ELDER Project Fairfield University School of Nursing Haitian Culture Cultural Diversity ELDER Project Fairfield University School of Nursing Haitian Culture Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture Objectives: Upon completion of this session, the participants will be able to …. Discuss the role of religion, traditional health care beliefs, social values, and family structure of Haitian Culture and the impact these factors have on health care. Identify specific culturally sensitive practices that can be incorporated into your work with Haitian patients and Haitian American patients. Identify similarities and differences between the Haitian and Jamaican cultures. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture Introduction: The Haitian community in the United States is diverse and their differences in social class and regional variations make it difficult to generalize about this population. This group is comprised of 95% Black and 5% Mulatto. Most Haitians indicate Black or African American as their racial category, but do not identify with that culture. Currently, there is no category for them on surveys. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture Introduction: Haiti’s history has been plagued with political violence for most of its existence: In 1492 Columbus landed on the island of Hispaniola (Spanish Island) which was originally inhabited by Taino and Arawak Indians. Almost immediately the Spanish set up agricultural settlements using the natives on the island as labor. Early 1500’s – The Spaniard began to bring over slaves from West Africa Early 1600’s – France became interested in the island 1697 - The Spanish cede the western third of the island to France via the Treaty of Ryswick. Formed a French colony called Saint-Dominque and became one of the richest colonies of the time period. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture Introduction: 1789 - The French Revolution started 1804 - After 3 decades of slave revolts, Haiti declared independence from France and became the first black republic in the world. The leader at the time chose an Arawak name meaning “country of mountains”. 1844 - Dominican Republic declares its independence from Haiti 1915 - The Unites States invaded Haiti as a strategic move during World War I, and occupies the nation for almost 25 years. Although the U.S. did improve the conditions of the cities, poverty and illiteracy still predominated. The Americans left in 1934, leaving behind a well-trained military. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture Communication: Two official languages-Haitian Creole (known as Kreyol) and French Kreyol (mixture of French and African languages that Haitian slaves spoke). Creole is spoken by the majority of Haitians. Identifying as French is an indicator of social class. Oral forms of communication are preferred over written forms of communication. Word of mouth is used to disseminate information. It is common for Haitians to use a lot of hand gestures while talking. Speech may be loud, but it is not an indication of anger. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture Communication: Direct eye contact is appropriate to use with friends, along with an active tone of voice. Eye contact is avoided with those of higher socioeconomic status or someone of authority. Touch is accepted in informal situations; however, embracing those of the opposite sex is not typical. A stern handshake is an acceptable greeting in formal situations. Often smile and nod head, but this does not indicate understanding. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture Family and Social Structure: Family is very important and often those Haitians living in the US have financial responsibility to those who are still in Haiti. Haitians in the U.S. do not identify themselves solely as residents of America or Haiti, but instead live life that bridges both countries Home is geared towards the needs and strengths of the extended family. Households often consist of multiple generations Traditionally a patriarchal society: Men are the bread winners and do not get involved in child care at home. The man has ultimate control. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture Family and Social Structure: Children are viewed as a gift from God. Elderly parents live with children. It is considered an honor when a parent has chosen the child’s home to live. Mother, father or elder family member makes the healthcare decisions. Elders are viewed as knowledgeable and their counsel is sought. Education is important; it can improve social status. Gender roles are strictly defined: In healthcare, nurses are women and physician are men and expected to be an authority and trusted to do what needs to be done. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture View of Illness: Illness is thought to have either a natural or supernatural cause. Natural illness occurs due to an imbalance with nature, thus a short duration. If hot and cold equilibrium is disturbed, it results in a natural illness. Illness can also be caused by sympathetic magic, such as voodoo dolls and magicoreligious beliefs Supernatural illness is caused by God or the spirits and usually appears suddenly, without warning. Sick person becomes passive and allows others to help. Family typically comes to their assistance. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture View of Illness: Illnesses specific to this group: Fright (seizisman): Result of extreme fright, surprise or shock. Believe blood is moved from the head into the body and causes headache, visual disturbance and temporary mental problems. Oppression: Describes asthma or a state of hyperventilation and anxiety. Evil eye (maldyok): Result of a person’s envious glance and could be accidental. It can cause gastrointestinal problems (diarrhea) in children. It is treated by an herbalist or a voodoo practitioner. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture Folk Medicine: Believe they are sick if the illness interferes with their ability to work. Home remedies are used first and include herbal preparations, massage, and over-the-counter medications. These remedies are often passed on by the family and Haitian Americans will even have ingredients sent from Haiti. Often biomedical care will be simultaneously used with magico-religious care. Strong belief that the quality of a person’s blood signifies the health of the person. