Culturally Competent Care and Social Justice
The passing of Paul Farmer, MD was a great loss to humanity. He devoted his life to making healthcare accessible to vulnerable populations by bringing both material and non-material aspects of care to the people. He emphasized that caring is built on humanistic relationships and grounded in the life conditions of the people. He championed awareness of social determinants of health made evident by immersing in the community of vulnerable populations. Being present in the social and environmental contexts of the people permits understanding of their authentic needs and priorities. Often, providing food has greater impact on health than giving antibiotics. According to Dr. Farmer structural violence causes social injustice creating unfair disadvantages in population groups.
Leininger emphasized culturally congruent care as embedded in the cultural and social structural dimensions of populations, which need to be understood in order for caring to be assistive, supportive, facilitative and enabling. Both Farmer and Leininger emphasized immersion in the social and environmental conditions of the people because caring is inseparable from the people’s way of life. Culturally congruent/competent care is logically rooted in social determinants of health. Caring must be informed by the people and the community where they are situated to be effective and meaningful.
It is imperative that we protect the fundamental right to health and promote access to quality healthcare and living conditions particularly for vulnerable populations. Compassionate empathy is facilitated by immersion in vulnerable communities. Compassionate empathy is the impetus for action to achieve social justice and beneficence.
Dula F. Pacquiao, EdD, RN, FTNSS, FNYAM
Professor Emerita, Rutgers the State University of NJ