From Flu Wiki 2

Forum: Cultural Considerations and Their Impact on Individuals and Communities

04 November 2006

FloridaGirlat 15:38

In many countries, the population consists of many nationalities; some are more diverse than others. Cultural and Ethnic considerations should be taken into account and respected. To my knowledge, Cultural Considerations has not really had a thread devoted to this topic, yet it is an issue that may have an impact on the course of a pandemic.

Culture is loosely defined as the totality of socially transmitted behavioral patterns, expression of arts, beliefs (voiced or not), values, customs, and thought characteristics of a population of people that guide their view of the world and decision-making in their lives. These patterns may be explicit or implicit, are primarily learned and transmitted within the family, are shared by most members of the culture, and are emergent phenomena that may change in response to global phenomena. Culture is largely unconscious and has powerful influences on health and illness.

Consider the health practices of people of different heritage… or their death and burial practices. Look at what we have learned just by translating news in the Indonesian Thread. They seek cures from the village healer. They do not always seek help from a hospital or physician. Some would rather take medicinal herbs before they would take “western medicine”. For their deceased loved ones, they wash the bodies, and bury as soon as possible. There is much touching of the dead, but they (for the most part) do not allow autopsies.

Some cultural aspects of individuals or groups are actually religious in nature. Many cultural aspects are traditions that have been passed down from generation to generation.

Cultural diversity is dependant on many things and tends to be individualized when you get down to the specifics. Factors that may contribute to this would be how and where they were raised, where they reside now, the length of time the person has been outside the influence of their native culture, the age of the person, their exposure to other cultures, etc.

Even though the individual(s) should be respected for their beliefs, sometimes it is difficult to understand the why’s and what’s of someone else’s culture when it may be vastly different from our own. Understanding a culture may also allow some insight into how we can integrate individual’s beliefs into any interventions that may be needed to mitigate the impact of a pandemic.

Your insight into the following cultural norms may prove to be beneficial in implementing those interventions.

FloridaGirlat 15:40

This model is used in health care, yet it has a truth inherent for all of us who interact with other people.

PURNELL MODEL

1. All cultures share core similarities.

2. One culture is not better than another culture; they are just different.

3. Cultures change slowly over time.

4. Differences exist within, between, and among cultures.

5. Culture has a powerful influence on one’s interpretation of and responses to health care.

6. To be effective, health care must reflect the unique understanding of the values, beliefs, attitudes, and worldview of diverse populations and individual acculturation patterns.

7. Learning culture is an ongoing process that develops in a variety of ways, primarily through cultural encounters.

8. Prejudices and biases can be minimized with cultural understanding.

9. Cultural awareness improves the caregiver’s self-awareness.

10. Each individual has the right to be respected for his or her uniqueness and cultural heritage.

11. Individuals and families belong to several cultural groups.

12. If clients are coparticipants in their care and have a choice in health-related goals, plans, and interventions, their compliance and health outcomes will be improved.

13. Differences in race and culture often require adaptations to standard interventions.

14. The primary and secondary characteristics of culture determine the extent to which one varies from his/her dominant culture.

15. Caregivers need both culture-general and culture-specific information in order to provide culturally sensitive and competent care.

16. Caregivers who can assess, plan, intervene, and evaluate in a culturally competent manner will improve their care of clients.

17. All health-care professions share the metaparadigm concepts of global society, family, person, and health.

18. All health-care professions need similar information about cultural diversity.

19. Professions, organizations, and associations have their own culture, which can be analyzed using a grand theory of culture.

anon_22 – at 15:41

Interesting! I’m waiting to read the rest of it.

FloridaGirlat 15:44

Since the Amish were recently in the news…. I will start with them.

The Amish

OVERVIEW AND HERITAGE

Today’s Amish live in rural areas in more than 20 states. They have settled in states westward from Pennsylvania, Ohio, and Indiana to as far west as Montana, with a few scattered settlements in Florida and the province of Ontario, Canada. But, more than half live in Pennsylvania, Ohio, and Indiana. The Old Order Amish, so-called for their strict observance of traditional ways that distinguish them from other, more progressive “plain folk,” are the largest and most notable group.

