Indian culture and health care go hand in hand

[Thunderwolf, MSN, RN]

Some folks may think or even believe that culture has very little to do with health or even health care. As one who lives and works in the predominate culture, much of which is very blended, I can understand why some may, at times, come to those conclusions....because often times, becoming immersed in the dominant culture can easily blind oneself to different cultures that fall outside of it. It is also not uncommon for us, being of the dominate culture, to become blinded or even numb to our own culture..."Culture? What do you mean, culture? Ah, it's just a silly notion by some group of sociologists"...as we go about our day.

Maybe, the best way to understand culture and its relevance to a people is to think back upon one's own family of origin (your culture of origin)...your roots...where you come from...and how it shaped you or failed to shape you. To deny the impact it has had on your development or upon your psyche would appear to be plain foolishness by most folks...and so it is. Just like "Your body is from what you eat"..."You are 'from where you came from.'"

The Indian culture, which is actually an assortment of many cultures, are like families of origin. Each has its own customs and traditions...just like your own family and in how it compares and contrasts with your own neighbors close by. Also, it stands to reason that what impacts your neighborhood, impacts the neighborhood's families...and what impacts the family, impacts the individual. The Indian, as a people of different traditions from our own, are no different in this regard. When it impacts their neighborhood, they also feel the impact individually.

Yet, in a very different way, their experiences and the impacts upon their "neighborhood" are vastly different from our own. We have not lived their history...we have not lived in "their historical back yard"...although we had no trouble taking away their front yard, from one generation after the next. When we compare our watered down, blended culture with their own (which many hold on to out of pure fear of extinction), we fail to see the importance. And as such, we being of the predominate culture, may be at a loss in how it all relates, in how it relates to us, and in how it relates to them...and "why is this so damn important now anyway?"

As a culture numb unto ourself, we may find it difficult for us to even empathize with them. As a culture blind to ourself, we may find it even difficult in describing our own culture when asked outright. Many folks overseas have their notions about who we are, as a member of our dominate culture....yet, why do we fail to see it? And why do we insist that others need to follow suit with us when we arrive as visitors on their own doorstep during our vacations/business trips? How can we be so blind, so numb...even arrogant? So easy. It is because it is part of our own social experience and upbringing...to blend, to mix, to lose one's strong sense of personal identity. I am not talking about identity that one puts on and takes off depending upon one's company at the moment like a false mask. I am not even talking about a national identity. I am talking about a real personal, if not ethnic, identity...who you really are...and from where you come from. Put in another way, to help understand what I mean, when you come to meet your maker (if you believe in him), it is the person standing before him. Many folks actually don't know who they are and spend most of their lives trying to find themselves. Many folks actually do know where they come from and try most of their lives to run like hell away from it, from who they are or were....but, it is part of them nevertheless...they can't out run it...like their shadow, it is always connected at their heel. However, many Indian actually embrace their identity, for their identity and traditions are often all that they have left...for better or for worse. And, because of our own personal and/or societal numbing experiences, it becomes easy to fail in our empathy for them. It becomes easy for us to fail to see the connection of the "shadow of the past and present" still connected at the Indian heel.

So, how does this all relate with health and health care with the Indian?....culture, this nebulous thing, that we of the dominate side of the fence have such a hard time with. It relates to everything for many Indian...and that is another reason why we have such difficulty in meeting the needs of the Indian...because culture is quite often a difficult thing for us to grasp. It is not that we lack it ourselves....we just have a hard time seeing it and understanding it for ourselves. Part of the modern experience is that if it is "not right in front of our face", it fails to exist. We are constantly bombarded by stimuli. Our memories are very short lived ones as a people. Commercial advertisers know this...and unfortunately, they end up being the one's that define our culture for us...because we just don't have a clue.

