Cultural Competency – How Does it Help?

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Four years ago, the FBI (Federal Bureau of Investigation) conducted a raid on a mosque in Miami, Florida. What could have been a disastrous, public relations nightmare for both the Muslim community and the FBI was carried out so well and so carefully that most of us had no idea the raid took place. I wrote about it then, but I bring it up again now.

I believe this story has good insight into how cultural competency helps in any area of work.

I am not one to praise the FBI or government in general, but it is important to give credit and recognition where it is deserved. I was amazed with the thoughtfulness and cultural awareness with which the raid was carried out. All the evidence points to actions that took into account the larger Muslim community and efforts that were taken to inform and involve this community.

First: The story goes that the activity of the imams had been watched for some time so when the decision was made to arrest and question these men, the FBI consulted with a cultural broker about the best time to carry out the raid. It is a large and active mosque with prayers going on five times a day and activities in between. It was decided that a Saturday morning at 6am would be the ideal time. This ensured the fewest number of people and the least amount of chaos.

Second: The officers took off their shoes before going into the mosque. They took the effort, despite the obvious seriousness of the situation, to display sensitivity that this was a place of worship and it was important to abide by the rules of the mosque.

Third: They spoke to the imams in Pashto, through an interpreter. It was their native language so there was no ambiguity about the arrest and no miscommunication because of limited English. The Pashto was clear and precise.

Fourth: They did not interrupt morning prayers, but waited until the prayers had finished before they entered the mosque.

Last:  Before the media had any idea that this had occurred, the spokesperson for the FBI contacted leaders in the Muslim community. The neighborhood surrounding the mosque is heavily populated with Muslims and, while an arrest of a religious leader within any religious community would be difficult, given the current attitudes toward Muslims this is one of most difficult and potentially explosive things that can happen. They wanted the community to have an opportunity to frame a response before a media frenzy began inciting fear,  indicting all Muslims as well as spouting assumptions that everyone in this community was involved in suspicious activities linked to terrorism.

In a climate of police violence, FBI gaffes, and abuse of power by people in the role of law enforcement, the FBI used principles of cultural competency in carrying out this raid. Just days before the operation many of the officers had attended a training program that gave tools on working in a culturally sensitive way with Arab and Muslim communities.

What did the FBI do right?

They asked and they listened! Sometimes it’s as simple as just asking. They asked a cultural broker because they knew they were interacting with a culture and community they knew little about. But if we ask, we must also be willing to listen to the answer, to not impose what we think we know on a situation.

They adjusted their behavior. Not only did they ask and listen, but they adjusted their behavior based on what they learned.

They understood the importance of language and didn’t take any chances with misunderstanding. Cultural competency always takes language into consideration.

They respected the larger Muslim community. Respect is imperative in culturally competent interactions. We don’t have to agree with people, we don’t have to believe what they believe or adhere to their values, but respect is important. The people involved in this operation understood that these Imams did not represent the broader Muslim community. They didn’t stereotype and see a single story, instead they focused on the problem and actions of a couple of individuals. “The problem with stereotypes,” says Chimamanda Adichie “is not that they are untrue, but that they are incomplete.”

Cultural competency can change outcomes, can make a terrible situation a bit easier on a community. Whether it be health care, education, law enforcement, counseling, social work, faith, or any other area, taking into account the cultural beliefs and values of a community gives us better outcomes. 

As you think about the way the FBI handled this situation, how do you think your work place handles sensitive situations? Do they practice cultural competency through asking, listening, adjusting, understanding the importance of language, and respect? 

There’s another question I ask myself — and that is this: What lessons could law enforcement in Ferguson, Missouri learn from the way another law enforcement agency handled a difficult situation? 

Photo Credit: http://pixabay.com/en/police-search-block-security-171454/

A Word About the Weather…

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A Word on the Weather by Robynn

Nothing serves to highlight the differences between where I used to live and where I now live more poignantly than the weather.

In South Asia the weather is a static reality. It rarely changes. For ten months of the year it’s hot. Overlay two months of monsoon rains midway through those ten months and it’s now wet and still hot. Two months of the year are noticeably different. December and January are cold (not cold cold but certainly colder than hot). Sweaters, shawls, socks all come out smelling like mothballs from their hot hiding places and are worn out of pure necessity. The cold demands fashions accommodate a sweater-vest, or an accompanying shawl.

Imagine my shock at the weather here in Kansas! It remains a source of constant surprise. Locals like to joke, “If you don’t like the weather– stick around…” It’ll change, sometimes dramatically in one day! We’ve even experienced three different seasons in one single day!  I’m amused by Kansans and their fixation with the weather. Everyone always knows what the weather will be today and for the remainder of the week. They listen to the weather forecast religiously. They check it on the internet. The weather app is a part of every smart Kansans smart phone repertoire. Most Kansans have emergency weather alarms, weather accommodating houses. Kansans keep t-shirts and shorts; sweaters and jeans out all year long! To be Kansan is to be weather savvy.

