Page 204 - Creating Spiritual and Psychological Resilience

“To Do No Harm” Spiritual Care and Ethnomedical Competence 173

Box 7: EC–ipr CasE CorrElations
1. As an American physician, I remained more inclined to have contact
(educational or therapeutic) with relief workers rather than primary
victims for the following reasons:
• The emotional vulnerability/susceptibility of workers is frequently
less than that of primarily affected victims. Even if I was working
in one of the South Asian languages I speak fluently, I believe I
am always capable of teaching something culturally inappropri-
ate, and workers are in a better position to say, “Stop, this is not
working.” Such a structural power gradient is due to at least two
factors: class differences (in which poorer, disenfranchised ben-
eficiaries are likely to affirm whatever is being offered to them
without contradicting the speaker) and voluntary agency work
culture (in which staff are exposed to or thrive upon a culture of
debate and resistance).
• Workers can determine what parts of my education/therapies are
applicable to primary victims. Workers thus act as an additional tier
of cultural adaptation—adding to EC. This process is displayed in
the feedback from the Pakistani trainee who said, “… skills I learned
today I will pass them on to other people in the community who suf-
fered a great deal due to the earthquake.” Conversely, a worker can
protect primary victims from any interventions that might clash
with the cultural context.
2. When my queries for local healers or traditional healing practices were
met with a lack of interest or inquisitiveness, I decided not to pursue
this line of inquiry in acute or subacute phases. While not inappropri-
ate to ask in any phase, a more aggressive pursuit should be deferred for
chronic or in between phases. Action Sheet 6.4 of the IASC (2007, p. 137)
Guidelines advises: “Information may not be immediately volunteered
when people fear disapproval from outsiders or consider the practices to
be secret or accessible only to those sanctioned by the community.”
3. While I have intuited that it is inappropriate to use Laughter Yoga with
disaster survivors or with workers in the acute/subacute phases, it has
been well received when I do it for disaster worker capacity building or
burnout prevention in chronic or in between phases.
4. In the Pakistani case, we proceeded to make compressed digital (mp3)
recordings of the “Noor” Muraqba Meditation so that workers could
email it to each other.
5. Evangelism, as hinted upon in the Sri Lankan case, should be checked
in disaster zones. Action Sheet 6.4 of the IASC (2007, p. 138) Guidelines
addresses this in the following way: “International and national ‘outsid-
ers’ should take a nonjudgmental, respectful approach that emphasizes