When you get sick or ill, how do you typically take care of yourself? When a family member is sick or ill and under your care, how do you take care of him/her? What do you do? What are the expectations?...and do you follow them? How has your family of origin influenced you or in the decisions that you make in caring for yourself or family? How has it shaped you in your outlook regarding the dying process? How have drugs/alcohol in family or self influenced your own personal psyche and choices? How have religious/spiritual beliefs impacted these choices and will it impact/fail to impact them in the future...as a person, as a family? What resources do you typically use or have available to you when ill? What past experiences have influenced your choices in treatment options? What "barriers" did you or family experience in receiving adequate/better health care when it was needed? What were your own past experiences as a child or as an adult with different health care professionals/facilities and in how they treated you as a person and from where you came from? Were you ever turned away? Were you ever dismissed or looked down upon...especially in what you believed? Were you afraid to even open your mouth? Believe it or not, this may be the closest thing for many of us, in coming to understand the Indian experience in health and healthcare in relation to culture...thru our own sense of family, thru our own sense of personal history. To understand, to empathize...for it requires a bit of personal relativeness on our part...to thwart some of our own personal cultural numbing.

What I am getting at finally is that for many of Indian background...health and health care is "a process" of personal relativeness...to self, to others, to nature...like family. Their culture or way of life is a large part of their identity...a concept we often fail to grasp for ourselves or simply don't care to grasp at all. The health care industry is really only been getting a sense of this lately...they call it personal service...treating the person, not only the illness. Hmmm...the Indian knew this a very long time ago. However, the industry still remains in its infancy in this...because the true motivator for this concern is for the return of the individual for his/her insurance dollar (a false mask). The Indian would say, "What if the Indian doesn't have insurance?" Well, eh...we know the answer to that...and so do they. Genuine concern for the individual may still be quite secondary. Trust has been broken often with the Indian...even in the sanctity of health care...and continues...to this very day. Much has changed, but really...little has changed. As a result, some tribes have resorted to building or buying their own hospitals and clinics in order to help take care of their own...some being funded thru casino profits, used in an attempt to pump monies back into their own communities....the fortunate tribes that may have them. For some tribes, the casino revenues may fall way short, however, once the figures are broken down, making little difference in this effort. Yet, many in our health care environment remain numb to the fact...very similar to the numbness of culture...that the failure to deliver quality medical health care to the Indian remains...and that the health disparities between Indian and non-Indian still remain enormous. To many Indian, health care is not "an act of caring", but "a genuine process in relating" to them thru "their own ways" of living...what some folks call, culture...just like how our own family behaves during days of illness...as well as during days of wellness.

Peace

[nurseboy9999]

illness is illness culture has nothing to do with it ..the person with the illness is the one that deserves the respect of all no matter what culture ,,remembering that the care giver also has a culture to be respected by the patient and families

[Thunderwolf, MSN, RN]

I have to respectfully disagree...that culture has nothing or little to do with it. Thank you for presenting your position.

[Sharon C]

Hello, I just found your article and I am so glad. My graduate paper is on cultural sensitivity in health care especially related to American Indians. I have found my research to be fascinating and useful. I am amazed at some of the similarities to other cultures and many differences. Thank you.

[zenman]

illness is illness culture has nothing to do with it ..the person with the illness is the one that deserves the respect of all no matter what culture ,,remembering that the care giver also has a culture to be respected by the patient and families

As a person living in Asia, I can tell you culture pretty much has to do with almost everything, including illness.

[Elementary]

Hello, I just found your article and I am so glad. My graduate paper is on cultural sensitivity in health care especially related to American Indians. I have found my research to be fascinating and useful. I am amazed at some of the similarities to other cultures and many differences. Thank you.

Hospitals have become an integral part of the Navajo culture. A large percent of the older Navajos are in renal failure, and most are the primary caregivers to their grandchildren. So it is not uncommon to have the whole family hang out at hospital like it's a day in the park.

[AmericanRN]

illness is illness culture has nothing to do with it ..the person with the illness is the one that deserves the respect of all no matter what culture ,,remembering that the care giver also has a culture to be respected by the patient and families

I respectfully disagree. Illness is not illness. Response to illness has a lot to do with culture and in some cultures it is everything. Respect should be key to both sides but part of being respectful is to be mindful that in many, many cultures there is no way to separate the illness from the culture or the response or lack of response to a situation. I also feel that it is up the caregiver to show respect first, often times people reflect back what was projected to them first. A caretaker or those who feel they are should offer the respect first, the rest will fall into place.