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It is becoming increasingly difficult to ignore the fact that a cross-cultural perspective plays a considerable role in a contemporary healthcare. This tendency can be explained with multiple factors, but the main reason is based on the evidence that various cultures differently perceive traditional healthcare services. Regarding that, a modern healthcare practice attempts to implement strategies that will address the cross-cultural perspective. Beyond a doubt, designing a solution to this issue requires healthcare practitioners to study foreign cultures, especially those that are known for a peculiar attitude towards traditional medicine. There is a wide range of various cultures to be studied. That is why a need to duscuss personal culture becomes more reasonable for contextualization of the entire study. The following paper focuses on a description and discussion of Haitian culture, which generally does not thwart potential patients from accessing traditional healthcare services.
Culture Overview
Cultural Ancestry
When speaking about cultural ancestry of Haiti, a strong influence of France should be indicated (Munro, 2010). As a result, manners, table etiquette, and form of politeness are mainly French in Haiti communities. A strong influence of French culture can be explained with a proactive colonization of contemporary Haitian territories. At the same time, many manners are taken from Latin America. However, its influence is not strong, which is why French origin of Haitian culture is more relevant to describe a cultural ancestry (Munro, 2010). French influence can be mainly traced in etiquette and interpersonal communication while religious and ethnic traditions remain unique. To be more specific, Haitian culture values Vodou practices (World Health Organization, 2010). As a consequence, Haitian culture recognizes valuation of ancestors and people of a senior age. By the same token, family is a central cultural value of many Haitians. Overall, Haitian culture is strongly conservative and unwilling to change. Such positioning of the culture can be explained with a profound basis of valuation traditions and uniqueness of ancestors. That is why most Haitians are convinced that they would betray their historic memory in case they adopt a new culture or adjust to foreign traditions. As it has become apparent, the main driving force of such positioning is a spiritual domain.
Willingness to Express Oneself
Haitian culture presupposes a very reserved manner of communication. As a matter of fact, delicate subjects are not discussed in public. Business, politics, personal relationships, or any other subjects that are potentially controversial are a taboo for public discussion (Munro, 2010). Haitians follow a simple principle of not talking about subjects they do not know well. In the same way, Haitian culture implies that it is strongly offensive to discuss delicate topics with barely known people. Haitians explain that with the fact that coverage of a particular theme may potentially offend or hurt a guest. It is definitely a communicational domain of Haitian culture (Purnell, 2015). In addition, it is appropriate to note that this manner has also French origin, which is why such a considerate attitude towards conversation with strangers can be observed. Beyond a doubt, Haitians communicate in the way described depending on the discourse of conversation, which is why speaking on delicate subject can be appropriate with relatives, doctors, or official representatives of the government. Haitians become less reserved in communication when they are absolutely sure that a particular subject concerns an opponent to the same extent.
Practice of Touch
When speaking about culture of touch in Haiti, it is worth noting that none of special considerations can be traced in a local culture. Therefore, men usually shake hands at greeting and departing while women kiss each other in a cheek or make a light hug. Kissing in a cheek is also appropriate for close relatives while kissing barely known woman is recognized as an extremely aggressive behavior (Munro, 2010). In general, the practice of touching is not accepted in Haitian culture of communication, as it is considered a private action. A more complicated issue is presented with Vodou religion, which makes certain obstacles for traditional healthcare services in Haiti. As a matter of fact, Vodou religion is regarded as a secret spiritual practice. That is why evidence relating to this practice cannot be shown to strangers. It is especially peculiar for intervention of nurses or doctors: some Haitians refuse to undergo examination by a doctor because they are unwilling to share secrets of their Vodou practice (World Health Organization, 2010). Such cases are not widespread. However, the practice of touch culture under specific circumstances is a matter of personal outlooks and beliefs of Haitians.
Spatial and Distancing Strategies
As it has been already mentioned, private actions and discussions do not occur with strangers in Haiti. In the same way, Haitians kiss or hug their close relatives and keep a sufficient distance from people they do not know. The same principle is applicable to romantic relationships, so that more close contact between partners is possible after some period (Munro, 2010). However, Haitians do not completely ignore strangers. In fact, greeting a guest with standing up and smiling to him/her is a sign of a good manner in Haitian culture. Standard rules of politeness and etiquette are also typical for Haitian culture. Haitians are not expressive publically while very affectionate in private contact, especially in a close relationship with an opposite gender (Munro, 2010). At the same time, Haitians value relations within a certain community. In such a way, several families are united in one community with its informal leader. Likewise, it is absolutely appropriate to ask neighbors to look after a house and do domestic work while the owners are travelling. Even though Haitian culture suggests reserved behavior towards unknown people, relations within a closed community are strong because all representatives of this community know each other to a sufficient extent.
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Eye Contact and Interpersonal Relations
Eye contact is a social norm in Haitian culture, since it demonstrates respect and willingness to listen to the opponent. Nevertheless, it does not have to be confused with staring at strangers. Such behavior is unacceptable for Haitian society, as long as it is recognized as the intrusion in an individual’s privacy. In addition, Haitian culture does not suggest that making eye contact means involvement of some magic practices or any other malicious intentions. At this angle, Haitian culture follows completely European pattern. Still, interpersonal relationships are quite unique in comparison with French culture.
