Western Mindanao State University

COLLEGE OF NURSING
Zamboanga City

LITERATURE REVIEW: ETHNONURSING ON WESTERN

OR NON-WESTERN CULTURE
FINAL TERM: WRITTEN OUTPUT

Submitted to
Mary Dianne S. Mendoza, RN, USRN, MAN
Adviser

In Partial Fulfillment
of the requirements
in
DECENT WORK EMPLOYMENT AND
TRANSCULTURAL NURSING NCM 120
A literature review on Alaskan Native Culture
By:
Roiya N. Alam
Isabelle Celeste A. Flores
Janna S. Kadah
Shuaiba Alyanna T. Najal
Geferson A. Omamalin
Rizzelle Kyla T. Tumacas
BSN-4D
 ALASKAN NATIVE CULTURE

Cultural competence is a buzzword in the news, journals, and education. But how does a nurse
develop cultural competency? Culturally competent care includes knowledge, attitudes, and skills
that support caring for people from various languages and cultures. Culture influences not only
health practices, but also how the healthcare provider and the patient perceive illness. Knowledge
is being cognizant of the culture base of those in your service area, such as the shared traditions
and values of that group. Being aware of your patients' ethnicity common genetic elements shared
by people of the same ancestry is also important. It is critical to address attitudes in order to
become a culturally competent caregiver. Understanding how culture influences individual
behavior and thought allows you to provide the best care for your patients. Understanding the rules
of interactions within a specific cultural group, such as communication patterns and customs,
family unit division of roles, and spirituality, will help you better understand your patients'
attitudes. A set of skills that improves cultural competency Learn how to communicate in ways
that will help your patient understand the plan of care. (Murphy, 2018)

The natives of Alaska have healing practices that date back more than 10,000 years, and today
those practices are beginning to reappear. Historical events have dampened these practices due to
weakening trust in their effectiveness and fear associated with missionary doctrines. However,
there is now a resurgence in the use of traditional healing methods. Programs have been developed
in which these methods are used by Western-trained tribal physicians and allergists to incorporate
Alaskan indigenous beliefs and values to promote health, prevent disease, relieve pain, and
improve emotional well-being. A blend of elements of Alaska Native cultural practices and Native
American tribal practices used by tribal physicians and traditional healers. There is great diversity
among Alaska's various indigenous cultures in regards to beliefs and practices (Brave, 2016)

This review’s purpose is to to provide information to increase the awareness of specific cultural,
racial, ethnic, and tribal influences on health and health care of Alaska Natives. This review
revolves in four themes; Ethnocare Expressions and Practices on Marriage; Ethnocare Expressions
and Practices on Pregnancy to Childbirth; Ethnocare Expressions and Practices on Care of Dying
and Death; and Major Cultural Values, Beliefs and Practices on Health and Illness. The
arrangement of the information discussed is subject-based, this study conducted a subject-specific
literature review. Expressions and practices of basic cultural values, beliefs and behaviors related
national care for marriage from pregnancy to labor, care for death and death, and health and disease
were among the new research themes.

B1. Ethnocare Expressions and Practices on Marriage;

