[ Music ]
One word to describe
cultural humility
for me is love actually.
If I had to encapsulate
cultural humility,
the whole concepts
of cultural humility,
it doesn't do it
justice, but the word
that I think of is essence.
Escuchar.
Being.
You.
Opening.
Receive.
Compassion.
Love.
The principles of cultural
humility offer one more
framework to contribute
to what has got
to be our ultimate goal, yes.
Our ultimate goal is that there
will be a sense of equity,
a sense of equality
and a kind of respect
that we are driving forward.
[ Music ]
Cultural humility is a
multidimensional concept.
And certainly Melanie Tervalon
and I conceptualized
three dimensions.
The first is lifelong
learning
and critical self- reflection.
And in that critical
self-reflection it is the
understanding of how each of
us, every singe one of us,
is a complicated,
multidimensional human being.
Each of us comes with our
own histories and stories,
our heritage, our point of view.
You are looking at me now.
I am very fair skinned.
When I was a little
girl my hair was blond.
My eyes are blue.
People often tried to call me
anything but African-American.
I have a history.
My identity is rooted
in that history.
My parents gave me the knowledge
of my own social identity,
and my own experience in
life has created that.
I get to say who I am.
The second tenet
after self-reflection
and ongoing lifelong learning
and development is this notion
that we must mitigate the
power imbalances, to recognize
and mitigate the
power imbalances
that are inherent often
in our clinician patient
or clinician client for service
provider community dynamics.
And then finally the piece
that I would offer that Jann
and I feel people often either
don't read or don't like.
And the institution has to
model these principles as well.
[ Music ]
An African-American
nurse caring
for a middle aged Latino
woman several hours
after the patient had
undergone surgery.
A Latino physician
on a consult service
approached the bedside
and noted the moaning
patient commented to the nurse
that the patient appeared
to be in a great deal
of post- operative pain.
The nurse summarily dismissed
his perception informing him
that she took a course in
nursing school in cross-
cultural medicine and knew
that Hispanic patients over-
express the pain that
they are feeling.
The Latino physician had a
difficult time influencing the
perspective of this
nurse who focused
on her self-proclaimed
cultural expertise.
It was curious to this
Latino physician who first
of all was Latino,
not like all --
in his case not like
all Mexican-Americans,
know everything there is to know
about Mexican-American patients.
That wasn't it.
But he might have
been a resource
for that African-American
nurse in that moment
that she didn't feel
like she needed, again,
because she had bought into
this notion of competence,
of cultural competence.
The distinction
between cultural humility
and cultural competence was
that we were in a process
and a relationship that had
many other layers to it,
and that we were less
comfortable with even the term
of competence in a way that I
think people understand well.
And that it implies especially
for people who are providers
and are trained in academia
that you are then all
knowing and all powerful.
And we felt like that was
not what was happening for us
as we were learning from
community and understanding
in a very practical way
how families were coming
to the hospital and feeling
as if they really were not being
heard from their own heritage
in history, and how that
impacted what they came
to the hospital with that we
didn't know anything about,
hadn't even a clue about.
For us this is part of
the humility piece of it,
getting to understand that.
Not trying to humiliate you,
not trying to make you feel bad,
trying to help us all understand
that life is like this.
And that in a certain
sense you're really happy
about not knowing.
In April of 1992 in the wake
of the Los Angeles riots
following the initial not guilty
verdict of the police officers
accused of beating Mr. King,
the Children's Hospital open
community was compelled to meet
in a series of highly
charged sessions to expose
and critique our own patterns
of institutional racism,
injustice and inequity.
My name is Dr. Melanie
Tervalon, and I am Direct
of Multicultural Affairs here
at Children's Hospital Oakland.
I want to thank
everybody for coming
to what is a celebration
for me of this year.
>> Jann and I had the good
fortune really to be together
in the same place when
this work was evolving.
Jann and I while we were
several years difference
in age are both African-American
women.
And we were both raised by
women who were teachers.
And we come out of that -- and
fathers who were working men,
who come out of that
southern tradition
and who participated fully
in the civil rights movement
in a way that meant that
they made sacrifices
and their children made
sacrifices, and they taught us
about those sacrifices
and raised us each in ways
to understand that we
were here to serve.
[ Music ]
Patty.
Hey.
How you doing?
How are you?
It's good to see you.
It's so good to see you.
It's been a long time.
I know, yeah.