The Amish originated around 1693, when they parted ways with the Anabaptist movement that occured in Switzerland in 1525. After experiencing severe persecution and martyrdom in Europe, the Amish and related groups immigrated to North America in the 17th and 18th centuries. The Amish groups or settlements are sometimes named after their factional leaders (for example Egli and Beachy Amish); and some are called conservative Amish Mennonites; and other, New Order Amish. No Amish live in Europe today.

The Amish have transplanted and preserved a way of life that has the appearance of pre-industrial European peasantry. In the U. S., they have persisted in relative social isolation based on religious principles. Over time, the Amish have continued to adapt and change at their own pace, accepting innovations selectively. Although most Amish homes do not have electric and electronic labor-saving devices and appliances, that does not preclude their openness to using state-of-the-art medical technology necessary for health promotion.

COMMUNICATIONS

  • English is the language of school, of written and print communications, and of contact with most non-Amish outsiders.
  • At home and in the immediate Amish communities, Deitsch, or Pennsylvania German, is used.
  • School age and older Amish tend to be fluently bilingual. They readily understand spoken and written directions and answer questions presented in English, although their own terms for some symptoms and illnesses may not have exact equivalents in Deitsch and English.
  • The Amish (elders) have severely restricted their own access to print media, permitting only a few newspapers and periodicals. Most have also rejected electronic media such as radios, television, and entertainment and information applications of film and computers; Although some computers are used for business purposes.
  • The Amish are clearly not outwardly demonstrative or exuberant. Fondness and love of family members is held deeply but privately. Demut, humility, is a priority value, the effects of which may be observed in public as a modest and unassuming demeanor. Hochmut, pride or arrogance, is avoided because of frequent verbal warnings.
  • The expression of joy and suffering is not entirely subdued by dour or stoic silence.
  • The Amish present in an unpretentious, quiet manner, with modest outward dress in plain colors lacking any ornament, jewelry, or cosmetics.
  • They are unassertive and non-aggressive and avoid confrontational speech styles and public displays of emotion.
  • Amish self-perception is grounded in the present. In public, Amish avoid eye contact with non-Amish, but in one-on-one clinical contacts, clients can be expected to express openness and candor with unhesitating eye contact.
  • They are generally punctual and conscientious about being on time and keeping appointments.
  • Using first names with Amish people is appropriate because there is only a limited number of surnames. For example, it is preferable to use John or Mary during personal contacts rather than Mr. or Mrs. Miller. Within Amish communities, individuals are identified further by nicknames, residence, or a spouse’s given name.
  • Telephones (a few Amish businesses have them) and automobiles are generally owned by nearby non-Amish neighbors and used by Amish only when it is deemed essential, such as for reaching health-care facilities. Some Amish do drive, such as those who have occupations as firefighters or EMT’s.
FloridaGirlat 15:47

AMISH (continued)

FAMILY ROLES AND ORGANIZATION

  • Amish society is patriarchal, but women are accorded high status and respect. Practically speaking, husband and wife may share equally in decisions regarding the family farming business. In public, the wife may assume a retiring role, deferring to her husband, but in private they are typically partners.
  • The Amish family pattern is the three-generational family. This kinship network includes relatives consisting of the parental unit and households of married children and their offspring.
  • The highest priority for parents is childrearing, a charge given them by the church. Babies are welcomed as a gift from God.
  • Young people older than 16 years may experiment with non-Amish dress and behavior, but the expectation is that they will be baptized Amish before marriage. Unmarried children live in the parents’ home until marriage. Single adults are included in the social fabric of the community.
  • Families are the units that make up church districts. The size of church districts is measured by the number of families rather than by the number of church members.
  • Grandparents have respected status as elders; they provide valuable advice, material support, and services that include childcare to the younger generation. Family emotional and physical proximity to older adults facilitates elder care.

BIOCULTURAL ECOLOGY

The Amish are essentially a closed population, with exogamy occurring very rarely. Most are of German and Swiss descent; therefore, their physical characteristics differ, with skin variations ranging from light to olive tones. Hair and eye colors vary accordingly.

