Cultural Competency
Cultural competency is not just learning a language but understanding the society, the roles of gender, the effects of the economy, belief systems, and the many other aspects that make up a culture. Cultural competency becomes a great task and comitment when trying to bridge a culture. However, the more an anthropologist can gain cultural competency the greater the
effectivness of the applied and/or critical medical anthropology models.
In both applied and critical medical anthropology, cultural competency plays a vital role. One cannot focus on anthropology and bridging culture with healthcare without being culturally compentent. Cultural factors are crucial in these models when looking at diagnosing, treating, and care. This means that as one works to bridge a culture they have to become fully engaged in the understanding of that culture. "Anthropologists emphasize that culture is not a single variable but rather comprises multiple variables, affecting all aspects of experience." (Kleinman & Benson 2009: 35)
Cultural competency is not just learning a language but understanding the society, the roles of gender, the effects of the economy, belief systems, and the many other aspects that make up a culture. Cultural competency becomes a great task and comitment when trying to bridge a culture. However, the more an anthropologist can gain cultural competency the greater the
effectivness of the applied and/or critical medical anthropology models.
In both applied and critical medical anthropology, cultural competency plays a vital role. One cannot focus on anthropology and bridging culture with healthcare without being culturally compentent. Cultural factors are crucial in these models when looking at diagnosing, treating, and care. This means that as one works to bridge a culture they have to become fully engaged in the understanding of that culture. "Anthropologists emphasize that culture is not a single variable but rather comprises multiple variables, affecting all aspects of experience." (Kleinman & Benson 2009: 35)
Was applied medical anthropology applied to Anne Fadiman's The
Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and
the Collision of Two Cultures?
Throughout Fadiman’s book, we have been able to see through the eyes of an immigrant how it feels to be placed in a completely new environment, culture, and surrounded by an unspoken language. In this case, we followed a journey of the Hmong family, the Lees. Throughout the book, we see how the medical staff’s care and treatment towards the Lees could have been improved.
I feel that the medical staff did not do a very good job at being culturally sensitive, nor try to understand why the Lees did or did not do what they did. “The fact that Lia’s parents refused to give her the medications at least in part because of cultural or religious reasons (of which Neil was only hazily aware) would probably have cut little ice in court…” (Fadiman 1997:80) is a perfect example. Did the medical staff truly understand why Lia’s parents did not give her the ordered medications? It just seemed that they just labeled them as being noncompliant. It led to the point of removing the child from their custody. Medical anthropology was disregarded as the medical staff did not take this into consideration. It was mere miscommunication because of the lack of proper communication, which in the long run may truly have made a difference in the life of this little girl. Also, with the proper communication, patient education could have been improved. Besides allowing the Hmong family to be able to communicate their cultural practices and the medical staff help them to understand the importance of the medication and treatment, maybe a middle ground could have been met. Instead, delay in treatment ended up resulting in a serious medical condition. The young girl ended up handicap for the rest of her life.
Being in a completely different country, a completely different cultural atmosphere, and speaking little to no English, was a huge challenge to them. Their child was then removed by Child Protective Services. The parents had no way of communicating with them, and did not know where they took their daughter. Foua had said “When I came home, my husband told me they took the baby and he said that they didn’t tell him where they took the baby. I didn’t know any English so I didn’t know what to think or say. I told my elder relatives but they said,‘Well if these people came to take her, then you can’t do anything’” (Fadiman 1997:82). America did a very poor job communicating to this family, and helping them understand what was happening. A poor job was done, trying to help understand this family’s culture.
Many healing practices were done by the Hmong and had their own importances. When the Lees returned home, a txiv need performed the ritual chant that accompanied his journey to the realm of the unseen. A shaman performs his ceremony while shaking the ring of rattles and dancing, speaking with the spirits, was what Fadiman had mentioned in his book. Also Fadiman had mentioned about “the txiv need tied spirit-strings around Lia’s wrist and gave her some green medicine from roots and things like that”(Fadiman 1997: 112). Also, Nao Kao told about sacrificing a pig or chicken and saving the blood from the animal (Fadiman 1997: 109). A chicken was sacrificed and the Hmong were saving the blood as it dripped into a pot. Also, a cow’s head and its legs and tail were left at the back doorstep as the Hmong chanted. In the book, “during the chant, the cow’s severed head was sitting on the Lees’ front stoop, welcoming Lia’s soul”(Fadiman 1997: 109). Many doctors found controversy in these practices. Why? I believe that here doctors practice medicine. Cultural aspects have not been placed on a high enough pedestal and cultural practices are out of the “norm”. Let’s find the problem, diagnose it, and treat it. That tends to be the mentality. However, with the ever-changing and ever-culturally diverse nation, there needs to be a renewed openness to cultures and its practices.
Towards the end of the book, however, both applied and critical medical anthropology were both seen in hospitals across the country became more culturally aware. One good example of both were applied when a young combat veteran tried to hang himself in a California transit facility. We was isolated in a hospital room where he given American food, and forced into a medical workup, including a lot of blood work. He refused to eat and sleep. Finally they gave him Hmong food, and let a Hmong man stay with him overnight. He finally began to eat and sleep. Doctors also discontinued the blood work. When they learned of his fear of not being able to provide for his family, they helped him out with getting refugee cash assistance. They also showed him hope for his future and showed pictures of his future home. As a success story begins this man resettled successfully with his family in Iowa (Fadiman 1997:263-264). This just goes to show when we take a moment to be culturally sensitive and apply applied and cultural medical anthropology, many more people can be helped. We can learn so much about others and their cultures when we are willing to take the time.