Cultural Competence

Last year, VOSH chapters visited more than 30 countries to offer their services. This myriad of countries, each with its specific history, culture, gender relations and traditions, also represent a diversity of attitudes towards health conditions and care that need to be understood for our collective impact to be maximized and sustained for longer.

The knowledge of and sensitivity to cultural considerations in the delivery of health care in all populations is critical. Culture is the integrated pattern of human behavior that includes thoughts, communications, actions, customs, beliefs, values and institutions of a racial, ethnic, religious or social group.  Competence implies the ability to functional effectively.   Cultural competence is necessary for health care professionals/volunteers/organization to work effectively in cross-cultural situations.  There needs to be this competence at all levels:  personal, organizations, institutional and governmental.  In order to be culturally competent, the health care professional/volunteer/organization needs to be able to value diversity, be aware of the dynamics when cultures interact, understand all cultures involved, and importantly be able to develop adaptations of care provided reflecting the understanding of cultural diversity and the culture where the care is taking place.

Being culturally competent will enable us to provide the best care to everyone in a way that allows the individual of a different culture to fully participate in their own care.  It enables us to respond appropriately and respectfully.  This applies as we see patients in our practices and in our clinical participation on VOSH trips.  How can we become more culturally competent in our care?  We can begin this process by doing research about the cultures you will be working with.  Understand the customs, beliefs and values of the people you will be working with.  It is important to be sensitive, understand and apply this.  It will make for more effective care.  If you frame your management within the context of the culture you are working with, it is more likely to be accepted by the people in that culture.  You will be able to tailor your care to meet the patients need in the context of their social, cultural and linguistic needs.

Another good way to increase your knowledge is to participate in the Fellowship of VOSH/International (FVI).  The FVI programs seeks to help people understand the “global challenge of preventable blindness; to foster the development of future leaders to meet the challenge of VISION 2020 and to prepare individuals who may be asked to consult with governmental agencies, educational, private, or public institutions, and the media on issues related to the mission and vision of VOSH/International.”  For more information please see: https://vosh.org/get-involved/vosh-fellow/.  VOSH/International is a diverse organization that embraces and celebrates all cultures and diversity in society.  We strive to increase cultural competence within our organization and as we can in organizations that we work with.

For additional reading: 

Cross, T., Bazron, B., Dennis, K., & Isaacs, M., (1989). Towards A Culturally Competent System of Care, Volume I. Washington, DC: Georgetown University Child Development Center, CASSP Technical Assistance Center.

Betancourt, J., Green, A. & Carrillo, E. (2002). Cultural competence in health care: Emerging frameworks and practical approaches. The Commonwealth Fund.

Hartman, E, Morris Paris C and Blache-Cohen, B. Fair Trade Learning: Ethical standards for community-engaged international volunteer tourism. Tourism and Hospitality Research: Vol 14 (1-2) 108-116, 2014.

Vincent, JE, et al. the rationale for shifting from a voluntary clinical approach to a public health approach in addressing refractive errors. Clin Exp Optom 2007; 90: 6: 429-433.

Burks, DJ and Kobus AM. The legacy of altruism in health care: the promotion of empathy, prosocial and humanism. Medical Education 201: 46: 317-325.

American Association for Health Education, http://www.aahperd.org/aahe

http://criticalservicelearning.org/2014/01/21/just-collecting-data-white-guys-community-impacts-service-learning-africa/

https://casaforchildren.wordpress.com/2018/07/11/the-importance-of-cultural-competence/

Tracy Matchinski, OD, FAAO, FVI
President VOSH/International

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Updated COVID-19 and VOSH Humanitarian Clinics Advice

VOSH/International recently consulted its US and International Chapters about the feasibility and timing to restart our humanitarian clinics. While the vaccination process continues with different levels of success depending on availability and acceptance, it is evident that vaccine inequity and the availability and reliability of data in several countries are issues we need to consider.

Even if already vaccinated, our chapters are still concerned about the wellbeing of our volunteers and patients.  Some chapters, are organizing clinics locally where they are better able to comply with the existing safety requirements and respective state/country regulations.

The COVID-19 pandemic is being experienced quite differently depending on state, region, country, vaccine availability, vaccine acceptance, and the spread of SARS-COV-2 variants. Most VOSH chapters are not holding clinics or traveling internationally in 2021.

Thus, VOSH/International is slightly moderating its overall guidance against clinics and travel issued in late March 2020 and renewed in January 2021. This will be reviewed and communicated on a quarterly basis.

If a VOSH Chapter choses to hold a clinic or travel internationally, we highly recommend that the chapter performs due diligence to comply fully with the requirements established by the visited country, ensures all VOSH volunteers are aware of and follow strict safety guidelines and all existing protocols and regulations of the country, and keeps the principle of “do no harm” embedded in all its decision making. As always, the wellbeing and safety for VOSH volunteers and our patients is of utmost importance and central to any decision-making process. We have published our updated clinic guidelines with best practices to be observed in this new context. VOSH chapters in specific countries are using protocols that need to be considered as well. You can download VOSH/International clinic guidelines here.

*VOSH/International is formed by autonomous US and international chapters that are fully and only responsible for their activities, fundraising and decision-making.  VOSH/International can only provide recommendations based on our best knowledge and information at the time.

Also please keep checking the following sites with official and most recent updates:

World Health Organisation: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

US CDC: https://www.cdc.gov/coronavirus/2019-ncov/travelers/when-to-delay-travel.html

US Government Travel Advise: https://travel.state.gov/content/travel/en/traveladvisories/COVID-19-Country-Specific-Information.html

Thank you for your hard work and dedication to improving vision and eye health throughout the world.

John Daniel Twelker, OD, PhD, FAAO, FVI

President, VOSH/International

July 2021