I was admitted to hospitalised due to breathing difficulties. I was undergoing tests to establish the cause. An X-ray established that my sternum had been dislodged. Although I knew that the injury had been sustained due to domestic violence, I did not want to tell the consultant. I was hospitalised for two weeks for observation and to monitor the healing. Whilst in hospital, one of the nurses noticed that something was not quite right as I had not had any visitors, and there was bruising to other parts of her body.
I disclosed the domestic violence to the nurse and the nurse stated that she would make a referral to the hospital Social Worker. The Social Worker came to see me, and I told her of several accounts of violence that had occurred over the years. I said that I need to escape the situation but I would need help to do this. The Social Worker stated that she needed to speak to her manager and she would come back to see me. This was because she was not sure of how to deal with this due to my “culture”.
When the Social Worker returned to see me she told me that both her and her manager thought that they would probably make things worse for me if they intervened, so it was best that they took no action. The Social Worker said that as they have little knowledge of the Asian culture they don’t want to make things worse for me.
It took a lot of courage to make this disclosure and it took another few years for me to leave.
1. Identities of the actors in the situation
Patient: Female, 23 years old, British Indian, born in the UK and is in her third year at university (she is a part time student). She is a receptionist working in a social work team, She is married with two very young children and lives in an extended family setting with her mother in law and father in law. She is a non-practicing Sikh.
Social worker: Female, in her late 40’s, White British. She is a hospital Social Worker and can be described as white middle class.
2. Context of the situation
The incident occurred at a hospital in Warwickshire. It was during a hospital stay when the patient was experiencing difficulties breathing. She was admitted to hospital for observation and monitoring.
3. Emotional reaction
The narrator was shocked that the Social Worker was fearful of intervening due to her own lack of awareness around Asian culture. So much so that she had to consult with her manager before offering support.
The narrator also felt let down by the Social Worker in that she was unable to offer any support for the fear of making things worse.
The narrator felt angry and frustrated as a result of the Social Worker’s lack of support and intervention. This was the first time that the narrator had asked for help, which took a lot of courage and building up, which she felt was for nothing. In this instance the narrator also felt trapped with her situation at home.
4. Representations, values, norms, ideas, prejudice: The frame of references of the person who experienced the shock.
Role of social worker – The narrator felt that is was the social workers professional role so support her as a victim of domestic violence.
Expectation of empathy from other women– The narrator assumed that social worker would be able to understand her situation and feel strongly that women should not have to endure this violence.
Violence is not right and should not be tolerated, once you ask for help, you should receive it.
Equality, non-discrimination: a demand for protection against domestic violence should be treated in the same way no matter the cultural background of the person who suffers it.
Hierarchy – that professionals and healthcare teams are experts and would be the best people to ask for help and to be able to support victims.
Transgressing wife’s duties towards the respect of the husband or the community – by making the disclosure the narrator denounced her husband, which is a threat to the respect of the husband and the dignity of his family. An internal domestic issue becomes public – at least shared with a public professional, which can bring shame on the family or the community.
5. What image emerges from the analysis of point 4 for the other group (neutral slightly negative, very negative, "stigmatized", positive, very positive, real, unreal) etc?
Negative and dismissive
6. Representations, values, norms, prejudice: The frame of references of the person or group that is causing the shock / that caused the shock in the narrator.
Professional’s role: it is not part of the responsibilities of a social worker to address issues of cultural diversity.
Cultural differences should be respected, even when they seem irrational from the majority’s point of view. The professionals don’t feel the need to investigate the rationality / reality of what they suppose to be a cultural pattern.
Gender equality: the professionals are probably aware of cultural differences in the conception and approach to gender, different systems of distributing power between men and women. They seem to relativize the idea of gender equality, accepting a double standard: what is expected in the dominant culture (i.e. than husband cannot mistreat wife) cannot be expected from some minority cultures.
Application of different rules: specific rules can apply to minority cultures, the same interdictions do not necessary apply to members of specific cultures, even concerning violence.
Hierarchical communication: preconceptions about the cultural background of the patient prevail over her own accounts of what happened to her. The professional takes the decision with her superior and they do not involve the patient in this decision, as if her opinion / claim was secondary.
7. Does the situation highlight any problem concerning the professional practice, or in general about the respect of cultural differences in intercultural situations?
Professionals often perplexed by the question of to what extent and how they should take into account the patients’ cultural background. On the one hand the can be accused of insensitivity when they seem blind to cultural differences, but they can also fall in the trap of the other extreme: enforcing a cultural interpretation in situations when that is not so appropriate. Using a cultural interpretation in a situation where other explanation factors could be more relevant is a form of prejudice called culturalisation. In extreme cases such as this a culturalist interpretation can prevent adaptive response in a crisis situation, merely be the fear of making a cultural “faux pas”. This problem is further aggravated by the fact that often professionals are afraid of asking directly the patients the questions that may help to see clearly. They remain with a first – often erroneous – interpretation.