Reasons to Trust

“Madax adiga aan lahayn, taladaada ha ku darin.”
“Do not put your trust in a mind that is not your own” 

Growing up, I always noticed how the people around me were very careful about who they put their trust in, especially when it concerned their health. Trust was not something that was automatically given to someone because they were a doctor, teacher, or really any other professional. It was something that had to be built. A person became easier to trust when they were known through family, shared a religion or culture, or had some connection to someone you already knew. 

As I got older, I began to wonder why this really mattered when it came to healthcare. 

At first, I thought distrust of doctors was simply a matter of personal preference. Some people trusted Western medicine, while others preferred advice from family members, religious leaders, or traditional practices. 

But, the more I listened to the people around me, the more I realized that their hesitation was rarely based on one thing. It came from experiences, beliefs, and stories that had accumulated over years and, sometimes, generations. To understand how those ideas could be carried from one generation to the next, I came to someone whose experiences began long before my own: my ayeeyo (grandmother) Amina. 

She grew up in southern Somalia during the 1950s and 1960s. Her family was relatively comfortable compared with many other families around them, and she grew up surrounded by older brothers and sisters. Her experiences with medicine were shaped by a very different environment from the one I know today. Healthcare was not approached in exactly the same way as it is in the United States, and knowledge about illness was not limited to what came from a medical professional. 

Family members, older people, and the wider community all had their own knowledge about sickness and how it should be treated. That history matters when thinking about trust. Someone who grows up learning to rely on the people around them may not automatically place their trust in an unfamiliar individual. 

Instead, trust can begin with familiarity. A doctor who shares a patient’s language, religion, culture, or background may feel easier to approach because there is an assumption that they understand something about the patient’s life beyond the illness itself. 

A 2010 paper published in Social Science & Medicine, a peer-reviewed journal about social science research and health, examined the relationship between Somali immigrant/refugee women and the American healthcare system. 

“Somali women generally perceived health and illness as part of their larger, situated life experiences,” the researchers wrote. “[…] In reality American healthcare systems usually fragment health and prioritize physical over social and mental well-being.” 

Some were frustrated by short appointments and felt that American doctors did not have enough time to understand their background, family, or history. The researchers found that differences between Somali health beliefs and the biomedical model used in Western medicine could also create different expectations about treatment and communication. 

A similar paper published in Health Care for Women International, a peer-reviewed healthcare journal, found that immigrant women in Canada felt the same as the Somali women in the Social Science & Medicine paper. 

After reading about this research, I realized: When patient expectations are not met, it can become much harder to build trust in the healthcare system. 

This does not mean that Somali patients simply reject Western medicine. In fact, the relationship is much more complicated. 

Research by Asmaa Ferdjallah and Mohamed Hassan, published in the Journal of Religion and Health, found that Somali communities in the United States may use traditional practices alongside Western medicine. Some illnesses can be understood through physical explanations, while others may also be understood through spiritual or social ones. 

Prayer, quraansaar’s (Quranic prayers), traditional remedies, and other practices often exist alongside visits to doctors and hospitals.  

As a large majority of Somalis are Muslim, Islam is ingrained in everyday life, including how health and illness are understood. These religious beliefs may influence medical decisions and can lead to patients wanting their healthcare providers to understand their beliefs rather than dismiss them. 

But personal experiences may be just as influential as cultural or religious beliefs. 

During my interview with my ayeeyo, she said, “Qofku wixii uu soo maray si fudud uma illoobo. Haddii qof wax xun soo maray, marka dambe wuu ka fiirsanayaa cidda uu talo ka qaadanayo.” 

In English, this directly translates to: “A person doesn’t easily forget what they’ve been through. If someone has had a bad experience, afterward they’ll be more careful about who they take advice from.” 

A person who has felt ignored by a doctor, struggled to communicate through an interpreter, or felt judged for a cultural practice may carry that experience into their next appointment.  

Even when a later doctor has done nothing wrong, the memory of an earlier experience can make trust harder to give. 

Then, there are the experiences that do not happen directly to you.  

In a close community, stories travel. Someone’s aunt has a bad experience at a hospital. Someone’s neighbor says a doctor did not listen to them. Someone’s parent remembers how healthcare worked differently back home in Somalia. 

These stories become part of the knowledge people use when deciding whom to trust. This does not necessarily mean that every story is completely accurate, but it can still influence how people approach healthcare. 

This is where the idea of Somalinimo becomes important. Somalinimo, broadly understood as a sense of Somali identity and belonging, can create strong connections between people who may not otherwise know each other. Within a community where family, religion, language, and shared history overlap, another Somali person may not feel completely like a stranger. There is a sense of having something in common before a relationship has even been established. 

When I asked my ayeeyo about this, she explained how meeting another Somali person when abroad is a completely different feeling than meeting someone completely unfamiliar.  

“Wherever Somalis meet, they already have many things in common,” she said. “Even if they have never met before, the other person doesn’t feel like a complete stranger.” 

What she described helped me understand that this connection does not necessarily mean Somalis automatically trust every Somali person they meet. It means that familiarity provides a solid starting point. You may not know someone personally, but you may already share a language, religion, culture, or history with them. A connection to someone’s community can provide a solid foundation for trust to form. 

The more I learned about this, the more I realized that what I had initially called “distrust” was not necessarily a refusal to trust. Sometimes it was a demand for a reason to trust. People wanted to know that the person treating them understood them, would listen to them, and would respect the beliefs and experiences they brought with them. 

For my ayeeyo and for others in my community, trust in medicine cannot always be separated from trust in people. It is shaped by where someone comes from, what they have experienced, what they have heard from others, and the people they feel connected to. 

What may look from the outside like a simple distrust of Western medicine can actually be the result of years of experiences and knowledge being carried from one person to another. Understanding that difference matters. 

If healthcare professionals see distrust only as resistance, they may miss the reasons behind it. But if they understand that trust is built through relationships, listening, cultural understanding, and respect, they can begin to meet patients where they are. 

For a community that has learned to be careful about who it trusts, earning that trust may be just as important as providing the medicine itself.

 

---

 

Amira was a fellow in the 2026 Story Gathering Workshop, a program that gives young writers the opportunity to publish an article for our news outlet, Voices.