Page 114 - Cultural Competence in Health Education

92 Cultural Competence in Health Education and Health Promotion

Vignette from an Immigrant Women’s Health Conference
Ann Swartz
One hundred women of many cultures, strangers two hours earlier, are moving in a rhythmic
circle dance around the room as they chant in Aramaic, to a saying that literally means “Peace
be to this house.” Each stops to bless with touch and visual gaze every person she passes.
Energy and peace pervade the room. These women are attending a health conference for
immigrant and refugee women where the theme is “creating health by nurturing inner
balance.” The keynote speaker, Libby Tisdell, has spoken about spirituality and culture and
led them through an exercise, “Freeing Our Sacred Face,” based partly on the work of David
Abalos (1998). In pairs, participants talked with each other about symbols for their negative
feelings, internalized oppression, and healing from their cultures of origin. In small groups
we created metaphors for freeing our sacred face. My group included a Roman Catholic of
Italian heritage, an Egyptian woman and her daughter who had just gained entry to the
United States, and a Muslim woman from Sudan. As we introduced ourselves someone sug-
gested we share the meaning of our names, and from this simple act our metaphor emerged.
When it was our turn to share with the large group, we four women joined hands and
bowed our heads as the young girl rose from the center of our circle. This expressed the
combined meaning of our names: a young girl becomes a beautiful rose through wisdom,
grace, and prayer.
How different from the setting in which I had met the immigrant woman who had cre-
ated the organization sponsoring this conference. That was a wonderful experience that
mixed refugees with refugee service workers and mental health professionals with the goal of
establishing connections that would lead to improved mental health services for the popula-
tion. We spent 120 hours together, learned a great deal, and met many people. But the
approach tended to be cognitive and psychological, and there was no cultural or spiritual
component. Our learning about those aspects of each other came during breaks and in the
evening, through the sharing of food, song, dance, and family stories; but only for those who
were comfortable trying to cross boundaries or question their own assumptions. Some good
programs were created out of the new knowledge we gained. But distrust remained between
the three groups of attendees. Would this have been so if spirituality and culture had been
called to presence?

Certain assumptions we are making about the meaning of health and education for
health and why they both relate to spirituality and culture are at play both in the exam-
ple just presented and in the following discussion. First, health and spirituality, in the
original sense of each of those terms, are intimately related. As discussed earlier,
the word health comes from the root term hal, which means “ to be whole. ” Similarly,
research studies indicate that when people talk about spirituality they are most often

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