children of 12-17 months of age were more
likely to receive any CFP (OR: 2.63, 95% CI: 1.14-6.07).
Other variables were not significantly associated withthe dependent variable “any feeding practice”.
According to the results of multinomial logistic
regression analysis (presented under the categories of
inadequate and adequate take ‘no CFP’ as a reference inTable 4.3), children of illiterate fathers had significantly
less likelihood of having adequate CFP (OR: 0.32, 95% CI:
0.11-0.95). Children from the socioeconomically middle
class families were less likely to receive adequate CFP

Figure 2: Percentage of complementary foods received
by children (BDHS 2011)(OR: 0.28, 95% CI: 0.09-0.86) as compared to richchildren. Children of families with no exposure tonewspaper/magazine also revealed significantly lesslikelihood of receiving adequate CFP (OR: 0.38, 95% CI:
0.16-0.92) than reference category. Place of residence

187

had somewhat significant effect (P=0.09) on adequate
CFP.
Most of the socio-demographic variables were notsignificantly associated with CFP. Some factors, such as,
children age, father’s education, socioeconomic status
and frequency of reading newspaper/magazine hadsignificant effects on adequate CFP.
4.4 Association between child malnutrition (underweight)
and CFP
Table 4.4 highlights the association between childunderweight and CFP. CFP was significantly (p=0.005)
associated with underweight. More than 30% children
received inadequate complementary foods were
underweight. Other factors, such as, children age,mother’s education, father’s education, father’soccupational status, socio-economic status, watch
television weekly, read newspapers/magazine weekly,
food insecurity, place of residence and region ofresidence
were significantly
associated
with
child
underweight.
Binary logistic regression
analysis showed that CFP hadsignificant effect on childunderweight. Children who
were fed inadequate food had
more chance to be underweight
than those who did not receive
any complementary food. Other
factors, such as, children age,socio-economic status, watch
television
weekly,readnewspapers/magazine weekly,
food insecurity, place ofresidence and region ofresidence had significant impact
on child underweight.
5. Discussion
The study reveals a low levelof CFP (composed of no CFP or
low CFP) among children aged
between 6 to 23 months in
Bangladesh.
Thehigherprevalence of under-nutritious
complementary foods during
the early mentioned “critical
window” period of growth for children. Our findings are
consistent with the findings of a study in Bangladesh(Kabir et al. 2012) and other South Asian countries such
as India, Pakistan, Sri Lanka and Nepal (Patel et al. 2012,
Joshi et al. 2012, Senarath et al. 2012, Hazir et al. 2012).
Lack of knowledge and awareness regarding appropriate
CFP may influence the poor nutritional supplements
among children (Wamani et al. 2005).

Table 4.1 Mean level of complementary feeding practice
Variables
Mean ( ± SD) (%)
Children age (months)
6-11
12-17
18-23
Sex of child
Male
FemaleMother’s education
Illiterate
Literate
Father’s education
Illiterate
Literate
Father’s employment status
Currently unemployed
Labours
Service holders
Businessmen
Socioeconomic status
Poor
MiddleRich
Watch television weekly
No
Yes
Listen to radio weekly
No
Yes
Read newspapers/magazine weekly
No
Yes
Food insecurity
No
Yes
Place of residence
Urban
Rural
Region of residence
Southern
Southeastern
CentralWestern
Mid-western
Northwestern
Eastern
Total

SD, Standard deviation; SE, Standard error;a = ANOVA test; b = T-test

Standard Error (SE) (%)

P values<0.001a19.1 (
26.2 (
28.0 (± 11.7)± 11.8)± 12.2)

0.40
0.42
0.45

23.9 (
24.5 (± 12.4)± 12.5)0.36
0.36

0.332b

18.8 (
25.2 (± 9.97)± 12.7)0.51
0.28<0.001b19.8(
25.7 (± 10.7)± 12.7)0.43
0.30<0.001b22.6 (
23.3 (
26.1 (
28.8 (± 13.9)± 11.8)± 13.2)± 14.5)

1.91
0.29
0.59
1.20

19.6 (
21.4 (
26.7 (± 10.6)± 11.1)± 12.8)

0.47
0.52
0.34

<0.001a20.7 (
26.5 (± 11.1)± 12.8)0.36
0.34<0.001b24.1 (
25.3 (± 12.5)± 12.8)

0.27
0.89

0.179

22.9 (
30.4 (± 11.8)± 13.7)0.27
0.68<0.001b25.3 (
22.2 (± 12.9)± 11.3)0.33
0.40<0.001b27.4 (
22.8 (± 13.4)± 11.8)0.49
0.29<0.001b23.7 (
22.3 (
23.6 (
28.8 (
26.2 (
25.9 (
21.1 (
24.2 (± 12.5)± 12.9)± 12.7)± 11.4)± 11.8)± 11.2)± 12.6)± 12.5)

0.76
0.58
0.66
0.69
0.67
0.65
0.67
0.26

<0.001a<0.001aAccording to our knowledge, no previous studies have addressed the level of CFP through dimension index based on 20
complementary food items. We found significant interclass variations of CFP for different individual, household andcommunity level variables. For instance, receiving complementary foods were significantly lower among children of theyounger age group (6-11 months) than among those in the older age group (18-23 months). Several studies reported thatpercentages of infants receiving complementary foods increases with age but did not show any significant variations (Patelet al. 2012, Charmaine et al. 2011, Khanal et al. 2013). CFP was also found significantly lower among children of illiterateparents, children of fathers who were labourers, socioeconomically poor families, children of families never exposed tomass media, food insecure families and rural settlement. These findings were consistent with another study conducted in
Nepal (Khanal et al. 2013).
The United Nations Children’s Fund (UNICEF) reported that in Bangladesh over 33 million children under 18 years ofold, which accounts for around 56% of the child population, are currently living below the international poverty line andaround 57% are deprived of adequate nutrition (Bangladesh 2015). Bangladesh is one of the South Asian countries wherefemale children experience higher mortality than males (Sharma and Kader 2013). In this country, more attention is paid
to male children in intra-family food distribution and healthcare. Such kinds of discrimination against female children canaggravate the situation of under-nutrition and other health hazards among female children compared to male (Henry et al.
1993). Regional variation also has been observed in terms of CFP. Variations in CFP may conceal important intra-regional
differences due to diverse cultural norms and needs more investigation.

Eubios Journal of Asian and International Bioethics 28 (November 2018)
Table 4.2 Associations between multilevel factors and complementary feeding patternComplementary feeding pattern
Variables
No
Inadequate CFP
Adequate CFPChildren age (months)
6-11
12-17
18-23
Sex of child
Male
FemaleMother’s education
Illiterate
Literate
Father’s education
Illiterate
Literate
Father’s employment status
Currently unemployed
Labours
Service holders
Businessmen
Socioeconomic status
Poor
MiddleRich
Watch Television weekly
No
Yes
Listen radio weekly
No
Yes
Read newspapers/magazine weekly
No
Yes
Food insecurity
No
Yes
Place of residence
Urban
Rural
Region of residence
Southern
Southeastern
CentralWestern
Mid-western
Northwestern
Eastern
Total

189

P values

41 (4.8%)8 (1.0%)19 (2.6%)

791 (92.7%)753 (94.1%)
656 (91.1%)

21 (2.5%)
39 (4.9%)45 (6.2%)<0.00136 (3.0%)32 (2.7%)1109 (92.5%)
1091 (92.9%)

54 (4.5%)
51 (4.3%)

0.903

11 (2.9%)57 (2.9%)362 (95.3%)
1838 (92.2%)

7 (1.8%)98 (4.9%)

0.028

19 (3.1%)
49 (2.8%)580 (95.9%)
1620 (91.6%)6 (1.0%)99 (5.6%)<0.0013 (5.7%)45 (2.7%)
17 (3.3%)
3 (2.1%)48 (90.6%)
1568 (94.2%)
457 (89.8%)
127 (87.0%)

2 (3.8%)52 (3.1%)
35 (6.9%)
16 (11.0%)

15 (3.0%)
17 (3.7%)
36 (2.5%)474 (95.4%)
433 (95.0%)1293 (91.1%)

8 (1.6%)6 (1.3%)91 (6.4%)<0.00131 (3.3%)
37 (2.6%)880 (94.6%)1320 (91.5%)

