Cultural Humility

Nick and I began our time in Africa with a week-long meeting conducted by the scientists behind the Together Tomorrow study (Drs. Rob Stephenson, Lynae Darbes, Tim Lane, and Heidi van Rooyen) that involved community partners from both South Africa and Namibia. This allowed for a large overview of this study of male-male couples in southern Africa. After the meeting, Nick and I have been tasked with assisting in the development of the survey for this study, which will be implemented beginning this fall, and will assess HIV prevention behaviors, needs, and preferences of male-male couples. Through this process, we have also been fortunate to meet with a number of individuals from the Gay and Lesbian Network of Pietermaritzburg, a community-based organization that is helping to implement the study. We have even been able to engage in some experiential learning into context-specific methods of disseminating research back to the community of participants. This particular experience consisted of riding in a caravan of 10 pickup trucks with study staff yelling in Zulu on megaphones and handing out fliers about the next day’s meeting time and place while we drove through three rural communities. Certainly different than advertising for a town hall in the US!

Throughout this diverse set of interactions—many of which involve discussions of sensitive topics like sex behaviors, gender identity, and drug use—Nick and I have come to realize that we are not the experts. While neither of us are the great minds behind the project and our own immaturity in research is no secret to either of us, I think that there is another element at play, as well: culture.

Culture is the culmination of the regulations and tendencies—both spoken and unspoken—that belong to a specific group of people. These can, to a certain extent, be taught to and learned by outsiders. This process of learning and adapting, however, is not an overnight process, and there will always be dynamics that are missed by those that are not a part of that culture. To the culture which this project is addressing (that of men who have sex with men in South Africa and Namibia), Nick and I are certainly outsiders. The two of us cannot possibly understand the intricacies of what it is to be in a male-male relationship in South Africa or Namibia, and we cannot suppose that we know the answers to questions of health disparity, or even the questions to ask. We can, however, seek to learn and can take seriously the guidance offered to us by those who understand much better than we do.

Through seeking and heeding the advice given to us, we have been learning the importance of a posture of humility. If we are humble enough to know that we do not always know, humble enough to ask for direction and clarification, and humble enough to admit when we have been mistaken or we have assumed inappropriately, we can form the relationships and acquire the knowledge necessary to make a meaningful contribution to the study.

By the same token, Nick and I have begun to understand how incredibly important community engagement and participation is in research. Who are we to make assumptions and pretend that we understand the complexities of a culture, when we can tap the expertise of those who are living it? Without the investment of members of the community about whom the research is being conducted, investigations will inevitably miss the mark, ignore important information, and provide results that lack the depth and significance that are possible. With the investment of the community, however, research gains a depth of insight and applicability that can facilitate a deeper understanding of the results and, more importantly, can bring about real change toward greater health and equity, which is the ultimate goal of all that we do.

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