JULIA FONSHELL
CULTURAL COMPETENCE
My spring semester of my junior year at the university of South Carolina, I lived and studied abroad in Kenya. My program, run by The School for International Training and recommended by the study abroad office here at USC could not have been a more perfect fit for how I imagined my semester abroad. Titled, “Kenya: Urbanization, Health and Human Rights” our semester was to be spent focused on hands on learning in this topic. Each of us in our small and diverse cohort were to live with a host family in both rural and urban Kenya, be conversational in Swahili and complete an independent research project.
THE IMPORTANCE OF CULTURAL COMPETENCE IN RESEARCH
My time in Kenya began with lessons focused on the most pressing public health concerns facing Kenya’s diverse population and the healthcare systems in place to treat them. I learned that Kenya’s constitution, ratified just recently in 2010, is extremely comprehensive and created a decentralized system of government. Decentralized governments distribute powers previously granted at a national governmental level to a local one. This should theoretically empower county governments with the resources, local understanding and ability to deliver services such as better infrastructure and healthcare more efficiently. I, however, witnessed many of the most at need people in Kisumu County, Kenya still lack access to the critical health care they should be receiving. Fascinated by this disconnect, I designed my research study to gauge public perception on how devolution has impacted governmental service delivery in Kisumu County. My goal was to interview government leaders and their constituents to compare perception and pin point areas of improvement. That said, not being from the country I was working in I had no understanding of how to conduct this project in Kenya.
For this reason, my research advisor connected me to Fred Misach. Fred is a community health worker (CHW) who was born and raised in Kisumu County and has made improving health care his career. In HPEB 300 “introduction to health promotion, education and behavior” we learned that public health professionals can only establish meaningful change in communities if they have a thorough understanding of the issues and practices of the community they hope to serve. Essentially, public health professionals must always be culturally competent, that is, aware of the cultural traditions, practices and differences within a community. Being culturally competent, particularly when attempting to implement public health programs, means being able to effectively and respectfully work within the proper cultural context.
Fred helped me prepare to be the most culturally competent I could be. Before learning from Fred I had no idea about the network of CHWs working in Kenya. I also was not aware that in order to work within a village you must first contact the village elders. Additionally, I did not know how to navigate the public transport system of matatus, tuk tuks and boda bodas or even how much is typical to pay for a ride. Moreover, the questions I had planned to ask were not yet framed in a manner my subjects would be able to understand. Under Fred’s guidance I was connected with village elders and knew how to graciously and respectfully enter their communities for my research. He helped me practice my Swahili and taught me Luo, the tribal language my research participants would feel most comfortable greeted in. I gained a thorough understanding of the complicated public transportation system used in Kisumu and even eventually gained the flexibility to work in “Kenyan time,” ultimately gaining an appreciation for a cultural that is much more relaxed than my own American one.
Ultimately, had I not become more culturally competent my research project would have never been completed. I needed to know the ins and outs of the culture of the community I was working within to be the most successful I could be.
THE NECESSITY CULTURAL COMPETENCE IN GROUP WORK
Cultural competence was essential to conducting successful research in the field, but it also became vital to the relationships I built with my peers in the classroom. As aforementioned, our small cohort was very diverse. We were seven students representing five universities, three home countries, two continents, four different majors and five different racial identities. While I was excited to meet and learn from people with different backgrounds than myself, I failed to recognize how our various experiences prior to entering our study abroad program could impact our experiences during our semester abroad, nevertheless our ability to adapt to our new surroundings. For instance, my American peers and I were very vocal. We loved to bounce ideas off of each other, think out loud and vocally reflect on our experiences studying abroad. We also easily embraced the very communal culture of our Kenyan host families. With many of us growing up with siblings and close families, we were no stranger to sharing small bathrooms and having little privacy. Our peer, from Asia, however, had a more challenging time. She preferred to work independently and in silence. She was also an only child and grew up with parents that were only children as well. She had come from a small family and considered herself very independent from them.
We had no idea how our respective backgrounds were impacting our experiences until one day, in a fit of frustration, she stormed out of our classroom. When confronted, she finally shared how challenging it had been for her to adjust to two very different and cultures from her own, Kenyan and Western, at the same time. Relationships with her family, teachers and classmates in Kenya were all very different from what she was used to. Ultimately, she had felt lonely and unable to express her frustration as it seems nobody else was experiencing the same culture shock she was. Our group discussed our own learning preferences, work habits and comfort levels and made a plan for the rest of the semester to fit everyone’s needs.
CONCLUSION
I realized it was naïve of me to expect that we would each be able to adapt to our new surroundings and learn in the same way. I learned that when working with other people it is important to take into account that each of our unique backgrounds and experiences could mean we may approach situations differently. Cultural competence is necessary when working in another country or with another culture of a group of people. However, it can also come into play when working in a diverse group, even in the United States. It is important to practice cultural competence by recognizing our differences and using them to create a work environment that allows everyone to thrive.
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