How have you been?
Pretty good.
Good. Thank you
for having me.
I'm invested in children
and in that population
because I've been
there for so, so long.
Since we were residents.
And I'm seeing like second
generation of my families now.
The multicultural curriculum
program really started
in about 91- 92 as a pilot.
When was Rodney King,
I thought that was 90 --
It was provoked in 92.
92, yes.
The Rodney King
incident that people saw all
over the world really at
Children's meant that we started
to talk again about what
we called our own private
Rodney Kings.
The circumstances
where families felt
as if they were not being taken
care of in a respectful way.
That was a big part of
our work, being certain
that we were living
up to the principles
that had clearly
been established
through the conversations
already in the hospital.
That given the composition
of the faculty at Children's
and given the composition of
the patients we were taking care
of that the faculty could really
not teach about the issues
of culture and race and
difference in time and the like.
And so we spent a lot of time
working with community groups
and families to actually
come in and teach.
When I think of the two
terms, cultural competency
versus cultural humility, for me
cultural competency implies kind
of a subject, a topic, you know.
And people do feel like I
need to know this or not,
and if I don't know this
I'm not smart or whatever.
Whereas for me cultural
humility is a philosophy,
it's an approach, it
is a tool, you know.
So it's not something to be
I'm going to master it or not.
It's my approach, it's how
I will handle the situation.
>> Last year I was
the coordinator
of the student support
team which are the meetings
that families have with teachers
when their kids are
having trouble.
And it was quite interesting
to just try to navigate that,
those meetings in
a way that worked
with the principles
of cultural humility.
Just to really try to say
to my colleagues let's hear
what this parent is experiencing
and what this parent hears
about from their child.
And let's try to talk about that
as a starting point rather than,
you know, your kid is XYZ.
One of the things that
helped me out a lot to be able
to also kind of make
peace with not knowing is
that for a long time
I mistook not knowing
for lack of intelligence.
And a dear friend of mine
pointed out to me once
when I was having a conversation
about this, he said it's not
that you're not intelligent,
it's that your fount
of knowledge in this particular
area you don't have it.
So it doesn't take away
from your intelligence
by any stretch of
the imagination.
You don't know because
no one has told you
or you haven't asked
that question.
And it allowed me to be able
to ask a million questions
because now I didn't feel
like I was saying to the world
or to the person
or to the patient
or to the community I'm stupid.
I was happy just saying
I just don't know.
And the same way with
the fount of knowledge
with medicine there's no way
for you know something
unless you learn about it.
But in no way, shape or
form does it take away
your intelligence.
So once I could distinguish the
difference I was comfortable
with not knowing anymore.
>> The article gets written
but not published right away
about what we learned from all
of this work working
with communities.
And this is the cultural
humility piece
that people have now
used in many venues,
not just in medicine
but in education.
Many nonprofit organizations use
the cultural humility principles
in their work.
The principles are not just
about individual
activity and behavior.
Institutions have got
to be self-reflective.
Lifelong learners have to really
believe that the communities
that are being served really
do know what they want
and what they need, right, and
they're in the best position
to let us know what that is.
[ Music ]
People living in poverty
have the least access to power
to change the structure
of policies of poverty,
and are often denied
effective solutions
to combat the violations
to their human rights.
And I care about this issue
because my brother is an
innocent man with special needs
who has been held in what
I call modern day slavery
for two years now for a
crime that he did not commit.
And I come to you because the
so called justice
system is not designed
to benefit my community.
And I can hear the voice of
the oppressed that echo, no,
you don't deserve
to have rights.
Just us. You don't have
a history, just us.
You don't have the strength
to control your mind, just us.
You don't remember what
the fight is about.
Just us.
There are these moments
that grab everybody's attention
that we can take advantage of.
And I think the Rodney
King, more of the response
to Rodney King, is what inspired
a lot of conversation and a lot
of soul searching and a
lot of people seeking ways
that we could have
these conversations
with better result.
And then it fades.
[ Music ]
The three police officers
facing felony criminal charges
were among a group of 15
who stopped a 25 year old
Black man last Saturday night,
then beat him, kicked
him and clubbed him.
At WHAT Radio host Mary
Mason fielded scores of calls
from members of the
Black community angered
by the verdict, shocked by
the violence that followed.
We need love and
respect for one another.
We need [inaudible].