Weather serves as a memory maker and life marker for a community. Here in Manhattan, KS they remember the Great Flood of 1983. Some still talk about the Great Flood of 1951. People drinking hot cocoa in warm houses with the glow of lamps lit and overhead lights on still reminisce about the ice storm of 2007 where the electricity was off for two weeks in the middle of December. No one here will ever forget the recent tornado of 2008. These things serve to bind a community together. Neighbours reach out to neighbours. People help one another. Sleeves are rolled up, debris is sorted through, extra soup is made, access to hot showers is shared. In the face of the wild side effects of weather, humanity remembers her heart and reaches out with kindness to those around her.

There is a rhythm to the weather’s seasons here in North America: spring, summer, autumn, winter. A whole collection of winters and summers, springs and autumns all joined together like beads on a rosary. Glory be to the Father, and to the Son, and to the Holy Spirit. As it was in the beginning, is now, and ever shall be, world without end. Amen. Day in, day out. Month in, month out. Year after year the weather marches on across the continent.

However, the newly arrived, the foreigner, the immigrant may not immediately connect to these predictable patterns. They can’t necessarily relate to the seasonal cadences. To them the weather serves to isolate.

Severe winter storms make for lonely cold people. Spring winds taunt the memories of warmer breezes. Hot summers set off sparks of wild homesick fires. An autumn that bids trees, all the trees at once, to fall their leaves is unsettling to the uninitiated.  A friend teaches in the ESL program here at Kansas State University. On a day when the thermometer reached 50* F (10*C), a shivering student asked her, “Does it get much colder than this?” Last week on a day when the warmest it got was 14*F (-10*C) I wondered after that poor student.

I will never forget that first winter back in North America, years ago, when I had returned to college on the Canadian Prairie. That first winter took my breath away. It sucked all the life out of me. I remember one forlorn day in the middle of January, that year, looking out the window, to more snow, more cold, more wind. The tears were falling down my face faster than the flakes were flailing from the chilly heavens to the frigid earth below. I closed the curtains and crawled back into bed—where I stayed for nearly a week. Winter sealed in my despair. Any morsel of remaining hope I had was piled under the shifting snow drifts outside my Saskatchewan window.

At boarding school our life was mostly climate controlled. When the winter snows began to fall in the Himalayan foothills, they broke up the school year to allow us to winter in a more temperate region. Kids and chaperones, bedrolls and trunks, suitcases and footlockers were dispersed by train or plain or jeep or bus to the far flung corners of Pakistan, where a more mild winter had settled. In the spring when the sun had regained her heat, we were allowed to escape back up to the cooler mountains, where, hopefully the snows were beginning to melt. We never had to endure the severe extremes of Pakistan’s weather. It was one thing that they tried to protect us from.

Winter has already arrived with stamina and severity to Kansas. The weather viciously turned on us a couple of weeks ago. The skies are bright and the sun is deceptively chipper and yet one step out the front door and your breath is plucked from your lungs and your extremities immediately begin to question your rational decision making abilities. It’s hard for me to maintain my emotional equilibrium in the face of such cold. I battle bitterness and bitchiness. I struggle to find joy and hope during the endless winters here. I find myself longing for other places, more temperate spaces.

I know my war on winter is petty in light of huge global issues. But it’s my honest struggle these days. Faith, hope and love are not dependant on the weather. The Holy One and the fruit he bears out in our souls (love, joy, peace, patience, kindness, goodness) is not thermostat controlled. His power can permeate frozen hearts of stone. He alone can transform those frigid heart-blocks into warm beating; life pulsing hearts of soft flesh.

I’m asking him to melt my icy attitude to the world outside. I’m asking for the courage to try on cheerfulness.

I’m asking him to make me aware to where life and warmth thrive, to where he is busy melting and moving, to those sacred hearths where he invites me to join him.

 

What’s Wrong With Halloween?

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Maybe it’s that I’m sick of the sexy nurse costumes, completely demeaning my profession. 

Maybe it’s that I think making a “sexy Olaf” costume, sexualizing a little snowman from the movie Frozen is despicable.

Or perhaps it’s that Halloween is a six billion dollar, yes – six billion dollar – industry. 

But what really pushed me over the edge is the cute baby in the marijuana costume. For a mere $29.99, you too can dress your cuddly, darling to look like a pot plant. So let’s get this straight: Refugee moms are fighting to keep their babies alive, free from dysentery, scabies, upper respiratory infections, and numerous other diseases that one has to fight against in resource poor settings while moms in North America are purchasing costumes that resemble marijuana. 

If I thought I couldn’t go farther over the edge, I was mistaken.I became incensed when I found out that people are actually planning on dressing up as sexy Ebola workers. Yup. You read that correctly. A disease that has claimed countless lives, that has family and community members weeping at graves where they aren’t even allowed to wash the bodies of their loved ones, the spoiled West decides this is funny. So they decide that going as a Sexy Ebola Worker is a good idea? On what planet is this a good idea? I wouldn’t wish Ebola on anyone…but I’d like them to see the disease up close. Maybe it would change them. One can hope.

