Page 122 - Cultural Competence in Health Education

100 Cultural Competence in Health Education and Health Promotion

Sometimes an aspect of pilgrimage is involved. Always the person seeking healing
has an active role of calling upon her own powers of healing. The family is likely to be
included. Many healing rituals actually require the presence of family and community
members, and they engage in ritual singing and dancing to contribute to the healing
and also to strengthen interpersonal connections, which are often the source of spiri-
tual distress. Interpersonal connection through spiritual interventions of touching,
instilling hope and faith, and practicing presence requires a relationship (Achterberg,
Dossey, & Kolkmeier, 1994; Anderson, 2001; McEwen, 2005). It was these aspects of
healing that seemed to hold the most potential for doing something different, not
offered by biomedicine, that had a chance to reach across ethnic boundaries without
requiring a lot of language, and to resonate with what families naturally do to create
and maintain family health.
Learning to address spirituality related to health and illness in my practice has been
a nonlinear process (unlike the rational deductive diagnostic process of Western medi-
cine). The approach to a person is a search for places to build connection, to uncover
relatedness, and the “ work ” always has to do with his creation of meaning and, in turn,
my creation of new meaning. It is a constant building through connection. The “ assess-
ment ” is not of someone or of some community ’ s “ need ” or “ problem ” as is usual in
health care. It is about identifying how this person is organizing himself (or how a
group is organizing itself) — and thereby creating his health — in response to various
connections with other people, his family, the communities he belongs to, the Divine,
and then using connection to cross a boundary and become part of that process. It is not
knowledge of risk factors and evidence - based outcomes for diseases that make this pos-
sible but the elements of spiritual expression, beyond words. Therefore this may not be
seen as a practical approach or one that is easily measured, but it works!

CONCLUSION
In conclusion, it is clear that there is certainly a place for spirituality in culturally
responsive education for health and wellness. It is not just that there is a place for it but
that it seems that if one is really concerned about healing (as opposed to curing, which
is not the same thing), then it is important to consider all the pieces of the person, as
she moves along her journey to greater health, or dances her way along the journey to
wholeness. Spirituality is an important part of this process. Thus it is important for
culturally responsive education for health.

POINTS TO REMEMBER

■ WHO supports a holistic definition of health that attends to spirituality and
culture.
■ The field of health education espouses multidimensionality and has begun to dis-

cuss spirituality, but in practice emphasis remains on the purely physical.

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