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Mary, a visiting health professional, is unable to establish a trust-based relationship with her client.
Judged by Western standards, Mary's actions are polite and acceptable.
However, in this situation, Mary is working with Jake, an Australian South Sea Islander, who interprets her actions in a different light.
Jake is a 50-year-old Australian South Sea Islander who is experiencing limited movement in his hands. Mary must interview Jake to determine whether Jake is eligible for certain services.
Again, this story is based upon a specific event and does not categorise the cultural patterns of all Australian South Sea Islanders.
Mary makes an appointment to see Jake at 1 pm. At 1 pm precisely she calls at his house and is surprised to find that Jake is not ready for the interview. In fact, several members of his family have called on him. He invites Mary to join the party. Mary is annoyed – she wants to conduct the interview straight away.
Jake introduces his visitors to Mary and invites her to share their lunch. Mary doesn't really listen to the introductions – after all, she is here to talk with Jake, not his family. Mary is a little annoyed – and wonders why the family would schedule their visit during her interview.
Mary politely declines the invitation to share lunch. Jake's family are insulted. They are beginning to think Mary is unfriendly.
Mary glances at her watch. It is 1.10 pm! She has another appointment in less than an hour. With an air of agitation, she asks Jake if she can conduct her interview with him right away.
Jake doesn't want to embarrass or annoy Mary by refusing her. He tells Mary that she may begin the interview. However, he feels distanced from Mary. How can he possibly confide in someone so obviously different to himself? He is certainly not in the mood to talk with her about personal medical problems.
Mary and Jake sit down in the lounge room. The entire family gathers around to hear the interview. Mary feels threatened. She is not used to conducting her interviews in the presence of a large group of people. Her body language shows that she wishes Jake's family would leave the room.
Mary is also nervous because she is aware that she is dealing with a cultural group of whom she has little knowledge.
Jake's family thinks Mary must be very arrogant as she is a visitor in this house and she obviously wants them to leave the room. They stay where they are and begin to giggle.
Mary feels threatened by the laughter.
She takes out her list of questions, a pen and notepad and begins firing questions at Jake.
Jake gives short responses and seems uncomfortable when Mary questions him about incontinence or the extent of his disabilities. He is evasive. He play downs the extent of his disabilities. Having finished asking her questions, Mary closes her folder, says good-bye to Jake and flashes a big smile at the other members of the family. She feels a little embarrassed about excluding them from her conversation and not showing any courtesy to them. She is effusive in her goodbyes. The family is polite but not effusive in return.
Upon leaving the house, Mary feels somehow deflated. She feels as if something has gone wrong, but can't figure out what.Based on Jake's responses, Mary makes the decision that Jake is ineligible for services. Her decision is wrong – Jake does need help. How could Mary, an experienced health professional, make such a terrible mistake?
Select the More information button to find out about some of the hidden cultural influences at play. The information you read is not comprehensive – you may recognise some further cultural patterns that are not mentioned.
It is vital that health staff members avoid situations like this one. Health staff members need to do all they can to help Australian South Sea Islanders feel comfortable about accessing health care.If Mary had conducted her interview differently, she would have received a very different response from Jake.
In short, she would have built relationships that work – and go on working.
As it is, Jake and his family continue to be wary of accessing health care services – a cultural pattern that exists throughout many Australian South Sea Islander communities.
Mary was unaware of the complex combination of cultural patterns at play.
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