19 (2.0%)
86 (6.0%)<0.00161 (2.8%)
7 (3.4%)2013 (92.9%)
187 (91.2%)

94 (4.3%)
11 (5.4%)

0.691

59 (3.0%)
9 (2.2%)1850 (94.0%)350 (86.6%)

60 (3.0%)45 (11.1%)<0.00145 (2.9%)23 (2.8%)1421 (91.7%)
779 (94.7%)

84 (5.4%)
21 (2.6%)

0.005

14 (1.9%)54 (3.3%)

660 (90.5%)1540 (93.7%)

55 (7.5%)
50 (3.0%)<0.0014 (1.5%)22 (4.4%)
7 (1.9%)6 (2.2%)8 (2.6%)9 (3.0%)12 (3.4%)
68 (2.9%)252 (94.7%)
451 (90.4%)354 (93.7%)
248 (92.2%)285 (92.5%)278 (93.0%)332 (93.8%)
2200 (92.7%)

10 (3.8%)
26 (5.2%)
17 (4.5%)
15 (5.6%)
15 (4.9%)
12 (4.0%)
10 (2.8%)105 (4.4%)<0.001

0.398

6. Recommendations
Although numerous policies and strategies have been issued in Bangladesh to improve the IYCFP, some challenges suchas insufficient resources and lack of coordination among stakeholders are impeding their implementation andenforcement.
1. Strengthening of the existing strategies such as eradication of poverty through marginalized and vulnerable groupdevelopment, empowering women to practice decision making autonomy and minimizing rural urban differential
through planning and providing modern facilities are urgently necessary to improve the situation of CFP in Bangladesh.
2. Proper CFP can also be ensured by undertaking social safety net program and community-based nutritional
interventions, for example, food for education, food for work for slum dwellers and so on (Kabir et al. 2012).
3. The feeding practice of home-based foods with various textures should be encouraged (Liubai et al. 2011).
4. Health promotion program through cross-collaboration among various organizations are needed to ensure proper CFP.
5. Behavioral change communication through nutritional education, particularly in slum and rural areas, which supportand educate mothers, need to be developed for improving appropriate feeding practice to children (Garg et al. 2009,
McNukty 2013, Faber and Benade 1998). In addition, more efforts should be given to review existing nutritional
interventions that target the IYCFP in Bangladesh.
6. Longitudinal studies are recommended to determine the cause-effect relationships between plausible factors and CFP in
Bangladesh.
7. Conclusion
The overall level of CFP among children is still low in Bangladesh and needs further improvement. The levels of CFP arefound to be strongly associated with several individual, household and community factors. Some of these factors namely
children’s age, father’s education, socioeconomic status, mass media exposure and place of residence are justified to be190

Eubios Journal of Asian and International Bioethics 28 (November 2018)considered while developing strategies or interventions to address the issue of child CFP in Bangladesh. More studies areneeded to assess the level of CFP in Bangladesh.
Table 4.3 Results of multivariable logistic regression analysis
Complementary feeding pattern
Variables
Any CFP (yes/no)
Inadequate CFP
Adjusted
AdjustedP
P values
OR (95% CI)
OR (95% CI)
valuesChildren age (months)
6-11
12-17
18-23 (ref.)Sex of child
Male
Female (ref.)Mother’s education
Illiterate
Literate (ref.)Father’s education
Illiterate
Literate (ref.)Father’s employment status
Currently unemployed
Labours
Service holders
Businessman (ref.)Socioeconomic status
Poor
MiddleRich (ref.)Watch Television weeklyNo
Yes (ref.)Listen radio weeklyNo
Yes (ref.)Read newspapers/magazine weeklyNo
Yes (ref.)Food insecurityNo
Yes (ref.)Place of residence
Urban
Rural (ref.)Region of residence
Southern
Southeastern
CentralWestern
Mid-western
Northwestern
Eastern (ref.)CI, 95% confidence interval

Adequate CFP
Adjusted
P values
OR (95% CI)

0.55 (0.32-0.96)
2.63 (1.14-6.07)
1.00<0.001
0.037

0.57 (0.33-1.00)
2.68 (1.16-6.19)
1.00

0.050
0.021

0.22 (0.10-0.47)
1.84 (0.72-4.71)
1.00<0.0010.206

0.92 (0.56-1.49)
1.00

0.725

0.91 (0.56-1.50)
1.00

0.719

1.01 (0.54-1.89)
1.00

0.978

1.11 (0.52-2.37)
1.00

0.779

1.11 (0.52-2.35)
1.00

0.792

1.48 (0.46-4.69)
1.00

0.509

1.01 (0.54-1.89)
1.00

0.981

1.03 (0.55-1.92)
1.00

0.934

0.32 (0.11-0.95)
1.00

0.040

0.42 (0.08-2.25)
0.94 (0.28-3.20)
0.68 (0.19-2.40)
1.00

0.313
0.918
0.551

0.44 (0.08-2.36)
0.98 (0.29-3.35)
0.70 (0.20-2.48)
1.00

0.341
0.976
0.584

0.23 (0.02-2.12)
0.49 (0.13-1.89)
0.50 (0.13-2.01)
1.00

0.193
0.297
0.330

0.85 (0.39-1.84)
0.69 (0.35-1.34)
1.00

0.539
0.687

0.86 (0.40-1.86)
0.70 (0.36-1.37)
1.00

0.704
0.297

0.55 (0.18-1.70)
0.28 (0.09-0.86)
1.00

0.299
0.025

0.89 (0.51-1.57)
1.00

0.695

0.90 (0.51-1.58)
1.00

0.712

0.68 (0.31-1.49)
1.00

0.336

1.24 (0.55-2.81)
1.00

0.607

1.24 (0.55-2.81)
1.00

0.608

1.21 (0.42-3.44)
1.00

0.722

0.82 (0.38-1.77)
1.00

0.602

0.86 (0.40-1.85)
1.00

0.702

0.38 (0.16-0.92)
1.00

0.032

0.83 (0.47-1.46)
1.00

0.526

0.83 (0.47-1.46)
1.00

0.518

0.90 (0.42-1.95)
1.00

0.796

1.43 (0.75-2.70)
1.00

0.275

1.40 (0.74-2.65)
1.00

0.300

1.93 (0.90-4.13)
1.00

0.090

2.40 (0.75-7.70)
0.72 (0.34-1.49)
1.67 (0.64-4.34)
1.34 (0.49-3.73)
1.19 (0.47-3.01)
1.19 (0.48-2.92)
1.00

0.276
0.140
0.380
0.294
0.570
0.711

2.40 (0.75-7.68)
0.71 (0.34-1.47)
1.65 (0.65-4.30)
1.32 (0.48-3.66)
1.17 (0.47-2.97)
1.17 (0.48-2.88)
1.00

0.141
0.357
0.304
0.592
0.735
0.733

2.84 (0.65-12.38)
1.26 (0.44-3.58)
2.42 (0.69-8.45)
2.44 (0.66-9.01)
2.03 (0.59-6.99)
2.04 (0.58-7.13)
1.00

0.164
0.663
0.165
0.182
0.263
0.263

8. References

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Eubios Journal of Asian and International Bioethics 28 (November 2018)

191

Table 4.4 Association between underweight and child feeding practice
Variables
Under Weight (n=2227) Underweight (No/Yes) (Binary logistic regression
results)
PrevalenceChild feeding pattern
No (ref)
Inadequate
Adequate
Children age (months)
6-11 (ref)
12-17
18-23
Sex of childMale (ref)FemaleMother’s education
Illiterate (ref)Literate
Father’s education
Illiterate (ref)Literate
Father’s employment status
Currently unemployed (ref)Labours
Service holders
Businessmen
Socioeconomic status
Poor (ref)MiddleRich
Watch Television weekly
No (ref)
Yes
Listen radio weekly
No (ref)
Yes
Read newspapers/magazine weekly
No (ref)Yes
Food insecurity
No (ref)
Yes
Place of residence
Urban (ref)RuralRegion of residence
Southern (ref)Southeastern
CentralWestern
Mid-western
Northwestern
Eastern

P values(Chisquare)95.0% C.I.
B

S.E.

