“It is important to have culture as part of nursing and midwifery training to equip nurses and midwives with the skills to be able to offer nursing care that is culturally competent, gender-sensitive, and holistic. We do this so that they can interact with patients from any cultural background," says Horatius Musembi, the supervising instructor who curated the Health and Culture week at the Aga Khan University School of Nursing and Midwifery (AKU-SONAM) in Kenya.
On January 10, 2022, students from the Bachelor of Science in Midwifery and Nursing (BScM and BScN) at AKU-SONAM prepared a potluck for fellow students, faculty and staff. It was put together as part of the Health and Culture week* celebrated by students annually to recognize the different tribes and cultures that exemplify Kenya. Health and Culture is also a course offered at SONAM to enable students to understand the cultural landscape that they operate in. Typically, it involves a semester-long course as well as field visits to the Bomas of Kenya, which is a living museum where the colorful tribes of Kenya are showcased and celebrated. The students had already accomplished this visit in November 2021, before the potluck. The field visit is then followed up by an activity that allows the students to fit into the shoes of cultural groups that are different from their own.
According to Mr Musembi, the potluck was key to appreciating the nuances inherent in each community, especially about food. He shared: “We wanted the students to find out how the meals that different communities partake in affect people's health. Which meals do some communities take that are nutritious but are not consumed by other communities? How do cultural differences affect the provision of care? These are some of the things we wanted them to learn because food is a pre-disposing factor in illnesses such as diabetes, hypertension, renal diseases, and many others."
Mr Musembi recalled a story one of his midwifery students told him that influenced his thoughts on culture: “One of my midwifery students, a man, told me how in some Cushitic communities, women expect to be managed only by another woman during childbirth, yet he was the only midwife available. He had to talk to the patient and her family until they appreciated that they were better off with him providing care rather than having them go without care. Ultimately, he handled the delivery, and it is those little details that show us why cultural sensitivity matters in healthcare."
Several students admitted that the last time they were in a cultural environment similar to Bomas of Kenya was when they were much younger, during their primary school days. However, impactful learning, particularly at SONAM, welcomes a holistic approach that may extract nurses and midwives from their clinical settings, and into real-world settings.
Keziah Njeru from the Midwifery program appreciated the relevance of these practical lessons as part of the curriculum. Ms Njeru represented the Maasai and Pokot communities during the potluck and shared that she had learned a lot about the two cultures: “In the Maasai culture, they have what is popularly known as Dawa ya Maasai which is a traditional concoction made up of blood and herbs. They believed it could cure almost all illnesses, including infertility. It is good for communities to believe that if they are unwell, there is a cure. However, scientifically, you cannot tell what the herbs consist of and in which quantities they were consumed. Therefore, if a patient is brought to me having already consumed the traditional herbs, I wouldn't be sure if any other drug that I administer will have a negative or positive reaction on the patient," noted Keziah. She went on to say that “I believe that cultural awareness, especially regarding alternative or complimentary medicine, is important. Modern medicine should seek to understand, respect, and see how best to incorporate its practices into the community without overlooking their beliefs and the benefits they bring."
* AKU-SONAM hosts a Health and Culture week annually to promote the celebration of cultural diversity with a specific focus on health.