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Afghan Culture

Afghan Culture. Jessica Swartz. Background: Geography. Located in Central Asia Borders many countries Located on historic trade route Kabul is the capital Population about 31,000,000 85% rural or nomadic Land locked and mountainous Difficult climate Hot and dry in summer

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Afghan Culture

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  1. Afghan Culture Jessica Swartz

  2. Background: Geography • Located in Central Asia • Borders many countries • Located on historic trade route • Kabul is the capital • Population about 31,000,000 • 85% rural or nomadic • Land locked and mountainous • Difficult climate • Hot and dry in summer • Heavy snowfall in winter

  3. Background: Ethnicities and Languages • Pashto and Dari are the official languages • Pashto: 35% • Dari: business • Both use Arabic alphabet • Diverse population • Tajik, Uzbek, Pashtun, Hazara

  4. Religion and Practices • 99% of Afghanistan is Muslim • Sunni: 80%; Shi’a: 19% • Five pillars of Islam: Shahad, Salah, Zakat, Sawm, and Hajj • Salah: prayer, holy day • Sawm: Ramadan, fasting • NANDA Nursing Diagnosis “Spiritual Distress”

  5. Religious Holidays • Ramadan • 9th lunar month • Fasting • ill and women with certain conditions are exempt • patient may refuse medications, injections, fluids and food during this important religious holiday. • Eid al Fitr • Eid al Adha

  6. Traditional Medicine and Spiritual Healers • Pre-Islamic Shamanistic traditions • Shaman: diagnostic, healing or mystical abilities • Malang: spiritual healer in Afghanistan

  7. Daily Living • Clothing • Conservative, Chadri • Grooming/Personal Hygiene • Left vs. right hand • Patients may need help with washing before prayer • Food Practices • Alcohol and pork are forbidden • Halal meat: meat killed according to Islamic tradition • Family Structure • Strangers/Hospitality

  8. Communication • Verbal • Non Verbal and Gestures • Eye contact, offensive hand gestures • Greeting • Elder first, shake hands with same gender only • Silence • Difficult and controversial topics • Pausing between thoughts • Privacy • Certain illnesses may bring shame upon an Afghani so the HCP should be prepared to maintain confidentiality and privacy to protect the patient

  9. History in a Nutshell • History of conflict and invasion • Began to modernize during the 1950s and 60s • Coup of 1978 • Russian invasion 1979-1989 • Civil War • Taliban gaining stronghold 1990s • War continues on with US presence

  10. 1950s and Current State

  11. Afghan Communities in US • Immigration waves • Russian Invasion (1979-1989) • Civil and US War (1990-present) • Settlement Patterns • Fremont, CA • generous welfare benefits during the 90s • Preferred welfare over a job deemed unworthy • Flushing, Queens • Northern Virginia • Estimated about 140,000 Afghanis in the US

  12. Views on Illness and Wellness • Hot/Cold Theory • A person is whole, not just an aliment • Aliments are classified as hot or cold and equilibrium is restored by ingesting food with opposite properties • Health consists of a positive state of total well being including physical, social, psychological and spiritual aspects. • Symptom management • Some cultural beliefs may inhibit healing, for example some patients may not ambulate because they believe they need to conserve their energy for healing • Many Afghanis believe the sun has healing properties, allow them to go outside if possible to absorb sunlight • Large amounts of visitors and extended visitor stays is part of the healing process

  13. Health Beliefs • Belief about healthcare system • Taliban impact on healthcare for women. • Many Afghanis are uneducated and do not understand our healthcare system or treatment options • Vulnerable to misdiagnosis and misunderstanding • Birth and death rituals • Birth:. The newborn has call to prayer recited in each ear and may have all the hair removed from their head. • Circumcision is customary for Afghanis but the age it occurs is up to the parents. • Death: Turn the patients face toward Mecca, tie big toes together to prevent legs from opening, close eyes and mouth to prevent evil spirits from entering and keep body covered at all times. • Organ donation is allowed and up to individual • Development and sex issues • Recommend that only female nurses and physicians attend to female Afghani patients • Afghani women shunned by their husbands • Suicide, mental illness, drug use are taboo

  14. Health Care Implications Discussion Time!!

  15. Nursing Diagnosis: Risk for Spiritual Distress r/t inability to perform or participate in religious obligations. Nursing Interventions •  Allow a clean appropriate place for patient and family to pray and inform them of the direction to Mecca •  Coordinate care to not affect prayer time •  Try to allow access to a Qur’an •  Address fasting and abstaining from medication with patient and family •  Do not have morning and midday meal sent to patients room an inform staff about respect for fasting patient

  16. Can anyone think of a health care issue that Afghani Americans face? Remember that most Afghan Americans are refugees due to decades of war.

  17. Reason for Mental Health Initiative: High Risk for mental Illness (PTSD) • Exposure to war violence and terror • 87% in life threatening situations • 22% of men and 6% of women held hostage by police, military or warring faction • 71% of the men held captive were tortured • Loss of spouse, children, family and friends • 78% had close family member or friend killed • Out of that 78%, 39% lost five or more close family members or friends • Family ties in Afghanistan and throughout world • People suffering because they have family that can not leave Afghanistan

  18. Questions?

  19. References Afghan Culture Awareness (2010). Center for Army Lessons Learned, 10:64. Retrieved from http://usacac.army.mil/cac2/call/docs/10-64/ch_3.asp#sec8 Afghan Coalition (2008). Afghan Community Health Survey.Retrieved from http://www.afghancoalition.org/afghan-survey/ Afghanistan (n.d.). Retrieved from Spirasi Cultural Profiles Web site http://cultural.profiles.spirasi.ie/countries/afghanistan.shtml Eigo, T. (n.d.) Afghan americans. Retrieved from http://www.everyculture.com/multi/A-Br/Afghan-Americans.html#b Five Pillars of Islam (2013). Retrieved from Office of the Royal Embassy of Saudi Arabia Web site: http://www.saudiembassy.net/about/country-information/Islam/five_pillars_of_Islam.aspx Graham, B. (2011). Afghanistan in america. Himal Southasian, 2011:02. Retrieved from http://himalmag.com/blogs/blog/2011/02/ Jarvis, C. (2012). Physical examination and health assessment. St. Louis, MO: Elsevier Inc. Miller, J. (2010). The afghans of fremont. City Journal, (20,4). Retrieved from http://www.city-journal.org/2010/20_4_fremont-ca-afghans.html Monsutii, Alessandro. (n.d.) Afghanistan. Retrieved from http://www.everyculture.com/A-Bo/Afghanistan.html Sidky, M.H. (1990). Malangs, sufis, and mystics: An ethnographic and historical study of shamanism in afghanistan. Asian Folklore Studies, 49:2. Retrieved from http://www.khyber.org/publications/041-045/afghanshaman.shtml Stuhlman, A. (2013). Afghan finds many cultural barriers in adjusting to US life. New Haven Register. Retrieved from http://www.nhregister.com/general-news/20130803/afghan-finds-many-cultural-barriers-in-adjusting-to-us-life Yourk, D. J. (2008). Nursing in afghanistan: A cultural perspective. American Nurse Today, 3:2. Retrieved from http://www.americannursetoday.com/article.aspx?id=4256&fid=4236

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