Enter the cultural navigator

One of the most interesting things about being a community-based organization is that at work on a daily basis, cultures clash. I don’t mean that in a destructive way, although sometimes it can be uncomfortable to sort out. But because Open Arms has a community-based program and our communities are very diverse, we are finding that there’s a deep need to have help in navigating these cultural differences.

Culture is a fascinating thing. It permeates everything we (and yes, you) do, our attitudes, our decisions, our very way of life, and yet most of us are unaware of how deeply culture is ingrained in who we are.

Each community has a culture – not only individual communities such as the American, Somali or Latina communities that we work with, but the cultures within particular families, religions, and even different areas such as educational systems, social services, or health care and medicine. Whenever different cultures interact, there is the potential for misunderstanding, and with that comes either the opportunity to communicate and learn, or a risk of breaking down into conflict or avoidance.

Ideally everyone would be aware of our own culture enough to step away from the issues at hand to explain our own cultural assumptions and find the overlap and the areas of difference – but let’s face it, that is a lot of work. Most of us carry on without defining or even thinking about our basic cultural assumptions and then are shocked when suddenly we realize we had a conversation that failed to have any degree of connection or understanding. As a very simple example, how many marriages fall apart because spouses each come from a particular family culture – perhaps the wife’s family may argue loudly and passionately to reach a resolution in a conflict, whereas the husband’s family prefers to withdraw until the problem becomes clear and then discuss in a rational, unemotional way. Both thinks their way is the “normal” way, even the “right” way, because it’s ingrained in their family culture. It’s not a problem until the two different cultures meet in times of stress and neither understands or respects the other. If neither is able to address their cultural differences, the actual issues at hand will likely not be resolved either and the relationship eventually dissolves. Or, what if someone finds out they have a severe illness – if culture says that one must accept this and nothing can be done, then is that person able to follow instructions to improve health or begin treatments? If it’s pointless, why would someone make changes to improve health? Understanding cultural assumptions is critical.

The arrival of a new baby is filled with traditions in every culture. Most of the time, there isn’t a reason to clash. Yet Open Arms doulas regularly find themselves serving new families when suddenly a crisis happens: there is a medical event during the pregnancy, the baby is born ill, a severe illness in the family requires hospitalization and ongoing medical treatment, or any number of other situations. Once a family is thrown into the medical culture or the American culture in a time of crisis, communication and understanding can fall by the wayside and huge problems can occur unless this cultural component is addressed. The stakes are high – for example when a family finds themselves with a baby admitted to the hospital, the doctors want support from family to follow instructions, but if those instructions aren’t understandable in terms of the family’s culture, they won’t (and can’t) be followed. Each has the baby’s best interest at heart, but without a deeper understanding of both sides, communication will fall apart and frustration escalates.

Enter the role of cultural navigator. Open Arms doulas are from the communities they serve but are also very familiar with American culture, and therefore are truly able to help a client (and sometimes a caregiver) navigate not only the issue at hand but the culture as well. Families are better able to take care of themselves, ultimately leading to better outcomes. By empowering our clients with information about differences in culture and identifying underlying assumptions, and by helping the medical profession learn more about the culture of the patients they serve, everyone benefits.

The idea of cultural navigator is a concept that is just beginning to take form. What does it mean to be a cultural navigator? What does a cultural navigator do? Cultural navigation affects families, caregivers in the medical profession, educators and others. Although the Open Arms role is to serve women throughout the childbearing year, the need for cultural navigation is broad and deep. We hope to begin this discussion over the coming months.

We invite your comments and experience on this topic.

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