Cultural Competency – Tools for the Trade

If you have not read the previous posts on Cultural Competency, you are welcome to take a look! Today is the last in my 3-part series on Cultural Competency.


Building Bridges city

“It’s easy! All it takes is caring!” 

“All you have to do is be sensitive!”

“I don’t know why this is such a big deal! In our [insert company name] we treat everyone the same!” 

These are a few of the things a colleague and I have heard when we talk about cultural competency, specifically when we conduct workshops on cultural competency.

We always breathe deeply and slowly before we respond. 

As normal as those phrases may sound, they are exactly the sort of phrases that create barriers to achieving cultural competency.

  • “It’s easy! All it takes is caring!” First off, let me say this: caring is good! Caring is essential. Caring is a great start. But, and this is a big but, it doesn’t give us what we need to communicate and function effectively across cultural boundaries. It’s a great and necessary first step but it is important to move beyond caring to offer culturally competent care and services. Here’s an example: For a long time I worked as a home care nurse. I would go to the homes of patients who had come out of the hospital but still needed nursing care. My patients ranged from new moms who were struggling postpartum, to oncology patients who were struggling with chemotherapy. The range of reasons for going to see patients was huge. The agency I worked with would always give me the “foreign” patients. It didn’t matter where they were from, it was assumed that because I had grown up overseas and then lived overseas as an adult with a lot of experience working across cultures that I would be the best one for the job. And sometimes I was, but not always. I remember a Japanese patient that I was caring for. I cared deeply for her, but I found it impossible to communicate. I felt loud and big in contrast to a woman who was quiet and small and lovely. One day with a shock I realized I would always put this patient at the end of the day, a time when I was busiest and had the least amount of time or energy. If I saw her then, I had a good excuse for a quick visit. I was not giving her good care. I was not communicating adequately and I didn’t know what was really going on with this patient. I cared – but caring wasn’t enough.
  • “All you have to do is be sensitive!” This is similar to caring. Sensitivity does not a culturally competent person make. Sensitivity means that an individual or organization responds to cultural differences and attempts to take them into consideration in their line of work. But if I don’t know what those cultural differences are, how can I take them into consideration? If I am unaware of the beliefs, values, and behavior of those I work with or serve, then sensitivity won’t take me very far. Again an example: Western biomedicine places high value on something called evidence-based medicine. Evidence-based medicine is a way of taking the best scientific evidence and linking it with a physician’s clinical expertise to better treat patients. What evidence-based medicine doesn’t do is recognize dual causality – the idea that the mind and body interact with each other and patients from different cultures and backgrounds believe there is both a scientific and a spiritual reason for their disease or ailment. A doctor needs to know their patients well enough to know if they believe in dual causality in order to give them the best care possible. They need to know that their patient believes that both chemotherapy and snake oil will cure their cancer. One of the best examples of collision of cultures when it comes to medicine is in the book The Spirit Catches You and You Fall Down by Anne Fadiman. I write about it here and highly recommend reading the book.
  • “I don’t know why this is such a big deal! In our [insert company name] we treat everyone the same!”  There is so much wrong with this I don’t know where to begin. First off, it’s a huge deal. We wear culture like our skin – we don’t even think about it until it is bruised or torn or burned. We don’t realize that everything we do is based on our cultural beliefs, until we encounter someone with behaviour and beliefs completely different from our own. And it’s all very well to say we treat everyone the same, but the reality is that they might not want to be treated the same. Their cultural norm could be completely different, whether it’s around greeting people or modesty or any other number of things.

So what are tools for the trade? We looked at some of these in the story about the FBI. Here are others that I think are excellent. I originally posted them in this piece: Tips for Working Cross-culturally in Healthcare Settings and Beyond. 