In 2010 Arizona passed a law
that authorized local police
to check the immigration status
of anyone of whom they suspect
of being an illegal immigrant
to the United States.
Who has the right to call
another human being illegal?
Most of these illegals are the
ones working in the fields,
cleaning homes, landscaping
at jobs that have the right
to pay lower than minimum wage.
There are things that
are difficult to hear,
and there are things that
are just plain hard to see.
So how it is a fish
doesn't see water.
It's very hard when you benefit
from great privilege
to see it as that.
And I would say it takes
constant reminding.
And I certainly don't
see it all the time.
And each time I'm
reminded of it I'm reminded
that I'm reminded of it.
That why do I have to be
reminded of it, oh but I do.
I heard the white woman
behind us say you foreigners
have no manners.
My initial reaction was
anger and confusion.
Anger because I felt
discriminated
against and judged.
Confusion because she was an
older woman, so hadn't she been
around long enough to know
that she is not a native
of this country either?
We are constantly bombarded
by subliminal messages
that light skin is superior.
Immigration policy is
continuously debated
in the White House, while
brown men are hoping
to land a side job
outside of Home Depot.
How does cultural
humility come to life
at Berkeley Media Studies Group?
I have to credit Tony
Borbone [phonetic].
Bony Borbone, may
he rest in peace,
was a violence prevention
advocate par excellence
who I met early in our years in
working on violence prevention
when we first started the
Berkeley Media Studies Group.
And Tony just confronted me and
said you live in California,
how many of your
staff speak Spanish?
And I had to say none.
And Tony in I was
going to say loving,
it wasn't in a loving way, it
was in a confrontational way.
I mean we grew to love each
other and each other's work
and had great respect
for each other I think
as our relationship blossomed.
But he had no fear about
saying what was important.
[ Music ]
It's really important
to show up.
Take the time from your
life and show that you care
about the community
and be there.
So the workers were
participating in actions
to bring pressure on
a poultry market owner
who owed her workers wages.
The workers were going
out with picket signs,
and I went with them, too.
In that way I felt nervous.
You do kind of feel exposed.
You're in the environment
that's very different from some
of the other things
that I'd done.
[ Music ]
So when we had these
meetings everybody
on the project was
really experienced
in doing community research.
But there's a dynamic.
When you're in a
professional culture you're used
to participating in meetings
and trying to get in your word.
And then on top of all
that we're conducting
all these in English.
And so the other two staff
from the Chinese Progressive
Association were interpreting
for the non-English
speaking staff member.
And so they're not fully
able to participate.
And then everything is happening
so fast, people are talking
over each other,
that for the non-
English speaking staff member
it was hard for her to sort
of get a word in edgewise.
We did reflect on this
and people noticed it.
Then we started to conduct
the meetings in Chinese.
And then all the English
speakers wore the headsets
with simultaneous
interpretation.
The native English
speakers were quieter,
and that changed
the dynamics a lot.
But the workers were
still quiet.
In terms of cultural humility
we were really challenged
to think I think a
little bit more deeply
about what culture is and
how it doesn't mean thinking
about a list of traits that
you can ascribe to people.
But that it's actually
that it involves you
and your assumptions and how
you project your assumptions
onto somebody else versus what
is their actual experience
of who they actually are.
[ Music ]
I first heard about
cultural humility
when I was a graduate student
in the master's program here
at San Francisco State.
But I feel like I first
understood cultural humility
as a concept a lot
earlier in my life.
It came from a place of
invisibility, a place of kind
of suppressing who I
was as a woman of color
and now has completely
transformed as an educator,
realizing who I am,
where I stand
in the classroom,
what my privilege is.
But also what my voice
means in the world
and what it means
as an educator.
It came from trying to fit
in, to do whatever I could
to be Indian at home and
not out in the world.
And not express that, and it's
become this marker of identity
that I knew was always there
that I could never
really express growing up.
And now it's saying
who that person is
and acknowledging both my own
power and privilege in I've got
to check myself kind of way.
In the same respect it's also
saying I am a woman of color,
I have something important
to say and here I am.
I think as long as
power and privilege exists
in society we will always being
struggling with being too humble
as women of color,
as women who come
from working class
backgrounds, as women who come
from low income backgrounds
or under resourced
backgrounds, right?
As long as there's
power and privilege
in society I know I will
always be struggling with that,
and I struggle with
that on a daily basis.