As for interpersonal relations, a particular attention is paid to people of senior age. It is extremely impolite not to greet the oldest member of a family or ignore her/his inquiry. Hence, children are usually seen but not heard in Haitian culture. They should obey the elder relatives, make no noise, and speak to adults when only they are asked about something. Respect of senior people as well as ancestors is the basis for the entire cultural doctrine of Haiti. It is a domain of family relations, which is why Haitians consider that to be the most important code of ethics in their communities.
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Emotions and Gestures
As it has become abundantly clear, Haitian culture does not presuppose expression of strong emotions in public. Shouting, loud laughing, etc. are also considered to be impolite actions. Such rules are explained with a spiritual domain of the culture (Purnell, 2015). Haitian respect of Vodou religion suggests that a human is a single spirit among the entire community of spirits (World Health Organization, 2010). Therefore, standing out someone’s personality is morally wrong, as long as a human is the smallest element of the Universe. Unlike emotions, etiquette of gestures is related to the origin of communicative cultural domain (Purnell, 2015). For instance, pointing at someone or something in public is an extremely offensive behavior in Haitian culture. In the same vein, touching somebody by the hand while talking to him/her is also an aggressive form of behavior in Haitian community. The rest of gestures and emotive expressions comply with a standard code of ethics in the majority of European and American countries. This perspective is not affected much with Vodou practice, which is why Haitians are extremely polite with strangers as well as foreigners (World Health Organization, 2010). It is appropriate to draw a conclusion that this perspective does not create obstacles to accessing healthcare services in Haiti.
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Temporal Orientation
As it has become explicit, Haitian culture is focused on the historical past, which is why many issues are perceived throughout experience of past generations. Consequently, Haitian culture is conservative: valuation of ancestors, senior people, conducting ancient rituals, and communication with past generations are typical for cultural insights of Haiti. For the same reason, a proactive family valuation can be traced in Haitian culture. That is why orientation of cultural values is also based on appreciation of family and respect of its eldest members. This tendency can be traced in the entire cultural code of Haiti. Devotion to a spiritual past of the ancestors is reflected in Vodou religious practices, which sometimes become a reason for declining traditional healthcare services (World Health Organization, 2010). Vodou practice involves a strict hierarchy of priests, among which some priests serve a function of a local nurse or a doctor. Evidence of inappropriate care is not commonplace, but the main problem is based on the fact that Haitians are convinced that the religion of their ancestors is a more effective treatment than traditional healthcare services. They are not prohibited, but frequently are not trusted because of the reasons mentioned above.
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Greeting
Haitian culture does not deploy any specific forms of greeting, except for a tradition to greet a guest by standing up. The rest of greeting manners are typical for French and Latin American norms of public behavior, which is why no specific cultural differences can be detected. As for table toasts, it is appropriate to say the first toast for health, as it is also regarded as the key value of Haitian culture (Munro, 2010). In a similar way, it is polite to greet the eldest person first and then greet other individuals according to their age.
Impacts of Culture on Healthcare
The entire paper promotes a view that in spite of strong influence of Vodou practice, healthcare in Haitian society is a generally accepted social norm. However, some major exceptions can be noted. First of all, already discussed unwillingness to be touched by a doctor should be indicated. Haitians, who participate in Vodou religious services may refuse to accept traditional healthcare treatment because they are convinced that it would compromise their sacred belonging to a call of the ancestors (World Health Organization, 2010). Another influence of Vodou religion can be traced in a so-called zombification (World Health Organization, 2010). This term defines a phenomenon of a dead person being raised with an evil magical power for some malicious purposes. A state of zombie is often confused with different states of mind, consciousness, and evident mental illnesses. People with loss of memory were perceived as zombies revived with evil spirits. Likewise, various mental health disabilities are recognized as a special trance possession or call of the ancestors. These issues thwart traditional healthcare services to be provided in Vodou communities, but the practice itself does not generally prohibit intervention of doctors in the health environment of Haitians.
Conclusion
It is appropriate to make a general comment on the fact that Haitian culture does not mainly prevent the provision of traditional healthcare services. However, exceptions can be made with involvement of Vodou religious practices that are considered sacred. Therefore, Haitians may refuse to undergo doctoral examination or any other type of intervention owing to the fact that it will compromise their participation in the communication with the ancestors. Consequently, a deep respect of ancestors and elder people is reflected in a more past-oriented reaction on the events in the surrounding world. That may result in refusal to use traditional healthcare services and consult folk medicine instead. The current state of knowledge does not witness about any harm from these practices, but some cases are present and profoundly studied. In such a way, a phenomenon of zombification in Vodou religion is often confused with various mental disabilities and states of mind. In addition, various states of mind are regarded as state of trance possession caused by a call of the ancestors.
This evidence prevents Haitians from accessing traditional healthcare services, but it is essential to admit that it is still a matter of personal choice rather than a strict cultural code. Finally, a compliance of all aspects of Haitian culture with Purnell’s model can be confirmed. Therefore, a cultural approach in treatment Haitians is quite reasonable, but not compulsory, as long as consulting traditional healthcare services is a personal choice. Additionally, Vodou practice should not be associated with harmful influence on mental health of Haitians, since methods of a folk medicine are not proved to be dangerous.
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