  • Be aware of your cultural values and the beliefs you hold. This is a first and critical step to being able to effectively communicate across cultures. If you don’t understand the importance of culture — why you value what you do, how you make decisions, essentially how you live all of life, then it will be difficult for you to understand how culture affects others.
  • Become a student of the culture and the community. Even if you’re an expert in a certain area it’s important to rethink your role and be willing to learn as a student.
  • Recognize differences in narrative styles and practical behaviors across cultures. Be willing to research these differences and ask questions.
  • Understand that  limited language proficiency (whether your’s or another’s) does not mean limited intellectual ability. People with limited language skills are usually capable of communicating clearly and effectively in their native language.
  • Have a high tolerance of ambiguity.
  • Seek help from bilingual/bicultural co-workers and individuals – find those who can help explain cultural nuances, the complexity of culture, dual causality and more.
  • Know the role of interpreters and learn to use interpreters effectively.
  • Allow the use of story-telling and props when speaking with others – we learn so much more in a story than in a list of facts. For healthcare providers, realize the symptoms are often in the story.
  • Recognize the primary person you are working with may not be the decision maker in the family.
  • Use empathy, curiosity, and respect as you work across cultural boundaries. Empathic listening, curious questioning, respectful observing.
  • Learn to be capable of complexity.
  • Be able to laugh at yourself and potential mistakes — if you don’t laugh you’ll find yourself crying way too much.
  • Build bridges – just as a bridge connects two bodies of land together over a vast chasm or river, so it is with us. The chasm of cultural disconnect and misunderstanding can be bridged, but it takes humans to bridge it.

I’ve said it before, I’ll say it again and again and again. None of this is easy. It’s not easy to listen. It’s not easy to be reflective of our own cultural values and see where bias, both conscious and unconscious, is present. It takes time and effort. It means putting some, not all, but definitely some of our values temporarily to the side while we focus on what is important to those around us. But it can make a huge impact and change outcomes no matter what sphere we find ourselves.

“Building bridges means moving beyond my enclave of cultural comfort, moving to a place of cultural humility and willingness to learn”Between Worlds, Essays on Culture and Belonging 

“Ignorance of cultural differences is one of the chief causes of misunderstanding in a world that is getting more and more interdependent on the one hand and increasingly torn with strife on the other.” – Fali Chothia

I would love to hear from you through the comments! What would you add to this list? 

Blogger’s note: Just this morning a friend of mine from Families in Global Transition wrote this piece: How to Build a Bridge for Mental Migration. I love how well it complements this series and wanted to link to it.

Forget Diversity! It’s Cultural Competency that We Need.

cultural competency

I live in a diverse neighborhood in a diverse area. Every day I ride the subway with people of many different backgrounds and ethnicities. I go to work and sit next to a man from Malawi and have friendships and work with women from Haiti, Jamaica, Costa Rica, Senegal, Portugal, Cameroon, and Roxbury – and that’s just naming a few.

But so what? Just because there is diversity in my life doesn’t mean I know how to navigate diversity. It doesn’t mean I exercise cultural humility in my interactions. It doesn’t mean that I don’t make mistakes and show my prejudice, sometimes well dressed and well hidden, other times more overt.

It’s not enough to recognize, and be sensitive toward, diversity. We need to learn how to navigate diversity.

In the 2012 census, census officials in the United States said that by the end of the decade “no single racial or ethnic group will dominate the majority of children under 18.” By the end of three decades, the same will hold true for the population at large.

More and more, the United States is seeing communities change from predominantly white, to a veritable ‘salad bowl’ of color. A place where people from many ethnic and racial backgrounds live, work, play, and fight together.

I’m tired of hearing about diversity. As long as we just talk diversity, nothing will change. Because diversity just means ‘difference.’

This is what the dictionary says when defining diversity:

  • the quality or state of having many different forms, types, ideas, etc.
  • the state of having people who are different races or who have different cultures in a group or organization

When it comes to a health care organization, a school, even a church, that definition is singularly unhelpful. Because all it gives you is the what – not the how. It gives you nothing about the good and the hard of a diverse population of people living, working, playing, and fighting together.

I think we need to stop talking ‘diversity’ and start talking about ‘navigating diversity.’ One of the ways to do this is by learning what it is to be culturally competent — learning how to function effectively across cultural differences.

As I think about the many tragedies that have affected the United States in the past few months, I am struck by the fact that no one has been talking about the importance of learning how to function effectively in the midst of difference – whether that difference be racial, socioeconomic, cultural, or physical.  And that is just naming a couple of areas where we see diversity in our communities.

We can talk all day long about diversity, but if we don’t have tools on how to navigate this diversity, than the talk is empty and nothing will ever change.

So for a moment, I want to talk about cultural competency. A disclaimer here – when it comes to cultural competence I am most familiar with how this plays out in the world of health care. This is where I see difference and inability to navigate difference played out regularly. So the way I approach this is from that perspective.  I want to talk about what it is, why we need it, and some tools for how to move forward in this area.  I hope to do this in the next few blog posts so I would love it if you tracked with me.

