One of the things that are both delightful but at times frustrating with the Haitian culture is their laidback and friendly nature. Things can move along on their own schedule with very little concern or panic with expediency. A cordial and fun-loving nature ensues. This serves the climate well for the most part, as it can be difficult to “control” circumstances, schedules and outcomes given the predictability for the unknown. However, with a “western” agenda to be able to provide the most help and care for individuals within the shortened amount of my time here and the realities of tighter staffing levels this week, I was challenged to find the right balance of competing cultures this afternoon.

As I was trying to maximize efficiency of the best care to the most patients, I was challenged in trying to locate a hard-to-find interpreter, interrupting socializations or keeping patients on “task” with their therapy programs. In addition, there was a cacophony of power tools with new cabinets being built in the tight confines of our therapy clinic. We all got through it intact. I needed to adjust my “agenda”. I realized that it is still possible to “accomplish” the work, when still having time to enjoy the process. I am going to have to work hard to bring this back to my regular work back home.

I have recently read the book, “The Spirit Catches You and You Fall Down” by Anne Fafiman, about the clash of cultures between a Hmong family and the American Medical system.  Though there are many differences between the Hmong and Haitian culture, there are still some similarities too. One doctor, after a harrowing medical episode, was interviewed with his experience with the daughter who had a severe epilepsy disorder. He reflected: “When there is a very dense culture barrier, you do the best you can, and if something happens despite that, you have to be satisfied with little successes instead of total successes.”  

As I read this section later that night, it really helped me to put the experience in perspective. My frustrations are minor and even being able to provide some “successes” with therapy, while respecting the culture, will serve the individual and community far better in the end.

Another doctor interviewed by Anne Fafiman in the book said, “You need to understand that as powerful an influence as the culture of the Hmong Patient and her family is on this case, the culture of biomedicine is equally powerful.  If you can't see that you own culture has its own set of interests, emotions, and biases, how can you expect to deal successfully with someone else's culture?”

This is a potent message. All too often, being so entwined with the culture of medicine, we forget our own assumptions and biases that we bring in caring with a patient. In addition to the individual’s own cultural heritage, we need to overlay that with that which biomedicine brings. These cultural awareness and tolerance will be important lessons to carry back with my continued work in healthcare.