Howdy! Today is Wednesday, August 9th, 2023. This was the Ukweli 2023 team’s third full day in Sierra Leone.

It was yet another day waiting for Institutional Review Board approval for our team’s cervical cancer research, but we are plugging along! 

Sierra Leone is not only about long stares, flying kisses, and welcoming waves that we get from strangers–it is about learning to transcend languages and create an impact. The morning was as normal: wake up, breakfast, and out the door. At the start of the day, we met with Edwin Abu, the director of the cervical cancer screening department of World Hope International. We began reviewing our bank of twenty-five interview questions with him. but we realized it was best to have our translators–Alieu and Memunatu!–join us as well. As they are going to be relaying all of the questions day to day, we wanted their input and expertise in Krio to truly ensure women will understand the questions we are asking.

We reached out to Alieu and Memunatu, and they joined us for a second meeting around noon today. Together, we went over each one of the twenty-five questions individually. It was an arduous three-hour process, but incredibly fulfilling. Our group ran into some difficulties at the beginning with translating the English questions in real-time, so we pivoted our approach to translating each question. We wrote the translations for each question directly on our preparation documents, rather than needing the two to commit each complicated translation to memory. With the difficulty and abstraction of many of the words, as well as with the need to be mindful of the interviewees we will engage, this was certainly the right move.

Each of the questions was read through in English, and edited to ensure they were in straightforward, simple language. This makes the translations more accurate. Next, we inputted each question into ChatGPT. Though not perfect, the artificial intelligence translations from English to Krio were great. Memunatu and Alieu felt they were generally really accurate. They were strong enough that each of the questions could be better understood. Edwin, Alieu, and Memunatu were in constant collaboration about the translations they were doing. It was awesome to see. They spoke in fluent Krio, exploring common words that would or would not translate best in Krio. Sometimes, words might be better understood by other dialects like Limba or Timne. When they struggled with the selection of a word to Krio, we all stepped in and attempted to rearrange the question’s phrasing so that it could be translated better. The entire process was enlightening. I don’t think any of us have engaged in something like this together before.

What was especially fulfilling about our translation work was that it felt like our first full step diving into our work here in Makeni. The long hours in the hot office pass by when we know that we are able to work together and create an excellent research selection. We all believe the work we do here is so valuable and ripe for opportunity to make strides in the development of cervical cancer screening methods in low- and middle-income settings, as well as improving maternal awareness of health. It is great to have two motivated, friendly, and college student translators on our side, as they share our curiosity and gratitude.

After we meticulously went over each question, the group brainstormed locations we could visit for each of these interviews. Choosing locations that are different from the locations the team visited last year was important to us. This ensures a wider demographic and range of people we can include in all of our data. 

We agreed so far upon six locations: Kabombeh (Safroko Limba), Talent Town (Gbanti), Old Mabanta (Gbanti), Patevana (Bombali Shebora), Manonkoh (Bombali Shebora), and Maboileh (Bombali Shebora).

Ideally, we will have ten locations total so that we can interview approximately twenty women per location. This helps vary the local setting, as well as potential other factors such as income disparity and wealth concentration, to give us as holistic an understanding as possible of cervical cancer awareness in Sierra Leone. Edwin and we decided that this list is a good start, and we will ensure we constantly add to it. A great connection we’ve enjoyed is Mohammed Jawara. Jawara is very familiar with Makeni and introduced us to our translators. We plan to speak with him tomorrow, as he might be able to contribute places that would get us diverse interview subjects.

When we returned back to our workspace, the room was full with the smell of banana bread. We again missed buying snacks from our local vendors! Hurriedly, we visited the gateman and asked him to get us some roasted peanuts from the store right across the street. Almost every team is moving in and out of the office constantly, but we’ve stayed put. Quick snacks have been a great way to get immersed in Makeni life before our cervical cancer research gives us a direct opportunity to do so. It downpoured in the afternoon, and it was absolutely beautiful.

Our team is excited to visit local tailors in the Northern Bombali area soon! They are able to stitch dresses with local fabric. A standout part of Sierra Leonean culture is fashion; it’s lovely to see people wearing so much color! They reflect the same color and vibrancy in their hospitality. Everyone here is very kind and welcoming. 

