Cultural encounter is the process during which the nurse engages in cross cultural interactions with clients from

diverse backgrounds (Wilborn, 2000). As a nurse we interact with people of various ethnicities and backgrounds every day. Being prepared and knowledge will help guide a nurse toward the right steps an encountering a client with a different culture. The country will look at is Haiti. Haiti is a country that most people would say will never find peace. The country of Haiti has been dealt numerous blows throughout the decades. Although they have gone through disastrous earthquakes, which killed hundreds of thousands, to its renowned corrupt political system, this small country of seven million still stands. Haiti has a very rich cultural history. The countrys customs are a blend of cultural beliefs that were derived from the many ethnic groups that inhabited the island of Hispaniola (Brown, 2010). Using the Purnells Model for cultural competency, we can gain a closer look into the intriguing culture of Haiti. We will identify their heritage, communication, high-risk behaviors, nutrition, and death rituals. The country of Haiti occupies one-third of the island of Hispaniola, with the other twothirds of the island occupied by Haiti's neighbor to the west, the Dominican Republic. Haiti's terrain is mostly mountainous and the climate is tropical. The country has the claim of being the poorest nation in the western hemisphere. The per capita Gross Domestic Income (GDI) in 2001 was 480 compared to a 2000 GDI in the U. S. of $34,100. Haiti's history has been overwhelmed with struggle (Colin, 2003). In 1804 Haiti declared its independence from France and became the first free black republic in the world. After gaining independence, Haiti divided itself into two classes: the elite and the peasants. The elite comprised of the mulatto and light skinned Haitians, while the peasants were mainly dark skinned. The elite lived in towns, controlled the government, and spoke French while the peasants lived in rural areas, continued in their African traditions, and spoke only Creole. The elite tried to keep the peasants within their class by

limiting education and living conditions. In 1957 Francois "Papa Doc" Duvalier was elected and declared himself "President for life". He was a very harsh leader who used military force to control the residents. After his death in 1971 his son Jean-Claude "Baby Doc" Duvalier was installed and he continued the reign of terror. Thousands of people left the country in exile fleeing the dictatorial government. In 1994 Aristide was made president of Haiti with the support of the United States. Despite the rulers' intentions, Haiti continues to be a nation of extreme rich and starving poor. Most waves of Haitian immigration into the U. S. resulted from political and economic instability in Haiti (Colin, 2003). . The official languages of Haiti are French and Creole. French has always been the language of business, and Creole, the language of the people. French is considered to be the language spoken by higher class. Haitian Creole is derived from a pidgin. A pidgin is a shortened form of a base language with portions of other languages added. Creole is spoken by the majority of Haitians, while only about 10% of the population can communicate in French. In years past, even those who spoke only Creole were unwilling to allow Creole to be taught in the schools. The feeling was that if their children could speak French, they would have a better chance to elevate their position in society. Because Creole is beheld as the language of the poor, most Haitians will claim to be able to speak French. If Haitians do speak French, they will initiate conversations in French with persons unfamiliar to them. To suggest that someone only speaks Creole, even if they do only speak Creole, can be construed as an insult. When speaking with friends, Haitians will use direct eye contact, and an active tone of voice. Eye contact is usually avoided with people of a higher socioeconomic status or position of authority. Tone mirrors emotion. Speech is usually accompanied by hand gestures. Speech may get loud, but this does not necessarily mean there is anger. Except when discussing certain personal topics,

communication tends to be direct. When in informal situations, touch is accepted, like embracing or kissing. In formal situations, a stern handshake is the accepted greeting. Gender is also a factor in touch; people do not generally embrace members of the opposite sex, even if they are friends. Haitians require much less personal space than Americans, so they may position themselves close to another in communication. Name formats are similar to that of traditional U.S. name formats (Colin, 2003). . Sexually transmitted diseases (STDs) are a common health problem in Haiti. The rates can be attributed to the acceptance of the polygamous lifestyles of men. Also, due to their health belief system, many Haitians do not associate STDs with sexual intercourse. Haitian men are generally not willing to use contraceptives. In addition, STDs are more difficult to eliminate in this population because it is common to stop taking antibiotics once symptoms subside (Colin, 2003). Food is very significant to Haitians for many reasons. In traditional Haitian culture, being fat means being healthy, whereas being thin indicates poor health. Because of economic constraints, malnutrition is very common in Haiti. Food can be used as a loan or as good will for those who are in need. The loan is made with the understanding that when the benefactor is in need, the favor will be returned. Haitians usually eat their main meal in the middle of the day with bread and coffee at breakfast and soup or hot cereal in the evening. Traditionally men are given the biggest portion of meat or protein because they need the energy in order to provide for the family. Haitian cuisine has both French and African influences, and also uses spices commonly found in the Caribbean. One common dish, griot, is fried pork cubes that have been marinated in sour orange juice and garlic. Haitians will not eat cottage cheese, yogurt or runny egg yolk. Haitians have a strong belief in the hot vs. cold equilibrium. Illness is a consequence of an

imbalance concerning hot and cold. Haitians also believe that to maintain health, a balance of hot and cold foods is necessary (Colin, 2003). When death is impending, the entire family will gather to pray, cry, and use religious medallions or other spiritual artifacts. When a person dies, the entire extended family is affected. The oldest family member makes all the arrangements and notifies the family. The body is kept until the entire family can gather. The last bath is usually given by a family member. Organ donation is not viewed as an option. Cremation also is not considered since the body is thought to be necessary for resurrection. Haitians prefer to die at home, although the hospital is acceptable. An autopsy may also be demanded to guarantee that the body is actually dead and not a zombie. The notion of Zombies seems to be more dominant with rural Haitians than with urban residents. Zombies are created as a result of greed or malevolence. Mourning practices include veye , dernier priye, and prise de deuil. Veye are preburial activities. Dernier priye is a 7 day home based ritual consisting of 7 days of prayer. This procedure is to help the soul pass into the next world. Prise de deuil takes place on the 7th day and is similar to a funeral. This begins the official mourning period (Colin, 2003). It was very interesting to read about Haitis culture. I was able to correlate certain aspects of their culture with my own. As nurses we should be prepared to encounter different cultures that we come across. Maintaining an attitude of humility and sincerity can make any client feel at ease. After working in Haiti, one nurse quotes, Analyzing my past experiences in Haiti provided insight into my successes and failures and prompted me to search for personal and professional reasons to provide care for the poor in the future. This type of reflection is essential for health care providers who work with the underserved, regardless of their religion or the country in which they work (Emmott, 2008). Learning and respecting ones culture can lead to a better and

more trusted relationship with a client. It will enable the nurse to guide the client through the healing process smoothly and will enable the client to feel more at ease. It is already scary enough to be ill in another country so being a nurse; I can be their advocate if no one else can. Nurses are the ones patients trust the most and in order to maintain this trust, we must always keep an open mind and heart towards out patients.