Cultural
Connections in Our Changed World
Michael Carter, DNSc, FAAN, APN,
BC
Many of us have experienced a number of changes in our world following the tragic events of September 11, 2001. Events that cause such loss of life along with the images of the destruction are burned into our memories by the constant replay on television and in other media. Embedded in the tragedy are important lesions in understanding the value of cultural connections.
This column will focus on one of the basic concepts in understanding culture and one that seems to raise its ugly head during times of stress and strife. That concept is ethnocentrism. To fully understand the concept of ethnocentrism, we must first remember that culture is a set of learned attributes including behavior patterns, language, arts, beliefs, values, customs, lifeways and the other products of human work. (Purnell, 1998) Ethnocentrism refers to the position that one particular culture is more important or better than another. There have been discussions in the news in which the commentator refers to the “American Culture” as though there were but one monolithic culture. George Will (2002) goes so far as to indicate that following Sept. 11, we are seeing a new wave of nationalism and that “nationalism is the assertion of national superiority. Nationalism is the rejection of cultural relativism, the basis of ‘multiculturalism.’” (p. 6B) This form of ethnocentrism has the potential to be a destructive force and can take a variety of forms leading to bias in delivering health care. To advocate for a single culture over others denies the rich tapestry of cultures that make us our great nation and our proud heritage in the Delta.
Ethnocentrism is well understood by people living in the delta for many have the lived experience of this form of bias and can testify to its pernicious effects. In addition to the most obvious issues that can be traced to the region’s history of slavery, the Delta is also the site of the removal of large groups of Native Americans over the Trail of Tears and the internment camps for Japanese Americans during World War II. These tragic events from our past are forms of ethnocentrism carried out by the federal government and supported by the population under the guise of nationalism.
Today, however, ethnocentrism can take on different forms. There have been many examples of anger and intolerance particularly directed toward Muslims following the destruction of the World Trade Center and Pentagon. Members of the Muslim community expressed fear for their safety following these events. Some even worried if they should hide their Muslim identity. Where once was touted strong support for diversity, some now wondered about tolerance.
Letters to the editor in a recent edition of The American Journal of Nursing (2002) share even more disturbing feelings of ethnocentrism. One writer, (Bruffee), speaking to a Muslim nurse, (Baqi-Aziz) who had felt anger directed toward her for wearing khimar (head coverings) says: “Lose the towel, lose the attitude and get with the program.”(p.13). Bruffee seems to demand cultural imposition on Baqi-Aziz through strong anti-Muslim statements. In response, Baqi-Aziz points out that “Women of Cover” can be found a number of places in this country including Catholic nuns, Muslim women, Old Order Mennonites, the Amish, and Orthodox Jewish women. Her response points out that others often share a particular characteristic. Ethnocentrism in any from is never pretty and often very destructive.
These letters suggest that health care professionals and particularly those in primary care delivery are not immune to ethnocentrism. We often pride ourselves with our ideals of universal access to care. We give lip service to meeting the needs of our patients. Yet, it is not so clear that we really want to support diversity when the patients and their families have characteristics that distinguish them from ourselves or when we feel as though we are under assault.
Rural communities can seem very far removed from the troubles seen in New York and Washington, DC but ethnocentrism can exist everywhere. Rural communities can be locations of limited tolerance for differences. Families are often closely related in genetics, religion, language, and customs. People who do not fit the norm can be viewed as inferior because of their differences.
Now is a time for all of us in health care to rededicate ourselves to eliminating ethnocentrism in our personal and professional lives. To do this we must first be aware of the subtle forms that ethnocentrism can take. We can begin by asking what it is about another that seems unusual to us. This can be dress, language, food, religion or any other cultural attribute. Then, we can learn from the other person the meaning that characteristic has and some of its history. The meaning that we ascribe to the particular attribute may not be the meaning that the other person has at all. Once we know the meaning, we can then better understand a larger picture of the culture of the other person. There are times that we enjoy this process and I would suggest that we use these experiences to help us along. For example, many people enjoy eating in an ethnic restaurant. These foods are different from what would usually eat at home and it is this difference that makes the experience so enjoyable. I would suggest that you see if you cannot spend some time visiting the home of someone who is very different from your family. Learn their meanings of important events for their family and community such as the birth of a child, the death of a loved one, or attend their place of worship. For a Baptist to visit a Methodist church is not sufficient, in my opinion, but could be a start if you are reluctant to venture very far. Most can do much better.
Our strength as a region comes from our rich diversity. All of us should strive to understand and value (not evaluate) these differences. We should celebrate the freedom to be different and teach our students to celebrate these differences as well. Health care providers have an opportunity to lead the nation during this very difficult time. Our patients deserve no less from us.
Bruffee, G. & Baqi-Aziz, M. (2002). The rights of Muslims [Letters to the Editor]. American Journal of Nursing. 102(3). 13.
Purnell L & Paulanka, B. (Eds) (1998), Transcultural health care: A culturally competent approach. Philadelphia: F. A. Davis
Will, George (2002, March 14). Welcome changes since 9-11. Arkansas Democrat Gazette, p. 6B.