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glossary |
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Many believe that Canada is now a multicultural nation and that everyone has, or should have, access to all they need in life. But many people, including Aboriginal peoples, have been marginalized by the powerful processes of colonization and colonialist policies that have reinforced privileges for some at the expense of others. Listen to what Sheila Dick has to say about sending her young children off to school for the first time.
The marginalizing, or "othering" processes is one major way that privilege is sustained. If you have not done so already, read Canales' article on exclusionary and inclusionary othering. Canales describes how people who are different from the dominant, or mainstream, culture, are "othered" and how their difference is considered to be a problem. As long as "othered" individuals and groups are expected to conform to the dominant culture, they will continue to be marginalized. Many of those in the mainstream have yet to understand that demanding that everyone conform to one way of being, living, or experiencing life disrespects difference. Experiencing the festivals, art, music, and food of people from different backgrounds, while enjoyable, does not help people in the mainstream fully understand the issue of power and privilege. In her article, Canales asks us to think about inclusionary othering, that is, to put ourselves in others' roles and connect with them through difference. This provides an opportunity to consider, or confirm, that difference is a good thing, rather than something bad that needs to be changed. Above all, it creates some space to reflect on our commonalities as human beings and celebrate, not fear, our differences. CultureHave you noticed that health care has a dominant culture? What have you noticed about it? In the recommended article by Stephenson, there are many important examples of how the dominant medical culture can create ethical dilemmas not only for marginalized people and groups, but also for health providers, including nurses. After reading Stephenson's article, take a few minutes to reflect on the concept of "culture." You may come up with a list of examples such as ethnic heritage, religion, values, beliefs, dances, songs, and artifacts. What culture do you think is dominant in Canada? How do you define Canadian culture? Do you consider yourself a member of this culture? Now, go to the Glossary on this website to read a more detailed discussion of how culture relates to this discussion.
Take a few minutes now to do Activity 2, What is This Thing Called Culture? Culture is complex and not an "object" or "group" to be studied. All of us create culture constantly and, in doing so, create and sustain power relations. Cultural safety demands the recognition that all people are bearers of culture. Problems arise when culture is objectified or behaviour or health is explained in terms of culture. For example, Aboriginal peoples are commonly assumed to experience a higher incidence of diabetes due to poor lifestyle and diet choice, caused, in part, by their culture. Missing from this analysis is the recognition, in terms of cultural safety, that life choice or life opportunity is closely linked to historical, social, political, and economic factors relating to our experiences. Mainstream analysis ignores the colonial legacy that informs health, as well as the fact that choice for Aboriginal peoples may mean something very different than that for members of the dominant culture. Thus, in this example, explaining health only in terms of culture objectifies culture, making it something that can be seen, studied, or judged. In a similar way, when the dominant culture objectifies individuals or groups based on certain characteristics, these individuals or groups may then be labelled or stereotyped in negative ways, thus becoming the "other." Culture is not restricted to an individual or group's ethnic background, skin colour, beliefs, diet, country of origin, and so on. Culture is also created and experienced in terms of age, ability, sexual orientation, physical size, education, and income, among many other things. The many intersections of our experiences, based on these characteristics, are helpful when thinking about our social location. Reflect on your social location. What characteristics come to mind? Culture is the medium through which all of these factors are experienced and created and through which we experience and make meaning of our lives.4 Think about the culture of your workplace. What happens when you want to do something different from the norm? What happens when patients/clients ask for something that is not included in official procedures or policies? Now is a good time to read the article by McGibbon, which is about the power of the knowledge you have as a nurse and how your power and knowledge can help you, your colleagues, and your clients. After reading McGibbon's article, do Activity 3, "Flower of Power." To conclude this section, read Chapter 2 by Papps, in Wepa's Cultural Safety in Aotearoa New Zealand. In the late 1980s, Maori people in Aotearoa were not satisfied with the quality of their health services. The dominant health care culture left no room for their voice, and they felt excluded from and overpowered by the system. They subsequently worked to change the system so that, today, all nurses in Aotearoa must meet cultural safety competencies. This means nurses must be able to reflect on their own culture, as well as respect difference and the knowledge of Maori people. When you look at health services or individual experiences through the lens of cultural safety, you can appreciate the ways in which colonization, power, and privilege come together to affect how people experience health. Think about how power has affected the lives of Joan Morrison (who you met in Module 1) and her mother while you watch and listen to Joan's video clip.
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