NUTRITION

  • Most Amish families grow their own produce. Typical meals include meat; potatoes or noodles or both; a cooked vegetable; bread; something pickled, such as red beets; cake or pudding; and coffee.
  • At mealtimes, all members of the household are expected to be present unless they are working away from home.
  • In general, snacks and meals tend to be high in fat and carbohydrates. Common snacks are large, home-baked cookies about 3 inches in diameter, ice cream, pretzels, and popcorn.
FloridaGirlat 15:53

AMISH (Continued)

PREGNANCY AND CHILDBEARING PRACTICES

  • Children are considered gifts from God. The average number of live births per family is seven. Birth control is viewed as interfering with God’s will and the Amish tend to avoid it. Nevertheless, some Amish women do use intrauterine devices, but this practice is uncommon.
  • Most Amish women prefer home births and choose to use Amish or non-Amish lay midwives who promote childbearing as a natural part of the life cycle. The Amish have no major taboos or requirements for birthing. Men may be present, and most husbands choose to be involved; however, they are likely not to be demonstrative in showing affection verbally or physically.
  • The laboring woman cooperates quietly, seldom audibly expressing discomfort. Women sometimes use herbal remedies to promote labor.
  • The postpartum mother resumes her family role managing, if not doing, all the housework, cooking, and child care within a few days after childbirth. Grandmothers often come to stay with the new family for several days to help with care of the infant and give support to the new mother. Older siblings are expected to help care for the younger children and to learn how to care for the newborn.
  • When hospitalized, the family may want the patient to spend the least allowable time in the hospital.

DEATH RITUALS

  • Families are expected to care for the aging and the ill in the home. However, when hospitalization is required, the Amish will wish to remain with the family member. A wake-like “sitting up” through the night is expected for the seriously ill and dying.
  • The funeral ceremony is simple and unadorned, with a plain wooden coffin. Although grief and loss are keenly felt, verbal expression may seem muted as if to indicate stoic acceptance of suffering.

SPIRITUALITY

  • Amish settlements are subdivided into church districts similar to rural parishes, with 30 to 50 families in each district. Local leaders are chosen from their own religious community and are generally untrained and unpaid. No regional or national church hierarchy exists to govern internal church affairs. To maintain harmony within a group, individuals often forgo their own wishes. In addition to Sunday services, silent prayer is always observed at the beginning of a meal, and in many families, a prayer also ends the meal.
  • When choosing among health-care options, families usually seek counsel from religious leaders, friends, and extended family, but the final decision resides with the immediate family.

HEALTH-CARE PRACTICES

  • The body is considered to be the temple of God, and human beings are stewards of their bodies. Medicine and health care should always be used with the understanding that it is God who heals. Nothing in the Amish understanding of the Bible forbids them from using preventive or curative medical services. They are highly involved in the practices of health promotion and illness prevention. Men are involved in major health-care decisions and often accompany the family to the chiropractor, physician, or hospital.
  • Health-care decision-making is influenced by three factors: (1) type of health problem, (2) accessibility of health-care services, and (3) perceived cost of the service. Grandparents are frequently consulted about treatment options.
  • Many Amish do not carry health insurance. Some have formalized mutual aid, such as the Amish Aid Society. Some communities assist families with medical expenses.
  • Those providing care should be aware that some individuals may withhold important medical information from medical professionals by neglecting to mention folk and alternative care being pursued at the same time.
  • When the Amish use professional health-care services, they want to be partners in their health care and want to retain their right to choose from all culturally sanctioned health-care options.
  • Care is expressed in culturally encoded expectations, which the Amish best describe in their dialect as abwaarde, meaning “to minister to someone by being present and serving when someone is sick in bed.”
  • Some accept medical advice regarding the need for high-technology treatments such as transplants or other high-cost interventions.
  • The client’s family seeks prayers and advice from the bishop and deacons of the church, the extended family, and friends, but the decision is generally a personal family choice. Family members may also seek care from Amish healers and other alternative care practitioners, who may suggest nutritional supplements.
  • Herbal remedies include those handed down by successive generations of mothers and daughters.
  • Health-care knowledge is passed from one generation to the next through women.
  • When providers of care must inquire about the full range of remedies being used, they need to develop a context of mutual trust and respect in order for the Amish client to be candid.
  • When catastrophic illness occurs, the Amish community responds by being present, helping with chores and relieving family members so they can be with the afflicted person in the acute care hospital.
  • The Amish are unlikely to display pain and physical discomfort. The health-care provider may need to remind Amish clients that medication is available for pain relief if they choose to accept it.
  • There are no cultural or religious rules or taboos prohibiting blood transfusions or organ transplantation and donation. Some may opt for organ transplantation after the family seeks advice from church officials, extended family, and friends, but the patient or immediate family generally makes the final decision.
  • Children with mental or physical differences are sometimes referred to as “hard learners” and are expected to go to school and be incorporated into the classes with assistance from other student “scholars” and parents. The mentally ill are generally cared for at home whenever possible.
FloridaGirlat 15:56

