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■ explore his or her own cultural identity and heritage and confront biases and stereotypes;
■ develop an awareness and understanding of the complexities of the modern health care delivery system—its philosophy and problems, biases, and stereotypes;
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■ develop a keen awareness of the socialization process that brings the provider into this complex system; and
■ develop the ability to “hear” things that transcend language, foster an understanding of the patient and his or her cultural heritage, and the resilience found within the culture that supports family and community structures.
Given the processes of acculturation, assimilation, and modernism, this is often difficult and painful. Yet, once the journey of exploring one’s own cultural heri- tage and prejudices is undertaken, the awareness of the cultural needs of others becomes more subtle and understandable. This is well accomplished by using the umbrella of HEALTH traditions as the point of entry.
A student I once taught described the journey this way:
I was born in 1973 to fourth-generation Japanese American parents. I understood Japanese culture and the way of thinking and did not question when my parents told me to eat noodles on New Year’s Day to bring long life. Then I changed schools and went to the Caucasian school. I came to hate my heritage and wanted to scream that “I’m as white on the inside as you are.” I was bitter and embarrassed by my heritage and blamed my family, who were proud of their ancestry. When my parents tried to teach me about Japanese American history, I was not interested. I came to know, understand, and hate racism. On the inside I felt as “white American” as everyone else but I soon realized what I felt inside was not what other peo- ple saw. I now acknowledge who I am and I accept myself.
The voice of this young student speaks for many. In the course of having to explore the family’s traditional health beliefs and practices, the student be- gan to see, think through, understand, and accept herself.
Although curricula in professional education are quite full, CULTURALCARE studies must be taken by all people who wish to deliver health care. In the wake of September 11, 2001, it is obvious that it is no longer sufficient to teach a student in the health professions to “accept patients for who they are.” The question arises: Who is the patient? Introductory sociology and psychology courses fail to provide this information unless tailored to include culture aspects of HEALTH and ILLNESS. It is learned best by meeting with the people themselves and letting them describe who they are from their own perspective. I have suggested 2 approaches to the problem. One is to have people who work as patient advocates or as nurses and physicians come to the class setting and explain how people of their ethnic group view health/HEALTH and illness/ILLNESS and describe the given community’s HEALTH traditions. Another approach is to send students out into communities where they will have the opportunity to meet with people in their own settings. It is not necessary to memorize all the available lists of herbs, hot–cold imbalances, folk diseases, and so forth. The objective is to become more sensitive to the crucial fact that multiple factors underlie given patient behaviors. One, of course, is that the patient may well perceive and understand HEALTH from quite a different perspective than that of