P values

ORs

Lower

Upper

13 (20.6%)675 (32.6%)
18 (19.6%)

0.005

0.60
0.23

0.33
0.49

0.041
0.585

1.00
1.82
1.26

0.95
0.54

3.48
2.93

197 (24.6%)
246 (32.5%)263 (39.4%)<0.001

0.50
0.76

0.11
0.12

<0.001<0.001

1.00
1.65
2.13

1.31
1.68

2.09
2.70

-0.01

0.09

0.900

1.00
0.98

0.81

1.19

0.69

1.22

357 (31.8%)
349 (31.6%)

0.905

160 (45.8%)
546 (29.1%)<0.001239 (42.4%)
467 (28.1%)<0.001

11 (22.9%)546 (34.9%)
119 (24.9%)30 (21.9%)225 (49.1%)
167 (38.7%)
314 (23.5%)

-0.08

0.14

0.573

1.00
0.92

-0.10

0.12

0.392

1.00
0.90

0.70

1.14

<0.001

0.53
0.43
0.43

0.36
0.37
0.41

0.444
0.142
0.250
0.296

1.00
1.70
1.53
1.54

0.83
0.73
0.68

3.47
3.20
3.50

<0.001

-0.32
-0.76

0.14
0.14

0.023
<0.001

1.00
0.72
0.46

0.54
0.35

0.95
0.61

-0.28

0.11

0.010

1.00
0.75

0.60

0.93

-0.01

0.17

0.975

1.00
0.99

0.70

1.40

-0.25

0.15

0.090

1.00
0.77

0.57

1.04

1.08

1.64

365 (41.9%)341 (25.1%)<0.001649 (31.9%)
57 (29.5%)

0.498

632 (34.1%)
74 (19.7%)<0.001394 (27.0%)
312 (40.5%)<0.001167 (24.1%)
539 (35.1%)<0.00184 (33.3%)
152 (32.8%)110 (30.7%)
57 (22.1%)
80 (28.1%)
85 (30.6%)
138 (41.6%)<0.001

0.28

0.10

0.007

1.00
1.33

0.14

0.11

0.229

1.00
1.15

0.91

1.44

0.09
-0.11
-0.46
-0.26
-0.28
0.35

0.17
0.18
0.21
0.19
0.19
0.18

0.580
0.534
0.027
0.184
0.151
0.061

1.00
1.10
0.89
0.62
0.76
0.75
1.42

0.78
0.61
0.41
0.52
0.51
0.98

1.55
1.28
0.94
1.13
1.10
2.05

192

Eubios Journal of Asian and International Bioethics 28 (November 2018)

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Vice President, Youth’s UNESCO Club, Nepal
Email: adhikaribibec@gmail.com- Darryl Macer, Ph.D., Hon.D., MPH
President, American University of Sovereign Nations
Email: darryl@eubios.info

Abstract
Youth constitute one third of total population in Nepal.
This paper looks at the work and motivation of youth
volunteers in disaster management in Nepal in order toevaluate how these ideas and values among the youth
played roles in the re-construction of the Nation fromthe 2015 Earthquake. The study used primary data
through group interviews with volunteers of Youth’s
UNESCO Club in Kathmandu city who were actively
involved in disaster-relief programs at Sindhupalchowk,
Kathmandu, Bhaktapur and Ramechhap districts,
together with key informant interviews and case studies.
Findings from the study shows most youth joined in thevolunteer program on their own initiative.
They are concerned about issues including personalsafety, quality and appropriate training, coordination,
wrong attitudes, gender inequality and media coverage.
People engaging in similar acts may have different
underlying motivations for doing so. Findings from the194

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study shows that mostly, the volunteers are motivatedbased on their values which are welfare of others or
unselfishness. Other underlying motives include
opportunity to learn, career prospects, social pressure,
to reduce feelings of guilt and enhance one‘s self-esteem.
Activities for taking forward their work includes
ensuring quality and appropriate training andappropriate gears and tools for search and rescue work,
awareness raising, recognition and visibility of theirwork. Psychosocial counseling is important after rescue
operations, as it is important to heal the psychologicalwounds after an emergency or a critical event. The study
suggests involving volunteers in all stages of disastermanagement planning process. It is a matter of
combined responsibility that volunteers are recognized
for the contributions and their needs are ensured forthem to accomplish their efforts successfully.
1. 2015 Earthquake
On April 25, 2015, an earthquake registering 7.8 on the
Richter scale struck Nepal’s with epicenter
Sindhupalchowk and Gorkha, which is less than 50 miles
northwest of Kathmandu, the Capital of Nepal, directly
affecting the lives of 2.8 million people (approximately athird of the national population), and causing the deathsof an estimated 8700 people including the 150 people
killed in major aftershock of May 12. The data (MOHP,
2015) shows around 22,200 people were injured in theearthquake. 40% of Nepal, 39 out of 75 districts reported
damage. More than 505,000 houses were reported to be
destroyed and 279,000 damaged. Deaths were also
reported in neighboring Tibet and India.
During the first year, youth involvement in order tosupport the Government of Nepal to meet the immediateneeds of the affected population in early recovery. Youthare also supported by the Government of Nepal inleadingandpromotingcoordinatedresource
mobilization and planning among multiple government
and non-government partners for immediate, medium
and longer-term recovery. In the immediate aftermath ofthe earthquake, Youth also coordinated various Clubs,
NGOs and INGOs to deliver the set of relief materials (e.g.
tarpaulins, blankets and mattresses) for earthquake
affected families of Sindhupalchowk, Dolakha, Bhaktapur,
Lalitpur, Gorkha, Dhading and other highly affecteddistricts in coordination with District Disaster Relief
Committee (DDRCs).
This paper explores the role of youth as volunteer ofpeace-builders, illustrating their unique potential toaffect social change through a number of examples. The
purpose of this research was to understand the
motivations and barriers for youth volunteers so that thereal world volunteer management practitioners have abetter understanding on the motivating factors as well as
the barrier for volunteers. It was also to identify the roleof youth involvement in relief program, the strengths
and weaknesses of youth volunteer activities, and key
challenges and critical success factors those support theimplementation and delivery.
2. Definition of Youth and Youth Policy
A core challenge for youth is that the concept of youth
is itself debated and it is difficult to define the term
“youth”. Youth is “an important period of physical,
mental and social maturation, where young people are

actively forming identities and determining acceptableroles for themselves within their community and society
as a whole. They are increasingly capable of abstract
thought and decision-making in new ways (Wisler,
2007). “Some favor biological markers, in which youth isthe period between puberty and parenthood, while others
define youth in terms of cultural markers—a distinctsocial status with specific roles, rituals, and relationships”(USAID/CMM 2005). Definitions of youth by age vary
drastically across different institutions; the UN has
defined youth as person from 15 to 24 years of age,whereas the National Youth Policy of Nepal defines
youth as persons from 16 to 40 years of age. Donors and
INGOs often bring in their own definitions of youth
which are not always adapted to the country they workin. It is argued that the age based definition of the youth
is a Western product and writers such as Durham statethat youth is a social construct and has more to do withstatus and behavior and less to do with age (USAID,
2005).
There is a lot of cross cultural variation on when an
individual becomes youth and a generally accepted
concept is that youth is a transitional phase fromchildhood to adulthood. It is even more difficult to define
female youth. In developing countries such as Nepal,
where societies are influenced predominantly by
patriarchal values, females generally have to accept
more responsibilities at an early age. Motherhood tends
to change the social status of female youth far more thanfatherhood alters male youth lives.
The Nepalese National Youth Policy defines youth aspersons from 16-40 years of age. However, individuals
having a “youth mindset” are also considered youth in
Nepal. In these situations, individuals even aged 60 weresometimes considered “youth”. This is particularly
evident in the field of politics where there is a lack ofopportunity for those in the second generation of leaders
who are waiting for their turn in the political leadership,
and who remain 'youth leaders' until that happens. The
quota system in the CA encourages the inclusion of youth.
However, the youth who are included generally fall near
the maximum age which causes under representation ofyouth who are under the maximum age. Among thedonor community and international organizations, there
is no conformity about the age of youth. They select theirage group often according to the definitions they havefrom their home countries. Nepali culture often
understands youth to be those individuals who are notyet married and, more often than not, are irresponsible.
The main objective of the present national Youth
Policy is to develop and expand the role and potentialityof the youths in the nation building and national
development, to create disciplined and efficient workforce having responsibility of good citizen and creative
mentality with a view of involving the youth in thenational development stream as well as having respect
towards national heritage and culture through a planned
process. To ensure favorable environment towards
productive practical education, training and selfemployment for the youth and bringing out all dormant
potentialities including their leadership quality aiming at
national progress. This was also to develop the youths as
the basic energy of development by developing
creativeness, entrepreneurship and innovative aptitude

