Cultural and linguistic competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations. Competence implies the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors, and needs presented by consumers and their communities.
Female genital mutilation is now recognised as an important public health issue in the UK, requiring action from nurses and midwives. School nurses in particular are being enlisted to identify and support girls at risk of FGM, and help teachers have the confidence to intervene. Every nurse needs to know how to support women living with the consequences of FGM.
Patient Educ Couns. 2014 Aug 28. pii: S0738-3991(14)00363-2. doi: 10.1016/j.pec.2014.08.014. [Epub ahead of print]
‘Gosh’: A cross-cultural encounter with a Somali woman, a male interpreter and a gynecologist on female genital cutting/mutilation.
I saw the woman for the first time on the gynecological emergency at a Swiss University Women’s Hospital. She was referred for assessment of lower abdominal pain, which turned out to be a ‘cover-up’ for the subsequent case presentation. The 22-years old, married woman had a low proficiency in English and none in German, and was an asylum seeker from Somalia. The history and clinical examination for lower abdominal pain revealed no pathological results – but her female external genitalia presented an unforgettable finding I had never seen before during my clinical career in Switzerland and also in Cameroon.
Aproximation to the ablation/female genital mutilation (A/FGM) from the transcultural nursing. A bibliographical revision. (Article in Spanish)
Jiménez Ruiz I. Almansa Martínez P, Pastor Bravo MM, Pina Roche F
Objective: Analysing the argumentations in favour to the Female Genital Mutilation (FGM) with the intention to know and understand the complex and subjective reality of this practice. Material and method: bibliographical search and revision on the net in order to accessing Web directories of organizations and the main health sciences data bases. Results: The analysis of the biography contributes with a big quantity of information regarding the supportiveness of this practice and the complications derived from it, clarifying the complex situations involved in its perpetuation. Conclusions: The FGM is understood as a cultural care of women determined by socio-cultural, hygienic-aesthetic, religious-spiritual and sexual factors among others related with health. In this way, a wide range of secondary complications to FGM have been described.
Mayo Clin Proc. 2013 Jun;88(6):618-29. doi: 10.1016/j.mayocp.2013.04.004.
Female genital cutting: an evidence-based approach to clinical management for the primary care physician.
Hearst AA, Molnar AM.
Department of Medicine, University of Washington, Seattle, WA 98104, USA.
The United States has more than 1.5 million immigrants from countries in Africa and the Middle East where female genital cutting (FGC) is known to occur. Often, FGC occurs in infancy and childhood in the countries where it is practiced, but patients of any age can present with complications. Lack of understanding of this common problem can potentially alienate and lower quality of care for this patient population. We provide an introduction to the practice of FGC and practice guidelines for the primary care physician. We reviewed original research, population-based studies, and legal research from PubMed, Scopus, CINAHL plus, PsycINFO, and Legal Trac. The terms searched included female genital cutting, female genital circumcision, and female genital mutilation alone and with the term complications or health consequences; no limit on date published. Legal databases were searched using the above terms, as well as international law and immigration law. Editorials and review articles were excluded. This review discusses the different types of FGC, important cultural considerations for physicians caring for patients with FGC, the common early and late medical complications and their management, and psychosocial issues associated with FGC. Current laws pertaining to FGC are briefly reviewed, as well as implications for patients seeking asylum status in the United States because of FGC. Finally, the article presents evidence-based, culturally sensitive approaches to discussions of FGC with girls and women for whom this is an issue.
Education and the Knowledge Society. IFIP International Federation for Information Processing. 2005, 161: 231-236.
E-solidarity, a means of fighting against FGM (Female Genital Mutilation)
This project aims to contribute to the eradication of the practice of Female Genital Mutilation (FGM) throughout the Maasailand in Kenya in agreement with the World Health Organisation (WHO) policy by large-scale distribution of information to the remote Maasai villages, by creation of awareness, by proposing alternative rituals, by improvement of the social (and economic) status of women and by encouragement of Maasai families to send female children to school. e-Society means will be used in the understanding that these are not in opposition to preserving tradition and ethnic identity
[Las mutilaciones genitales femeninas: reflexiones para una intervención desde la atención primaria] [Article in Spanish]
Kaplan Marcusan A, Torán Monserrat P, Bedoya Muriel MH, Bermúdez Anderson K, Moreno Navarro J, and Bolíbar Ribas B.