Cultural competency is a field of study, a series of behavioral changes, and a strategy for working with and serving diverse populations. The term was born in the field of mental health but didn’t make its way into medical literature until the early 1990s. The words and ideas behind cultural competency began to get more recognition in 2002 when the Institute of Medicine published a report (now a book) called Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. This report highlighted extensive areas where racial and ethnic minorities receive lower quality health care, even when their income and insurance status were the same. Among several recommendations given at the end of the study was the need for systematic cultural competency trainings.

There are several different definitions for cultural competency.

A colleague and I use prefer this one, partly because it is simple and short:

A learning process that enables individuals and organizations to respect, value — and function effectively in the midst of — cultural difference.

The definition accurately portrays cultural competency as something that is ongoing, something that has to be learned and practiced. Cultural competency is a continuum and needs to be seen in stages. 

Why do we need it?

We need cultural competency because there are overwhelming disparities in almost any area we could mention. In health care, everything from access to pain medication to being offered treatment for cancer shows overwhelming differences in quality of care. For example, in one study minority patients were more likely to be under-medicated for pain than white patients (65% vs. 50%), and more likely to have severity of pain underestimated by caregivers. Another study in the area of mental health indicated that 44% of White English speakers to 27.8% of Blacks received treatment after a diagnosis of depression. These disparities are well-documented in the book I cited above.

In an extensive survey conducted by the U.S. Department of Education’s Office for Civil Rights showed that racial disparities are well documented and pervasive in various areas of education. Here are some of the key findings from this survey:*

  • Access to preschool. About 40% of public school districts do not offer preschool, and where it is available, it is mostly part-day only. Of the school districts that operate public preschool programs, barely half are available to all students within the district.
  • Suspension of preschool children. Black students represent 18% of preschool enrollment but 42% of students suspended once, and 48% of the students suspended more than once.
  • Access to advanced courses. Eighty-one percent (81%) of Asian-American high school students and 71% of white high school students attend high schools where the full range of math and science courses are offered (Algebra I, geometry, Algebra II, calculus, biology, chemistry, physics). However, less than half of American Indian and Native-Alaskan high school students have access to the full range of math and science courses in their high school. Black students (57%), Latino students (67%), students with disabilities (63%), and English language learner students (65%) also have less access to the full range of courses.
  • Access to college counselors. Nationwide, one in five high schools lacks a school counselor; in Florida and Minnesota, more than two in five students lack access to a school counselor.
  • Retention of English learners in high school. English learners make up 5% of high school enrollment but 11% of high school students held back each year.

We need cultural competency in health care because it is one of the ways we can provide quality care. We need cultural competency in education because our schools have students of all colors, backgrounds, and religious beliefs. Cultural competency is one way to serve these diverse students and their families. Learning doesn’t take place in a vacuum and the student’s family and culture are critically important to their education. We need cultural competency in law enforcement because those in the field often encounter the challenges of interpreting and understanding the behavior and attitudes of those who are culturally and linguistically different than they are.

Talking about navigating effectively through difference is far more difficult than talking about being sensitive to, or appreciating difference. Navigating or functioning effectively in the midst of diversity is hard work. It is a learning process. It takes tremendous humility – recognizing that the way you view the world is not the only way. It takes guts. It takes a sense of humor. It takes willingness to say sorry, to admit we are wrong. It takes negotiation and communication.

In the next couple of blog posts I hope to discuss a fraction of how I think cultural competency can help us to work, serve, and form friendships more effectively as well as some tools that increase people’s ability to navigate across cultural differences.  In the mean time, what do you think? Do you talk about cultural competency in your area of work? Why or why not? 


Photo Credit: word art by Marilyn R. Gardner

A Guest Post – The Gift of Longing to Belong

I’m delighted to introduce you to Cindy Brandt today. Cindy is a TCK raising TCK’s and we connected through A Life Overseas. Her post today makes me celebrate those times when I feel uncomfortable, when I long to belong, seeing them as a gift and not a deficit. I think this post“The Gift of Longing to Belong” will resonate deeply with many of you.



TCKs know what it’s like to not fit in. Whether it’s growing up in a country as an expat, never quite fitting into local culture; or repatriating back into our passport country and not feeling at home, we quickly discover we don’t belong in any category except the category of the “other.” Feeling like an outsider everywhere brings with it a crushing loneliness. I feel a pang whenever people reference a childhood commercial ditty I am completely unaware of, or when I embarrassingly make a joke no one understands because of missed assumptions, and when finding someone who “gets” me is so hopelessly elusive. We struggle with a transient identity, the definition of selfhood slips from our grasp just when we thought we’re getting a handle on it. This drives us to search vehemently for a place to belong.