Our team is geared up to engage in a series of mock interviews with the women who work in World Hope International tomorrow. Recognizing the need for accessibility and inclusivity, we are committed to reworking the questions at hand. Their input will be incredibly valuable in finding our flow and refining our content. We’ve noticed our questions possess a level of sophistication that aligns with well-educated individuals, and those who have invested considerable time in thinking over the intricate political details of healthcare accessibility in Sierra Leone. The importance of democratizing this knowledge and making it graspable for everyone does not go unchecked by us. Our research helps a diverse range of voices be heard, and we aspire to contribute to an ethical, richer understanding of health matters that concerns us all.

The rest of the day went pretty smoothly. We enjoyed a new meal tonight: white rice, curried chickpeas, okra, and bread–delicious! We rode back to the hotel in a rainy truck bed. The fresh air of Makeni will never get old.

Our program-wide meeting happened right as we got back, giving us the night to finish up work and relax. Sterling taught Reeza how to play chess tonight. Allegedly, it ended in a stalemate, although it was anyone’s game.

Until next time, yours truly,

Ukweli 2023

Hi! Today is Tuesday, August 8th, 2023. This was the Ukweli 2023 team’s second full day in Sierra Leone. 

The morning began earlier for every team; we woke up at 7:30am, grabbed our breakfast, and headed over to the World Hope International office in Makeni. Our team had an early meeting with two prospective Krio translators for our cervical cancer research interviews. Their names are Alieu and Memunatu, and they are incredibly friendly. Both are university students–Memunatu is studying arts, and Alieu would like to pursue law.

Mohammed Jawara and Professor Khanjan Mehta accompanied us for the introductory negotiations of our meeting. It was important for the terms of payment to be established, as any ambiguity on payment may lead to discrepancies and issues when we arrive home to compile our research. Khanjan and Jawara’s experience with the Ukweli 2022 team allowed us to clearly outline the job duties required of each translator. Alieu was a translator for last year’s research effort, and his experience is very valuable in tuning up our questions and expectations for fieldwork!

We are determined to hit two-hundred interviews during our time in Makeni. Today, we received the update that our International Review Board approval is progressing. It may hopefully be approved within two to three days… it is a bit frustrating to not have the opportunity to dive into our research. Despite this, we are making the most of this downtime and preparing our question translations to be as refined and informative as possible.

Once our research approval lands, we are ready to hit the ground running! Our interviews will be an all-day everyday activity, spanning over a ten to fourteen-day period. Based on Ukweli 2022’s work, we discussed with Alieu and Memunatu that each interview should be no longer than twenty minutes and that the transcribing and digitizing will take about thirty to forty minutes after. We aim to conduct up to twelve interviews a day.

We also got the chance to plan our team division; Lorraine Rwasoka will be joining us on Friday evening, which is amazing news! Reeza Chaulagain, Brooke Lee, Sterling Salmini, and Lorraine will split into two groups, each with a translator, surveying in different parts of Makeni.

After contract terms were agreed upon with our translators, we spent a bit of time reviewing the interviewee’s consent forms and extensive questionnaires with them. Alieu and Memanatu gave valuable advice on what answers we may expect to cervical cancer questions from Sierra Leonean women based on their experience, as well as what questions may be a bit difficult to effectively translate into Krio. Our team spent the rest of the morning reviewing questions, simplifying many.

In the afternoon, Brooke made a lot of progress on developing the Artificial Intelligence Strengthening Healthcare Access team’s crash courses. Utilizing ChatGPT, she was able to generate several direct paragraphs of information for each of yesterday’s one-hundred crash course topics. Although the tool is incredibly useful, you must be careful when using it; it’s important to input several very specific questions that can translate into a digestible lesson. She is halfway through the courses!

Brooke has been a wonderful contributor to both the Ukweli and AISHA team this year. Healthcare workers and curious cats will be able to not only answer hundreds of basic, essential questions about health, but the crash courses will be part of a “Test Your Knowledge” feature that provides even more in-depth information across one hundred topics. The Amazon Alexa technology will hopefully make for a great educational tool and healthcare assistant down the line.