Marriage in Native American Communities
Marriage and relationship education are viewed by many today as an important tool for
maintaining strong families, providing a stable environment for children, and promoting thriving
communities. Healthy marriages are associated with better child social, emotional, and academic
outcomes, reduced rates of substance abuse among parents and teens, and higher earnings among
fathers. In the Native American community, marriage education is often called Family
Preservation education, since the Native American community views marriage in the larger context
of family and community. When it comes to providing relationship education skills for married
couples and youth, most Family Preservation programs use existing marriage education curricula
and face the challenge of modifying curricula lessons, anecdotes, and exercises to be culturally
relevant for their Native American clients. Few relationship skills curricula have been developed
specifically for a Native American population. This next section describes the concepts of marriage
and family in Native American communities and offers examples of how Family Preservation
program providers are delivering programming that is culturally relevant. This section also
addresses the unique issues faced by Native American youth and strategies for delivering
youthfocused relationship skill-building services. According to the 2007 American Community
Survey published by the U.S. Census Bureau,8 approximately 39 percent of the American
Indian/Alaska Native population is married. The same percentage has never been married, and
approximately 13 percent are divorced. NativeAmericans have a higher divorce rate than Whites,
African Americans, and Hispanics. In 2005, about 63 percent of births to American Indian or
Alaskan Native women occurred outside ofmarriage, compared to 25 percent for White women,
48 percent for Hispanic women, and 70 percent for African American women.9 In addition,
intermarriage is commonplace among Native Americans, with about 56 percent of their marriages
involving individuals from other racial or ethnic groups10.
In general, traditional Native American culture does not place barriers between married couples
and their extended family or others in the community. The Native American system of care defines
a range of key people that are involved in a couple’s marital life. They can include
friends, teachers, grandparents, elders, siblings, traditional healers, and professional providers.
Practitioners working with a Native American couple should be aware of who in the pair’s life
comprises this extended system of care, what type of influence they have in the couple’s life, and
ways in which they may need to be incorporated into the program. For instance, programs may
want to encourage the participation of extended family members in class sessions.
B2. Ethnocare Expressions and Practices on Pregnancy and Childbirth:
The Belief of the American Natives on Pregnancy and Childbirth
In the 17th century, several anthropologists described the preparation of a woman's childbirth
between Mohawk and Mohican Indians in what is now New York. Women say they go alone to
streams and remote areas near streams, prepare shelters with mats and blankets, make the necessary
preparations, and wait for delivery without an attendant or someone's help. It has been evacuated.
They rarely get sick after birth and do not feel uncomfortable. (Donch, 2018) There are many
similar explanations for painless single births among Native American observers in Europe,
because most of these observers were male and males were rarely present at birth. , These
explanations are probably inaccurate. Although each indigenous culture has its own beliefs and
rituals regarding childbirth, scholars believe that many firstborns share certain practices, including
close family participation and the choices of others in the community. increase.
During Native American pregnancy, women were very limited in intense activity and paid special
attention to their diet and behavior to keep their babies safe. For example, the Cherokee (North
American Indians) believed that certain foods could harm the foetation. Pregnant women avoided
foods that they believed would harm their babies or cause unwanted physical characteristics. For
example, they believed that eating raccoons and pheasants could cause babies to get sick or die.
Eating spotted trout may cause bruising. Eating black walnuts may give your baby a big nose.
They believed that wearing a kerchief during pregnancy would strangle the umbilical cord and
staying at the door would slow down labor. Pregnant mothers and fathers participated in rituals to
ensure safe childbirth. For example, I washed my hands and feet every day and hired a shaman to
perform rituals to promote childbirth.
19th-century anthropologists said women and their families followed various rituals as childbirth
approached to ensure easy and healthy childbirth. They recorded the Cherokee ritual in and were
able to scare the child from the womb. A relative of the mother's woman would say: You are a
little man, get up now. An old woman comes here. The terrible [old] is coming a little further.
listen! fast! Get a bed and run away. Ju! Then the female relatives repeated the formula, replacing
"little woman" with "your grandfather" if the baby was a girl. There was also a brew made from
the root bark that her mother drank just before the onset of labor. Many indigenous people used
similar treatments. A Cherokee woman drank an injection of wild cherry bark to speed up her
delivery. (Mooney, 2016)
Despite many explanations for a single childbirth, other reports describe childbirth with a midwife
and other relatives. Men were rarely allowed to enter the maternity room, and they were never
allowed to see the birth. An American woman in labor stood, knelt, and sat, but did not lie down
and give birth. Usually no one cares about catching a baby that has fallen on a leaf under her
mother. In the postnatal ritual, the mother ritually threw her child into the river and repeated it
daily for two years. Therefore, the ritual "has made the children so strong that they will not rattle
or deform." (Mooney, 2016)
European descriptions of Native American women`s quick recovery from childbirth may have
been exaggerated. But generally, Indian women`s excellent physical conditioning certainly aided
in their recovery from childbirth. Barring any serious complications – which, of course, did
happen occasionally – Native American women returned to their regular duties in a very short
period of time.
B3. Ethnocare Expressions and Practices on care of Dying and Death:
The Death Customs of American Native
The Census Bureau predicted that Native American / Alaska would have a life expectancy of 78.4
years, 81.1 years for women, and 75.8 years for men. They face problems such as cultural barriers,
geographical isolation and low incomes that prevent access to quality medical care. Some of the
major pathological conditions are heart disease, cancer, unintended injuries, diabetes, and stroke.
It is also common in teenage pregnancy, substance use, mental health, and suicide.
Native American / Alaskan people have a great variety of beliefs and practices. Each tribe has its
own traditions, all of which observe proper behavior in sacred rituals that can be inferred from the
worldview (FuneralWise, N.D.). Your concept of health includes the concept of holism. Part of
their belief is that illness means an imbalance with nature. As people who are intimate with nature,
their habits are mostly eco-friendly because they believe that nature is sacred. There are similarities
between Native American habits and the nursing profession, such as achieving health and healing
when the mind, body and spirit work together for better results. This commonality leads to end-
of-life holistic and culturally acceptable care.
The dying process of each culture is different and nursing care during this time is essential and
must be tailored to meet the needs of the patient. Native Americans/Alaska Natives seek advice
from traditional healers/healers during illness, especially late in life. This practice can be
incorporated into patient care as it does not necessarily negatively affect patient care, so
consultations with traditional Native American healers are appreciated and therefore should be
continued.
As for funeral customs, most are natural or continental. According to Fu TangGuide (2016), some
tribes bury the dead with personal items believing that it will help them in the afterlife, while others
have the custom of leaving the coffin slightly open for spiritual purposes. the soul escape or let the
body decompose naturally on the tree. or on a burial platform. Burial of the dead with personal
items can be maintained as it has no negative impact on the dead person or the community, while
leaving the coffin open or leaving the corpse to decay on a tree can be satisfied.
agreement/settlement by placing the cadaver away from the population.

