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Caring for African American, Mexican, & Navajo Populations
A.   Describe the importance of folk medicine practices and folk healers to African Americans in the rural setting. 
Some African Americans in the rural South may practice folk medicine based on spirituality. These forms of folk medicine include witchcraft, voodoo, and magic. Some African Americans who employ these forms of medicine also incorporate mainstream orthodox medicine in their lives. African American folk medicine traces its roots back to West Africa. When some of these Blacks were brought to the Americas as slaves, they also carried their culture and folk medicine into the Americas with them. Even after slavery, practices from folk medicine continued to be handed down from generation to generation. (Haddad & Giger, 2020)
In African American folk medicine, illness is perceived as either a natural or unnatural phenomenon. Certain disease processes that may be the result of environmental hazards, bacteria, viruses, lifestyle, or even genetics may be perceived as an unnatural illness. It may be viewed as punishment from God, or a spell cast by an evil person doing the work of the Devil. This may cause some African Americans to be in denial of their disease process and be reluctant to seek traditional medical treatment when ill. (Haddad & Giger, 2020)
In folk medicine, there are different types of practitioners. The first type is the “Old Lady” or “Granny” who acts as a local consultant providing her expertise in many different remedies made from certain spices, herbs, and roots that can be used to treat common illnesses. She may also make appropriate referrals to other practitioners when an illness or particular medical problem is beyond her scope of practice. Another type of practitioner is a spiritualist. A spiritualist combines rituals, spirituality, and herbal medicine to act as a cure for certain illnesses or ailments. The third type of folk practitioner is the voodoo priestess. She is usually a woman who inherits the title only by birthright and a perceived special gift. Individuals look to a priestess not only for medical advice but also for advice in their daily lives. Individuals from varying cultural and socio-economic backgrounds seek the advice of a priestess. Some leaders from powerful countries may consult these individuals before making decisions. (Haddad & Giger, 2020)
B.    Mrs. M., a Mexican American who just gave birth, tells the nurse not to include certain foods on her meal tray because her mother told her to avoid those foods while breastfeeding. The nurse tells her that she doesn’t have to avoid any foods and should eat whatever she desires. What concept does this demonstrate? 
The concept that this demonstrates is that of social organization. In the Mexican American culture, the family is the most valued institution and the main focus in their lives. Some Mexican Americans live in multifamily and multi-generational households. This allows the family to be supported both socially and economically. (Haddad & Giger, 2020)
In the case of the Mexican American woman who just gave birth, she values what her mother told her about avoiding certain foods while breastfeeding. The nurse has to respect her beliefs. She can also respectfully ask the patient why she feels that way. She can also ask the patient what the possible side effects of eating the foods presented to her can cause. She may recommend that the family bring food from home if it is not contraindicated with the patient’s diet. (Haddad & Giger, 2020)
C.    Describe at least two communication barriers encountered by non-Navajo nurses when providing care to Navajo clients. 
The two communication barriers encountered by non-Navajo nurses when providing care to clients include touch and the use of silence. Navajo individuals have certain taboos associated with touch in their culture. They are agreeable to a handshake in welcoming others. However, some Navajo cultures prohibit the touching of dead bodies or the bodily fluids of a dead person. Therefore, Navajo Indians may be reluctant to touch a dead body, a dying person or items associated with death. This can crossover into interventions that require an organ or tissue donation from a cadaver. This may cause them to decline from accepting those organs or tissues. (Haddad & Giger, 2020)
When meeting a person that is Navajo for the first time, they may seem a bit reserved. They may not use direct eye contact or point towards objects or individuals because it is perceived as disrespectful or intrusive behavior. Every form of touch, eye contact, and daily activity should be carried out with respect for self, objects, food, and nature. (Haddad & Giger, 2020)
When communicating with Navajo Indians, it is important that nurses teach their patients the importance of their health. An increased awareness of their disease process can help them make informed decisions about healthcare leading to better patient outcomes. Many of the decisions that a person that is Navajo may make is based on tradition or lack of knowledge. The Navajo language did not become an official written language until after World War 2. Therefore, a Navajo patient may need an interpreter to convey diagnosis, results, care plans, and follow-up visits. It is important that the nurse ensures that the patient understands the state of their health. (Lalla et al., 2020)
References
Haddad, L., & Giger, J. N. (2020). Transcultural nursing: Assessment and intervention (8th ed.). Elsevier.
Lalla, A., Salt, S., Schrier, E., Brown, C., Curley, C., Muskett, O., Begay, M.-G., Shirley, L., Clark, C., Singer, J., Shin, S., & Nelson, A. (2020). Qualitative evaluation of a community health representative program on patient experiences in navajo nation. BMC Health Services Research, 20(1). https://doi.org/10.1186/s12913-019-4839-xLinks to an external site.