For their afternoons, Sterling and Reeza made progress on the Ukweli Test Strips’ subteam grant proposal. It was a rainy afternoon today, and it made for some beautiful scenes on the verandas of the World Hope Office. During downtime, our group played some games on the second floor’s balcony, overlooking the forests and far mountainous of the Northern Province. We tried a fish empanada this afternoon, but unfortunately missed out on the coconut saleswoman who strolled by! 

Sterling got the opportunity to travel with other teams to a peripheral health unit too. The rain didn’t stop people from hopping in the back of World Hope International’s pickup trucks. Kids wave and holler at us as we drive through town, it’s lovely. Every student got a chance to visit the supermarket today, and it is strikingly different from the ones back home (as everything is)., Friendly families were selling fresh fruit out front.

After shopping, we headed to dinner–same as last night–and got to taste a new fruit! Sierra Leoneans call it a plum, although it is much more like an apple. Many people like to dip theirs in salt. The routine follows from yesterday: come home after dinner, shower, hold our program-wide debrief, and finish up the day’s work.

Tomorrow at 9:30am, our team has an interview with Edwin Abu of World Hope International. We will be going over our interview question drafts and getting his input. Edwin will be going over each of the questions with us to give us feedback, especially in terms of ensuring that they translate well, et cetera. From there, we are going to be running “mock interviews” with him and some other individuals in the office. We want to keep practicing these questions and get down to our interview style. 

We need to ensure that each of us is fully confident talking about the topics of cervical cancer, so the women may feel comfortable talking about health issues that are generally regarded as private. Our team hopes to visit a peripheral health unit altogether as well tomorrow. The experience would be super helpful in seeing the clinics where Ukweli Test Strips are sold in person. It also gives us a sense of the medical care system we are actively trying to engage in and improve!

It’s been a new experience every day here in Makeni; we’re excited to see what tomorrow holds.

Until next time, yours truly,

Ukweli 2023

Hello, and welcome to our blog!

Today is Monday, August 7th, 2023. This was the Ukweli 2023 team’s first full day in Sierra Leone, along with the rest of the Global Social Impact Fellowship groups. Our team members embarking on the trip are Reeza Chaulagain, Brooke Lee, and Sterling Salmini. We hope to be joined by Lorraine Rwasoka in the coming days.

Our home for the next nineteen days is the Makambo Village Resort, a comfortable compound with plenty of bedrooms, a dining hall, and–gratefully!–running water and electricity. Makambo Village Resort is located in Makeni, the largest city in Sierra Leone’s Northern Province, and capital of the Bombali district.

The day kicked off with an early wakeup and an 8:30am breakfast. Breakfast was a small pancake, a little omelet, bread, and a sausage. There was tea available to brew with hot water, as well as packets of instant coffee and powdered milk. Most everyone made their way to the dining hall by 9:00am. Teams had the opportunity to mingle and prepare for our work days–nobody was quite sure what to expect!

Two students collected cash from all teams to be exchanged and personally used over the next ten days. Another helped collect the numbers of everyone whose phone was unlocked and could use a SIM card. Two students, including Reeza, volunteered to be the transportation coordinators for the trip, taking the role of collecting team agendas and ensuring drivers were tuned to where they needed to be and when. A program-wide meeting was held at 10:00am. Professor Khanjan Mehta relayed the day’s agenda, gave insight into the day-to-day life and social expectations of Sierra Leone, and fielded all of our first-day questions. At 10:30am, it was time to head off to World Hope International!

World Hope International’s office in Makeni is lovely. The ride was our first daytime experience diving into Sierra Leonean life. Eight of us packed into a land cruiser which was actually quite comfortable, despite being squished together. Sierra Leoneans were out and about their marketplace and homes. There were motorbikes everywhere. The temperature was hot and humid, as it is most days, but the clouds cooled the city down a lot. Ukweli 2023 arrived at World Hope International’s office before everyone else. The gated office building is beautiful and sunny, with organization vehicles packed in the compound’s front lot. A big tree bedded with flowers shades the courtyard, and makes it extremely comfortable! Our team headed into the office, setting up at the desk, and spending the day there.

Ukweli is dedicated to saving the lives of women in Sierra Leone. Our 2023 team spent the spring semester navigating a new era in the project’s lifetime. Ukweli is divided into two subteams; Ukweli Test Strips and Cervical Cancer Research.

