Wednesday, November 10, 2010

Cultural aspect in Medicine 1 : Lone Ranger

Lone Ranger
Being a lone ranger is a challenging task. As an outsider, you need time to squeeze in a new setting --> food, place, people, culture, language and also to mix around with the origin people.  Fortunately I'm stranded in Jogja, which all those things that I mention is not really different from my country but still there are. 

Each of us has a cultural background, although some are more mixed that others. Our friends, neighbors, coworkers, and patients also have their own cultural backgrounds. Cross-cultural interaction occurs when two cultures come into direct contact with each other. Ok, what is a culture? there are a lot of definitions. 
  • systems of meaning, belief, knowledge and action and how people organize their lives
  • man-made of the environment
  • set of ides, concept, rules transmitted socially from one generation to the next and regulate people's lives and society
  • set of belief or behaviours, art, morals, law, customs or capabilities shared by a group 


Mostly Indonesian people will communicate in bahasa, so there is no problem with it. But, it will make a  huge problem when come to elderly, because they usually talk in Java, and for sure I don't understand. Let me explain a little bit about this language. It has 3 level which are : 
  1. Ngoko is informal speech, used between friends and close relatives. It is also used by persons of higher status to persons of lower status, such as elders to younger people or bosses to subordinates.
  2. Madya is the intermediary form between ngoko and krama. An example of the context where one would use madya is an interaction between strangers on the street, where one wants to be neither too formal nor too informal.
  3. Krama is the polite and formal style. It is used between persons of the same status who do not wish to be informal. It is also the official style for public speeches, announcements, etc. It is also used by persons of lower status to persons of higher status, such as youngsters to elder people or subordinates to bosses.


Javanese people is polite, and yup, it is true. Something that I found out in Indonesian people that they don’t like people hands on hips during conversation since this is considered impolite/insulting, don’t do impolite things in sacred places, don’t put your feet up on tables or chairs, or use them to point with, don’t be angry when someone on the same sex holds your hands or walks arm to arm, it’s the Indonesian way of showing a friendly relationship and there a lot of things. I'm pretty sure that some of your culture habit is contradict with others culture. Well, it is just a variation in life and we must respect each other even for our point of view it is funny or silly.
with Javanese guy wearing a traditional java clothes (during 1st year)

Medical Student in Jogja
Because of the unique relationship between the doctor and the patient, it is essential to find an effective way to communicate across cultures. While language differences are a significant barrier to effective communication between doctor and patient, cultural differences go far beyond this initial hurdle. 

Before this, I have experience in Puskesmas, and when the doctor anamnesis patients, i can't understand what are they talking about. It is like duck talking with chicken, language is alike but totally different. So, lets learn basic Java language because one day whether I like or not, I still need to go to rural area as a Koas student.


Some tips for you and me when communicate with someone with different culture

  • use short, clear simple sentences
  • speak at normal speed
  • confirm comprehension by asking " What do you understand?" rather than "do you understand?"
  • do not raise your voice, they can hear you
  • avoid humour
  • be patient and do not interupt
  • respect differences, do not judge others based on style of speaking or accent
  • if you are angry, try to calm down before listening
  • empathize with what the other person may be thinking or feeling
  • listen to understand rather than reply, try to help the speaker feel at ease.

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