Cultural safety: xenophobia within the same cultural group

An interesting experience I had with cultural safety was when I volunteered at medical camps in rural Pakistan at age sixteen. My parents had taken my brother and me back to Pakistan—a country that we belonged to but had never resonated with—to visit our extended family and “get in touch with our roots.” As part of my parents’ efforts to help us become more aware of the privileged North American lives we lived, they insisted that I work with some doctors in running a medical camp. Having been attracted to medicine since I was a child, I leapt at the opportunity… only to shy away from the idea five minutes later when they told me that the medical camps were in rural Pakistan. I was scared. I didn’t want to desert the comforts of urban Pakistan, where McDonald’s and Pizza Hut were a block away and where I could still wear my Canadian attire. I was certainly not comfortable with the idea of working with a group of people so different from myself and so different from the modern, chic Pakistani society that my relatives lived in.

Despite my resistance, I ended up volunteering at the medical camps. My feelings of fear of the unknown and anxiety around being in a place in which I did not belong had heightened by the time I arrived. The first day that I volunteered at the camp was disastrous. I was bumbling around, trying to be useful, but finding myself rejected by those whom I tried to help. As we drove back to my ancestral family home in the city later that evening, I kept reflecting on the day’s events. A profound thought occurred to me as we approached home around 8pm: “Those people are people of my own ethnicity who speak the same language, and yet I do not feel safe around them… perhaps they don’t feel safe around me either.” I shared my concerns with my parents and—to my utmost horror—they laughed boisterously. They then asked me, “How will they trust you and feel safe around you when you haven’t accepted who they are? How will they let you help them if you don’t show them the kindness in your heart and that you relate to them, first and foremost, as human beings?” As a naïve sixteen-year-old, I was mind-boggled in that moment. I spent that night lying wide awake in my bed, vowing to be better the next day.

Over the course of the next few days, I tried something new—something different. While it is difficult to convey what this new approach was in English, a rough translation from Sindhi would be ‘opening the doors of my heart.’ I let go of previously-held misconceptions and stereotypes and strove to ask the villagers at the medical camps how they would like to be helped, taking care not to let socioeconomic status, background, and culture impede our ability to relate. I related to them on the basis of our shared humanity, not upon the basis of similar worldviews or experiences. To my delight, the villagers opened up and told me the stories of their lives, health, and daily struggles. It warmed my heart to be in the presence of those who had such few materialistic comforts in life but possessed hearts of gold and the courage of lions. Above all, I felt privileged to have met them and to have been a part of their care.

This experience largely solidified my decision to enter medicine, and it also taught me a few critical life lessons. In terms of cultural safety, this experience taught me that being of the same nationality or sharing a common language has nothing to do with cultural safety, inclusivity, or optimal patient care. It is relating to one’s patients—and, most importantly, having the willingness to relate to one’s patients—that makes a world of a difference. I know this experience will make me a better physician because it serves as a constant reminder to not only keep my eyes and ears open while I am practicing medicine, but to also keep the doors of my heart open. I believe this will enable me to treat my patients holistically rather than just treating their illnesses, as well as to establish a personal connection and rapport with them. This experience helped me to develop a genuine curiosity to learn about how patients would like to be helped based on their unique cultural background and experiences. Ultimately, I believe that this experience and all the lessons it has taught me about life and about cultural sensitivity will be invaluable in shaping my future practice.


The original article can be found at cmaj blogs.