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

[Irish339]

It's so interesting to be enlightened with the values and beliefs of other cultures. It is so important for us to remember that we are treating more than the 'sick part'. Thanks so much for the insight!

[Elvish, BSN, DNP, RN, NP]

Wow, Wolfie. Incredible!!!!

[TitanicNurse]

Wolfie, your article is brilliant. I'd have to read it many more times to really have it sink in.

[Thunderwolf, MSN, RN]

Thanks, everybody, for those who read and for those with kind words.

Peace

[Aukake405]

As I read your article, my roots flashed before my eyes and I could see my grandmother holding a cone of paper over my ear and blowing smoke into it in an attempt to help me with an ear infection. "Going to the doctor" wasn't part of our vocabulary in those days. Native American's close to their culture associated doctors and hospitals with death. To a certain extent, that idea is still true for those closest to their "roots." Even in this day and age, if you practice and believe in your culture, you try tribal medicine first, Indian Health Service second and one of them is bound to cure you.

[Neats, BSN]

Thank you for your view on Indian Culture and Health Care. Where I live Native American culture has a huge impact and each tribes culture contributes differently to the way health care is delivered. You are spot on!

[Warpster]

My attitude about cultural healing ceremonies of all types was that I didn't need to believe in it. If the patient did, then s/he would get better more quickly. I saw enough of it have exactly that effect to become very tolerant with a few caveats.

If a Santero needed to sprinkle blood, he needed to clean it up after. Drumming, chanting, and other noisemaking activities had to be muffled so as not to disturb other people who were trying to rest. If ingesting a substance by the patient was required of an NPO patient, they had to touch the substance with a finger and touch the finger to his/her tongue. Oh, and fire laws had to be respected. Smudging had to be very abbreviated so the smoke alarms wouldn't go off and could not be done if 02 was in use.

I never had anybody violate those rules because I explained the need for them as they came up. I know the ceremonies made the families feel much better, that they'd done all they could do, and I saw instances when the patient improved dramatically to the point I knew European/American medicine hadn't done the whole trick.

Tolerance never harmed a single patient.

[matokokepa]

pilamayelo for such a wonderful piece. I read and i was even more then plus happy for those who reached out and shared......i beleive their will be a better tomorrow with children such as yourselves helping usher in the next generations......for if our first americans are taken care of and treated with the dignity and respect they deserve what a difference it could be for all of us..........i had tears thank you much to all of you with your good hearts and hands....from the cheyenne river sioux family....keep up the good .....stay balanced.........

i have not posted in long time.....so overwhelmed with homework....but i do love reading your postings ...so encouraging!!

[NICUrn2B]

I just have a quick question...

Why do Native Americans still accept the term 'Indian' to describe them when that was a mistake by Christopher Columbus who thought he was in India?

[Thunderwolf, MSN, RN]

easy to answer.

our government (an outside entity of the indigenous culture) historically, since its inception, has continually referred to its own [color=#333333]indigenous people as indians as a whole...therefore, perpetuating the term.

the term "indian" has also over time become the accepted term by the indigenous, in most parts per se, referring to themselves as a people/person when faced with those outside of their culture...sort of like a blanket term. if i announce myself as an indian to a non-indian, the non-indian has a point of reference (despite of any perceived negativity that may be attached). so, the term "indian" has become a generally accepted term on both sides of the fence...although, historically incorrect (referring to india).

however, the indian culture is actually not just one culture, but a multitude of indigenous cultures. although there may be a few similarities between them, there are also many, many differences that separate them...providing them their own unique identities. language being one of those major differences.

another difference is what they call themselves when they are amongst their own.

for example, a sioux indian may refer to him/herself to the outside world as either a sioux or as an indian or as a sioux indian. but, amongst their own people of culture, they may often refer to themselves by their true native name as a group...lakota/lakhota (which means friend or ally in that native tongue). but, even today, for some lakota, the terms sioux or lakota or indian may be thrown around interchangeably in referring to themselves...within and outside of their culture...times change things. but, historically, only an enemy (typically of the white establishment or of the ojibway culture) referred to them as sioux....a friend to them did not. the name "sioux" is an abbreviated form of nadouessioux borrowed into french canadian from nadoüessioüak from the early odawa exonym: naadowesiwag (sioux)...meaning little snake. the iroquois were viewed as the big snake or big enemy by the ojibway at that time.

sorry for the history lesson.

good question though.

thanks.

[AmericanRN]

Thunderwolf

Your "history lesson" was excellent and that is exactly how it is. When I used to do cultural diversity shows we introduced ourselves as "ndns" once we had everyone's attention we would say what tribe or nation or whatever that everyone was since there would be a lot of us at these shows.

For instance one of our friends is a Dakota and Ho-Chunk and we would explain at that point that some might know the Dakotas by the word Sioux but that Sioux was not the name for themselves and that they are a nation consisting of Lakota, Dakota, and Nakota with dozens of sub bands under that. Gets kinda funny sometimes, especially when we try to show the subtle little vocal differences like the word "kola" for friend is Lakota but Dakotas will say "koda" and yet again this is for males since it they have gender specific nuances in their language whereas some tribes don't. Then we end up getting questions about Ho-Chunks and why they are also known as the Winnebagos.

We also show the connecting links between each tribe like how everyones name for themselves will translate evenutally into the People of the........fill in the blank. The Principle People, The People of the Long House and so and so on.

We also tend to circle back to helping people understand say the Seminoles of Florida and Oklahoma and how the Miccosukee's and Seminoles in Florida are indeed the same nation but with a political split.

But anyways I'm just talking shop with you now because heck it's fun and I don't get to do it now that I'm in school for nursing. hahaha

Maybe you can put together a breakdown one day for those who are interested on stuff like how the Cherokees are the Eastern band, western band, and United Keetowah and how that came to be the same tribe with 3 different distinct governments. :) Good thing we aren't talking clans huh?