En los últimos 20 años, España se ha convertido en punto de destino de movimientos migratorios de personas procedentes de diversos países del África subsahariana. No emigran los continentes ni los colores, sino las personas y sus culturas. Para los profesionales de la salud, esto ha supuesto descubrir realidades culturales diferentes y afrontar nuevos retos asistenciales1,2, en el marco de complejos procesos de aculturación e integración social. En 28 países africanos, la realización de mutilaciones genitales femeninas (MGF) es una práctica habitual, en el contexto cultural de los ritos de paso a la edad adulta y como elemento de socialización de las niñas. Existe un entramado de creencias culturales, tradiciones y gerontocracias que perpetúa estas intervenciones contra la integridad física de las mujeres…
Aims: Waves of immigration from the latter half of the 20th century have changed the cultural and ethnic mix of major regions of the world. Dynamic multicultural societies now are a reality across the Western world. The relationship and influence of these diverse cultures to the understanding and identification of child abuse and neglect is challenging and complex. Health professionals working with children from culturally and linguistically diverse groups often find themselves with the challenge of exploring and resolving the tension between definitions of harm in child protection practice and various cultural and child-rearing practices. In this paper, we set out ways of thinking about the influence of culture when approaching and dealing with the suspicion of child maltreatment.
Methods: We will explore how culture shapes the experiences of childhood, child-rearing practices, and identify common barriers in working with children and families from culturally diverse backgrounds when presenting with child maltreatment. We will use case examples from Europe and Australia to illustrate the real life challenges of working in the area of child maltreatment across cultures. We will review the scientific literature exploring the nexus between culture and child maltreatment, identifying the gaps in the literature and highlight areas for future research.
Results: We suggest a model for dealing with cultural issues in child maltreatment that is culturally competent and respectful.
Conclusions: The model for cultural competency in child health and child protective services incorporates four domains for advocacy and action – individual, professional, organisational and systemic.
The encounters that rupture the myth: contradictions in midwives´descriptions and explanations of circumcised women immigrants´sexuality
Leval A, Widmark C, Tishelman C, Ahlberg BM
The purpose of the study was to analyze how Swedish midwives (n = 26) discuss sexuality in circumcised African women patients. In focus groups and interviews, discussions concentrated on care provided to circumcised women, training received for this care, and midwives’ perceptions of female circumcision. An analytic expansion was performed for discussions pertaining to sexuality and gender roles. Results from the analysis show the following: (1) ethnocentric projections of sexuality; (2) a knowledge paradox regarding circumcision and sexuality; (3) the view of the powerless circumcised women; and (4) the fact that maternity wards function as meeting places between gender and culture where the encounters with men allow masculine hegemonic norms to be ruptured. We conclude that an increased understanding of cultural epistemology is needed to ensure quality care. The encounters that take place in obstetrical care situations can provide a space where gender and culture as prescribed norms can be questioned.
The experiences of African women giving birth in Brisbane, Australia.
Murray L, Windsor C, Parker E, Tewfik O.
School of Public Health, Queensland University of Technology, Kelvin Grove, Brisbane, Australia. firstname.lastname@example.org
Our purpose in this research was to uncover first-person descriptions of the birth experiences of African refugee women in Brisbane, Australia, and to explore the common themes that emerged from their experiences. We conducted semistructured interviews with 10 African refugees who had given birth in Brisbane. Essences universal to childbirth such as pain, control, and experiences of caregivers featured prominently in participants’ descriptions of their experiences. Their experiences, however, were further overshadowed by issues such as language barriers, the refugee experience, female genital mutilation (FGM), and encounters with health services with limited cultural competence.
“They get a C-section…they gonna die”: Somali women’s fears of obstetrical interventions in the United States.
Brown E, Carroll J, Fogarty C, Holt C.
University of Rochester Medical Center, Rochester, NY 14620, USA. email@example.com
The authors explore sources of resistance to common prenatal and obstetrical interventions among 34 Somali resettled adult women in Rochester, New York. Results of individual interviews and focus groups with these women revealed aversion to or outright fear of cesarean sections because of fear of death and substantial resistance regarding other obstetrical interventions. Because Somali women expressed resistance to many common U.S. prenatal/obstetrical care practices, educating health professionals about Somali women’s fears and educating Somali women about common obstetrical practices are both necessary to improve maternity care for non-Bantu and Bantu Somali women.