GSIF Fieldwork Lessons Learned

Three things I learned during my GSIF trip this summer:

1. Spending three weeks focused on learning about sickle cell in Sierra Leone, I had one main take away: our device has to be implemented as part of a bigger program. Although up until now our research has all focused on designing the physical screening device, the fieldwork made me realize that the biggest challenge in combating the high childhood mortality associated with sickle cell is with what to do next. Specifically, although most healthcare workers in Sierra Leone know about sickle cell and agree that it is a problem, there are only two centers in the whole country which provide treatments for diagnosed individuals. In other areas, even when a patient is suspected to have sickle cell (there aren’t diagnostic services available to confirm), nothing is really done. This is because there aren’t any national protocols in place on how to treat sickle cell. Additionally, although most healthcare workers know that prescribing folic acid helps, the majority that we spoke with did not even bother prescribing it to their patients, because they knew they would stop taking them because they weren’t free. In this way, in order to actually ensure that our device helps, it would have to be implemented alongside public education on the symptoms and treatments of sickle cell, a government policy change on national protocols for treatment, and a sustainable funding source for providing life-long treatments.

2. In addition to learning a lot about the future direction of our project, my fieldwork experience also allowed me to learn a lot about the global health arena. In Sierra Leone, everywhere you look you see signs stating which government or NGO funded that building or program. Despite the global support, most healthcare workers we spoke with expressed a need for more help. Many of them told us that people and projects come and go trying to help, but most of them end leaving an even bigger gap. Hearing some of these comments, I learned just how important sustainability is in making an impact.

3. Finally, during my time in Sierra Leone, I learned a lot about ethics and privilege. Coming in to Sierra Leone as white Westerners, we were automatically given a lot of access. For example, whenever we arrived at clinics (often unannounced), the healthcare workers would stop everything to speak with us, leaving their patients to wait for services. Although part of this was probably due to the welcoming culture in Sierra Leone, I think a lot of it was also due to the perception that we were “coming to help.” Having seen this over and over, I learned how important it is to be aware of your privilege, as well as making sure to present yourself ethically (for example, later in our fieldwork we found out that many of the individuals we were interviewing thought we were medical students or healthcare workers; knowing this, I believe that we should have been more upfront with who we were, and what exactly our projects were looking to accomplish).

Three ways the GSIF trip facilitated my professional development:

1. One of the most important professional skills I developed during the field work was how to network. Speaking with doctors, NGO representatives, researchers, and someone from the WHO, I gained invaluable practice in building relationships and speaking professionally. As one of the most important skills for building a career, this experience will be particularly beneficially in the future.

2. Additionally, I developed skills working as a team, both with peers and advisors. For example, although some of my team’s early interviews were confusing and jumbled, by learning off each others strengths and accepting constructive feedback, we were quickly able to figure out how to work together to get everything we needed from an interview efficiently and smoothly.

3. Finally, during the GSIF fieldwork, I developed significant cross-cultural communication skills. Two of the most valuable lessons I learned about communicating cross-culturally with and without translators is to be very precise and avoiding leading questions. For example, when asking villagers about sickle cell, we noticed that our translator would sometimes include additional descriptions which weren’t necessarily accurate, and we would therefore get answers which didn’t always make sense. Additionally, we noticed that we could get very different answers depending on how we asked questions.

Three ways the GSIF trip helped me grow personally:

1. One of the biggest ways the GSIF trip helped me grow personally was by reaffirming my career goals. I have always wanted to be a doctor, and recently that aspiration has grown specifically to working in developing countries with organizations such as MSF. Not only did this trip help confirm that I love working in that environment, but seeing all of the health challenges and knowing my own skills and interests, I realized that that future really is the best fit for me, and will also allow me to make the most impact.

2. Additionally, this trip was especially beneficial at pushing me to be more comfortable in uncomfortable situations, and in being more confident. Working in unfamiliar environments, as well as with highly accomplished professionals, I quickly grew in my ability to navigate these new situations.

3. Finally, this trip made me realize how much I enjoy working on a project which has true potential. Speaking with doctors in Sierra Leone, we realized that there truly is a need for a low-cost sickle cell screening device, and that many people want to work with us. Getting this feedback was incredibly motivating, and inspired me to continue focusing on projects which I am truly passionate about.