Page 173 - Cultural Competence in Health Education

Communication and Cultural Competence 151

medium of communication. Specific symbols mean different things. When a sender

(a health educator) does not understand the culture of an audience (and hence faces a
communication barrier), serious communication breakdown can occur, which then af-
fects the message. In many cultures an oral tradition of storytelling plays an essential
role in transmitting information to both children and adults alike. However, exercis-
ing cultural competence also means that the health educator is aware of the ethical and
cultural incongruence of assuming the role of the storyteller without proper training or
education for that role and without a thorough understanding of the cultural implica-

tions of storytelling for learning in a specific cultural context.
When a health educator is adapting a communication to a specifi c community, it is
imperative for the sender of the message to educate himself or herself in all aspects of

the communication mechanisms (for example, posters, flyers, pictorial symbols, story-
telling, and so forth) within the community ’ s culture. The educator needs to be cultur-
ally competent in the community ’ s cultural expressions before embarking on any
health education and promotion intervention program planning, implementation,
and evaluation. The health educator must be aware that even when the chosen meth-
ods and materials of communicating health are appropriate, questions about when and
how they should be used may still need to be addressed. As Airhihenbuwa (1995)
states, “ alternative methods of cross - cultural communication should be explored to
ensure that the process does not dis - empower the target group ” (p. 9).
A community is a group of individuals with a shared belief system, values, inter-
ests, or other attributes. Each cultural community has established particular codes,
symbols, and strategies as methods of communication. These methods encapsulate the
essence of meaning that such community groups bring to the development and acqui-
sition of knowledge. Program planners should carefully examine these verbal and
nonverbal communication methods as they relate to health behavior change processes
and infl uence people ’ s cultural values and beliefs. As stated earlier the power of the
spoken word (oral tradition) is an ancient cornerstone of many cultures. Songs and
dances too are found in the foundations of many cultures. Interpretations and decod-
ings of the spoken word are embedded in storytelling, which may be expressed in
songs and dances. Songs and dances are commonly used in different forms of rituals.

HISTORICAL PERSPECTIVES ON COMMUNICATION
ACROSS CULTURES
Communication across cultures has been a dominant and recurrent theme throughout hu-
man history. Misunderstanding and mistrust among communities due to lack of effective
communication can result in internal or external conflicts. This can be seen in all the

wars that have taken place throughout history to the present time. Instances of deliber-
ately misinforming people of particular cultures, as occurred during the Tuskegee
Syphilis Study and in a program of sterilization of Indian women, have had long - lasting
negative effects on intercultural communication and have raised awareness of ethical

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