B4. Major Cultural Values, Beliefs and Practices on Health and Illness:
Then and Now of the American Native/Alaska Native

With more than 500 Native American tribal communities present in today’s time, we can say that
each of them have their own similarities and differences when it comes to cultural values, beliefs
and practices on health and illness. Just like the other practices that we know of, here in our
homeland – the Philippines – such as the use of herbs, prayers, etc., the American Native have
their own beliefs to these as well. Before we dive in to these cultures and practices, let us first
discuss the history of the American Native/Alaska Native to further understand how they
developed and became the people that they are today.
In an article entitled “Yup’ik Culture and Context in Southwest Alaska: Community Member
Perspectives of Tradition, Social Change, and Prevention” which was written by Paula Ayunerak
along with her team, it is gave us an overview to the cultures and traditions of the natives before.
The co-authors share their culture and community from personal experience and ancestral wisdom
garnered by learning and living the Yuuyaraq or Yup'ik way of life. Yup’ik, also known as Yupiit
or Western Eskimo, are indigenous Arctic people who have traditionally lived in Siberia, the
Bering Sea, and the Bering Strait, as well as Alaska. They are culturally linked to Canada's Chukchi
and Greenland's Inuit, or Eastern Eskimo. The Yup’ik's traditional economic activity was the
hunting of sea mammals, particularly seals, walrus, and whales until the latter half of the nineteenth
century. In addition, the Yupik traded with local reindeer farmers and others. Harpooning from the
shore or from boats, spearing animals in land drives, and, subsequently, the use of weapons were
all used in hunting. Auxiliary activities included hunting fur-bearing animals, fishing, and
gathering plant food. Coastal mobility was provided by kayaks (closed skin boats for one person),
baidarkas (open, flat-bottomed boats), and whaleboats; on land, dog teams and sleds were utilized.
In connection with their hunting as their way of living for their survival, the Yup’ik community
also has their belief in their creator named ‘Ellam Yua’ to whom they offer their prayers before
and after they hunt to show appreciation and thanks to their said creator.
As time pass by, hunting from place to place for survival is no longer evident in the American
Native tribe since some chose to stay in one place to build their own community and people learned
how to fish and farm using technologies and as well as study the surroundings around them. During
these times, herbalists, spiritual healers, and medicine men or medicine women have been part of
their tradition already – and is still evident up until now. Many American Indians and Native
Americans Native Alaskans go to their healers for spiritual reasons, such as seeking direction.
Truth, balance, reassurance, and spiritual well-being are all important components of spiritual
well-being. They might still utilize it. Conventional medication to treat "white man's sickness," but
there is a catch; the concept that healing is inextricably linked to the spirit. Herbs are one of the
most well-known kinds of Native American healing due to some Native American tribes' great
knowledge of them. Teas, tinctures, and salves are all examples of herbal therapies. The bark of a
willow tree, which contains acetylsalicylic acid – commonly known as aspirin – is a well-known
pain reliever. In various Native American healing ceremonies, purification and cleaning of the
body are also significant. Sweat lodges are unique, gloomy chambers heated by firestones. The
healer may also employ special teas to induce vomiting for this purpose. Smudging is a ritual in
which sacred plant smoke is used to cleanse a space or a person. These techniques can be used to
achieve a different mental state and increased awareness. They are carried out in order to make a
person more receptive to restorative procedures. Symbolic healing ceremonies are another form of
Native American healing that can encompass entire villages. Chanting, singing, painting bodies,
dancing, exorcisms, sand drawings, and even the usage of mind-altering narcotics are all part of
these rituals. All of this is done to aid in the recovery of the sick. Rituals of this nature might extend
for hours, days, or even weeks. These rituals are a technique of requesting assistance from the
supernatural realm. Prayer is also an important component of Native American healing rituals.
Reading the tradition and culture of the American Native, we can really tell that this somehow falls
in what we call “quackery.” Quackery is the practice of quacks or charlatans who claim to have
knowledge and skills they do not have, especially in medicine. People who practice quackery is
known as “doctor quacks.” In the medical field, these quackery or alternative medicines/practices
that we know of is a big ‘NO’ as these could further worsen the patient’s condition and since
medicine heavily relies on evidenced-based practices, and it takes years before a
medication/therapy/practice/intervention/etc. can be approved, quackery remains a myth to the
medical field. But since we live in a world where we practice equality and autonomy, as a medical
practitioner, we must give respect to these traditions and cultures that these people have in them.
Conclusion
In summary of this review of Alaskan Native culture, where it aims to give information to help
people comprehend the many cultural, racial, ethnic, and tribal influences on Alaska Native
health and health care. Marriage is considered as part of a wider familial and cultural framework
with Native Americans, and they do not establish barriers between married couples. Native
American women are to avoid food that might harm their babies and refrain from doing vigorous
work. Illness is believed to be a result of natural imbalance, because for them the environment is
sacred. American/Alaskan natives seeks assistance from healers when sick and for spiritual
reasons, such as seeking guidance. Their culture involves mediation between people and spirits,
souls, and other immortal beings. Such beliefs and practices were once widespread, but today are
less common.

