My experiences as a journalist, limited in pure time but rich in intensity and practicality, have demanded that I open up communication with strangers, be persistent and sometimes not take no for an answer. Above that, I have learned to always consider any and all sides of a potential story and to think critically outside of my shoes as a reporter about who might have a stake or want a chance to share their perspectives on a specific topic. Journalism has required me to give all sides a say; a “voice to the voiceless” and an opportunity to offer underrepresented or overlooked segments of society a role in our society’s discourse. A design process of mine would be one that makes a conscious effort to hear from all stakeholders in an unfiltered setting. My job is not to filter, time or cut off a stakeholder, but rather get a glimpse into their stream of consciousness. And to be clear, identifying all stakeholders and then getting ahold of each is no easy task – sometimes the hardest but most critical groups appear “unreachable.” It is my job to defeat that roadblock. After hearing from each stakeholder, unfiltered, then I get the opportunity to synthesize, analyze and interpret. I have had the chance to talk to five people, for instance, and my readers will not have heard from any. So now it is my job to bring them those five people’s perspectives, in context, unbiased. Thus, my design process would be inclusive, in-depth, thorough, authentic and true. I suppose whether I am effective at this is up to the audience and any stakeholders who feel they have been left out of the conversation. But the principal nature of me knowing I do not know everything and reaching out to those who do have knowledge and expertise in specific areas and then holistically reporting on the knowledge each stakeholder has shared with me should result in a successfully genuine and practical design.

 

My gut reaction is to say that validating the usability and technology aspects of my team’s project will be easier, simply because it is more scientific in nature. One question must be answered: do the test strips work? That is, do they accurately screen positives and negatives for UTIs? But of course the more complicated question is how do we know, from Lehigh, that the test strips are working in Sierra Leone? Here is where the team will need to rely on partners on the ground and Community Health Workers, who are the first line of defense to illness in Sierra Leone. And of course this will require developing standardized validation protocol, like simple surveys or data points that CHWs must enter regarding the number of correct readings versus the amount of false ones in order for us to know the success of the venture or whether we will need to make adjustments.

Validation of the business model will pose its own challenges as well, since we are not after the money in terms of a traditional profit. Rather, we are after the sustainability of the venture – that is, to employ people on the ground, to continue to pay our OEM partner to make and ship the product, to expand our infrastructure throughout Sierra Leone and other developing countries, and to continue to renew our marketing license.

 

I honestly don’t have a grand philosophy of engagement. I really just want to help people live better lives. I’m not really in it for anything more than the look on someone else’s face when I have made a difference. I do question the notion of “throwing money at the problem.” It takes hard work, hand-to-hand combat so to speak, and can’t be done without seeing the issue up close and speaking to an array of perspectives. I will share the moment that I dedicated myself to making change. I was on a 10-day service trip to DC the summer before my senior year. One of our tasks was to go to this one park with a high homeless population and speak to one or more homeless individuals for one hour. I spoke with a man named Ben for a full hour and was heartbroken when my time was “up.” Leaving him there was a very hard thing for me to swallow. Since then, I have known my place is to help people.

 

One of my favorite examples of how nature can be applied as a unique mentor in my life is by taking a look at the system’s pure tendency to fall back into harmony, adapt and avoid (for the most part) catastrophic change. Of course, I am referring to the carbon cycle. Earth is known to maintain near perfect carbonic balance in the atmosphere: plants take in carbon dioxide, animals release carbon dioxide through respiration. Carbon is also stored in rock deep within the planet. Even though the Earth is no doubt being pushed to its limits with how much excess carbon dioxide is being emitted combined with increased deforestation, it is still remarkable at how resilient the system is. For centuries now, humans have burnt coal and oil – and yet, even with recent reports indicating rising temperatures, the Earth has largely been able to absorb this shock to the system and maintain a level of homeostasis only now being eroded. The same can be said for the hydrologic cycle, which typically provides enough rainfall for vegetation through evaporation but also doesn’t evaporate too much at one time to drain the world’s oceans. These kinds of harmonic systems are true models for how I like to live my life: maintain ideal balance when possible, but when things get thrown off, the ability to adapt and absorb these changes will eventually make or break my success or lack thereof.

 

Another example of my application of a natural process to my own life is the phenomena of tectonic plates and earthquakes. My thinking here is that while humans have improved in measuring the power of an earthquake, we are not really any closer to predicting when and where an earthquake could strike at a given moment. The lesson I take from this process is to always be prepared, and always build with stability in mind – whether that is physical building or mentally building capacity.