AMISH (Continued)

HEALTH-CARE PRACTITIONERS

  • Amish hold all health-care providers in high regard. Health is integral to their religious beliefs, and care is central to their worldview. They tend to place trust in people of authority when they fit Amish values and beliefs.
  • Amish usually refer to their own healers by name rather than by title, although some say brauch-doktor or braucher. In some communities, both men and women provide these services. Amish folk healers use a combination of treatment modalities, including physical manipulation, massage, brauche, herbs and teas, and reflexology. Most prefer professionals who discuss health-care options, giving consideration to cost, need for transportation, family influences, and scientific information.
  • Because Amish are not sophisticated in their knowledge of physiology and scientific health care, health-care professionals should bear in mind that the Amish respect authority and that they may unquestioningly follow orders.
  • Make sure that clients understand instructions and reasons why interventions are offered.
  • Because community is a big part of the Amish lifestyle, interventions that may impact the health of the community should be carefully explained to the elders of the community as well as individuals and families.
FloridaGirlat 16:01

PLEASE NOTE:

I should have added at the beginning, I will try to go thru the “list” alphabetically… If you think I have missed a culture that should be discussed, please let me know.

Also, While I did reference the internet and a book that I have, the observations listed may not reflect exactly your perception (or practice) of that culture. Please feel free to discuss what I’ve written and any differences you may find. This will help bring a better understanding to each culture.

FloridaGirlat 16:13

My observations:

I believe the Amish will fare well if the power, and communications fail since they have cultivated a way of life that would be impacted in a minimal way.

They have food and the necessities of living as well as the knowledge necessary to maintain the “supply”.

They have the support of the community, so that even families that are ill may have care.

They have knowledge of folk remedies that may or may not have any effect on the course of influenza, although for symptom relief they probably will do better than most of us if there is a general lack of medication.

They also have no real aversion to modern medications and vaccines and / or hospitalizations if it is deemed necessary and is available.

One concern would be that someone, whom the Amish elders respect, should speak to them about the use of antivirals and vaccines. They could then be better able to set up distribution points for the delivery and administration to the community.

janetn – at 16:20

I live in a community with many Amish and Mennonites. Heres a few of my observations. They are not anti medicine. Patients Ive treated were hooked up to all the bells and whistles. They have remarkedly low instances of CAD and low LDL levels despite diets high in fats????? They are remarkedly complient with drs orders. They have a great respect for the medicial community.

They tend to distrust government, God is the final authority. So for instance I dont know if they would suspend church meetings during a pandemic. Each church is different its going to depend on the particular leadership in each church They are completely autonmous. Reaching them with news is going to require local officials personally contacting the leaders. They really dont know much about currant events. Life for them is in the church community they live in. The children attend private church schools. or are home schooled. Lastly they are pacifists, this may doom them during a pandemic

FloridaGirlat 16:27

“effect” should be “affect” (sorry)

One thing to consider…. The Amish live mostly in the north. But wherever their communities are, they may be inudated with people looking to get out of the cities. This will have an unknown impact, as the Amish are generally believed to help other people in times of need.

The Amish rely on authorities for law enforcement. They do have their “rule-breakers”, but generally crime is pretty low. They may not have the means to “control” a number of people into their communities. Nor do most communities have the capibility to handel large crowds of people, except for communities who also function as a tourist destination. Even there, the Amish manage to keep their private lives private.

This aspect may prove to be an issue for them.

FloridaGirlat 19:58

janetn – at 16:20

You wrote: Lastly they are pacifists, this may doom them during a pandemic.

