First person: The clash of cultures

Abraham Megentta, an instructor at the Yale Global Health Leadership Institute, has worked in many international settings, and offers advice to those who travel and work outside their home country.
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Abraham Megentta is pictured here in 2012 in Lesotho in a a place called Kubunyane in Mohale's Hoek district. "Kubunyane is only reachable by small planes as there is no road access," he says. "At that time, I was working for Clinton Health Access Initiative managing a Rural Initiative project which was building clinics and starting health services in rural hard to reach areas. The plane is owned and operated by MAF (Mission Aviation Fellowship) an NGO working in areas not accessible by road."

If you have decided to travel and work outside of your home country, then you are surely going to experience a culture clash.

Working in global health in multiple countries, I have experienced this first hand. What I mean by a culture clash is the shock of encountering a way of doing things that is very different — and in some cases, very unacceptable — in your culture. I have seen this happen to friends, colleagues, and even myself, oftentimes leading to misunderstandings, frustrations, and a feeling of “why am I here?” This is common among global health workers who come from the western world, enthusiastic to make a difference in Africa.

When I was working in Rwanda, a colleague of mine who is Rwandese told me this story, which demonstrates how two well-intentioned people from different cultures can send the wrong message to each other without realizing it. My Rwandese colleague was invited by an American colleague to a potluck dinner, where he was expected to bring food or refreshments. Prior to the potluck dinner, he had invited his American colleague to his house and made sure that there was lots of food and drink, and that they had a good time. My Rwandese colleague was shocked at the potluck dinner invite from his American colleague, saying, “I invited him to my house out of kindness and made sure that there was food and drinks, but now he invites me back to his house but expects me to bring the food and drinks.” The potluck invitation was considered as a not-so-kind gesture; he didn’t realize that the American was probably trying to make the experience of getting together a more inclusive one.

Being an African who has worked in diverse environments with westerners and Africans alike gives me a unique perspective to appreciate and understand these culture clashes. While these culture clashes may happen even in the same country with diverse cultures, I want to give a few tips to global health workers coming from the western world and western cultures to work in Africa. It is probably wrong, to say “western culture” or “African culture,” as both societies are diverse, but I want to provide some tips based on some of the common culture clashes I have witnessed.

Take time to learn

Taking time to learn is the most critical step for any global health worker going to work in a different country. Don’t let the excitement of making a difference distract you from taking time to learn about how things are done in that country. You need to understand how the country’s government and society operates and how you can best fit into that environment. There is a good chance that most of your time and energy will be spent on human relationships and cross-cultural challenges, so take the time to understand these aspects of life in your new environment. This might require you to unlearn some of the ways you are used to communicating and interacting day to day. For example, your morning routine might be to get a strong cup of coffee and start getting things done at the office right away. If you are working in Ethiopia, on the other hand, you should start your day by giving warm greetings to the people working with you. I have seen western colleagues not invest the time and energy in offering these greetings, which often creates a roadblock to cultivating relationships.

To truly understand your new culture, you should get your information about it from multiple sources, since they may have their own biases and perspectives. You might be tempted to spend most of your time with your fellow global health workers, but you need to mix with locals and people from different walks of life to get the variety of perspectives you need to make your understanding complete. At the Global Health Leadership Institute, we emphasize that cultivating relationships is a key part of leadership and that there is a strong cultural component to cultivating relationships which you should be mindful of when working in a different culture.

Cultures are different, not better or lesser

In most cultures in Africa, if you invite a person for dinner, it is assumed that you are paying for it, whereas in the western world splitting the bill is common. Don’t try to judge which culture is better, just accept that they are different. Remember that the visitor should try to adjust to the culture and not the other way round — as long as it does not compromise your values. (For example, don’t start arriving late to meetings just because being late is customary in the place where you are working.) Deciding to work in a different culture should also mean deciding to open your mind and accommodate different ways of doing things.

Don’t be a complainer

Being an outsider can be difficult sometimes because an outsider has a fresh perspective and can quickly spot mistakes and breakdowns — just as someone new to your house will be quick to spot the crooked picture on the wall that has been hanging that way for 30 years without you noticing it. Fight the temptation to point out all of the “crooked pictures” in your new environment and making those who live there defensive. Don’t be a complainer; remember that you came to work in this country because it has many challenges and limited resources. Turn the urge to complain into positive reflections and ideas on what can be done to make a difference. Take it one “crooked picture” at a time, and remember that your host knows about the history of the problem better than you do and is best positioned to come up with the most effective solution. Your job is to provide a fresh perspective and build problem-solving and critical-thinking skills, which can be in short supply in resource-constrained settings.

Show genuine respect

I has been my experience that people who don’t even speak the same language can tell whether or not your respect for them is genuine. This may be because most communication is non-verbal or because humans share some common instinct across cultural, language, and racial boundaries. If someone feels that you don’t have respect for them, they will likely react by becoming defensive, ignoring you, or being non-responsive. Working in global health involves identifying problems and seeking the most viable option to solve them. Identifying problems involves uncovering vulnerabilities — which, in turn, involves having honest discussions about weaknesses. It has been my experience that people will reveal their vulnerabilities and weaknesses only after they feel that there is genuine respect.

Global health workers should understand how respect is earned and expressed in a given society — to learn the cultural gestures of respect. Some societies value age and experience, and younger global health workers needs to be mindful of how to earn respect in such environments. The first time I was given the responsibility of supervising a person who was older than me and had more experience while working in a culture that greatly values age and experience, I had to navigate a very delicate path. If you feel and show genuine respect for someone from another culture, then you have laid the groundwork for solving the problem at hand.

Realize that you have more to gain

During my years in global health work, I have benefited exponentially more than the countries I have worked in, and I believe this is the case for most, if not all, people serving in another country. The experience builds and forms you in a way that is so much greater than any contribution you might have made. So don’t go to another country with the patronizing attitude that you will be saving the “poor and disadvantaged” or “teaching them” — go to learn and contribute. I guarantee that you have the most to gain.

Abraham Megentta is an instructor at the Yale Global Health Leadership Institute.

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