Culture can be learned and shared, plus it involves values. Cultural values are embraced during childhood and become a “program of the mind” that every individual conducts through their social life, feelings and thinking. For instance, many cultural groups value family relationships but how and how often families interact or how family is defined could be different. Culture is often considered the core concept in cross-cultural communication. It influences people’s communication—verbal & non-verbal styles, approaches, behavior and reflects different value orientations of certain/group cultures.
As of 2016, the highest, diverse ethnic patient population we serve at Fairview includes Somali, Latinos, Indians, Ethiopians, Vietnamese, Russians and Hmong, in addition to African Americans, Native Americans and Arabs. Cross-cultural communication, in particular, with foreign-born generations, could be a challenge in a patient care setting while assessing a person’s physical, mental health and well-being.
High value on collectivism: extended family, respect for elders and religious leaders valued over individualism. Interdependence valued over independence. For example, culture and practices of ethnic population of our patients such as including Somali, Oromo, Ethiopians and many other diverse cultures acknowledge closed-friends as family and instead of names-“aunt” “uncle” “sister” “brother” will be used.
Somalis are 99% Sunni Muslim. Due to Islamic tradition, men and women do not shake hands with the exception of immediate family members such as brother, sister, father, grandfather, grandmother, maternal and paternal uncles and aunts. Father is the head of the family and when he is absent, an adult son or older male relative will lead family as a decision-maker. Mingling of unmarried men and women is minimized and must talk in a respectful manner without physical contact. However, two people of the same gender can come within close a distance and converse comfortably. They can make eye contact and touch each other while speaking.
- Ask permission before touching a patient to offer comfort.
- Use our trained medical interpreters. Never use children or other family members as interpreters.
- Ask your patients about dietary restrictions and food habits. Muslims do not eat pork.
- Don’t interrupt during prayer. It is the belief that the divine is present during prayer.
- Build relationships with patient and family member by using a few social greetings.
- A swift twist of the open hand means “nothing” or “no”
- Snapping fingers may mean “long ago” or and “so on”
- A thumb under the chin indicates “fullness”.
- It is impolite to point the sole of one’s foot or shoe at another person.
- It is impolite to use the index finger to call somebody; that gesture is used for calling dogs.
- Clasping hands stands for “shaking hands” practiced mainly by elders with the opposite genders
- Muslim men and women are taught to lower their gaze and not to make direct eye contact with non-immediate family members.
Source: Greetings & Everyday Expressions-Pilot Somali Language Class of Fairview Clinics by MCTC & https://stcloudsomali.wordpress.com/2008/08/04/somali-culture-2/ and Center for Intercultural Learning Country Insights https://www.international.gc.ca/cil-cai/country_insights-apercus_pays/ci-ic_so.aspx?lang=eng
Special Thanks to Zahra Hassan, Community Health Outreach Coordinator, UMMC.