By Zhu Hua, FAcSS, Professor of Educational Linguistics & Director of the Mosaic Group for Research on Multilingualism, School of Education, University of Birmingham
“Seeing cultural competence as a responsibility of those providing health and education programmes is certainly a step in the right direction.”
Public Health England’s recent report, Beyond the data: Understanding the impact of COVID-19 on BAME groups, puts forward a range of recommendations to address issues of disparities in risks and fatality. Among the recommendations, ‘cultural competence’ is highlighted as a key theme for future actions ranging from general health promotion to COVID-19 education and prevention campaigns. But what is cultural competence and why is it so important to addressing these issues?
Seeing cultural competence as a responsibility of those providing health and education programmes is certainly a step in the right direction, as I have argued that the burden of cultural adaptation and ‘fitting in’ is very often unfairly placed on the so-called minority groups as well as new migrants (Zhu Hua, 2019). However, irrespective of the question of who is accommodating whom, cultural competence remains an elusive concept. It is difficult to pin down what it actually means. There is a huge amount of literature defining the term in a variety of disciplines, in fact, more than 300 elements and skills associated with the term were identified in a review by Spitzberg & Changnon (2009). The expansive cultural competence lists often talk about ‘tolerance’, ‘respect’ and ‘culture specific information’. But how are these abstract notions embodied in another culture and mediated through different languages? How do we avoid stereotypes and reductionist profiling when we describe culture-specific information about the cultural other? And what culture and whose culture are we talking about?
Our recent work with the Chinese, Somalia and Polish communities in the UK has identified a number of changing dynamics of ethnic communities in the UK that have implications for the notion of cultural competence. While each community has been seen as a homogenous ethnic group in the past, there is an increasing level of internal diversity in terms of socio-economic status, employment, language skills, migration history and experiences, access to resources, and sense of belonging. All three of these communities reported such internal diversity. This then raises questions as to whether using ethnicity as a term is the best way to define these communities.
One thing that COVID-19 has proven is the interconnectedness of communities across the world. What is local and what is global is all relative. We have experienced unprecedented connectivity on a global scale between ethnic community members with their social networks ‘back home’, within the UK and elsewhere in the world. The ethnic communities in the UK are no longer making do with what is available in English, but have access to multiple digital and social media repertories available in different languages and promoted by a variety of digital platforms. Such connectivity, mediated by digital technology, means that news and information flows fast in multiple directions and culture contact (and comparison) takes place all the time. We cannot assume that what is happening thousands of miles away does not affect us.
Covid-19 and the Chinese communities in Britain
A widely circulated picture on WeChat jokes about the extent of Chinese communities getting involved in the pandemic. It says that if we could compare Covid-19 as a (football) match, China plays the first half, the rest of the world plays the second half, and Chinese people overseas play the whole match. What it says is true. For the Chinese communities here in Britain, the battle against the pandemic started in January 2020, when the news of COVID-19 in Wuhan broke out. Many of them organised donations to send to China and became part of the wider support network for China. Since the lockdown in the UK in March, many grassroot self-help initiatives took off within the Chinese networks: access to free on-line consultation with volunteer Chinese doctors was circulated among WeChat groups and health kits (健康包) containing PPE and Chinese medicine were distributed among Chinese scholars and students. And people in China began to send donations and supplies of face masks to the UK.
Cultural approaches to prevention methods – to wear or not to wear a facemask
The pandemic has also brought to light the different beliefs and values towards health issues and prevention practices amongst different communities. While the advice of washing hands has been widely accepted in Britain, wearing or not wearing facemasks has become a dividing issue between some communities and others. There are also ‘accidental’ differences in the system that confuse people. For example, in the UK, coronavirus risk level is measured by a five level, colour-coded alert system with five as the highest alert level, while China uses the opposite system with one as the highest alert. Quarantined between different cultures, many ethnic community members have had to find ways of making sense of conflicting advice and information. So if ‘cultural competence’ is key to understanding the impact of COVID-19 on the BAME community, this approach also needs to take into account differences in health beliefs and general practices.