1. Give three compelling examples of how cultural issues affect your project.
One example which affects my project is gender in Sierra Leone. In the country there is a clear distinction between men and women and what can be expected from them. The most prevalent form of medical professionals are Community Health Workers (CHWs) which work in undersupplied outposts. Most of these volunteers are male which poses a clear conflict for women. Many of the women don’t feel comfortable in telling these men about potential symptoms which may be a result of a UTI. Therefore if a culture of silence persists because of gender the women will be unable to utilize our test strips and therefore unable to receive the proper medical care.
Another example is the concept of time in Sierra Leone. Western culture observes very strict adherence to punctuality. A common phrase is “5 Minutes early is on time, on time is late. Late is unacceptable.” This way of thinking is not observed in Sierra Leone. A potential problem is scheduling meetings while in the country. Due to this it is important that our team remains flexible and has alternative plans if the schedule is to change in order to avoid wasting precious time.
Lastly, many people in Sierra Leone practice traditional medicine. This form of medicine relies on the use of herbs and other rituals. Although this could be used in conjunction with Western medicine, the use of traditional medicine in place of Western medicine could prove harmful. In order to navigate this particularly difficult area we must negotiate with the patients to gain their trust.
2. Have you experienced or observed any of these social situations at home? Describe at least three such situations.
I have personally observed the first example of gender roles posing clear roadblocks to medical care. I am not only an EMT but I have done an internship under the supervision of a OBGYN. In both cases it is extremely difficult for the patients to describe their symptoms in their entirety and with comfort. This results in less effective medical interventions which may not even be addressing the underlying ailment.
Additionally, I have encountered situations where religion has prevented me from rendering medical care. One case I had a patient who when asked if she had any religious observations which may change the plan of care she stated she was a Wiccan. Although at first I did not know what that meant I probed her further and she told me it was a modern form of Pagan witchcraft. Throughout the experience I had to maintain my composure although many of her beliefs I was confused and somewhat shocked by. Regardless I changed my plan of care accordingly and attempt to persuade her to allow me to conduct the typical medical interventions that her condition called for.
Lastly, time is something I have struggled with myself. When I went to Germany as part of an exchange program I had no idea how much earlier was considered “on time.” When I was told to be ready at 1200 and I was still getting ready at 1130 my host family was flabbergasted. However, I successfully shifted my schedule to follow their lead.
3. Give three examples of cultural practices that can be leveraged to addressed community / market problems.
One cultural practice is that of the social hierarchy in Sierra Leone. If we are able to successfully sway an individual who is held in a high regard this can prove very helpful since others are likely to listen to what he/she has to say. This is currently in place with our on-the-ground asset Hassan, however we could achieve even more by getting someone of even higher regard on our side.
Similarly the tendency of many people of Sierra Leone to form very tight knit communities could further strength the group mentality which will further progress the reputation of the test strips by word of mouth.
Lastly, we are able to leverage the cultural practice of many CHWs being volunteer. Although they do this work out of their love for those in their community fiscal incentives would prove even more effective. A possible form of this is a stipend for being trained or a potential profit to be made off of the test strips. Even though theoretically a CHW could abuse this system and overcharge or over distribute the strips they are not likely to do this since as I mentioned before the communities are very close and these volunteers are working to better their community rather than make a living.