After briefing with our team these first two weeks, one prevalent cultural issue that affects our Ukweli test strips project is differing styles of communication. My personal opinion is that in American culture, communication and direction in the workplace is somewhat more implied and subliminal rather than direct and intentional.

Within my home, I have experienced a surprising mix of direct and implied communication with my loved ones. I think the younger I was, the more direct my parents were in giving me instructions or enforcing expectations and responsibilities. This could have been anything from reminding me of my chores, how to behave, and even the standards I should hold myself to academically and why. Yet when I got older, my parents expected than these rules and expectations were already enforced, and that I was always conscious of them in my actions and thoughts. Of course, as all humans do, I fail… quite a lot. On a daily basis to say the least. I forget standard I should hold myself to and need direct guidance when I do. Even considering my experiences, I feel our culture focuses on a subliminal and implied way of communicating for a variety of reasons. 

In Sierra Leone, communication with our local team members needs to be direct and detailed. This is not so much of a language barrier (which is not the main concern), but rather a societal preference of Sierra Leone’s enforced over time that are team must continue to utilize and incorporate into our logistics and work. For example, we cannot ask a community health worker “Hey would you like to help me with x,y,z, etc.” Because it is not enforcing a job needs to be completed, but rather making an important task optional to how the person is feeling. We instead need to bluntly state to them “Come do x,y,z please. Write down this. Send this to this person.” and so on. For our project, team, and conditions we need to continue to enforce direct communication in order to ensure efficiency and results-orientated work and logistics. For this situation it is not harsh, it is just their normal way of communicating and getting the job done. 

Another prevalent cultural concern related to our project is related to gender norms and comfortability. It is usual for men to dominate the majority of community health workers in Sierra Leone, which coincides with a wage gap between men and women in the country. There might be difficulty in a male worker communicating how to use our urinalysis strip to women. Additionally, women are usually less inclined to hear a male worker’s words about caring for their bodies. 

At home, or in generally in the United States, I still find these gender norms regarding miscommunication and reliability just as prevalent. Here, we live in a very feminist-orientated mindset and individuality with our minds, bodies, and beliefs. I find myself sometimes even less inclined to listen to men, regardless of aligning beliefs and practices, when it comes to personal matters regarding a woman’s health or body. Even within my own home we have frequent discussions on this matter (considering my father is the only male in the house along with our French bulldog Derek). Even so, I feel that Americans are slightly less likely to encounter this concern due to our trust and reliance on biomedicine rather than faith or traditional medical practices (my next point). 

Within our team, one thing we will be continuing to utilize to address this concern is constantly working on a loose script for the community health workers to follow when talking to the women who are being screened. This will allow less human error for communicating proper health instructions. Additionally, our team is continuing to make connections with mother support groups in order to educate women in a safe environment about UTIs and preeclampsia, specifically one where they feel they can trust the information being given to them. 

A third cultural issue that I feel is a strong influence on our work is a lack of trust and willingness to rely on biomedicine (Western medicine) and instead rely more on traditional homeopathic and herbal practices. 

In my house, much of my family has struggled with (sometimes preventable) health concerns or have had negative experiences with the health care systems in our country. Our family does, however, trust doctors and Western biomedicine procedures and practices including prescriptions for ailments. Even so, my more immediate family is strongly Christian and believes not solely that God can heal them from their ailments but also that he may choose to give them the strength to live with them if it is His will. In this way and many more, faith does still play a dominant part in my family and I’s perception of medicine and treatment. I definitely think college has allowed me to gain a better understanding of why many nations are more hesitant to rely on Western medical practices. I had the blessed opportunity to take a course that covers a broad look at the history of medicine and practices in the African continent, which I feel challenged many stereotypes I had regarding what, how, and why homeopathic medicine is practiced in several nations in Africa. From certain perspectives, I relate to how faith is so intertwined with how they choose to take care of their bodies.

Even though we comprehend and utterly respect their beliefs, this can cause women to distrust the results of the or ignore going to trained specialists that can more effectively and quickly treat them. One way I will be working on this issue is assisting with the radio program created by the Ukweli team to educate stakeholders about the growing problem of UTIs and what can be done. Additionally, we plan to continue using local voices and professionals (especially women) to get our information across to a more willing audience. There are also posters and educational seminars that we will continue to make for people hoping to receive more helpful information.