Adapting health-risk communication to the specific cultural contexts of diverse populations : an assessment of malaria-treatment programs in Liberia

Drawing on theories of technical communication, rhetoric, literacy, language and culture, and medical anthropology, this dissertation explores how local culture and traditions can be incorporated into health-risk-communication-program design and implementation, including the design and dissemination of health-risk messages. In a modern world with increasing global economic partnerships, mounting health and environmental risks, and cross-cultural collaborations, those who interact with people of different cultures have “a moral obligation to take those cultures seriously, including their social organization and values” (Hahn and Inhorn 10). Paradoxically, at the same time as we must carefully adapt health, safety, and environmental-risk messages to diverse cultures and populations, we must also recognize the increasing extent to which we are all becoming part of one, vast, interrelated global village. This, too, has a significant impact on the ways in which healthcare plans should be designed, communicated, and implemented. Because communicating across diverse cultures requires a system for “bridging the gap between individual differences and negotiating individual realities” (Kim and Gudykunst 50), both administrators and beneficiaries of malaria-treatment-and-control programs (MTCPs) in Liberia were targeted to participate in this study. A total of 105 people participated in this study: 21 MTCP administrators (including designers and implementers) completed survey questionnaires on program design, implementation, and outcomes; and 84 MTCP beneficiaries (e.g., traditional leaders and young adults) were interviewed about their knowledge of malaria and methods for communicating health risks in their tribe or culture. All participants showed a tremendous sense of courage, commitment, resilience, and pragmatism, especially in light of the fact that many of them live and work under dire socioeconomic conditions (e.g., no electricity and poor communication networks). Although many MTCP beneficiaries interviewed for this study had bed nets in their homes, a majority (46.34 percent) used a combination of traditional herbal medicine and Western medicine to treat malaria. MTCP administrators who participated in this study rated the impacts of their programs on reducing malaria in Liberia as moderately successful (61.90 percent) or greatly successful (38.10 percent), and they offered a variety of insights on what they might do differently in the future to incorporate local culture and traditions into program design and implementation. Participating MTCP administrators and beneficiaries differed in their understanding of what “cultural incorporation” meant, but they agreed that using local indigenous languages to communicate health-risk messages was essential for effective health-risk communication. They also suggested that understanding the literacy practices and linguistic cultures of the local people is essential to communicating health risks across diverse cultures and populations.

Federal Authority and the Development of Corporate Mining, 1807-1847

While the 1913-1914 copper country miners’ strike undoubtedly plays an important role in the identity of the Keweenaw Peninsula, it is worth noting that the model of mining corporations employing large numbers of laborers was not a foregone conclusion in the history of American mining. Between 1807 and 1847, public mineral lands in Missouri, in the Upper Mississippi Valley, and along the southern shore of Lake Superior were reserved from sale and subject to administration by the nation’s executive branch. By decree of the federal government, miners in these regions were lessees, not landowners. Yet, in the Wisconsin lead region especially, federal authorities reserved for independent “diggers” the right to prospect virtually unencumbered. In doing so, they preserved a comparatively egalitarian system in which the ability to operate was determined as much by luck as by financial resources. A series of revolts against federal authority in the early nineteenth century gradually encouraged officers in Washington to build a system in the copper country in which only wealthy investors could marshal the resources to both obtain permits and actually commence mining operations. This paper will therefore explore the role of the federal government in establishing a leasing system for public mineral lands in the years previous to the California Gold Rush, highlighting the development of corporate mining which ultimately set a stage for the wave of miners’ strikes in the late nineteenth and early twentieth centuries.