I start by saying that this thought has been brewing for
many years and ultimately sparked my interest in public health.
We have been talking a lot these past few weeks, as well as
my exposure to literature on various concepts about applying programs,
services, and tools across regions and communities that would essentially
increase the amount of information accessible to people around the world. For
example, the HINTS survey and its abilities and mission to carry it forward to
multiple countries; an AMAZING outcome the more countries come on board!
Imagine the knowledge gain, the ability to move forward with have identified
knowledge on what needs to be done and where. Another example being mobile
applications and their use in public health around regions in India etc. are also becoming increasingly used and have shown tremendous results in
improving healthcare access. All of such
initiatives ultimately seek to decrease the health disparities in the
communities in which they serve and the very reason why we, I am sure, are all
wanting to continue to work in this field. However, in also being exposed to
the “strain”, as the video put it a few weeks back, that might be caused, it
got me thinking about “the other side”. What strains are we causing by using
technology for example in these populations that are increasingly becoming
saturated by the Western world?
So in my search found
numerous news articles on public health interventions with aboriginal and
indigenous communities and advocacy groups wanting to be protected and heard on
the impact that such modern takes are having on their culture. With such push back, how can we also motivate such communities to take part in the public health
interventions that are created in their benefit and not having them see it as a
threat to their cultural practices?
“There must be a model in place!”, I said to myself.
So I actively searched for one with little success on a
model that has been proven to be successful. I make it my mission (along with
graduating) that in my time as a researcher in public health that I create one
that is able to be measured and applied with success and transferable to indigenous
populations around the world.
found this article for example, a long with others in my
search that gave me the motivation I needed to get going! The work, “Overall
Approach to Health Care for Indigenous Peoples”, (King, 2009) discusses the importance of approaching health
care for indigenous communities as complex systems that need to be a collective
effort with researchers and practitioners with multiple dimensions to consider.
But where do we start?! How can we assure we are not influencing acculturation
in a manner that is detrimental to these cultures
and at the same time motivate them to
participate? How can we measure the impact and their likelihood to participate? Here is what I have as factors that I would
like to include and be able to measure in some way:
- Understand their attitudes towards the intervention
- Motivations to participate (behavioral intentions
- Culture/ ethnic identity (including subjective norm, perceived risk)
What would you
change?!!
Reference:
King, M. (2009). An Overall Approach to Health Care for Indigenous
Peoples. Pediatric Clinics of North America, 56(6), 1239–1242.
http://doi.org/10.1016/j.pcl.2009.09.005
Amy, your blog posts never fail to blow my mind. I have totally thought about this before as well as a little bit more recently that I’ll explain, and have wondered the same exact thing. One example that comes to mind is hearing a speaker a few years back that was working on a project (somewhere.. cannot remember) where the culture largely believed and practiced female genital mutilation. Her and her team had been in the area for years, trying to change/adjust the culture into one that did not incorporate this dangerous practice. Can you imagine how hard that would be? She described many challenges, including introducing sterilization, educating the young girls, then having to educate the grandmothers because they were the ones influencing the granddaughters. A lot of challenges to overcome. And then how does she not overstep boundaries? This was a large cultural practice, and who are we to say that they can’t do that? Obviously FGM is very dangerous, but the concept of changing a culture is still there. I am also interested in working with the Native American population after I graduate, and wonder what type of “cultural barriers” I will have to overcome as a nurse serving this population. Why would a culture change, if it has been practicing this for many years as part of the culture? An important question to address – keep us updated on your search!!
ReplyDeleteExcellent thoughts girls. Amy, there is a lot of stuff there and am glad you are shifting them constantly in your mind. This is the best way to achieve more depth, rigor and clarity in parsing out different concepts. Lisa, consider this question :- Is culture a barrier to health?
ReplyDeleteAmy and Lisa, thank you so much for your insights. This does raise very important and tough questions about the relationship between health and culture, such as Lala's: Is culture a barrier to health? In the case of FGM as Lisa was talking about, YES. Most definitely! No culture is without its unhealthy practices. When we talk about problematic non-communicable diseases in the US, such as diabetes, obesity, and cardiovascular disease, we have no problem saying that people need to shift their diet/exercise pattern/sleep-work schedule/priorities in order to maintain their health. Obesity is attributable in many cases to our culture of fast-food and TV-watching, but we don't fear that we are treading on their culture by asking them to change it! I believe it is acceptable to apply - with CAUTION and CONSIDERATION - the same principle to objectively unhealthy practices in other cultures, such as FGM. Yes, we must be careful about how we do it, we must gain trust of the local population, we must attempt to put the health-improving behavior into proper context so that they will accept it, but I don't think changing unhealthy practices, even if they are culturally engrained, is overstepping our bounds. Cultural relativism is a slippery slope; if we don't put a stop to FGM because it is cultural, what about racism? That is culturally motivated and engrained in many cases. What if it leads to violence? Genocide? These things are quite clearly wrong and no one would assert we were overstepping boundaries by attempting to put a stop to them. FGM, and arguably any health behaviors with serious and marginalizing consequences, are subject to the same scrutiny. At least in my opinion...
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