In a hospital corridor in Moshi, Tanzania about twenty students are crowded and the day in the maternity ward has begun. We move like a flock of sheep against the sounds of a woman giving birth. Want to observe. She lies naked on a bed with neither walls nor draperies to screen off and she's been through a whole night's labor. Tired and worn out, she will soon give birth to her child in front of an audience of curious glances.
Through the nursing education, I am fed with content with culturally coded values. The importance of patient participation in the care process. Preservation of its integrity. As on order, I therefore react to the situation above something like this: Why is there not a curtain to shield the bed with? And: There are too many students staring. Last: Can't she get something to cover her body with?
A study of Norwegian and Swedish nursing students' reflections on care in Tanzania and South Africa shows a clear lack of cultural competence in the encounter with care outside Scandinavia. After reading the study, I realize that my reaction reflects that of many of the students and am therefore reluctantly forced to admit that it contains ethnocentric ideas. I do not know at all how the woman experiences the situation.
So what exactly is cultural competence?
It is not a completely unproblematic concept because culture cannot be seen as something static. If one in the pursuit of increasing one's cultural competence attributes a culture to people in order to be able to relate to them on the basis of this, one risks consolidating stereotypical, generalizing notions of a person's needs and desires. Maybe I can instead use the term as a little reminder in the back of my mind when I criticize: Why do I think this way? Can it be linked to my culturally coded values? To be able to understand the birth woman's experience, I must be able to overlook my own expectations of how a birth takes place. A good start is to define this.
Cultural competence is crucial in ensuring patient-safe care. Not just in Tanzania and South Africa. At a time when the patient group in Sweden consists of many different ethnicities, it is also required here. And maybe it's not just patients who should be treated with cultural competence - maybe it can prevent misunderstandings in all our meetings.