Your word “pacifist” is the most apt use of the word for this group of people. Their belief in GOD, and their belief that GOD is in control of destiny, and has the power of vengence is one of the guiding princples of their lives. The Amish have a saying…. “Gottes Wille” (or “God’s Will.”).

Because of their beliefs, a severe pandemic which causes migration(s) of people from the cities in search of a safe haven, may very well cause a further disruption in the lives of these people.

05 November 2006

LMWatBullRunat 14:33

I value my Mennonite, Quaker and Amish friends and neighbors.

They do have objection to the use of any force. “they that take up the sword shall perish by the sword. Vengeance is mine I shall repay, saith the Lord.” I draw the line at initiation of force only, and I take particular exception to thugs taking advantage of the gentler people around.

Florida Girl- My culture is that of the Highland Scots-Irish immigrant to the United States. I would be interested in your assessment of that particular culture, if you have one.

janetn – at 15:09

LM My thoughts exactly. My neighbors are Mennonite they are wonderful people.

Influentia2 – at 15:28

Florida Girl 16:01

How soon will it be before you post something similar for the American Indian culture? Is there a link you have you could post that I could look at?

Thanks

janetn – at 15:50

They education of Amish/Mennonites re AF and the possibility of a pandemic is probably the first thing that officials should be doing. They are definatly not in the loop as of today. There coperation and assistance during a pandemic would be valuable. they are masters of helping their neighbor, including “the English”. Hmmm think Im going to have to have some coffee with my neighbor, see what access I can gain to educate them, Im sure they will be much less frustrating to deal with than my public officials.

Bronco Bill – at 15:57

Florida Girl --- Is there a way to shorten the descriptions of what your attempting to do here (or simply link to your sources)? That way, we don’t have a bazillion threads opened about various cultures.

Please don’t think that I’m looking down on this or have any problem with what you’re doing here. I’m only thinking about the number of threads that could possibly come to fruition… :-)

FloridaGirlat 16:14

Bronco Bill – at 15:57

I don’t really have any sources per se. But how about this… How about, I figure out how to create a wiki page with the information and then link to that? Then we can use the thread for discussion. (Any help on learning would be appreciated.)

Would that work?

crfullmoon – at 16:18

(Influentia2, any particular nation/part of the planet you had in mind?)

FloridaGirlat 16:23

LMWatBullRun – at 14:33

Influentia2 – at 15:28

I was going to try to do this alphabetically. But, I do not mind going out of order…. Someone will just have to keep me straight.

I will work on those now…

Bronco Bill – at 17:37

FloridaGirl – at 16:14 --- That would be perfect. Once you have the Wiki pages set up (you can create one then use it as a template for the others), I’ll also link to them from the Forum Index.

Influentia2 – at 18:10

crfullmoon 16:18

I went ahead and googled and found a Health News link and found some information about HHS Leavitt and a meeting in May 2006 so far. If you have some links on Lakota Sioux or Cherokee that would interest me too. Reading the beginning of this thread made me wonder how much information the American Indian has regarding pandemic flu and/or prepping. Just curious.

Thank you

FloridaGirlat 18:55

Bronco Bill – at 17:37

You can use them as a template? I have finished the Main Cultural Considerations page if you want to link that page.

At the bottom, I started a list for the different cultures. AMISH is started, but not finished. Looking up info for Infuentia2 and LMWatBullRun.

Influentia2 – at 18:10

Well, I had started a few weeks ago and did research on a number of cultures, but I did not have specifically Lakota Sioux or Cherokee, although Cherokee was on my to do list. I have started doing some research, but it generally takes a few hours to put it together. Promise though… I will work on it tonight (tomorrow also, if necessary)

LMWatBullRun – at 14:33

I have already started working on your culture: Highland Scots-Irish

You should Note: I did my culture also. I was quite shocked about some of what I found. Being an American, takes you away from cultural influences (Thank Goodness)… Even though you may have very few or no generations born in America (or other country) The differences are great. Ever see “My Big, Fat, Greek Wedding”?

Influentia2 – at 19:09

Florida Girl

Appreciate whatever you can provide. A link will do if space is an issue. I am going to do some research myself after I finish my Indonesian links searching out news there.

