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>> 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.
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>> 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.
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>> 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.
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>> 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.
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>> 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.
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>> 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.
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>> 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.
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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.
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>> 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.
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>> 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.
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