Sisters, friends or whānau?

This is a lengthier version of an editorial published in this month’s Kai Tiaki New Zealand Nursing Journal. It is based on an invited address I gave at the 10th Annual Conference of the Women’s Health Section:’Divine Secrets of the Sisterhood’ on April 26th  2012.

I recently spoke at the NZNO Women’s health conference about sisterhood. Not that I don’t care about men (I do deeply), but as one of three sisters and as a woman who has spent most of my adult life working in the female dominated profession of nursing, relationships between women are of great personal and professional interest. The call to action in the women’s movement almost thirty years ago emphasised sisterhood and demanded the end of oppression and the commitment to women as a social group (Klein & Hawthorne, 1994). However, the movement also raised questions of difference. Many suggested that in order to understand what women had in common they also needed to pay attention to what they didn’t have in common such as race, gender and sexuality. Focusing on similarity erased and overlooked important differences, but only focusing on difference led to the “othering” of others, stereotyping and pushing people away.

I believe these questions remain important for nursing, because I think our differences can make nursing stronger. An understanding of our differences can help us to better understand our similarities. As Audre Lorde points out “it is within our differences that we are both most powerful and most vulnerable, and some of the most difficult tasks of our lives are the claiming of differences and learning to use those differences for bridges rather than as barriers between us”. So I believe an important question for nurses is how can we capitalise on the energy and movement in difference and resist the coercive force of sameness?

One of the challenges is that differences raise critical issues of power, because differences are often institutionalised (Crenshaw,1994, p.411). Take the idea of the implicit ideal nurse-typically the ideal nurse is female, white, middle class, heterosexual, able bodied, nice, obedient and nurturing (Giddings, 2005; Reverby, 2001). Those nurses that fit the norm experience privilege and those that don’t are marginalised. Internationally, women of colour are present in practice settings with less prestige, lower wages, less security, and less professional autonomy (Gustafson, 2007). While, a disproportionate number of white men and women are ensconced in nursing management, academia and research, whose world view is supported by the dominance of white, Western, biomedical interpretations of health and illness. Grada Kilomba defines whiteness as “a political definition, which represents historical, political and social privileges of a certain group that has access to dominant structures and institutions of society”.  As Ang-Lygate (1997, p,2) points out “political sisterhood is suspect unless those sisters who enjoy privileges denied to other sisters are seen to share the responsibility of dismantling the differences”.

This dominance of whiteness in our workforce and our ideas about health and illness are present in nursing in New Zealand too. We are undergoing a period of unprecedented diversity. Transitioning from largely New Zealand-born European to being increasingly ethnically diverse, our dependence on overseas-born migrant nurses is evident in their composition of 29% of the workforce- one of the highest proportions in the OECD. At the same time Māori and Pacific Islands nurses are under-represented in our workforce while these communities experience the greatest health need. This inequity is challenging and as Margaret Southwick notes provides “justification (if one be needed) for the claim that nursing needs to take seriously the challenge of working with diverse and marginalised groups within society is to be found in the health status of these very same groups of people.” (Southwick, 2001).

So given the diversities in nursing and the health inequities that confront our communities, new strategies are necessary. I’m proposing moving away from sisterhood which implies the shared experience of being a woman and experiencing gender oppression to consider a new metaphor that allows greater consideration of our differences so that we can better articulate our similarities (Simmonds, 1997). There’s friendship for a start, a relationship based on equals who have affection, and interest in each other (Friedman, 1993, p.189). Its etymology is in the word free. It means to love, to love our own freedom, and to love and encourage the freedom of the other (Mary Daly, 1987). Friendship allows us to work in each other’s interests because part of what is compelling is our differences.

The notion of friendship as an alliance within the context of difference can be seen in this brilliant blog post entitled Queer Sisters Keep Saving Me: The Brilliantly Selfish Act of Being an Ally by Black Artemis

Heterosexual people especially women owe a tremendous debt to the LGBTQ struggle for some of the sexual freedoms we enjoy…the boundaries queer people bend and bust at the risk of their own lives in many ways expand our heteronormative privilege. Their radical decision to be simply who they are makes it much safer for the rest of us to redefine who we may want to be. We have a broader range of acceptable sexual expression because of the queer liberation movement for every time they push the envelope, they set a new “normal,” and it’s not even they who benefit the most for their courage. Rather it is those of us whose sexual identity is already validated.