Thanks

crfullmoon – at 19:55

http://www.mnisose.org/profiles/oglala.htm

nativetimes.com article about life on Pine Ridge

http://en.wikipedia.org/wiki/Pine_Ridge_Indian_Reservation

:-/

http://www.indiancountry.com/content.cfm?id=1096413661 September 15, 2006 “Preparing for the real terror; Flu pandemic remains a threat “ …”The outbreak revived world concern and vindicated the U.S. government’s decision to allot $250 million for state, tribal and local preparedness.

It’s to the credit of the U.S. Health and Human Services Department that it has included tribal officials in its training and to the credit of those tribes that have stepped up. American Indians and Alaska Natives are on the front line. Subsistence hunters in Alaska are providing first warning of the appearance of avian flu in the migratory flyways from Asia. They have helped provide 13,000 carcasses from 26 species for testing by the Interior and Agriculture departments, in a program now being expanded to include the lower 48 states. (So far none have shown the highly pathogenic form of H5N1, although a mild strain has turned up in Michigan swans and Maryland and Pennsylvania mallards.)

Emergency planning officers in tribes from the St. Regis Mohawk in upstate New York to the Lakota nations in the northern Plains to the Navajo in the Southwest have been preparing to cope with an outbreak. They face the added factor of rural isolation and realize they might have to rely on their own resources for much of the response. Other tribes in more densely populated regions are coordinating planning closely with state and local governments.

Casino-owning tribes could find themselves at the nodes of an epidemic, especially those with heavy international traffic. They could also bear the economic brunt of a quarantine.

By leading in the preparedness planning, tribal governments are not only tending to their own safety and the safety of their members, but vindicating their claims to sovereignty and self-determination as well. Performance is the best proof for self-government. In the American system of federalism, the governments that show they can do the job tend to gain a more respectful hearing for their claims to authority. This isn’t invariably true, of course, but states’ rights began to gain more favor in federal courts in the 1970s when state governments could show their programs were more innovative and effective than their federal counterparts. The more tribes lead in providing services like pandemic preparedness, the more respect they will command.

The St. Regis Mohawk Tribe, for instance, deserves commendation for its efforts to share its expertise with other tribes. Although its first attempt to host a conference on pandemic planning did not attract sufficient interest, it intends to try again in October or November when other tribes should be more focused on the threat.

Indian country, more than most other peoples of the world, should be sensitive to the impact of disease”…

Influentia2 – at 22:02

crfullmoon 19:55

Thanks for the links.

Bronco Bill – at 22:16

FloridaGirl – at 18:55 --- Your main Cultural Considerations page is now linked in the Forum Index here

FloridaGirlat 22:18

LMWatBullRun,

Because the highland scot-irish culture is part of the Appalachian heritage. I combined them under the broader title, or I would end up duplicating information.

Link to Appalachian Heritage page.
http://tinyurl.com/y3g5ad

Link to the Main Culture Page
http://tinyurl.com/tu4tk

I will be back with my observations after I think about it for a while.

FloridaGirlat 22:22

Bronco Bill – at 22:16

Thank you kind Sir…

Bronco Bill – at 22:27

Y’welcome. Let me know when you add more “culture” to the page :-). wturner3 at gmail dot com. I’ll add those as I did with the Amish link…

FloridaGirlat 23:21

Bronco Bill – at 22:27

Thank you much… I have a request though. Could you change the link for “Cultural COnsideration and their impact on individuals and Communities” at the top of that page to just take you directly to the link instead of further down the page. I will add to the top of the “Culture Main Page” Something like: “Specific culture Links at Bottom”

That way, the Culture page will be read first.

OR Change the wording on the first (top) link to…. “Overcoming barriers; Understanding Culture”

OR Change the wording on the first (top) link to…. “Considering Culture for Interventions”

Someone help me here…. My brain is dead!

FloridaGirlat 23:51

My Thoughts on…

Appalachian Heritage

Communicating the risks:

“Because of past experiences with large mining and timber companies, many dislike authority figures and institutions that attempt to control behavior. It may be helpful to “sit a spell” and “chat” before getting down to the business of collecting health information. To establish trust, it is necessary to demonstrate an interest in the client’s family and other personal matters, drop hints instead of giving orders, and solicit clients’ opinions and advice.”