Typical of TCK’s life choices, I lived as a global nomad through my young adulthood. Everywhere I moved, I looked for people who looked like me, thought like me, acted like me. I was incredibly desperate to belong somewhere. I would attach myself quickly to people whom I found some area of common ground, thinking this is it! I can belong with them. Inevitably, each of these stories would end in disappointment as reality hits: hardly anybody shared my background. Searching for a place to belong became like a quest for the Holy Grail, a mystical prize which is always a bit beyond my reach. I think this is why TCKs have such a hard time staying in one location, because we hold out hope and believe there is surely somewhere else in the world we might belong.

It is difficult for me to even form these words because it is a painful truth: perhaps there is no place we truly belong. Our complex backgrounds and intertwined cultural makeup creates a diversity too elaborate to contain in any one category. Our struggle to find belonging is destined to be a lifelong quest. Slowly, the hope grows dim of finding a place to feel at home.

Though I may have resigned myself to give up the search for the Holy Grail, I am starting to become comfortable with being uncomfortable.

After all, the beautiful rose grows amidst thorns. The trials of discomfort and loneliness are opportunities for growth. TCKs are notorious for our early maturity. Learning to cope with grief and loss can be devastating to young tender hearts, but they emerge with resilience and strength. When the waves of loneliness come crashing around us, we can choose to swim through the dark currents, allowing it to cleanse our souls, giving us greater clarity of self and those around us. The awkward distance between us and them forces us into deeper reflection and a renewed energy to close the gap. The process is not easy, but nothing worth doing ever is.

Coming to terms with our never-belonging trains us to become acutely aware of smaller bits of ourselves that do belong. As a bicultural TCK, I love both Chinese and American food. It is sometimes difficult to find people who enjoy such variety, but I can find some who enjoy one or the other. We can meet there. Even if they can’t relate to every taste in my palate, we find some common points of interest and delight in shared times of trading recipes, distinguishing taste, and exchanging restaurant reviews. It may not seem like a big deal to share a hobby. But for TCKs, any common ground is sacred ground because in this one small area, one tiny compartment of life: we belong. I used to be frustrated by not being able to find friends who can relate to the whole of me, both Western and Chinese and everything in between, but I have learned to fiercely guard each piece of common ground. I have my Chinese foodie family, Western foodie friends, and together we put on one fantastic banquet. The TCK life may not be as comfortable, but it is bigger, fuller, and everyone is welcome at the table.

Ironically, not belonging has allowed me a deeper connection to more people. Loneliness is not an ailment exclusive to TCKs, but because of our familiarity with it, we can more easily spot it in others and empathize more fully. We relate naturally with newcomers, strangers, and those on the fringe – offering our companionship graciously. Surprisingly, people don’t fear other lonely people, they relate.

The consistent gnawing feeling inside of us which longs for something more turns out to be a universal human condition.

Everyone can identify with moments in their lives when they want something they can’t have, a dream unfulfilled, a goal unreached. This longing propels us to draw close, to reach out, to connect, to achieve, to act, to create, to hope, to move forward. The constant longing turns out to be a blessing in disguise. Despite the times we curse it and want to cast it out for good – it is the very thing which makes us human.

Bio Photo (1) Cindy BrandtA Note from the Author: My name is Cindy Brandt. Like a true Third Culture Kid, I feel sure I belong someplace, yet live each day in search of it. Along the way, I write about faith, culture, and beauty in the margins at I live in Kaohsiung, Taiwan with my husband and two TCKs with very well-stamped passports.

Exploring TCK Bigotry

DSCN4615With thanks to Stan Brown for the topic and the wisdom of his response to yesterday’s post….

This one may hurt; may pack a punch and result in a bruise. But bruises heal and scars show that our hearts are alive to pain and growth.  

My post yesterday hit several of my nerves – I regretted posting it as soon as I hit publish. But as is often the case when we are honest, others come forward with the same struggles and share wisdom.

It was my brother Stan’s comment that challenged me to look further at prejudice and bigotry in the third culture kid: “There’s a series topic here for you Marilyn: Exploring TCK bigotry……”

Full disclaimer: In this area, among sinners I am chief.