Ukweli Test Strips are affordable, accessible, and efficient urinary tract infection test strips that have been onboarded to fifty-six peripheral health units around Makeni and Sierra Leone’s Northern province. The Ukweli Test Strip subteam has developed a unique business model which allows each party involved in strips’ manufacturing, shipping, distribution, education, and use benefits to earn a living and help their community. The technology and launch effort goes back to 2017 and has been massively successful, with thousands of tests being administered.

Sterling and Cindy Tran have lead the Ukweli Test Strips subteam, creating an exhaustive business model, which plans the program’s expansion across all of Sierra Leone and into neighboring Liberia as well. Ukweli’s valued funder Grand Challenges Canada backed the test strips’ launch back in 2019; we have been invited to transition to scale. The multi-year journey to scale will make affordable urinary tract infection and preeclampsia test strips accessible to millions of women.

Although this subteam’s grant proposal writing and business model development are not the focus of our fieldwork this summer, our team will visit partnered peripheral health units across Makeni to assess the lasting demand, accessibility, and popularity of the Ukweli Test Strip.

The Cervical Cancer Research subteam is the more newly established sect of Ukweli. The subteam researches effective methods of cervical cancer screening implementation in low- and middle-income countries. Reeza and Lorraine have lead this team’s work through the semester. Surveying Sierra Leonean women’s awareness of cervical cancer and their perceptions of receiving human papillomavirus vaccination is an essential part of creating a repeatable, game-changing process for screening across low- and middle-income settings. This local surveying will make up the vast majority of our team’s fieldwork time this summer.

Our team spent the first part of the morning creating contracts for the translators we will need to conduct live interviews and transcribe audio recordings. We are still waiting on Institutional Review Board approval for our interview protocols, which will allow us to engage in fieldwork research with the women of Makeni. The approval will be on its way soon! We took the rest of the morning to develop an agenda for our fieldwork.

We estimate each interview will be around fifteen minutes, and take a minimum of a half hour to transcribe. Forty-five minutes for an interview’s conduction and transcription means we are looking at a maximum of nine to twelve completed interviews per day. We took this into consideration when developing our translator contract’s pay rate, and expectations for what an average day of intensive fieldwork may be like. Although we are uncertain of the actual interview dates, a day’s routine of early wakeup, translator hiring, and transportation coordination has been figured out.

We had a video call with Lorraine, who ran into international visa issues on the date of our departure flight. Lorraine spent the summer at Mountaintop, developing our fieldwork and interview protocols, making her (and a fellow student’s) travel complications especially detrimental. We miss her a bunch! Nevertheless, we coordinated with her and got the information we needed to prepare today.

Brooke finalized her list of crash course topics for the Artificial Intelligence Strengthening Healthcare Access team’s education tool. Brooke is developing one-hundred short courses that introduce and inform on essential health topics that can be accessed with AISHA’s technology in Amazon Alexa. She has been collaborating with their team for the whole semester, providing their entire database of questions, answers, information, and translations used for AISHA’s educational technology. She will be working alongside their team to create infographics that demonstrate the technology’s use this week as well.

Our team was introduced to everyone in the World Hope International office–everyone was incredibly kind, welcoming, and grateful for our presence. Likewise to them, it is through our amazing local partners that life-saving work is possible. The afternoon was spent planning and exploring local shops. Around 6:00pm, everyone finished up work and headed off to dinner. Our team got to ride in the back of a flatbed truck today to dinner! The breeze was lovely, and the locals were incredibly friendly and humored to see American college students packed together in a truck bed.

Dinner was the same as our last night’s arrival meal: rice, beans, cassava leaf stew, and bread. We’ll definitely get used to having these meals every day. It is delicious! After dinner, everyone headed back to the Makambo Valley Resort and freshened up before an 8:00pm debrief. Everyone had an exciting first day.

Tomorrow morning, Ukweli is going to interview and negotiate with translators. We are also going to fully familiarize ourselves with interview protocols and conduct mock interviews with friends, so we can get a comfortable feel for the flow and tune of our fieldwork. We are hoping to buy fruit from some street vendors as well!

Until tomorrow, yours truly,

Ukweli 2023