Going Door to Door, Usira Ali ’22 Tackles an Enduring Taboo

By Rebecca Goldfine

For the remainder of the summer, Usira Ali will work every evening and weekend until she has completed her goal of knocking on hundreds of front doors in Portland's affordable housing communities.

Usira Ali talking to woman in her house
Usira Ali interviews a woman in Sagamore Village, one of Portland Housing Authority's communities

Her mission is to speak to as many women as she can about the kind of gynecological health care they have received in Portland. Though she will interview everyone she can, she hopes to connect in particular with refugee and immigrant women.

Growing up as a Muslim from Somalia, she is aware that, in some cultures—particularly traditional or devout ones—it is not uncommon for women to consider their medical issues taboo and to be hesitant about seeking care when health problems arise.

Ali proposed her public health project to the Portland Housing Authority (PHA) last spring. "The supervisor liked that I was passionate about the issue," she said. She then applied for and received a funded internship grant from Bowdoin to work on her health care survey.

Ali, a Geoffrey Canada Scholar, moved into a Portland Housing Authority development when her Somali family first arrived in Portland, as many newly arrived immigrants and refugees do. Her family has since moved to another neighborhood.

Using information she gathers this summer, she will help create an informational pamphlet—which will be translated into many languages—to send to all the addresses in the Housing Authority's Portland communities. The mailer will encourage women to seek female health services and it will include information about where they can find affordable care. 

In addition, Ali contacted Greater Portland Health to distribute a questionnaire to its staff asking about their encounters with immigrant women and what they saw as barriers to providing health care. "Health care providers are a vital part of this project," she said. "And I am 100 percent sure they are doing the best they can, but there is always a gap, a bridge between cultures."

Surveying Sagamore Village 

Ali times her weekday home visits for after five p.m., when people are arriving back home from work. On a recent evening with a light breeze, Ali walked up the concrete steps to a front door, announcing, "Good luck to us!" before rapping on her first Sagamore Village house.

Sagamore Village has about 100 families who live in duplexes lining quiet streets. On the night of Ali's visit, children's toys were scattered across people's mowed lawns, and a few people were outside working on cars.

Usira Ali speaking to a man, asking for a woman in the house

"What I do is knock three times," Ali said. If a man or child greets her, she asks whether there are any women in the house she can speak with. 

When a boy opened the door, he listened politely to Ali before yelling, "Hey, Mom, someone wants to talk to you! I don't know what's going on!" 

"It's nothing bad," Ali reassured him. "I'm with the PHA, and I'm doing a survey on women's health services they're receiving in the community." 

All of the women Ali has spoken to so far have been polite and accommodating, willing to answer her questions confidentially. While many of her conversations are in English, Ali also speaks Somali and Arabic, and she hands out her questionnaires in English, Arabic, and French. Her questions inquire about the last time a woman saw a doctor for female health, the quality of that visit, why it was positive or negative, and whether they asked questions during the clinical visit and how issues were explained to them.

Usira Ali laughs with a woman

By asking these questions face to face, Ali is already initiating an unusual conversation for some of the women, helping to accustom them to discussing sensitive subjects. The forthcoming pamphlet will also be written in a way to reassure women that it is important to talk about female-related issues with health care providers, and to encourage female patients to pose questions to their doctors.

Ali wants to become a gynecologist herself one day, to help forge these important bridges between the medical world and female patients with backgrounds similar to hers. "As a woman of color and as an immigrant in America and someone from a different culture, I know what it feels like to not have health care and to not know about opportunities for care," she said.