[ 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 ]