Eubios Journal of Asian and International Bioethics 28 (November 2018)
on the youths, and bring out the capacity inherent inthem (Nepal Youth Policy, 2010).
3. Disaster Management
In recent decades, government agencies, nongovernmental organizations (NGOs) and local
communities in Nepal have undertaken various
measures to mitigate the impacts of natural disasters,
including floods and landslides, on the people, economy
and society. It was also strongly felt by the public
institutions that if disaster preparedness could be
integrated in the socio-economic development process athousehold, community, regional and national levels, itwould build the long-term capacity of the community to
mitigate risk and vulnerability to disasters.
Government has a well-established disastermanagement system. The government, led by the
Ministry of Home Affairs, Disaster Relief Section has
undertaken various steps in the form of policy, strategy
and programs considering the concept of disastermanagement through mitigation, preparedness, recovery
and rehabilitation. The government established the
Nepal Center for Disaster Management (NCDM) under
the Ministry of Home Affairs, Disaster Relief Section in
Feb 2002 to promote disaster prevention, mitigation andpreparedness; to provide guidelines; and to organize
training and awareness for the concerned people andstakeholders to mitigate the impacts of disasters.
Alongside the development thinkers, international
development partners such as UNDP, DFID, Oxfam GB,
USAID, Care International, Caritas, United Nations,
UNICEF, WFP, World Vision, Plan Nepal are someinvolved in NCDM. Among national Youth UNESCO Club
Nepal and Engineering Adda Nepal, are some involved
with relief and rehabilitation activities and local NGOs
those are concerned with, and are experienced indisaster management in Nepal after the Earthquake
2015, and some that have been trained as Youth Looking
Beyond Disaster Ambassadors.7
3. Volunteerism and Youth Volunteers
A volunteer is any individual who offers him/herself toa service without an expectation of monetarycompensation (Shin and Kleiner 2003). Volunteer
management research has been an important topic in thesocial sciences. The different areas that have been
researched include the motives for volunteering, i.e., thereasons why people volunteer (Bussell et al 2002 andCanaan and Goldberg 1991). Opportunities for personal
growth, recognition, achievement, and a desire tocontribute to the community are some of the incentives
for volunteering cited by past research. Another topic
that has been studied in the past involves thedemographic characteristics of volunteers, such as
education and gender, and their relationship to present
and future commitment levels (Vianen 2008 and
Slammers 1991).
The area of volunteer retention and the analysis ofwhat practices encourage renewed volunteerism andwhy people continue to volunteer is also an important
topic (Hager 2004 and Gidron 1984). Some of the

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management practices that positively influence theretention of volunteers include recognition activities andmatching volunteers to appropriate tasks (Gidron 1984)
for example, cites task achievement and the quality of
the work itself as some of the variables that could better
predict volunteer retention. Each of these areas ofresearch reinforces the observation that volunteers playa vital role in the provision of assistance in humanitarianrelief situations. The manner in which they do so, andthe specific characteristics of their participation in relief
efforts play an important role in the development.
The willingness of community members to volunteer iscritical for the success of community-based Disaster Risk
Reduction projects. While much literature documents
the challenges of participation in community-based
projects, very little has been written on the motivationsof those who volunteer, and even less on the incentives
and barriers to youth volunteers in less developed
countries.
Volunteerism is critical and increasingly popular, foryoung people to bring about positive change in society,and it is becoming more and more relevant as amechanism to engage young people in global peace andsustainable human development. For instance, as
governments, United Nations entities and civil society
organizations debate and articulate the post - 2015
development agenda, there is a strong call for a bottomup process in which young people‘s voices are included
and youth are actively engaged in the process, andvolunteering is a viable mechanism for this (UNV 2014).
Youth volunteers around the world are involved inhundreds of different types of activities which mainly
involved are collecting, preparing, distributing, orserving food; fundraising; tutoring; coach, referee, or
supervise sports teams, elderly care, education,
healthcare, social mobilization and advocacy programs
and many other issues including disaster risk reduction
and response. Youth volunteers do community
development work in their local communities andcommunities outside their countries. It is a fact thatwhen a disaster strikes, local people are the first to
respond, before any other outside agencies arrives toassist in recovery efforts. Many of these first responders
who struggle to save lives with limited resources andskills at their disposal are energetic young people. Youngpeople must therefore be included, trained andempowered to carryout disaster prevention, preparation,and planning and response efforts.
In the past few years, however, some students andfaculty have begun to show interest in questions related
to the field of volunteerism. They are finding it difficult(if not impossible) to locate data with which to work andare beginning to recognize that information of the mostelemental sort must first be uncovered for centralizationof existing research, or--at a minimum--agreed-upon
taxonomies for indexing/abstracting purposes. There
are many unpublished masters and doctoral-level theses
on university library shelves that are not being
disseminated to serious volunteerism researchers. We
need to bring this basic research out into thevolunteerism forums (Ellis 1985).
The willingness of community members to volunteer iscritical for the success of community-based DRR projects.
While much literature documents the challenges of196

Eubios Journal of Asian and International Bioethics 28 (November 2018)

participation in community-based projects, very little
has been written on the motivations of those who
volunteer (Cumming 2012).) and even less on the
incentives and barriers to youth volunteers in lessdeveloped countries.
Despite the challenges and threats that millions ofpeople face, we must recognize that people, including
young people, in hazard-prone communities arethemselves agents of change. Helping communities toreach their potential requires new models of working
together to address the barriers to resilience. It is now amatter of collective responsibility, collective action andcollective accountability. While we cannot prevent
another tsunami, we can build better safeguards that willoffer greater protection for future generations. (Konoé
2015). There is indeed huge potential in youth
volunteers and it is critical that the challenges they facein their efforts are minimized and enhance theircapacities to be effective contributors in their endeavors.
4. Disaster management
Traditionally disaster management has been
dominated by top-down relief efforts assuming children
and youth are passive victims with no role in disaster
preparedness and response. Involving youth in disaster
preparedness process not only benefits them, theirfamilies, and communities, but also contributes tograssroots empowerment, which boosts levels ofownership within their overall disaster preparedness
plan (Omoto & Snyder 1990). Research has indicatedthat when young people receive preparedness training
they are more likely to act wisely and protect themselves
against abuse; exploitation and illegal drug trafficking(UNICEF 2011).
Though disasters are a local phenomenon, in thesemodern days their devastating impact can be felt beyond
borders of impacted nations in terms of human, material
losses or the flow of refugees. It is therefore, importantthat the disaster reduction efforts be addressed in a
multilateral and comprehensive way. These unforeseen
disasters require immediate, coordinated and effective
response by multiple government agencies, volunteers,
relief agencies and private sector in order to meet
human
needs
and
speed
recoveryefforts.
Comprehensive disaster management and emergency
preparedness should be based on the concept of active
young people‘s participation in all phases of the disaster
cycle. Rather than seeing disaster-affected youth as
victims or passive recipients of outside assistance good
disaster management must recognize the value of
including them in the planning process. There is no
better resource in a community than young people. It
may be easier to obtain funding for projects and related
disaster preparedness programs, but without sufficient
community resources in place, disaster preparedness
and risk reduction are not possible. Resource building
enhances community capability and provides positive
response to various emergencies; reduce disaster risks,and helps foster confidence, dignity, and resilience(DAPOTA 2015).
5. Group Discussions and Interviews
Primary data were gained through conducting two
group discussion programs with youth volunteers from

