As my team moves forward with designing and implementing a sickle cell anemia diagnostic tool in Sierra Leone, there are several cultural issues which we may have to be aware of; including religious beliefs, concepts of the good life, and gender roles. Specifically, religious beliefs could impact whether individuals choose to utilize our diagnostic tool due to a preference for traditional medicine, or a trust in “miracle services.” Additionally, the concept of a good life might not encourage individuals to seek out our diagnostic services. For example, since sickle cell anemia is not curable, individuals might not want to know their status. Finally, gender roles may impact the utilization of the test strip. For example, in some cultures, women are not allowed to be treated by men, or to go out without their husbands. Because of this, we should be aware of how gender roles and expectations could influence people’s access to our test strip.
I have also observed how these different religious beliefs, concepts of the good life, and gender roles can impact social situations at home in the US. Specifically, for example, religion can impact maternal health through abortion access, and with blood transfusion beliefs among Jehovah’s Witnesses. Additionally, the concept of the good life in the US stresses efficiency and profits. Coming from Germany, I have seen how this culture uniquely affects the work culture, such as through reduced vacation time and maternity leave. Finally, although there has been a huge social movement for increasing gender equality in the US, gender roles and expectations still affect every day life, for example with the gender pay gap.
In addition to these cultural challenges, I believe that there will be some unique challenges presented by the African context specifically. For example, because we are unfamiliar with the healthcare system, economy, and culture in Sierra Leone, there may be some unexpected challenges (such as the unforeseen consequences of the treadle pumps and hybrid corn). Additionally, although English is the primary language in Sierra Leone, the prevalence of different languages among different ethnic groups may create some communication difficulties. And finally, the economy in Sierra Leone, specifically with individuals typically only having small amounts of money at once and no steady salary, may present some unique challenges with figuring out how to pay distributers and getting reimbursed.
Although this unique context may preset some challenges, I also believe that there are some local practices which could be leveraged to address problems. For example, although the “gig economy” may be an adjustment for us, it could allow us to employ many more people for small tasks. Additionally, although the US is a very individualistic nation, a greater focus on community in the culture, for example, could allow for a more cohesive workforce. Finally, since learning is different depending on the cultural context, being in an environment where people learn through imitation instead of reading, for example, could allow us to make a bigger impact more easily.
Within the African context specifically, I believe that there may be several resources which could benefit the implementation of the sickle cell anemia test strip. For example, because Sierra Leone does have a large gig economy, I believe that finding individuals to help us distribute our product will be easy, and open up a lot of employment opportunities for locals. Additionally, because sickle cell anemia is the leading cause of child mortality, our product will be especially well received. And finally, because doctors are well respected in Sierra Leone, most people will choose to utilize our test if recommended.
In this way, I believe that there are many unique local challenges and opportunities we may be observe while trying to implement our test strip in Sierra Leone.