 

The “evolve and survive” life principle is particularly applicable to my GSIF project. The Ukweli team is currently in an advanced stage where we believe we have a viable product that is ready to be launched, but important details like a marketing strategy, funding, and logistics like employment and a tight concept of operations are now necessary for a successful implementation. Road blocks will come our way – they already have in our attempts to secure a marketing license, communicate with our manufacturer company in China and secure employees – but this motto of “evolve and survive” will certainly carry weight as we continue to push our project forward.

 

Cradle to cradle design in the Ukweli test strip project is a challenging concept to integrate, but I’m thinking if there’s a way to somehow use the natural elements present in a given situation to be able to “read” the applicability and effectiveness of the test strip at a given time. For instance, if our quality control measures show that the test strips will not function at temperatures above 100 degrees Fahrenheit and at a humidity level greater than 80 percent, if we could harness the energy possessed at those conditions to provide an “accuracy reading” on the test strip, that could be one way to incorporate the cradle to cradle design into our project.

 

I remember the first time I found out through a friend that people in other parts of the world drive on the opposite side of the road, or even don’t have traffic lights or turn signals. I had never considered driving being any different in other countries from how it is in America, and I had to ask my mom for confirmation once I got home from school that day. I also remember the day my dad (I count him as a friend!) explained to me that not all diseases are caused by bacteria and there a bacterial disease and a viral disease or infection were not synonyms and do not receive equal or interchangeable treatment. And I’ll never forget starting at the world map in elementary school and just being so confused as to why the United States is split into 50 states but other countries aren’t necessarily (or at least the various provinces don’t show up on a world map like they do for America). I finally had it nailed down after a full week of debate with my friend: there are continents, and America is in North America, for which I live in New Jersey, which is a state within the country of America. That was a lot to take in for me!

 

The five major stakeholders for my project are the women of Sierra Leone impacted by Urinary Tract Infections, community health workers, hospitals, and both the regulatory agencies of government in marketing and the economy. Arguably the most complex of these stakeholders is the very first one I mentioned: the women in need who would actually be using the Ukweli test strip that our team is devoted to designing and selling. It would be easy to say that their motivation is simply to prevent and detect disease to live a full life of meaning – and economically speaking, to continue to raise children and contribute to the family’s finances and quality of life. But this would be too simplistic. There are challenges to this stakeholder, who might be more motivated to think short term in helping out the family and selling goods at the market and prioritize these real challenges over long term health. Community health workers are the natural next stakeholder for my team’s project, who are the front lines for the fight against communicable and non-communicable diseases in Sierra Leone, waging a battle in each little village across the country to combat poor health. This stakeholder is likely driven by a motivation to improve the health of their community and country, and are doing so in the best way that they can given their limited educational and professional training capacities.

 

Hospitals are thus motivated in a similar realm as the community health workers, but it should be noted that hospitals – and consequently its workers – are far higher up the “chain” or “hierarchy” in Sierra Leone’s healthcare order. But the mentality of their basic motivation to help keep citizens healthy and disease-free will likely differ from that of the community health workers. Doctors in hospitals, which are located mostly in urban settings and are not easily accessible to rural communities, are instead the “last line of defense” in Sierra Leon’s healthcare system. So while community health workers do the best they can given their middle school education on average, and are tasked with screening and referring, the burden ultimately falls on the doctors – burdened and oversaturated with a horrible doctor to patient ratio – to cure. Thinking of Sierra Leon’s healthcare system as similar to the U.S. judicial system, hospitals represent the “Supreme Court” of medical care; what they say, goes.

 

Both the governmental agencies tasked with monitoring economic growth as well as marketing regulations will be key stakeholders to my team’s project as well. Obtaining a marketing license, which would permit our product to reach the people of Sierra Leone and be accessible in pharmacies and health offices, is now a significant priority of our project. Therefore, our project is reliant on economic and marketing agencies to approve our product and to allow its resale without restriction to keep costs low. Looking at these stakeholders with rose-colored glasses, one might think that these agencies have the people’s best interests in mind, and would gladly award a product that meets medical and manufacturing standards a marketing license for the good of those in need, who would stand to benefit from our test strip, as well as for the rightful creators of the product. But alternative motivations must be considered here. Could the government agencies attempt to deny a marketing license, in hopes of blocking money from leaving the country and going to a foreign entity? Does the government stand to profit off of women contracting urinary tract infections? This thinking may come off as cynical, but it should show my ability to question, think of all angles and understand the complexity of a single stakeholder.