Youth’s UNESCO Club, Nepal and Engineering Adda
Nepal who were engaged in disaster programs. Two key
informant interviews were held with the President ofYouth’s UNESCO Club, Nepal, and the head of theDisaster Response Department, Ministry of Health andPopulation. Information collected for case story wasdone through in-depth interviews with youth volunteers.
The data of both discussion and Interviews werecollected and documented in Nepali Language in astandard form and were translated in to English. The
area sselected for the study were in Kathmandu city,
Bhaktapur city, Sindupalchowk and Ramechhap district.
The selected participants for meetings and otheractivities are active volunteers of emergency relief andsome are still working for the rehabilitation andreconstruction. One group discussion was conductedwhen volunteers were attending an award giving
ceremony at the city office and one when volunteers
attending a meeting at the headquarter. The second
group discussion was conducted at a school in
Sindhupalchowk with volunteers of that area. Some of
the interviewees also did relief work across Nepal.
Zhang and Macer (2013) surveyed opinions of what
volunteers in two programmes, YPA and LBD, thought
about volunteerism. The area of volunteer retention andthe analysis of what practices encourage renewedvolunteerism and why people continue to volunteer isalso an important topic (Hager 2004 and Gidron 1984).
Some of the management practices that positively
influence the retention of volunteers include recognition
activities and matching volunteers to appropriate tasks.
(Gidron 1984), for example, cites task achievement andthe quality of the work itself as some of the variables
that could better predict volunteer retention.
Each of these areas of research reinforces theobservation that volunteers play a vital role in theprovision of assistance in humanitarian relief situations.
The manner in which they do so, and the specificcharacteristics of their participation in relief efforts play
an important role in the development. Young people andchildren must therefore be prepared and trained in all
matters pertaining to disaster response. They can use
this knowledge to save their own lives and even defend
their communities‘ livelihood (DAPOTA 2015).
6. Summary of Group Discussions
A total of 38 youth volunteers participated in thegroup discussion. The age of the volunteers ranged
between 16 to 32 years. There were twenty volunteer‘s
age between 20 to 32 years and 18 in the age range of 16
to 19 years.
The volunteers in their twenties were mostly involved
in search and rescue work and the rest are newvolunteers among them few participated in search andrescue work. Most of them are students ofundergraduate programmes in different areas. Four had
already graduated a few years ago. No one among thevolunteers was below school level. Eight female
volunteers participated in the group discussion session.
None of the female participated in search and rescue
work rather they preferred the post disaster relief
programs. Figure 6 shows the data showing the numberof participants.

Eubios Journal of Asian and International Bioethics 28 (November 2018)
Most youth joined Youth’s UNESCO Club, Nepal
volunteer programs because of their own interest. They
were motivated to become volunteers to serve humanityand vulnerable people. Some were motivated throughlearning and seeing various Youth’s UNESCO Club, Nepal
volunteer activities i.e. Education Material Distribution
programs, blood donation programs, volunteer work at
schools, and disaster responses. Some came to know of it
from friends and family members and from the different
media.
Most expressed that they liked search and rescue workin disaster response. Some expressed that helping
disaster-affected people is rewarding and gives theminspiration to serve people in crisis. They shared thatafter rescuing or providing service to see the relief in the
person or the people is highly rewarding. Also throughthese sort of work they develop friendships among
fellow volunteers. To work together side by side without
race and class is rewarding. They feel, as they are unable
to help people financially but being a member of Youth’s
UNESCO Club, Nepal they can provide relief goods andhelp people. They feel that with their support lives canbe saved and bring a smile on someone‘s face. To be able
to work selflessly for the vulnerable because it bringsout the humanity in them and they feel it is their duty
and responsibility, were also mentioned.
According to them it is a special feeling that cannot be
expressed in words. Not everybody gets the opportunity.
Being a volunteer they are able to work directly with theaffected people. All expressed that it is highly rewarding
when the support saves ones life or change someone‘s
life for the better. They feel service is human religion.
Discussing about the constraints some mentioned
there is lack of quality, appropriate and international
level training. Not getting adequate Personal Protection
Equipment (PPE), logistics and safety security for thework did occur. There is risk of life, physical injury andpsychological problems. Some are concerned that they
do not have life insurance when they do it.
There is also sometimes a lack of coordination,
nepotism, wrong attitude, and inequality in the work.
Some expressed that they do not like to do something
unnecessary against their will e.g. when law enforcement
authorities and others order them to do things for them.
They expressed it is difficult to work independently.
They mentioned about inequality between male andfemale volunteers. Opportunity, permission fromfamilies, social stigma/ status and time varies between
male and females in Nepalese culture. This is not fully
understood and addressed properly by the organization.
Also, sometimes it is difficult to work independently.
Sometimes, it is difficult to manage time when work
opportunity comes.
They are concerned that many people do not know
about volunteers and their work. As people do not knowmuch about the role of the volunteers different people
react differently towards them. This creates problem forthem, especially during emergency disaster response.
There is a lack of media coverage.
They feel proper training including practical training is
crucial for volunteers to do their jobs properly. They feel
it is important to get advanced training in life saving
techniques. They suggested developing volunteers at alllevels and provide appropriate training. Separate

197

training for natural disasters, accidents and during
normal situations, should be conducted. Training for Law
enforcing authorities to be respectful towards volunteers
is also important. They also mentioned about skill
development training and creating employment
opportunities for them. Personal Protection Equipment(PPE) should be ensured for all volunteers. Propertransport, other logistics and food are important factors
for the work needs to be ensured as well.
The groups felt that the authorities in the organization
should be involved in explaining to families of volunteers
about their work risks and opportunities. Social
awareness activities should be undertaken to convincefamilies of volunteers about their work and theircontribution. The authorities in the organization should
know the problems faced by them. They expect apleasant attitude towards volunteers from theorganization and from their peers.
They also feel that there should be life insurance forvolunteers. Safety should be ensured for volunteers sothat when they go for work they do not become victims.
There should be more motivation and development of
their confidence and other skills at work.
It is important to receive of recognition and respect.
There should be more awareness raising activities abouthumanitarian volunteers. Through raising awarenesspeople will understand the importance of their work.
There should be more media coverage to let people
know about volunteer‘s contribution in the communities
and for the country.
One female volunteer expressed to perform her duties
sincerely it is important that the Club should be moresensitive towards female volunteers. Being a woman
volunteer she has to go through many restrictions.
Especially over her mobility and work hours. Anotherfemale volunteer expressed that volunteers needs to be
more motivated and inspired. There should respect for
women‘s dignity.
While doing voluntary work they face many problems.
These problems need to be informed to all concerned.
There should be recreational arrangements forvolunteers.
For a few new volunteers blood donation work ismemorable. Many of volunteers stated the educationmaterial and temporary school construction part was themost enjoyable and memorable part of the Volunteering.
Several mentioned the the Earthquake incident was
the most haunting life experience they had everexperienced. They expressed rescuing the buried people
inside the destroyed houses was very hard when theaftershocks were still present. They expressed that they
couldn’t stand the smell of cadavers in the destroyedzone. The smell reminds them of dead bodies. Somevolunteers expressed that the incident still haunts them.
There were a few differences between Youth’s
UNESCO Club, Nepal volunteers and other volunteers. All
volunteers feel that they are independent and organized,
and time to time they receive training. Their relationshipwith seniors is less formal compared to other agencies,
which is a point valued by them. They are proud of theirlogo, uniform and ID, these help them to work easily.
They consider they can work more actively and withcourage compared to other volunteers. They have good
relationship with other volunteers.