  • Under communication the “sit a spell” and “chat” might be better served as an informal community function that is not too large, but would still meet the need of reaching more people. An invited guest, of someone who is respected within the community should speak about preparing. (The person should be comfortable doing presentations). Written stuff is OK, but they will get more from a talk, or PowerPoint.
  • Smoking should also be addressed.
  • This group of people are very receptive to factual information. Tell the truth, the facts as they are…. Then offer up ways of protecting themselves, their families and their community. They will understand.
  • Funerals may be an issue. Explain before a pandemic about modes of infection. Their funerals last up to 3 hours. The body is displayed for hours…. All will view the body. After the funeral services, fancy meals are served…. Everyone attends.
  • Churches serve as the social centers in the community. Alternative method of community support should be discussed.
  • Health Care practices include traditional and non-traditional folk and home remedies. Some of these practices are known to be risky, at best. Compromises need to be discussed.
  • The Appalachian people tend to wait until they are extremely ill before seeking medical care. Once they do seek medical care, They tend to have high expectations and they give themselves up to the physician’s decisions.
  • Trust will need to be developed with families before a pandemic. They will be non-compliant if a health care worker tries to rush them.

06 November 2006

Bronco Bill – at 08:31

FloridaGirl – at 23:21 --- Let me see what I can do.

Bronco Bill – at 15:53

FloridaGirl – at 23:21 --- Slight change in the links set-up on the Forum Index: I’ve left the name to reflect what your title here says. Click on the title towards the top of the page under “Personal Prepping” (that may change if/when I find a better heading to put it under); that will take you down the Forum Index page to the link to this thread, a Forum thread.
I’ve also included a link immediately below that link that will take you to the Wiki Page you created.

Also, I’ve added your Wiki page to the Wiki Index under “C” for Cultural. Hope this helps…let me know…

Bronco Bill – at 16:04

Now let’s do it and include the proper links!!
These are links to the Forum pages:

  1. The Forum Index
  2. Cultural Considerations

And these are links to the Wiki pages:

  1. Wiki Index
  2. Cultural Considerations
Grace RN – at 16:11

Should have a language barrier, dealing with visually/hearing impaired link……

Bronco Bill – at 16:18

Grace RN --- No threads or Wiki pages available to link to… :-(

FloridaGirlat 19:12

Bronco Bill – at 16:04

Thank You! You are so very helpful!

Grace RN – at 16:11

That is a great Idea. Maybe we should build an entry page called
“Barriers” i.e.

  • in educating the public;
  • in risk communication;
  • in indivual and Family preparation;
  • in business preparation, etc.

Do you want to start pages on Language barriers, visual/hearing impaired; Maybe a special needs page?

07 November 2006

Bronco Bill – at 12:37

FloridaGirl – at 19:12 --- It’s what I do. ;-)

Bronco Bill – at 12:38

FloridaGirl – at 19:12 --- Glad to help. It’s what I do. ;-)

08 November 2006

FloridaGirlat 20:17

Influentia2

I haven’t forgotten you… I have found LOTS of great info on Cherokee’s (Problem is… most of what I am finding are great stories, and historical culture. (And Of course I am reading them… ). That goes into the historical view…. But there isn’t any consistency in some of the certain areas I am trying to provide information on. I am researching the Journals now…

I have to take a short break until this weekend… School and scholarship stuff….

I will try to find you a story I read that was used to teach children about character.

FloridaGirlat 21:47

I find there is truth in these stories….

Cherokee Wisdom\\

One evening an old Cherokee told his grandson about a battle that goes on inside people. “My son, the battle is between two wolves,” the old Cherokee said. “One wolf is evil. It is anger, envy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies, false pride, superiority, and ego. The other wolf is good. It is joy, peace, love, hope, serenity, humility, kindness, benevolence, empathy, generosity, truth, compassion, and faith.” “This is a battle that rages inside of each of us… this battle of the wolves….”

The grandson thought about it for a minute and then asked his grandfather, “Which wolf wins?”

The old Cherokee simply replied, “The one you feed.”

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