If we are going to use the metaphor of sisterhood we consider the idea of a “chosen family” used by LGBTQ communities or the Māori concept of whānau. It too is based on love rather than biology and includes people as who are a source of love and support outside the heteronormative idea of family.

I’d like us to strengthen nursing by strengthening ourselves, for creating space for all nurses to be able to come together with our diverse traditions and values, to be united based on solidarity not sameness. I’d like us to be able to articulate our shared beliefs and practices while acknowledging how we differ.

I’m proud to be a nurse in New Zealand, I value the shared commitment to caring and to social justice in the shape of cultural safety. I’d like to build on our legacy and see nurses critically examine the values, goals, and intents shaping our profession. I’d like us to have some challenging conversations about power and privilege, to deconstruct our own classism, racism, and homophobia and to think about recognition and reparation. I leave my final words to Audre Lorde:

So this is a call for each of you to remember herself and himself, to reach for new definitions of that self, and to live intensely. To not settle for the safety of pretended sameness and the false security that sameness seems to offer. To feel the consequences of who you wish to be, lest you bring nothing of lasting worth because you have withheld some piece of the essential, which is you.

References

ANG-LYGATE, M., CORRIN, C. & HENRY, M. S. 1997. Desperately seeking sisterhood: Still challenging and building, London, Taylor and Francis.

CRENSHAW, K. 1994. Mapping the margins: Intersectionality, identity politics, and violence against women of color. In: FINEMAN, M. A. & MYKITIUK, R. (eds.) The public nature of private violence. New York: Routledge.

DALY, M. (1978) Gyn/Ecology: The Metaethics of Radical Feminism, Boston: Beacon.

FRIEDMAN, M. 1993. What are friends for?: feminist perspectives on personal relationships and moral theory, New York: Cornell University Press.

GIDDINGS, L. S. 2005. Health disparities, social injustice, and the culture of nursing. Nursing Research, 54, 304.

GUSTAFSON, D. L. 2007. White on whiteness: Becoming radicalized about race. Nursing Inquiry, 14, 153-161.

HAWTHORNE, S. & KLEIN, R. 1994. Australia for Women: travel and culture, New York, Spinifex Press.

LORDE, A. 2009. Difference and Survival: An Address to Hunter College” Rudolph, New York:, Oxford University Press.

REVERBY, S. 2001. A caring dilemma: Womanhood and nursing in historical perspective. In: HEIN, E. C. (ed.) Nursing issues in the twenty-first century: Perspectives from the literature. Philadelphia: Lippincott, Williams and Wilkins.

SIMMONDS, F. N. 1997. Who Are the Sisters? Difference, Feminism, and Friendship. 19-30. In ANG-LYGATE, M., CORRIN, C. & HENRY, M. S. 1997. Desperately seeking sisterhood: Still challenging and building, London, Taylor and Francis.

SIMMONDS, F. N. 1997. Who Are the Sisters? Difference, Feminism, and Friendship. Desperately Seeking Sisterhood: Still challenging and building, 19-30.

SOUTHWICK, M. R. 2001. Pacific women’s stories of becoming a nurse in New Zealand: A radical hermeneutic reconstruction of marginality. Unpublished Doctoral thesis, Wellington: Victoria University of Wellington.

 

Food and festivals: Consuming multiculturalism

Multiculturalism has acquired a quality akin to spectacle. The metaphor that has displaced the melting pot is the salad. A salad consists of many ingredients, is colorful and beautiful, and it is to be consumed by someone. Who consumes multiculturalism is a question begging to be asked.

Angela Y. Davis (1996, p. 45)

WOMAD main stage, March 2012

The New Zealand summer has ended, and as Autumn deepens there are a flurry of festivals making the most of sunshine hours and daylight saving before we turn to insular hibernation modes. In the last few weeks I’ve been to WOMAD in New Plymouth, Pasifika and the International Cultural festival in Auckland and a few smaller low key community functions. I’m interested in whether food and festivals, which are such visible and public celebrations of ‘culture’ (and especially culinary cultures) are anything more than what Duruz calls the appropriation of difference by a greedy white consumerist society.