To the non third culture kid – let me explain: Our life circumstances have gifted us with many things — a love of travel, flexibility, a strong identification with others who have lived abroad for extended periods of time, and a world view that extends miles, nations, and borders past our passport countries.

But along with that we struggle with being invisible immigrants – people who look like those who surround them but think so differently that they feel like chickens in the midst of humans, or aliens in the midst of natives. We are those who feel ‘other’. We don’t know the rules and make massive mistakes in our passport countries. We can be arrogant about what we know and insecure about what we don’t know. We are the only ones without a license, without a sense of fashion, without the common language of idioms and pop culture.

And though it’s difficult to voice, we are prone to prejudice and bigotry in our passport countries. This is ironic. That which makes its mark on us with indelible ink and shouts flexibility, adaptability, maturity and fun is suddenly hidden under disdain and inability to relate to those around us. Mark Twain wrote these words years ago – and those of us who are third culture kids love these words:

“Travel is fatal to prejudice, bigotry, and narrow-mindedness, and many of our people need it sorely on these accounts. Broad, wholesome, charitable views of men and things cannot be acquired by vegetating in one little corner of the earth all one’s lifetime.”

Yet what happens when that quote we love turns on us? Like pointing the finger at someone, and suddenly realizing the other fingers point back in our faces?  What happens when we take all that life experience — travel, cultural humility established through many years of negotiating cross-cultural interactions, our ability to understand dual causality and be capable of complexity — and turn it into weapons against those who have not traveled?

We become that which we dislike. We become narrow-minded in a reverse way. We become the dictionary definition of a bigot “a person who is obstinately or intolerantly devoted to his or her own opinions and prejudices”.

My faith tradition comes down hard on prejudice and arrogance. “Do nothing out of selfish ambition or vain conceit. Rather, in humility value others above yourselves,”*

“That’s simplistic” I want to cry out “It doesn’t take into consideration that this is hard for me, that I struggle with feeling ‘other’ and so out of step with those around me, that this is all I have.” The words above from the Holy Scriptures dance in my head but they need to be imprinted on my heart.

Stan’s comment from above didn’t end there. It goes on and challenges me further:

“So my problem is this and more – I find myself alternating among prejudices depending on where I am geographically. Sometimes I find myself feeling prejudice against my passport countrymen; then against my birth nation; then against my fellow TCK generation and, not surprisingly, mostly then against myself for feeling this way. Thankfully the opposite happens more and more where I find myself rejoicing in the diversity of cultures, appreciation for my passport country, and, again not surprisingly, at peace with myself.”

And hear this for it is critically important to the discussion:

“The degree of my prejudice seems directly related to the amount of direct and personal interaction I have with people of a variety of cultures (listening, learning) or, on the other hand, how much time I spend avoiding such interaction, leading to introspection and bigotry.”

When you sit down and learn about someone, see them as a person and get to know them, it changes the dynamic. I learn that the person who has lived in the same town since childhood went to a Catholic school in a poor area of Boston and tells amazing and humorous stories about the priests and nuns.  I learn that a friend with an Irish background grew up in an all Italian neighborhood and learned early on, as she went from house to house eating pasta before finally heading home to her mom’s boiled cabbage dinners, that she liked Italian food better. I learn that someone who has lived in the same town her whole life is a voracious reader and can talk about all kinds of places where I’ve never been with a knowledge far beyond mine.

And I begin to remember – it’s all about relationship. It was the key to loving my adopted countries, it continues to be the key to living in my passport country. As an Adult Third Culture Kid, I’ve had to re-learn the value of relationships, of give and take, of knowing and being known as a fundamental antidote to my TCK bigotry.

The antidote can be summed up like this: When I learn the story of another, when I’m willing to be in relationship, it’s hard to remain a bigot. 

What about you? No matter who you are or where you live, prejudice and bigotry can be subtle. Do you struggle with prejudice and if so, what is your antidote? 

Take a look at this piece, published in Between Worlds – Essays on Culture and Belonging called “Saudade” – a Word for the Third Culture Kid

*Philippians 2:3

Part 2 – Re-entry: Reconstructing our lives

In Part I, we discussed how the development of an individual identity, a sense of belonging with one’s peers, and close personal relationships are normal developmental tasks faced by every young adult.

Why then did it knock me off my bearings?

