At the heart of the story is the highly communal, family-driven society of Nampossela. While attractive on many levels to Holloway and John, it is also frustrating and mystifying to these Westerners. Family dictates all decision-making, especially for young girls and women. The society is deeply patriarchal, with a group of male elders responsible for approving or disapproving any changes in the village or in the villagers’ lives. As such, Monique cannot leave the village to take a brief vacation or visit Holloway in America, and Holloway cannot arrange for the birthing house to be repaired, without the elders’ approval.

Men rule in this society, while women are expected to serve the men and obey their mandates. This patriarchal power results in gender inequality, which manifests in several ways throughout the book. For example, all money is controlled by the men. Monique is one of the few villagers who can read; she is also the only villager with any medical training. She runs her clinic mostly by herself, and yet her salary is paid to her father-in-law. Her husband Francois, who resents the important role Monique plays in the village, flaunts her hard-earned money, spending it on frivolous material things and using it to dote on his girlfriend.