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture Folk Medicine: Health care practitioners include: Voodoo practitioners – They help with supernatural illnesses. They are well respected in the community. They diagnosis using cards, shells or trances. They treat with dancing, incantations, herbal preparations, prayer and the calling on of spirits. They utilize a holistic perspective. It is not uncommon for American Haitians to seek help of these practitioners even if it means going back to Haiti. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture Folk Medicine: Health care practitioners continued: Herbalists- Are the most common traditional healers Lay trained; have no formal training. Are sought out for common illnesses such as colds, fever, and diarrhea. They treat evil eye (maldyok) as well. They utilize a holistic perspective. Midwives- They deliver babies and provide prenatal care. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture Folk Medicine: Health care practioners continued: Bone setters- They treat musculoskeletal problems. Their treatment includes casts, massage, manipulation, poultices (soft, herbal treated, warm covering) and prayer. Injectionists- They travel from area to area giving injections of whatever is needed. They use medication and herbal preparations. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture Time Orientation: Dietary Habits: Present orientation. Sense of time management does not emphasize punctuality as this is not seen as an issue. Do not consider being late for appointments rude. Dietary Habits: Haitian cuisine has both French and African influences. Grains are a staple of the Haitian diet. Rice is eaten at almost every meal and is often cooked with beans and served with sauce. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture Dietary Habits: Typically the largest meal is eaten in the middle of the day. Heavy foods are eaten during this time and include: potatoes, cornmeal mush, and broiled plantains These foods provide energy for work. A good amount of spices are used in cooking. A common Haitian dish is griot: fried pork cubes marinated in sour orange juice and garlic. Food is often used to establish relationships and networks with new friends. Foods have a light or heavy characteristic. Light foods are eaten at night because they are easily digested. They include bread and soup. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture Dietary Habits: Haitians believe there are certain times when a person should not eat hot foods and certain times when a person should not eat cold foods. For example, if a person was hot from exercise, cold foods will not be eaten. The belief is that this can throw off a person’s equilibrium. Some may be reluctant to try new foods. They believe a healthy baby is a fat baby. This perspective carries over into adulthood. Weight is associated with health. Good nutrition means eating a lot. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture Religious Beliefs: Religious beliefs affect almost every aspect of Haitian society. 80% are Catholic Catholicism is very ritualistic and has adapted itself to local ritual. 16% Protestant This culture is most famous for Voodoo and exists side by side with the Christian faiths. Roughly half of the population practices Voodoo Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture Religious Beliefs: Voodoo is a fatalistic religion; it is believed that your destiny is controlled by spirits and only by contacting them can you control your destiny. Voodoo is a mixture of African and Haitian beliefs. It is made of a large number of spirits who have great influence on people and must be respected. Daily life is conducted according to what would make these spirits happy. Voodoo is the national religion of Haiti. No organized hierarchy or specific theology exists. To some degree, most Haitians practice or are affected by Voodoo in some way. Its most important tenant is healing people from sickness. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture Religious Beliefs: Ministers of Voodoo include priests or houngan and priestess or the mambo. Their major duties include: healing presiding over rituals foretelling the future dream reading spell casting creating protections making potions animal sacrifice Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture Religious Beliefs: There are two types of Voodoo: White magic (Rada) – which deals with peaceful worship of happy spirits. Black magic (Petro) – which deals with angry spirits, death curses and orgies. This practice only represents 5% of all Voodoo practiced. Black magic is related to Voodoo like Satanism is related to Christianity. Many are sensitive to being seen as voodoo worshipers, yet it continues in the U.S. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Haitian Culture Conclusion: Trust is a key issue with the Haitian culture. One way to establish trust is to sympathize with the patient and their family and acknowledge specific stressors, which can help calm fears. Just listening without saying anything can bring positive benefits. Sensitivity must be given to the specifics of Haitian identity. Health care providers must recognize Haitians as distinct from other Caribbean people and African Americans. Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Reference Cultural Competency and Haitian Immigrants. Retrieved January 23, 2011 from http://www.salisbury.edu/nursing/haitiancultcomp.   Haiti: A Historical Time Line. Retrieved on March 23rd, 2010 from http://www.theroot.com/views/haiti-historical-timeline?page=0,0 Jacobson, E. (2003). An Introduction to Haitian Culture for Rehabilitation Services Providers. Retieved January 11, 2011 from http://cirrie.buffalo.edu/monographs/haiti.php. The World Factbook: Haiti. Retrieved on March 23rd, 2010 from https://www.cia.gov/library/publications/the-world-factbook/geos/ha.html Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Power Point Presentation Created by: Joyce Cunneen, MSN, RN Fairfield University School of Nursing ELDER Project Education Coordinator Monica Starr, BSN, RN ELDER Project Program Coordinator Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858