It’s because we face these during the major life transition of re-entry. The cultural changes we face may include a loss of status, a sense of marginality, a loss of friends and perhaps family, and often a loss of purpose and meaning. And the novel ideas, values, people and customs we encounter upon re-entry create a tension between our host and home cultures.

Culture shock

They require a transformation of our approach to the world – a reconstruction of our lives, which emerges as an additional developmental task, one uncommon among our peers. This layering of stressors and life tasks can throw us off balance, and can magnify the anxiety we feel when exploring typical early-adult tasks.

The first couple of years upon return to the U.S., I felt a definite “culture shock.” I had been a blonde among Japanese and all of a sudden I was a blonde among other blondes who all looked like me and I felt lost in the crowd – I wished I looked different because I knew I was different. On the other hand, I also wanted to belong but found that there were many conversational topics that I knew nothing about… and also attitudes/customs that I was unfamiliar with… On one hand I felt “older & wiser” than my college peers, and on the other hand felt inexperienced in life as an American 18 – 20 year old. ~ Re-entered TCK, 31 years of age

It is very difficult to even begin to try to explain what a bicultural upbringing is really like and how it can tear at the very foundations of your life… The whole pace of life and values seemed to be totally reversed… I was neither American nor Indian and I felt like it, an outsider in both worlds… I wish I could explain my anguish to you, but I can’t on paper. ~Re-entered TCK, 28 years of age

During re-entry, most of us maneuver the external demands of our new worlds well. It’s the inner tensions related to our life reconstructions that take some time to work through. It’s wise to not be overly pre-occupied by these tensions; instead, compassionately allowing ourselves time to once more find our bearings. It takes time.

I don’t think people realize how different you are after living overseas. Another country becomes “home” and then you are thrown back int your real “home” and it isn’t really home anymore… After a while it became a lot easier and I finally felt like I belonged… I hardly ever talk about living overseas… ~Re-entered TCK, 20 years of age

When I came back [to my home country], I was very much like a naïve immigrant who thought the streets would be paved with gold; I had a very idealistic idea of what to expect… But when the shock of reality had worn off, …I pretty much accepted things which confronted me… yet to this day, I still feel a part from the world around me… I feel very lucky for having lived overseas and if I had to live my life over again, I wouldn’t want it to be any different than the way it has been. ~Re-entered TCK, 33 years of age

While having simultaneous life stressors can take a toll and leave us vulnerable, studies show that they also give us opportunities to build coping skills and personal strengths. Negative emotions can also be appropriate and helpful if they ground us in reality (e.g. loss of close friends and family) and move us forward to constructive action (e.g. seek out new friends).

It often has been a lonely road full of difficult decisions. But I feel I am a more creative individual than those around me because of it. Though I found it difficult to adjust to my new life in the States, I wouldn’t trade my years overseas for anything. I can see things from different perspectives, understand the world around me more and enjoy life a little more than those around me. ~Re-entered TCK, 22 years of age

The first couple of years, I had a hard time. I was lucky I found an interest to keep me going, setting goals, etc. I met nice people who were interested in the same things. ~Re-entered TCK, 23 years of age

I found that I questioned my sanity a few times because I felt about things differently. As soon as I was able to say to myself, “I just had a different experience and that is why I am different,” then I was able to feel comfortable with other people. ~Re-entered TCK, 22 years of age

What coping skills and personal strengths are/will be part of your life story based on your time abroad and/or re-entry experiences?

In Part 3, we’ll discuss what a life well-lived looks like, and how we might go about reconstructing it.

Wrapping Up the Week 2.23.13

This was a great week on Communicating Across Boundaries. We went from wrinkled ladies to third culture kid arrogance to beautiful pottery to recognizing that many times our worst fears are never realized! And the wonderful thing about this? – you were able to hear voices other than my own. Thank you Cecily, Stef, and Robynn as well as all of you for your part in making the discussions rich and meaningful.

Today I sit with my niece Melanie, drinking a latte, and grateful for family. I don’t write as much as I should about my extraordinary family – but let’s just say that there are a lot of moving parts — personalities, passions, and people. Today one of those moving parts is across from me sharing a slice of life.

On to the week wrap-up….

On Global Health: I try to keep a pulse on what is going on in global health through a variety of sources. Some of those include Save the Children, Partners in Health, and World Vision. While the western world battles with diabetes, obesity, and a combination of the two, the developing world is still in a place of battling tropical diseases that cause malnutrition, anemia, serious developmental delays and more. These are present in communities that are largely neglected and unknown. They are Neglected Diseases of Neglected People. The article linked cites the case for responding to these and argues that the return on investment is well worth making this a public health priority. Take a look at the article and see what you think.

