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The Crucial Importance Culturally Competent Nursing and Healthcare in Haiti

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Introduction

This paper is a brief cultural assessment conducted on a close friend. This friend has been interviewed regarding his cultural background. From the prepared questions, he answered the 12 inquiries as stated in the Purnell Model of Cultural Competence. This assessment will be presented according to the model stated above. For this paper, the interviewee will be called A.C. A.C. is 27 years old and living with his parents as Haitian immigrants in United States. He currently lives in a neighborhood of Miami, FL called “Little Haiti”. Overview, inhabited localities, and topographyA.C. was asked about the overview of his homeland country Haiti and its topography. According to A.C., Haiti occupies around a third of the island Hispaniola, near the Caribbean Sea. The rest of the island is occupied by its neighbor country Dominican Republic. Besides the Caribbean Sea that borders the South of the Country, the Atlantic Ocean borders the country on the North.

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Haiti is a relatively small country, a little less than 11,000 square miles. If compared with one of the States of United States, Haiti is a bit smaller than Maryland. Haiti’s inhabitants enjoy a tropical climate and its generally mountainous terrain.

As of the present, the total population of Haiti is counted as around 10.5 million people (Central Intelligence Agency [CIA], 2017). Being that Haiti is a small country and is so densely populated it is suggested to be a poor country (CIA, 2017). Many of the population of the country of Haiti are immigrating to United States due to economic and political instability. According to A.C., they sought in immigrating to United States to find greener pasture. While in Haiti, A.C.’s parents placed an emphasis on his education, however he was unable to attend college as he had to work to help support his family.

Currently he is enrolled in a nursing program at a local college. CommunicationAccording to A.C., the official and main languages used in Haiti are Creole and French. Most of the Haitian people speak Creole, however a few speak French as it is the business language of the country. As a child, A.C.’s parents encouraged him to learn French as it is believed in Haiti that learning French helps children rise higher in society. Therefore, A.C. is able to speak both Creole and French and is also taking classes to perfect his English. Family roles and organizationAccording to A.C., the Haitian family or society in general is a matriarchal society. Yet, even though the women in this society are regarded with status, it is still the man who takes control of the family. According to A.C., most of the marriage or unions in the country are common-law or as he called it “plasaj”. It is also common and acceptable for men in his society to have several wives. Health care decisions are usually shared between the father, mother and elderly family members in the household.A.C. also shared that in a Haitian family with two parents, like in his household, the role of the man and the woman typically follow gender lines. What this means is that the woman is responsible for taking care of the children, cleaning the house, cooking and other household duties while the father takes care of financially supporting the family. Yet, there are also many cases of single parent homes in Haiti where the woman is expected to find work, make a living and take care of her family on her own. A.C. also stated that whether he lives in Haiti or in the United States, his family is very important to him like it is for many Haitians.

Even though their family is now in United States, they still hold themselves responsible for those relatives they left behind in Haiti. A.C. has a younger sister in Haiti he is trying to bring to the United States and who he helps financially. Workforce IssuesThe workforce issues in the country also follow gender lines. Women are expected to hold positions such as that of a nurse while doctors are expected to be men. Doctors are highly trusted. A nurse would never dare to question a doctor’s order and neither would his patients. A.C. confesses that in Haiti it is completely acceptable for him to order his female coworker to make him a cup of coffee if he feels like having coffee. Another workforce issue is that they are usually late to work and other appointments. According to A.C., his church helped him find his first job in the United States, but he almost lost it because he did not understand the U.S. concept of time.Biocultural EcologyHaitians have similar physical features to African-Americans. A typical Haitian person has tightly curled black hair and dark brown eyes. Body hair in areas such as the arms, legs, and back are usually thin.

Though they look similar to African-Americans, Haitians are insulted if identified as such. They are proud to be Haitians and only like to be identified as such. Haiti is plagued by many diseases. Common diseases found in the country include malnutrition, sexually transmitted diseases (STDs), cancer, tuberculosis, and vector borne diseases.His mother has a history of hypertension, dengue, and malaria. His father also has hypertension.High-risk behaviorsA.C. believes that Haitians can benefit greatly from STD education. Many Haitian men have more than one sexual partner and do not understand the importance of using contraceptives to prevent STDs. This custom as well as the common practice of stopping antibiotics once symptoms subside has made it difficult to control the rate of STDs in Haiti.Haitians do not make time for exercise. They do not feel that exercise is an important part of life and actually prefer being fat over thin. In fact, A.C. revealed that Haitians associate being fat with wellness. They do not go to the doctor regularly, only as a last resort.NutritionAccording to A.C., the type of food Haitians eat depends on the time of day or activity. Heavier foods such as potatoes and cornmeal are eaten during the daytime, while lighter foods like bread and soup are reserved for dinner time. When the body is hot from doing hard labor, it is believed that one should not consume cold foods. In my practice as a postpartum nurse, a Haitian patient once told me it is bad to eat cold foods after having a baby because it can cause bleeding. She would always ask for her water without ice. Some sicknesses, for example diarrhea, are considered hot illnesses and the remedy is cold foods. Coffee is usually enjoyed for breakfast. In the family, the men are usually served greater portions because they need more energy for physical labor.

Pregnancy and Childbearing PracticesA.C. stated that Haitians see pregnancy as a blessing from God and do not believe in using contraceptives. Data collected reveals the average number of children per woman is about 4 (CIA, 2017). The Haitian culture also sees pregnancy as a reason to be happy and a time for celebration. It is not uncommon for Haitian women to deliver their newborn at home with the assistance of a midwife. Prenatal care is scant and women are taught to avoid spicy foods during pregnancy as it is believed to bother the baby. The father of the baby is not usually present during the labor process. During labor, women are usually physically and verbally expressive, often moaning loudly due to labor pains. The most common newborn feeding method is breastfeeding. All of A.C.’s siblings, including himself, were breastfed.Death Rituals and SpiritualityA.C. said that when there is a family member who is about to die, the whole family gathers to mourn and pray. A death in the family affects the entire family and everyone even extended family unites to assist with making arrangements. A family member is usually involved in bathing and preparing the body. When his grandfather died, he remembers his Aunt kept his body in her home until everyone could gather to say farewell.

Prayer is also very significant in helping the spirit pass on.Like the majority of Haitians, A.C. and his family are Catholics. Even though they left Haiti, A.C. and his family continue their Catholic faith and are very active in their church. A.C. also shared that many Haitians practice Voodoo. He recalled not being allowed to sleep over one of his Aunt’s house or hang out too much with his cousins because they practiced Voodoo. A.C.’s parents condemned Voodoo and did not want him involved in it.Health-care Practices and ProvidersPreventative medicine is not a common concept in Haiti. Most Haitians will not seek medical care until their illness keeps them from working. Initial treatment consists of home and herbal remedies or over the counter medicines. Many Haitians also believe that illnesses and diseases are caused by either a natural imbalance or by God. Some Haitians consult with Voodoo priests for treatment recommendations. Voodoo practitioners are highly respected and sought out in rural communities. A.C. recalls his mother seeking advice from a local herbalist whenever he or his siblings were sick. Another common health-care practitioner is a midwife. Midwives usually are the ones who deliver babies and provide prenatal care in his town.

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