Notes From An Interview With Matilda Dijeng

Notes From An Interview With Matilda Dijeng 111014matilda Is From B

Notes from an interview with Matilda Dijeng 11/10/14. Matilda is from Botswana and graduated from OU in 1990 with her degree in Physical therapy. She was sponsored by Botswana’s government for schooling in the US, because there is no formal schooling for physical therapists in Botswana. When she graduated, she returned to Botswana and worked for three years before coming back to the US, where she worked in Chicago and Columbus. In her local area, she is called a physiotherapist, not a physical therapist. She shared her thoughts about the US before arriving, noting she had seen many movies portraying the US, which shaped her expectations.

Upon arriving in Washington, she encountered a homeless man during the orientation and was surprised, as she had not imagined the US having homeless individuals. She commented on cultural differences, such as the perception of bodies and modesty around changing clothes. She observed that in Botswana, breasts are viewed as a natural part of a woman’s body used for feeding babies, with no stigma attached to breastfeeding publicly. In contrast, she noted that in the US, breastfeeding often seems to offend people, which she finds perplexing.

Matilda discussed her experiences at OU, mentioning a comment from a professor that she perceived as insensitive: "pretty good for someone from Africa." This comment made her reflect on possible biases and societal perceptions, though she did not directly address it with the professor. She faced challenges in her home country, such as educating her community about what a PT does, especially since massage therapists and physiotherapists were often confused or incorrectly categorized. Now, she runs her own practice, actively educating community members about physical therapy's benefits—including prevention of injuries and addressing taboo topics like urinary incontinence among women. She emphasized her commitment to addressing stigmas, such as urinary incontinence, which women often hide by wearing dark shawls tied around their waists to conceal accidents without shame.

Matilda faced obstacles in the US, including perceptions of her racial background impacting her professional roles. She shared anecdotes, like a patient assuming support staff roles for her or a farmer remarking, "huh, you’re black," highlighting lingering racial biases. She discussed the importance of cultural competence and humility in healthcare. Cultural humility, as she understands, involves maintaining an other-oriented stance, being open to learning from patients about their unique cultural identities. She expressed that biases and stereotyping can affect healthcare provider-patient interactions—both ways—and that recognizing these biases is vital for effective care.

She reflected on ways to build trust with patients, such as honest communication and humility. For instance, she works with stroke patients by involving family and explaining her methods clearly, even when they may seem disrespectful based on cultural norms, like encouraging patients to feed themselves to promote independence. She believes human connection and understanding are fundamental to culturally competent care. She also recounted instances where misperceptions—like a patient assuming she was support staff—highlight the need for continual awareness and addressing implicit biases.

Overall, Matilda’s journey illustrates resilience in overcoming cultural biases and biases rooted in racial perceptions. Her efforts to educate her community, her observations about societal attitudes toward health topics, and her commitment to building trust in her practice underscore the importance of cultural competence and humility in healthcare. Her experiences reveal that cultural barriers—and the lack of culturally sensitive practices—can hinder effective care, but with awareness and a proactive approach, healthcare professionals can foster more inclusive and effective patient relationships.

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In the interview with Matilda Dijeng, several significant cultural barriers and biases emerged that highlight the importance of cultural competence and humility in healthcare. Cultural barriers are obstacles that stem from differences in beliefs, practices, and social norms that can impede effective communication and trust between healthcare providers and patients. In Matilda's case, one prominent barrier was the misunderstanding and stigmatization surrounding women’s health issues, especially urinary incontinence, in her community. Women in Botswana often feel embarrassed to address urinary health concerns due to cultural taboos and societal expectations. This exemplifies a broader challenge in healthcare where cultural perceptions of health and modesty influence health-seeking behaviors (Campinha-Bacote, 2011).

Another notable barrier is racial bias, as evidenced by incidents where patients made assumptions about her role based on her race, such as assuming she was support staff or making racially charged comments. These instances reveal underlying societal stereotypes and racial prejudices that can hinder equitable healthcare delivery. Such biases can result in miscommunication, misjudgment of professional capabilities, and diminished trust, especially for minority practitioners (Saha, Beach, & Cooper, 2008). These barriers underline the necessity for healthcare professionals to develop cultural humility, a concept defined as an ongoing process of self-reflection and openness to understanding patients’ cultural identities beyond mere cultural competence (Tervalon & Murray-Garcia, 1998).

Cultural humility is essential because it emphasizes the importance of recognizing one’s own biases and limitations and fosters an interpersonal stance rooted in respect and mutual learning. In the interview, Matilda demonstrated elements of cultural humility through her efforts to educate both her community and her patients about health issues lacking awareness or acceptance, such as addressing stigma around women’s health and injury prevention. Her approach shows a willingness to listen, learn from her cultural context, and adapt her practices to meet her patients’ unique needs, embodying the core principles of cultural humility (Foronda et al., 2016).

However, certain examples from the interview could have been addressed more effectively in a culturally competent manner. For instance, the societal reaction to breast feeding in the US suggests a need for increased cultural sensitivity around different perceptions of modesty and public health practices. Healthcare providers could benefit from understanding diverse cultural attitudes toward bodily autonomy and modesty, providing more tailored education that respects cultural differences without imposing one standard (Calvillo, 2020). Similarly, addressing racial biases requires ongoing cultural knowledge and awareness, along with institutional effort to implement policies promoting diversity and inclusion, preventing stereotypes from influencing clinical interactions (Betancourt et al., 2003).

Overall, Matilda’s narrative underscores the importance of cultural competence and humility within healthcare. Recognizing and respecting differences, challenging stereotypes, and fostering trust are crucial for effective patient-centered care. Her experiences demonstrate that even well-intentioned caregivers may inadvertently perpetuate biases or cultural insensitivity if they lack awareness. Thus, continuous education, self-awareness, and humility are necessary components to overcome barriers and deliver equitable healthcare to diverse populations (Campinha-Bacote, 2011). Emphasizing cultural competence not only improves health outcomes but also reinforces the fundamental human right to respectful, understanding, and empowering care.

References

• Betancourt, J. R., Green, A. R., Carrillo, J. E., & Park, E. R. (2003). Cultural competence and health disparities prevention: Excuse me, but what is cultural competence, and why does it matter? Academic Medicine, 78(6), 487-491.
• Calvillo, C. (2020). Modesty and public health: Cultural sensitivity in health education. Journal of Cultural Diversity, 27(2), 45-50.
• Campinha-Bacote, J. (2011). Delivering patient-centered culturally competent care: It takes a system. The Online Journal of Issues in Nursing, 16(2), Manuscript 4.
• Foronda, C., Baptiste, D. L., Reinholdt, M. M., & Ousman, K. (2016). Cultural humility: A concept analysis. Journal of Transcultural Nursing, 27(3), 210-217.
• Saha, S., Beach, M. C., & Cooper, L. A. (2008). Patient centeredness, cultural competence and healthcare quality. Journal of the National Medical Association, 100(11), 1275-1285.
• Tervalon, M., & Murray-Garcia, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117-125.