References:
Ayunerak, P., Alstrom, D., Moses, C., Charlie, J., & Rasmus, S. M. (2016, September). Yup'ik
culture and context in southwest Alaska: Community member Perspectives of Tradition, Social
Change, and prevention. American journal of community psychology. Retrieved November 2,
2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119478/.
Brave Heart, M. D., & Lemyra M. (2016). American Indian and Alaska Native Mental Health
Research. Retrieved from https://stanford.edu/ethnonursing/alaskan/alaskan_references.html
Donch, R. (2018). Child bearing of an American Native. Retrieved from
https://capacitybuilders.info.childbearing-of-american-native.php
Encyclopædia Britannica, inc. (n.d.). Yupik. Encyclopædia Britannica. Retrieved November 2,
2021, from https://www.britannica.com/topic/Yupik.
Encyclopædia Britannica, inc. (n.d.). Quackery. Encyclopædia Britannica. Retrieved November 2,
2021, from https://www.britannica.com/topic/quackery.
Funeral Guide (2016, October 14) Death around the world: Native American beliefs. Funeral Zone.
Retrieved October 29, 2021, from https://www.funeralguide.co.uk/blog/death-around-world-na
tive-american-beliefs.
FuneralWise. (N.D.) Understanding native American Funeral Customs and Traditions.
Funeralwise. Retrieved October 29, 2021, from
https://www.funeralwise.com/customs/native_american/
Lowey, S. (N.D.) Nursing Care at the End of Life. MILNE. Retrieved October 29, 2021, from
https://milnepublishing.geneseo.edu/nursingcare/chapter/diversity-in-dying-death-across-
cultures/
Mooney, R. (2016) The Native American Women. Retrieved from
https://www,tandfonline.com/986546
Myrick, M. (2017) National Healthy Marriage Resource Center from https://calswec.berkeley.edu/
The importance of cultural competence : Nursing made Incredibly Easy. (n.d.). LWW.
https://journals.lww.com/nursingmadeincrediblyeasy/fulltext/2011/03000/the_importance_of_cul
tural_competence.1.aspx
Tribal Trade Co. (2020). Cultural Traditions of Native American Hunting & Gathering . Retrieved
November 1, 2021, from https://www.youtube.com/watch?v=ATEnazyeG6s.
Wellness along the cancer journey: American Indian, Alaska ... (n.d.). Retrieved November 2,
2021, from https://www.cancer.org/content/dam/cancer-org/microsites/circle-of-
life/documents/module9-complementary-and-alternative-medicine.pdf.