Page 174 - Cultural Competence in Health Education

152 Cultural Competence in Health Education and Health Promotion

requirements in medical experimentation. These two cases will be further discussed later
in this section.
Miscommunication between two countries of different ethnicity and cultural
understandings can bring about a war. As Moroccan philosopher Mahdi Elmandjra
(2003) has said, in discussing the prevention of such cultural conflicts or clashes of

value systems that result in war: “ We need people to communicate, to respect each oth-
er ’ s systems and cultural diversity. The international community has no choice but to
survive together ” (p. 1). When a nation goes to war, the majority of its people label the
people of the other nation with a single title. For example, prior to September 11, 2001,
Muslims were not considered terrorists by a majority of Americans. However, since
9/11, a majority of Americans have stereotyped Muslims into the category of terrorist.
It is a fact that the planners of the 9/11 catastrophe did inflict unprecedented damage to

the people of the United States; however, not everybody in Afghanistan plotted to at-
tack America. Other people ’ s cultures need to be viewed both as wholes and as made
of their own diverse parts, and also realistically, not stereotypically. And they need to
be taken into consideration in order to bring about peace on Earth. Without this, we
will simply be enclosed by our own borders and become our own prisoners.
A past event that has shaped the way many American Indians feel toward U.S. health
care today is the sterilization of twelve thousand Indian women over the four - year period
from 1972 to 1976. England (n.d.) provides an in - depth investigation of the moral issues
created by the Indian Health Service (IHS) when it falsely informed Indian women about
sterilization procedures. These Indian women were coerced and harassed into having the
surgery and were not provided proper information beforehand. Among the things these
women were told were that they were bad mothers and their existing children would
be taken away from them if they did not consent, that they had enough children and it
was time to stop having children, and that they could still have children after the opera-
tion. The atrocities committed by physicians on these women were inexplicable and
embarrassing for our nation. The lies told to these women have given many Indians a
historical perspective that warns them to mistrust U.S. health care, and they are likely to
continue to carry this perspective with them for many years to come. Prior to this event,
,
which Indians have referred to as “ genocide ” there were no laws concerning punish-
ment for those involved in coercive sterilization. However, in 1979, the National Coun-
cil of Churches condemned the policy of nonmedical sterilization and asked for a full
investigation into the IHS parent agency, then called the Department of Health, Educa-
tion, and Welfare, to find all the people responsible for this act and to determine the

extent to which the IHS had integrated these actions (England, n.d.).
Another historical episode that has led to mistrust in physicians is the Tuskegee
Syphilis Study. Conducted from 1932 to 1972 in Tuskegee, Alabama, this clinical study
took advantage of 399 poor, illiterate African Americans (CDC, 2005). The researchers
told the men who were infected with syphilis that they had “ bad blood ” and would
receive free treatment, transportation, a hot meal, and $50 for a funeral if they were to
die. They were not informed of their diagnosis, only told they had “ bad blood. ” In real-
ity, the researchers did not provide them with appropriate treatment, such as penicillin,

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