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 Cultural
brokering is provided in a safe, non-judgmental, and confidential
manner.
Health care
settings must ensure that cultural brokering programs are conducted
in a safe, non-judgmental, and confidential manner. This requirement
means that each aspect of this principle is incorporated into
the organizational philosophy, infrastructure, and practice
model. This includes, but is not limited to, articulating values
and principles and establishing procedures to ensure that providers,
staff, cultural brokers, and patients/consumers understand
and accept this approach to service delivery.
NAVAJO
HEALTH EDUCATOR MONITORS TRIBAL HEALTH THROUGH HOME
VISITS
Katie Tree, community advocate and diabetes health educator for the Dineh
(Navajo) tribe in Chilchinbeto, AZ, makes home visits once a week to
assess community members at high risk on the Navajo reservation, such
as the elderly, new mothers, and individuals with chronic illness. Tree
checks community members’ vital signs and medication and refers
them to the local public health nurses who visit the reservation monthly.
The home visits are a convenient and comfortable setting for patients
to receive basic checkups because the closest health care facility, grocery
store, or any other major retail outlet is 25 miles away from this small
Northeastern Arizona town. Tree serves multiple roles within this tribal
community. As a healer, she occasionally performs such indigenous ceremonies
for community members as blessing, crushing, and boiling corn pollen
to clear a person’s sinuses. As a cultural broker, she also helps
physicians follow up with patients by educating them about how Dineh
tribal members seek out different medicine men for various illnesses, “much
in the way the Whiteman sees a cardiologist for heart problems and a
dentist for dental problems.”
CULTURAL EXCHANGES FOSTER RECIPROCITY
BETWEEN SHAMAN AND PHYSICIANS
Using hand-held tape recorders, Hmong community outreach liaisons interview
shaman healers
to obtain their training history and life story. This
telling of stories is in a comfortable, folklore style and is familiar
to shaman and the Hmong community alike. “The voice recorders allow
shaman who are not literate to transmit information about their patients,” says
program director Marilyn Mochel. The tape recorders also allow shaman
to describe specific ceremonies performed for certain illnesses or conditions
for their current
patients. Story telling provides a safe format for the exchange of cultural
information. Moreover, Mochel states, “A deeper understanding of
the regional variations of shaman ceremonial styles is emerging.” These
stories also chronicle the shaman’s
accounts of their traumatic journey from Laos to settlement camps in
Thailand, and to their final destination in the United States as refugees.
At the same time, the histories help local physicians to understand the
shaman’s healing heritage. This knowledge allows local physicians
to accept the traditional ceremonial practices of the shaman without
judging them by Western medical standards.
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