And that’s what’s wrong with Halloween. At some point Halloween stopped being about kids and cupcakes, about jack-o-lanterns and Trick or Treat, about dress up and bobbing for apples. It ceased being about children and it became about spoiled adults. Adults who evidently think it’s funny to sexualize a profession that they will cry out to at many times in their lives. Adults who want to party hard and drink harder. Adults who haven’t grown up, instead foisting their pitiful excuses for fun onto children who should be able to be pirates and ghosts and cowgirls. Adults who are callous to addiction, pain, and suffering.

So what’s wrong with Halloween? It’s been co-opted by spoiled grown ups – that’s what’s wrong with Halloween. 

You’re Welcome.

P.S – “The UN health agency said that 4,555 people had died from Ebola out of a total of 9,216 cases registered in seven countries, as of October 14. A toll dated just two days earlier had put the death toll at 4,493 out of8,997 cases.” See Source

Oh Yeah! That’s Sexy….!

Picture Credit: http://pixabay.com/en/pumpkins-hokkaido-autumn-october-469641/

Culture – Weekly Photo Challenge

Google the word ‘culture’ and over 8 million results will pop up.

As Communicating Across Boundaries readers you know well the concept and the meaning of ‘culture’. As Edward Hall says “Culture is man’s medium”. It’s the way we make decisions, do government, create infrastructure, educational systems, court and marry, raise children. It encompasses all of life. So though I have never opted to take part in the weekly photo challenge hosted by WordPress, this week I had to. Choosing one picture to represent ‘Culture’ does not do the topic justice – but nor would a hundred pictures.

Today I’m posting three pictures that represent ‘culture’ to me. The first two are pictures of spices in spice shops in Cairo and Istanbul. The way the East sells spices is in stark contrast to the way the west sells them: the east in large burlap bags, the pungent aroma wafting through the air causing you to breathe in and sometimes sneeze; the west –  in pristine bottles with efficient labels to sit happily on your shelves. And the way Pakistanis store spices is also a contrast – so that is why I have posted the third picture – My Masala Dabba.

What I wish I could do is have all of you link up pictures that represent culture to you, instead I’ll ask you to use word-pictures. What picture would you post and why?

Culture

spices in baskets

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When a Piece of Bread is not a Piece of Bread –

In 2008 HSBC Bank unrolled a brilliant advertising campaign. Called “Different Values”, the campaign showed three pictures side by side.

Sometimes it was three identical pictures with a different word across each picture:

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Other times it was three different pictures with the same word across each picture:

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End of Life Care and Cultural Competency

I just finished speaking to a group of medical and nursing students on end of life care and cultural competency.

It’s a big topic.

In health care the two areas where cultural beliefs are profoundly obvious are during birth and during death. In other areas the belief systems are more subtle, the differences not always obvious.

But birth and death? These moments of coming into and going out of the world are rich with tradition, ritual, meaning, and emotion.

The first thing I ask people to do is to think back to their first memory of death in their family or community. Who was it? What were the circumstances of the death? What is their most vivid memory? What rituals and behaviors were observed by the family and/or community?

The answers are fascinating, particularly if it’s a diverse group. There are people who remember all the church bells in the town ringing — they knew someone had died because the bells were ringing at a time when they were usually silent. Others remember wailing waking them during the night. Still others will talk about death being a celebration, a party of sorts.

The important piece is that they talk. Most have never thought about this, let alone processed it in a group. And talking about their experience puts us in the best possible place to continue the discussion.

Because telling their stories helps them realize how significant those moments are, and how critical it is for them to hear the stories of their patients, to be fully present with their patients during the end of their lives.

We move forward into the discussion on the western view of the body as a machine, on how culture affects views of illness, expectations of care, and views of the process of death. We look at possible points of cultural collision – patient autonomy, organ donation, body preparation, the differences in both meaning and expression of pain and so much more.

I usually end the time with a short video telling the true story of a gentleman from Afghanistan named Mohammad Kochi. Mr. Kochi immigrated to the United States with his family and settled in California. At the time of the film he was diagnosed with stomach cancer. The film details some of his care and the disconnect and misunderstandings that occurred, resulting in his refusal of chemotherapy through a pump into his body — ultimately his death because of lack of treatment.

It is sobering and hard to watch. We sit somewhat stunned at the end and there is no gap in conversation.

How could this happen?

So preventable!

Such a misunderstanding!

But these types of cultural misunderstandings occur far too often despite the best of intentions.

There are so many things that come up in conversation, and so much to learn from each other. But we end talking about three areas where we can develop skills.

The first is in self-reflection – How do I react to cultural differences? How do I manage my own reactions? How do I negotiate with patients and families in the face of cultural differences?

The second is active listening Listening to and with the body, listening in with self reflection, listening out by learning from others; listening with the mind by hearing facts and stories; listening with the heart by being willing to hear emotions and feelings.

The third is bearing witnessbeing fully present with the person, letting them know they’re not alone, listening to their stories and their symptoms. 

As is usually the case, I leave contemplative, thinking about life in its entirety, life from birth to death. And I also leave with a renewed resolve to continue developing skills in the areas of self-reflection, active listening, and bearing witness.

Skills not only important in end of life but through all of life.