[ Music ]
I examined [inaudible] here
to see how inclusive
our current policies
and programming are toward
transgender students.
And I was just reflecting
about how it's actually
very relevant
to the topic this evening
of cultural humility
because we're talking
like transgender culture
or peer culture at [inaudible]
and how it's respected or not.
Right.
And how like the institution
can be culturally relevant
or humble or respectful of
the experience of transgenders
when they come to this place.
The health educators
that I work
with are all transgender
females.
And literally the second day of
my job I walked into a meeting,
and it was a committee
advisory board
of all transgender females.
And I was so uncomfortable
but at the same time they
made me feel so comfortable.
They started asking me questions
like they noticed, and they were
like so where are
you from, you know?
And I was like I'm Iranian.
Oh, we know this Middle
Eastern transgender girl,
do you know her?
And I was like no.
So my definition of cultural
humility is to be open
to learning all the time.
So what I want from you guys is
to go around, introduce yourself
and tell us what cultural
humility means to you.
I first became passionate
about cultural humility
as an undergraduate
student I was interning
with an organization.
And they were holding a
cultural competency training
for Pacific Islanders
and working
with Pacific Islander
communities.
And as a biracial Pacific
Islander woman I was really
excited and anxious to attend
the training and to really learn
about the material that was
going to be sort of discussed
and how others were going
to learn, myself included,
about Pacific Island culture and
working with Pacific Islanders
around health issues that were
important to the community.
And I think after attending the
training I realized there was a
sense of achievement
and completion
for those who participated.
And I then was introduced
to cultural humility
as an undergraduate
student in the class,
just so happened
around the same time.
And I realized that a sense of
achievement and accomplishment
and competence and understanding
sort of limits your learning.
I can't really tell you what
cultural humility means to me.
I feel like I practice
it and that's how I know.
The one thing that I think about
or that I can practice is
cultural humility is --
Poder hablar el idioma en el que soy
en el que me puedo expresar mejor, y
El idioma donde encuentro palabras
de poder contarle a alguien
exactamente como me estoy sintiendo.
Coming from a background
in science and coming
into public health and not
ever hearing cultural humility
in the sciences was
very telling for me.
Because culture is
something that's emphasized,
it's not something that's
talked about in a relevant way.
There have always been
very clear barriers present
for particular minorities
in science.
You can see it when you're
in the science classes.
You can see it when
you're in study groups.
You can see it when you're
looking at your professors.
And I'm not just talking
about racial minorities.
I'm talking about a lot of
under represented minorities
in the sciences,
like race is a factor
but gender, sexual orientation.
I learned cultural
humility in two places,
by my own culture being
Cambodian and Southeast Asian.
Not knowing anything about
it my folks roasting me
about I'm not speaking well.
And then after going to
college and learning about it
in anthropology and
interviewing my parents
about their experience
it opened my eyes.
One of the things that I
have learned in the past couple
of years I want to say is just
listening to what I'm saying.
And I mean like seriously
listening to what I'm saying.
And one of the things that I
have learned to listen to is
when I say I, I believe this,
I do this, and listen how
that is very different
from the we.
We I hear a lot in the
news, we Americans, right?
Like we, who is the
we speaking about.
It's to think about and listen
to when we use the I and the we.
Growing up I was like
always interested in culture
and other religions and just
really learning about things
from other backgrounds.
And so I just figured that
made my culturally humble
because I had an interest.
And so after studying a year in
West Africa I came back like,
oh my God, I don't know
anything, I don't know anything
about Black people, I don't
know anything about Africans.
I mean it just list
shifted my world.
Peace. I think when I am
sitting in a place of humility
that there's a quiet and a
spaciousness and an okayness
and ease that is just
close to peace with being
with another person
that I can imagine.
If I have to think about it
as a road then I think I would
think about I would think
about it as a road that spirals.
And a spiral actually doesn't
-- to me in a dance context,
a spiral that comes up
has to come down as well.
It's sort of a continuous loop.
And along the continuous
loop many things happen
and many forces may
change the shape of it
or the depth and reach of it.
Cultural humility is
definitely a journey for me,
and it's definitely a journey
that I know there's going
to be come challenges
and I'm ready for those.
And I know every challenge
I'm going to learn from.
And I think it's a process that
I have to go through every day
and that I'm okay
with going through.
And it actually makes
me stronger and smarter
and I hope wiser
than I was yesterday.
[ Music ]