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96 Cultural Competence in Health Education and Health Promotion

But what does this have to do with spirituality? As implied earlier, Latino writer
David Abalos (1998) suggests that in order for particular cultural groups to create and
sustain positive social change on behalf of themselves as individuals and on behalf of
their cultural communities, they need to reclaim four faces of their cultural being: the
personal, the political, the historical, and the sacred faces. In essence, an assumption that
I make about my students is that they deal with their internalized oppression and begin
to heal from it by reclaiming these four faces. People often find this reclaiming pro-

cess to be a spiritual experience (Cervantes & Parham, 2005). I have found that it is by
making meaning through image, symbol, and metaphor manifested in art, music, drama,
or dance that people connect to their culture and deepest identity, and often to their spiri-
tuality, and this helps them to engage and free their sacred face. Thus not only do I have
people in my classes do readings and write papers in order to engage the course content
in rational ways, but I also encourage them to collaborate with others on projects,
because knowledge by and for community use and healing is best made and given voice

in a community context. Further, I try to find a way to engage their creativity by using
music, metaphor, art, or dance at some point in the classroom processes, and I encourage
them to do this in their own lives. Very often people do experience these creative expres-
sions, which often also arise out of the interaction of their culture and spirituality, as an
important part of their journey toward wholeness and their journey toward greater health
and healing. This is also part of the way they can give expression to the knowledge that
has now become embodied and anchored in them in ways beyond the rational.
As suggested earlier, I engaged these same processes in a much less detailed way
in the time span of two hours at the immigrant women ’ s health conference. My coau-
thor has already described her conference experience with her small group as they cre-
ated and used metaphor after they had heard the cognitive explanation of internalized
oppression and the importance of engaging the four faces of one ’ s being, as described
by Abalos. There was group expression and there was music and movement. Indeed,
spirituality is about a journey toward wholeness, and journey connotes movement.
That was why they danced!
Spiritually Grounded and Culturally Responsive Clinical Practice
Ann Swartz
My question of how to position myself as a spiritually grounded, culturally responsive
health care provider was informed by my stepping outside the biomedical paradigm
and considering how traditional cultures theorize about disease causation and healing.
My assumptions were that even in the United States within the dominant culture, a
multitude of multiethnic traditional beliefs and practices still exist and that traditional
cultural beliefs of diverse ethnic groups are more similar to each other than they are to
biomedicine. I hoped that by taking this perspective I could join people and their fami-
lies through commonalities, share when invited whatever seemed potentially useful
from biomedical knowledge, and allow others to project onto me their perception of
healer as it made sense to them. I would hold myself accountable for remaining within
my legally prescribed scope of practice. Adopting this attitude led me to work with a

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