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As a result of training they feel their attitude, behavior
and service make them different from others. Comparedto other organizations they consider that they are betterin managing dead bodies. They feel others are notfriendly, but they are friendly and disciplined. The majordifference is that only they can provide immediate
response to work with the government national fireservice.
7. Summary of Interviews
Interviews with Mr. Nirmal Karki, Secretory of Youth’s
UNESCO Club, Nepal and chief of the Volunteer
Department, and Mr. Dipesh Pandey, Technical Director,
Engineering Adda Nepal, Kathmandu, revealed that they
are moved to see the motivational level and spirit of thevolunteers. In many cases, the volunteers work inadverse situations but they normally do not complain
unless there is serious problem. They feel that by getting
involved in volunteer activities creates a positive
attitude towards life. The volunteers tend to be moredisciplined and have increased sense of responsibilities
than non-volunteer youth. Through the work they are
positively engaged and their time is well spent. As they
are busy working as volunteers, it prevents them fromgetting involved in different types of crime anddelinquency including getting drug addiction and drug
abuse. These youth tend to be confident and motivatedto make a positive change in their communities and forthe nation. Their work marks a positive impact
throughout their life.
Discussing the constraints, Mr. Karki mentioned thatkeeping the volunteers occupied throughout the year is adifficult. Although there are various activities
undertaken by the volunteers, keeping them involved
throughout the year is still a challenge. Especially,
volunteers who are specialized in DRR because disasters
are not something that they want to occur. Unavailabilityof work can be demotivating factor for the volunteers
who are very much eager to work.
Both are working on improving training and capacity
building of the volunteers. They also mentioned theshortages of PPE, proper transport, other logistics andfood are other important factors for the work.
Monitoring routine work of volunteers is difficult due toshortage of monitoring staff. The purpose of themonitoring is not policing but to facilitate to find out
how the volunteers are working, what problems they arefacing and how they can be improved.
8. Reasons to Become Volunteers
Most youth joined the volunteer programs because of
their own interest. Doing something meaningful andhelpful is a key motivator and the opportunity to gainskills and work experiences are important as well. It wasobserved that they wanted to use their free time to dosomething meaningful and contribute their efforts toserve humanity. They believe that doing volunteer work
has a positive impact on one‘s personal development.
They also feel that this practice will enhance theirpersonal skills, i.e. confidence, courage and create
employment
opportunities.
Accordingtotherespondents the most important reasons forvolunteering were to help humanity and theircommunity. In addition, to learn new skills and to gain
experience to benefit their future career.
There are multiple benefits from volunteering (Hall etal., 2008). A national study of university students in
England found that respondents gave both altruistic andinstrumental reasons for volunteering (Holdsworth,2010). Research in US found that volunteering could
enhance students ‘academic development, personal skills
development, and sense of civic responsibility. Benefits
were also associated with career choice andemployability after graduation (Astin and Sax, 1998).
The U.K.‘s Russell Commission 2005 highlighted theimportance of an employability agenda for young people.
Instrumental motives and benefits—such as thoserelating to career development—dominate thevolunteering discourse as students recognize the need tobuild their personal capital (Holdsworth & Quinn, 2010).
However, these career-related factors exist alongside avariety of other motivations and benefits.
Globally most volunteers are motivated on their own.
Findings through discussions and interviews it appears
that there is an inner curiosity and interest among youththat motivated them to become volunteers. They are
eager to be engaged in something meaningful at thesame time to develop their confidence and other skills.
The high spirit of the youth is imperative for acommunity and a nation. It is critical that the youth
power is positively nurtured and developed for them tobecome excellent human beings, responsible citizens andbrilliant future leaders. The potentiality is there and an
opportunity to enhance their capacity is crucial for any
country.
According to the study “A Functional Approach to
Volunteerism: Do Volunteer Motives Predict Task
Preference?”, a central premise of the functional
approach is that the same behavior may serve different
functions for different individuals. Results suggested thatpeople idiosyncratically differentiate tasks based on the
motives they satisfy. Furthermore, when given a choice,individuals prefer tasks with benefits that match theirpersonally relevant motives.
The Value Function refers to concerns for the welfareof others, and contributions to society. This function has
been likened to altruism (Clary & Miller, 1986), thevalue-expressive attitude function (Katz 1960), and thequality of expressiveness (Smith et al., 1956). A study byAnderson and Moore (1978) provided empiricalevidence for the values function. Over 70% of the
respondents endorsed ―to help others as a reason forvolunteering. Findings from the FGDs shows most
preferred search and rescue work in disaster response.
The respondents feel this work is rewarding and highly
satisfying which cannot be expressed in words. This
relates to the above study. According to the groups noteverybody can do what he or she are able to do. All
expressed that it is highly rewarding when their support
saves one’s life or change someone‘s life for the better.
The functional approach, volunteerism may serve
more than one motive for an individual and likewise,
more than one motivation may be served within a groupof volunteers who are performing the same activity. Past
research has found that people do differ on their motives
for volunteering (Omoto & Snyder, 1990). Findings fromthe study suggest that, where possible, more freedom

Eubios Journal of Asian and International Bioethics 28 (November 2018)
should be given to volunteers in choosing specific tasks.
People prefer tasks they think will satisfy causes
important to them. Thus, letting volunteers performtasks with benefits that match their primary motives
should result in a positive volunteer experience, an
outcome favorable to all involved. I echo with thestatement of the study. “Thus, letting volunteers performtasks with benefits that match their primary motives
should result in a positive volunteer experience, an
outcome favorable to all involved.” (Hoyle et al., 2005).
The Understanding Function in which volunteerism
gives an opportunity to learn, understand, practice, andapply skills and abilities. This function is related to Katz‘s
1960 knowledge function and (Smith 1956) object
appraisal function. In support of this function, (Gidron1978) found that young volunteers (high school andcollege students) tended to view their volunteer work as
a learning and a self-development experience. Findings
showed that by getting involved in volunteer activities it
creates a positive attitude towards life. These youth tend
to be confident and motivated to make a positive change
in their communities and for the nation. Their workmarks a positive impact throughout their life.
The Protective Function refers as volunteers to reduce
feelings of guilt about being more fortunate than others,
or to escape from one‘s own problems. This function
could be likened to (Katz 1960) ego-defensive function,(Smith 1956) externalization function, and (Francies
1983) need to express feelings of social responsibility(SR). Schwartz (1970) found support for the protectivefunction in his study of volunteering to be a bonemarrow donor. It was observed that the respondents feelthey are fortunate than others and feel responsible tocontribute in helping the less fortunate or people incrisis. The feeling is more of social responsibility rather
than guilt feeling or escaping from their own problem.
The great personal responsibility was apparent among
the volunteers.
The Career Function may serve to increase one‘s job
prospects and enhance one‘s career. For example, Beale(1984) suggested encouraging students to volunteer as
the experiences may serve as stepping stones to
employment. Findings from the group discussion andInterviews show that the youth group considers
volunteer work enhances multiples skills for their future
careers.
The Esteem or Enhancement Function serves toenhance one‘s self-esteem, self-confidence, and selfimprovement. Results of studies have found support for
the esteem function. For example, volunteers working inmental hospitals showed an increase in self-acceptanceas a consequence of their volunteer participation(Holzberg et al 1970). My observation is that there is adistinct difference between the volunteers and nonvolunteers of the similar age and social groups. The
volunteers are clearly more confident, disciplined andhave increased self-esteem. The groups and Interview
stated how the volunteer work enhanced theirconfidence level, self-esteem and self-improvement.
A Psychological Strategy for understanding the
motivational underpinnings of volunteerism is also
involved (Clary et al., 2006). The aspects of a task thatwould match the volunteer‘s motive may not always be
immediately
evident.
Where
realistic,
such

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motivationally relevant benefits could be identified forvolunteers. If the targeted tasks do not address thesalient motives of volunteers, some attention can begiven to incorporating those benefits into the task if notinitially present. The investment of a relatively small
amount of time and effort at the beginning of thevolunteer process could return many dividends in termsof the satisfaction and commitment of the eventual
volunteers.
Motivators are often categorized as either intrinsic or
extrinsic. Intrinsic motivators exist without regard to
external rewards and align with personal motives andvalues. These motivators include empathy, altruism,
pride, and a desire for self fulfillment. Extrinsic
motivators are generated from external rewards andinclude money and opportunities for employment, nonmonetary material rewards (such as bicycles anduniforms), and non-material rewards, such asheightened social status and increased knowledge.
(Bhattacharyya et al 2001).
9. Constraints
The respondents feel that there is a need for adequate,
proper, practical, international level and advanced
training including life saving techniques. There should be
separate training on natural disaster, accident andnormal situation. There is also inadequate equipment
and logistics support for some of the work. The
organization must ensure proper gear and required
logistics for the volunteers especially in the case of
emergency response.
The respondents feel that authorities need to beoriented or trained to be respectful towards volunteers.
In this regard, since 2010 the training department, in
collaboration with the International Committee of the
Red Cross (ICRC), has been conducting First Aid andSearch Rescue training for the members of Nepal Police
to enable them for providing first aid and emergency
humanitarian services during their duty and as when asnecessary. Youth’s UNESCO Club training department
can take this opportunity by incorporating sessions onvolunteer‘s work to sensitize the target trainees.
The respondents feel they do not have the freedom towork independently. Sometimes, however, suchflexibility is not possible; organizations may have alimited number of activities available for volunteers. In
most cases volunteers working with any organization
are bound by the policies/regulations to work according
to the organization requirements.
The lack of work freedom meaning it is difficult towork independently and express one‘s opinion. My
understanding is that work freedom for volunteers issomething that may not always be ensured by theorganizations. The organization has to follow throughthe rules of business, polices and that is how things work.
These need to be clearly communicated to the new
recruits during their induction so that they a have clear
understanding of what is expected from them; to what
extend their work independence will be allowed andhow they will work. In regards to freedom of expressing
opinions it was clearly evident that the senior leaders
dominated the juniors, however many new recruits hadvery clear understanding of their work and expressed
their opinions about inequality openly in front of their