 

Solidifying both my team’s credibility and my own personal credibility are two of the most important goals for this semester. It has certainly been a game of “catch up” for me so far, given that half of my team was on this project last year as well. Therefore, I feel a strong need to carve my own niche of expertise within the group. The first means to validating our project will be to offer a presentation to a team of referees and peers alike. Importantly, these referees will have no prior knowledge of our project, and will therefore adequately assess our ability to convey our message, our goals and our means of execution. These presentations will also require us to answer tough questions and consider possibilities that we may not have previously considered. Our project will also become validated based on the success or lack thereof with obtaining a marketing license. This will be an affirmative answer to whether our project is viable in Sierra Leone, or if changes or modifications need to be made to our project. And a third means of validation would simply be evaluating the progress we have made come May upon looking back at where the project was at in January. After all, it’s all about advancing the project and the mission forward.

 

When working on any international venture, the impact of culture simply cannot be removed from the task; the two are embedded together, not two independent factors. This concept applies to my team’s Ukweli test trip project in Sierra Leone. Three examples of cultural issues that will affect the project and the mission of reducing the maternal mortality rate in Sierra Leone are the prevalence of “traditional” medicine, the conservative approach to masculinity that results in female restrictions in health settings and the stigma attached to survivors of major diseases like Ebola. The battle between scientific medical advances and traditional medicine is one foreign to me in America, and this increased competition will pose a viable threat to the success of our venture. Generally, men in America encourage female control of her health and will support a sick woman in seeking medical attention, but the same may not be necessarily true in Sierra Leone – especially if the doctor is male. And in America, we care for and cherish cancer survivors or stroke survivors or survivors of major car crashes or other tragedies – but in Sierra Leone, those who survived the Ebola epidemic are not treated well in society.

 

While these specific instances are rare in the United States, especially stigmatizing survivors of diseases, I have certainly seen instances in which women in a classroom setting are looked down upon or given microaggressions that attempt to diminish her intellect. And there are cases in which women may request a female physician – but men might do the same, so I’m not sure if there’s an adequate comparison there. Certainly differences exist in patient confidentiality standards and gender equity in the medical profession, as not only are there simply more doctors per patients but there are more female doctors as well. Some of these cultural issues are tough to compare to America, if I’m being honest. While I know there are segments of the population, especially Native Americans and Amish communities who prefer communal treatment and trust the strength of their community to heal over a doctor, I do not have personal connections to these groups and they are for the most part in the minority in terms of those specific beliefs.

 

It is hard to say which cultural practices can be leveraged, being that I am answering this question totally arbitrarily since I have never been to Sierra Leone. But from the outside looking inward, the cultural practices of a close family unit (many family members live together in one house) and of community members directly serving as health officials within those same villages can be leveraged to establish greater trust in our project. Greater trust means faster access to medical resources to save lives, which puts people back to their work to continue to earn money. Additionally, the deep roots of tradition, demonstrated in cultural dances and songs, can be leveraged for communication and educational purposes. Cooperating with community leaders well-versed in the nation’s African context will enhance our team’s mission as it relates to health and the local economy.

 

The African context is based in a much shorter-term economy, has larger gaps in quality of life, infrastructure and healthcare between rural and urban areas and has less accountability within the healthcare system when compared to the American context. These challenges will present themselves as the Ukweli team attempts to not only design a reliable product, but attempts to make it accessible and widely-used to maximize impact. A shorter-term economy could restrict a family or individual to choose between money and health. We will also likely see less access to hospitals and doctors in rural areas, or upon a doctoral referral, refusal by a rural individual to give up the time it takes to travel to such a far away city. And less accountability means les trust, less pay trickling down to CHWs and a lack of standards and procedures for medical training as well as drug testing.

 

The African context offers less advanced medical resources than in America. Finalizing the test strip itself will not work in Sierra Leone. The product must be made and workable prior to the fieldwork. However, Africa’s context offers different communication resources and opportunities. Radios and word of mouth are likely to be more powerful tools to leverage in Sierra Leone than they would be here in the United States. Close neighborhoods may listen together to popular radio stations and programs, and the Ukweli team can take advantage. And much easier, on-the-ground access to medical professionals will benefit our team in Sierra Leone, compared to the more elitist feel of medical professionals in the U.S. Since most villages have at least basic public health officials, our team will be able to get a feel for which communities are most in need and what resources such communities are lacking.