Verbal autopsy is a widely known method used for epidemiological and vital registration purposes by demographic surveillance sites throughout the developing world. While the interview assessing causes of death may be conducted and recorded in local languages, the information collected in survey instruments and used by medical personnel as a starting point for analysis is often in English, or other colonial languages. Given the thus far unexplored role of the fieldworker as an interpreter and cultural mediator, ethnographic field work was conducted in six Health and Demographic Surveillance sites in Sub-Saharan Africa that participate in the Alpha Network, with the aim to understand linguistic, cultural, and survey administration practices during each site’s ongoing Verbal Autopsy interview process. This chapter reports on initial results from the study, including challenges faced by the Verbal Autopsy teams, as well as providing initial solutions applicable to professionals interested in health and language methodology.