200

Eubios Journal of Asian and International Bioethics 28 (November 2018)seniors. However, there is clear distinction of hierarchy
in power relation. Most of the respondents expressed thepresence of nepotism and wrong attitude from senior
and fellow volunteers. Some expressed they are looked
down upon (heo chocke dekha). However, when asked
what type of nepotism and wrong attitude they meant, it
seems they did not want to talk about it further. Thesesensitive issues need to be addressed with the concerned
officials and come to agreed solutions through dialogue
and consultations.
In many cases work assigned to volunteers may not
match with their skills, experience and expertise, thisneeds to be carefully considered by the organization
authority. In such instances, it is suggested volunteers begiven the similar tools to determine which motivefunctions are relevant to the volunteers. This needs to beclarified to the volunteers by the senior authorities as towhy they are particularly assigned for particular work.
What the organization is able to provide them and if newvolunteers are interested to work in the proposed areas.
The clarification must be there from the beginning.
However, in relation to disaster response if theorganization does not have structured roasters forduties/responsibilities there is every possibility ofconfusion and chaos during response, which can lead to
low and dissatisfactory performance.
The respondents expressed that the Club authorities
should be involved in explaining to families of volunteers
about their work, safety and time. Families areconcerned about their wellbeing when they go to
emergency response work. Families worry about thephysical and emotional risks that may affect them. Also,
the timing, usually emergency response work requires
long hours much beyond normal work hours. A process
is being further identified through workshops and othermodes by involving family representatives, volunteers
and senior officials.
A number of studies have found evidence of poor
information sharing and coordination in inter-agency
disaster response situations (Dawes et al. 2004). In
regards to coordination information technology isessential to improving information sharing and decisionmaking for emergency responders as it has alreadydrastically reshaped the way organizations interact witheach other (Yang and Maxwell 2011). Technologicalaspects of Inter Organizational Information-Sharing
Systems (IOISS) can enable or impede the coordinationand sharing of disaster-related information. High levels
of integration and use of technology are likely to result inhigh levels of information sharing. On the other hand,forwarding all the available information to every
individual involved in the disaster response effort will
result in a serious information overload. IT can be usedappropriately to make sure that everyone receives therelevant information at the right time.
Currently, for emergency response SMS/text message
has been the main mode of communication for theYouth’s UNESCO Club volunteers. This is highly useful,user friendly and most available communication tool fordisaster risk reduction volunteers in Nepal.
Informal education involves disseminating standard
messaging but with the flexibility to accommodate theneeds and concerns of specific local audiences. This isparticularly effective because peer information, social

proof and social support are vital to shifting humanbehavior. Volunteers are leaders and role models thatoffer powerful examples as they engage the wider public.
Tools focused on stimulating discovery and problem
solving allows scope for endless creative activities andmaterials to appeal to various target-audience segments.
There are many facilitation tools from the IFRC‘s
Community Based Health and First Aid in Action
initiative are familiar models, including the facilitator‘sguide. Other examples include the Caribbean Red Cross
Societies‘Better Be Ready campaign kit and expect theUnexpected: Facilitator‘s guide by the Canadian Red
Cross.
The group is concerned that many people are notmuch aware about volunteers and their work. As a result
different people react differently towards them creatingproblem for them at work. Lack of media coverage is aconcern. In early 2015 Ministry of Education of theGovernment of Nepal has introduced the Red Cross
Movement in all secondary and higher secondary levelinstitutions (6th to 12th grade) as co-curriculum. This isremarkable to reach children, youth and families to learn
about the Red Crescent Youth movement.
In terms of social problems there is still inequality
between male and female volunteers from theorganization and in society. Women and girls areinvaluable in disaster risk reduction and climate change
adaptation processes if real community resilience andsignificant reduction of disaster impacts are to beachieved. Women must always be part of policy,
planning and implementation processes.
It was clear from discussion that female volunteers
were less involved in emergency disaster response.
Although there are remarkable contributions bycourageous Youth’s UNESCO Club female volunteers,
until now, not many women are included in this work.
This is due to the nature of the work, long hours awayfrom home and lack of training in emergency response.
The barrier is from both sides; from the families of thewomen as well the organization. Women in the groups
expressed their high interest in working in challenging
situations. They are currently mainly involved inorganizing cultural events, blood donation camps etc.
There is no clear guideline in Youth’s UNESCO Club inregards to gender roles in volunteer involvement indisaster situations. This is an area that the organization
can look into and involve female volunteers inchallenging work that they can do. There is a highdemand for female volunteers in emergency response inregards to providing support to women, children,
adolescent girls, elderly and differently able people. They
are good in proving psychosocial support, engaging
children in different activities, looking after misplacedchildren & adolescent girls, women and the elderly.
It is important to receive recognition and respect.
Awareness raising about volunteer‘s humanitarian work
should be increased. Through raising awareness people
will realize importance of the work. More media
coverage to let people know what volunteers do.
One female volunteer expressed to perform her duties
sincerely it is important that the Club is more sensitive
towards female volunteers. Being a woman volunteer
she has to go through many restrictions. Especially, hermobility and working hours. Another female volunteer

Eubios Journal of Asian and International Bioethics 28 (November 2018)expressed that volunteers needs to be more motivatedand inspired. There should respect for women‘s dignity.
While doing voluntary work they face many problems.
These problems need to be informed to all concerned.
There should be recreational arrangements forvolunteers.
10. Conclusions
The willingness of volunteering is critical for the
success of disaster risk reduction projects. While muchliterature documents the challenges of participation incommunity based projects, very little has been written
on the motivations of those who volunteer, and even lesson the incentives and barriers to youth volunteers in lessdeveloped countries.
Disasters are on the rise and youths in thecommunities are the first ones respond. Youth in Nepal
have played a crucial role in responding to theearthquake from clearing rubble to mobilizing their
networks to support relief efforts and providing
emotional support. They present their potential inbuilding the community in terms of response,
preparedness and recovery are crucial for the successful
Disaster Risk Reduction Projects. Comprehensive
disaster management and emergency preparedness
should be based on the concept of active young people‘sparticipation in all phases of the disaster cycle. Rather
than seeing disaster-affected youth as victims or passive
recipients of outside assistance, good disastermanagement must recognize the value of including themin the planning process.
There is no better resource in a community than young
people. It may be easier to obtain funding for projects
and related disaster preparedness programs, but
without sufficient community resources in place,disaster preparedness and risk reduction are notpossible. Resource building enhances community
capability and provides positive response to various
emergencies; reduce disaster risks, and helps foster
confidence, dignity, and resilience. In this regard
volunteer work requires further attention to contributein the disaster management in a more efficient way.
While searching for information and data for thisresearch it was found there is lack of data on volunteers
in disaster risk reduction. It is time the country to start
initiating a centralized and coordinated data base system
for the government to develop policy and strategy andguidelines. This should be carried out in consultation
with local, national and international concerned agencies.
Further research in this sector is needed for futureplanning,
designingandimplementationofcomprehensive disaster management programmes. The
vigilance and determination of the volunteers to save
lives reminds us how the timely and skillful response of
the youth volunteers made a difference in one of thehistory‘s worst disasters and how well they wereappreciated by the people they have helped. Volunteers
should be rewarded for such heroic work they do. It does
not necessarily have to be monetary; there are various
ways to rewarding. Promoting their contribution
through media, organizing award-giving ceremonies,
certificates, sending them to other countries to share
their stories and learning etc.