On Women: I will quote directly from an article that I think is a provocative, ‘must-read’ written by a woman who is African-American and in her words sees “where race and feminism collide in ways I can’t reconcile…”

First, the promotion and marketing of abortions in The United States of America was born out of an effort to control the population of African-Americans.  Today, the largest majority of locations offering abortions are housed in African-American or Latino neighborhoods.  One of every three abortions in the U.S. are African-American children.  When numbers and statistics like these collide, I put it on the same level with Female Gendercide in China.

I understand that it’s convenient to go on promoting abortions as a ‘women’s rights issue’ without regard to the fact that abortion has cut into the African-American population by over 30 million lives, yet it’s appalling and reprehensible to ignore the facts.” [From A Deeper Story – Why I Respectfully Decline Feminism]. I urge you to read both the piece and the links within this quote in  Why I Respectfully Decline Feminism.

On Friendship and Dialogue: Remember last year when the United States was divided not by Red and Blue, but by Support Chick-fil-A or Boycott Chick-fil-A? This year the anniversary of that day went by with barely a nod. Why? Why did something that caused such controversy not even come up? Largely because Dan Cathy, an older, white, avowed conservative Evangelical quietly began reaching out to the man who organized the boycott – a gay man who is married to his partner. It is an amazing story of reaching across ideological divide, not giving up your beliefs, but being willing to listen, to learn, and to forge an unlikely friendship. This is a story that should have been on the front page of every newspaper. As you read it, I believe you’ll be challenged to offer grace and friendship despite polar opposite beliefs. Read Dan and Me: My Coming Out as a Friend of Dan Cathy and Chick-fil-A – you won’t be disappointed.

On Film: Finally – this weekend the Big Event of Hollywood is on. It’s the Oscars.We are a big film family so will be watching and texting family members with either shouts of triumph or groans of despair. Will you be watching this event?

On my Beside Stand: I’m finishing the book First They Killed My Father with tears in Behind the beautiful Foreversmy eyes. So hard to read. Yet another reminder of the grace of human resilience. Another book has come on my stand and I’m already immersed. Behind the Beautiful Forevers: Life, Death, and Hope in a Mumbai Undercity by Katherine Boo. I first learned of this book through this blog post and wish I was going on vacation so I could curl up and read this 24 hours straight. More on this book after I’ve read and digested all that it offers.

What’s on your coffee table, bedside stand, or heart? Would love to hear through the comments. 

Making Peace with Changing Communities

What happens when a bitter racist is transformed?

In the movie Gran Torino, Walt Kowalski (played by Clint Eastwood) is a bitter old man living out his years in a neighborhood that has changed from working-class white to Hmong and Chinese.  He does not like it and makes no pretense of civility and no apology for being an open racist. No one is safe from this behavior, particularly the Hmong mother who lives next door and victim to Kowalski’s growling and racial slurs every time they happen to be on the porch at the same time.

In the course of the movie his character changes and he gradually makes peace with the neighborhood, befriending the teenagers who live next door becoming both friend and protector. A scene showing him at a Hmong feast eating food he has never seen before and still makes no pretense of liking is a great picture of the grudging respect he is gaining for these neighbors.

As I have watched areas in Massachusetts change, I have seen a lot of Walt Kowalskis and a lot of ‘Wanda’ Kowalskis who are at odds with neighborhoods they have deep ties to.  They grieve for a neighborhood that was and struggle with the neighborhood that is.  The words ‘us and them’ are present in their speech and often they are fearful.  Some of them move through a slow process of change, for others it’s too difficult.   The movie initially portrays the tension and hatred of a man at odds with his changing neighborhood, moves on to the slow process of change and ultimately brings the audience to an act of deep love and sacrifice as Walt serves as a human shield to protect his neighbors.  He gradually accepts, and dare I say loves the community that surrounds him.

Communities in the United States are, and will continue to change.  A community health center that I work with saw three thousand patients from 40 different countries and 60 different language groups in just a 6-month time period and that is just one of many examples. As the world continues to move closer, and our interactions become more diverse, the transformation process that Walt Kowalski undergoes in the two-hour film is worth watching and, if needed, modeling.