201

As the response for why youth choose to become
volunteers, what were the real motivating factors forbecoming a volunteer? What are the barriers and what istheir expectation from the organization, families, general
people and the government. It is important to recognize
them and address issues that need attention.
Available time, easy access to clear information about
opportunities and what they involve and the recognition
that they are doing something useful are important inenabling and encouraging volunteering. It can build on
what is known to be effective, for instance if volunteers
are most often recruited through word of mouth, aprogramme could be run to train existing volunteers asambassadors for volunteering.
It was great to see the high spirit of the volunteers at
the same time this is actually the expected spirit ofvolunteers. It was touching when they expressed that
“We are more fortunate than others and feel responsible
to contribute in helping the less fortunate or people incrisis. No other people feel that way.”
Quality, duration/number and practical training arelimited for the Youth’s UNESCO Club volunteers as the
respondents mentioned. Although Youth’s UNESCO Club
Training Department is facilitating various training
maybe due to the huge numbers of volunteers ‘adequate
appropriate training is still to grow. It is important that
Youth’s UNESCO Club conduct training needs assessment
for the volunteers; review their current training courses,
course curriculum for further advancement of training.
These can be done through a series of workshops,
consultations with volunteers, experts, trainers and theconcerned authorities.
Additionally, the volunteers wished for skill
development training in different trades/areas for future
career opportunities. My understanding on this issue isthat Youth’s UNESCO Club may not have the scope of
directly providing technical skills development training
as this not their area of business. In this regards, there
are agencies providing skill development training as wellas professional development programmes. Youth’s
UNESCO Club can facilitate linking the interested
volunteers with technical skill development agencies
through a special Memorandum of Understanding (MoU)
with the concerned agencies. Also, there should be
provision of clear understanding among the volunteers
what/how the organization can add value to their future
career development. Normally, people with volunteer
background tend to have better career chances than nonvolunteers of similar education and social background.
As mentioned earlier volunteer experience has thepossibility of serving as a stepping stone to employment.
The leadership in volunteer organization needs to be
active in recruiting volunteers, inspire and persuade
them to get involved. Each leader needs to mentor theirreplacement for the continued success of theorganization. Volunteer recruitment should be aconstant activity and be an important element of theagenda. A planned, organized look of the recruitment
package reassures the potential volunteer that theorganization is reliable, solid, capable, to put their time
and talents to good use. There was a significant positive
influence of the training provided by the Youth Looking
Beyond Disaster (LBD) program on some senior club

202

Eubios Journal of Asian and International Bioethics 28 (November 2018)

members prior to the earthquake, that led to enhanced
effectiveness of the whole club’s response.
Visibility of their work is important for their own
satisfaction, sense of achievements and informing public
about actually what and how they work. A motivated,reliable team of volunteers is not something that justhappens; it is the product of a focused, well-planned
recruitment and development effort. A strong brandreassures potential volunteers that the organization they
are considering is reliable and worthy of their services.
Although, Red Crescent/Red Cross Society is well known
Youth’s UNESCO Club volunteers. However, there areareas needing improvement. There are various ways ofraising media coverage in this era of media,
communication and advocacy. There is huge opportunity
in using print, electronic and social media appropriately
by utilizing professional expertise in this area.
Many women were included in emergency disaster
response to work. According to the groups this is due tothe nature of the work, long hours away from home andlack of receiving skills training in emergency disaster
response. The barrier is from both sides; from thefamilies of the women as well organization still not well
prepared to involve women in the work due to high risk.
The women in the groups expressed high interest in
working in challenging situations. They are mostly
involved in organizing cultural events, blood donation
camps etc. There is no clear guideline in Youth’s UNESCO
Club in regards to gender roles in volunteer involvement
in disaster situations. This is an area the organization
can look into and involve female volunteers inchallenging work that they can do. There is high demandof female volunteers in emergency response in regards
to providing support to women, children, elderly anddifferently able people. They are good in proving
psychosocial support, engaging children in different
activities, looking after misplaced children, adolescent
girls, women and the elderly and food distribution alongwith other work.
It is important to understand and recognize thecontribution and economic value of volunteers. The
volunteers themselves should have the understanding
about the value of their contribution as well.
Finally, findings from this study indicate highmotivation and dedication in the Youth’s UNESCO Club
volunteers. They are proud to be Youth’s UNESCO Club
volunteers. Although, they shared constrains in different
aspects of their work they are proud of their logo andtheir identity. They feel, their training, discipline,
attitude and behavior make them unique. They are wellaware about Youth’s UNESCO Club volunteers renowned
worldwide for disaster management and other voluntarywork. It makes them proud to be part of this famous
global team. This is essential for any volunteer, anyorganization involving volunteer and nation incontributing humanity.
There is a strong call for a bottom-up process in whichyoung people‘s voices are included and youth areactively engaged in the process, and volunteering is a
viable mechanism for this. It is now a matter of
combined responsibility, mutual action and collective
accountability that volunteers are recognized for theircontributions. Their needs are addressed for them toaccomplish their efforts successfully.

9. References
Ellis, Susan J. 1985. Research on Volunteerism...What Needs to Be
Done. From Journal of Voluntary Action Research, Volume 14,
Number 2-3, 1985, pages 11-14.
Flowers,J.
(2015,
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International Labour Organization 2007. Manual on the Measurementof Volunteers. Work Room Document. Prepared for the 18th
International Conference and UN General Assembly.
James, W. 1890. Principles of psychology (2 vols.) New York
Mukhier, Mohammed Omer 2015. Why the world’s youth are key toreducing disaster impacts. International Federation of Red Cross and
Red Crescent Societies IFRC.
Nawas, Farah, Shah Md Nurun 2011.Mechanisms and challenges for
managing disaster in Bangladesh. African Journal of History andCulture Vol. 3(7), pp. 104-112, ISSN 2141-6672
NCDM. (2008). Nepal Center of Disastor mangement . Retrieved fromhttp://www.ncdm.org.np/home_mission.php
Nepal (2010). Nepal Youth Policy.
News-Medical 2011. WTC disaster results in increased risk of physicaland mental health conditions after 9/11. An AZo Netwok
School, A. w. (2015, April 29). Retrieved from A world at a school:
http://www.aworldatschool.org/news/entry/nepal-earthquakethousands-of-schools-destroyed-or-damaged-1919
Schwartz, S. H. 1970. Elicitation of moral obligation and self-sacrificing
behavior: An experimental study of volunteering to be a bonemarrow do- nor. Journal of Personality and Social Psychology, 15,
283–293.
Snyder, M. (1993). Basic research and practical problems: The promiseof a “functional” personality and social psychology. Personality andSocial Psychology Bulletin, 19, 251–264.
Unicef 2013. Disaster Risk Reduction in Education Good Practices andApproaches. New York, USA
United Nation Youth 2008. “Volunteering and Social Activism:
Pathways for Participation in Human Development” Joint
publication of CIVICUS:
USAID. (2005). Youth and Conflict.
Wisler, C. D. (2007). The unexplained Power and Potential of youth aspeace-keepars. Journal of Peace Conflict & Development Issue 11.
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LiDUwQFggaMAA&url=http%3A%2F%2Fwww.creducation.org%2F
resources%2FPower_and_Potential_of_Youth_as_PeaceBuilders.pdf&usg=AFQjCNH03cTTpRIyn38qIS
Zhang, Min and Macer, Darryl. 2013, “Youth Volunteerism in AsiaPacific—YPA and LBD Trainees’ Voice of Volunteerism”, EJAIB 23:
38-46.

For forthcoming conferences see: www.eubios.info
Email to Darryl@eubios.info.

EJAIB Editor: Darryl Macer
Associate Editor
Nader Ghotbi (Ritsumeikan Asia Pacific University (APU), Japan)
Editorial Board: Akira Akabayashi (Japan), Sahin Aksoy(Turkey), Martha Marcela Rodriguez-Alanis (Mexico), Angeles Tan
Alora (Philippines), Atsushi Asai (Japan), Alireza Bagheri (Iran),
Gerhold Becker (Germany), Rhyddhi Chakraborty (India/UK),
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Kimura (Japan), Abby Lippman (Canada), Umar Jenie (Indonesia),
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Nasim (Pakistan), Jing-Bao Nie (China, New Zealand), Pinit
Ratanakul (Thailand), Qiu Ren Zong (China), Hyakudai Sakamoto(Japan), Sang-yong Song (Republic of Korea), Takao Takahashi(Japan), Noritoshi Tanida (Japan), Ananya Tritipthumrongchok(Thailand), Yanguang Wang (China), Daniel Wikler (USA), Jeong Ro
Yoon (Republic of Korea).

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