The pretext of a cultural festival is that there is an ‘us’ and a ‘them’, a national culture and an alien culture.  Migrants then are people who try and enter something that has ostensibly already formed into something and solidified (that’s why it feels like you are banging your head against a wall when you can’t get a job, because it really is a wall or a bamboo ceiling). This imagined sameness might not be very clearly articulated by the dominant culture, but everyone knows what does and doesn’t belong. If you don’t know, the media or a politician will tell you. The latter are renowned for either demonising or exoticising diversity. Festivals as less scary manifestations of diversity bring out enthusiasm, as Mayor of Auckland Len Brown speaks about the Auckland International Cultural festival (made up of dance and musical performances, an Ethnic Soccer Cup and over 100 stalls of ‘traditional’  food): ” …a fantastic celebration of Auckland’s ever-growing cultural diversity …which highlights the dynamic contribution people from other cultures bring to our wider community, and to New Zealand. Come along and sample the many sights, sounds and tastes of Auckland diversity.”

Monte con Huesillo: Chilean drink of dried peaches and wheat

The celebration and sampling of this dynamic contribution can be read as an enabler of social cohesion and community building. As Uma Narayan points out, the combination of prejudice, neighborhood and occupational stratification and segregation can mean that we have very little do do with members of other ethnic groups beyond seeing them as service providers to the detriment of “collective possibilities”. The public consumption of food is a great mechanism for intercultural exchange. The sensual enjoyment of the food of others can help us gain an appreciation of them as part of our communities even if we don’t know very much about the cultural context of the food.

The aspect of consumption that is on display also has a ‘feel good’ aspect. Where the media and its three stooges (Paul HenryMichael Laws and Paul Holmes) often lead us to view migrants (and Tangata whenua and several generations of Pacific peoples) as a political threat to the integrity of the ‘host’ white settler Pakeha nation. Festivals tame diversity into a strategic asset, that is managed and displayed for people to witness and enjoy. The elephant in the playing field or park though are the unanswered questions of racism and exclusion. The safe packaging inherent in festivals, where people embody their culture in a display allow ‘us’ to feel good about our city and the presence of ‘others’.  This low impact kind of engagement has very little performance pressure and even less demand for any kind of accountability or responsibility. Culture can be celebrated rather than acted upon as Arun Kundnani quips.

Hungarian Langos (Fried Bread) with a topping of pesto, tomato and feta-Yum!

The pleasures of consumption make diversity appealing, something to be shared and enjoyed as Sara Ahmed notes.  The consumption of ethnic food points to a desire to consume difference through appropriation of food and tradition as exotic, where ethnicity becomes spice for mainstream culture, losing its own legitimacy in the process. Instead of engagement, the other is consumed. Consuming diversity gets translated into ‘eating the other’. Heldke talks about a kind of “cultural food colonialism” where the food being cooked and eaten comes from economically dominated countries of the ‘third world’. Culture is there for the taking and “something to be be enjoyed, consumed at will and with discernment by the liberal subject.”. The new marker of sophistication is the latest ethnic restaurant find, a marker of street credibility and sophistication. Reflecting a desire for novelty and a sense of entitlement.

This differs to how might I think of food and festivals, as a diasporic subject. For me attending the cultural festival and more low key community events creates is a way of being at home in the context of a community far from ‘home’, being able to express aspects of my life that don’t often get a public viewing. As Ghassan Hage points out, cooking and eating familiar food is a way of making a home in the present. Food represents comfort, enjoyment, social life, memories and stories. As someone whose food choices were derided until they became fashionable (why did it take so long for curries to become popular in New Zealand? and what is wrong with tongue sandwiches anyway?). The advent of cultural food colonialism inflicts an old pain, food shapes us physically and emotionally, creating possibilities for enjoyment and pleasure. However, we must be mindful that power relations accompany our consumption choices and have implications for how we are to live in a multicultural society founded on biculturalism.

Cartoonist Alexyz and the author in Auckland at an exhibition of his work with members of the Goan community. February 2012.

So how do we reconcile these diverse ways of looking at food and its consumption? Perhaps we can use the gustatory pleasures we experience to build more powerful bonds between us as Uma Narayan proposes. These pleasures can have more power than intellectual understanding or knowledge. The sensual pleasures of food can counter our physical alienation in the unpressured form of contact that a festival allows. Perhaps the journey to greater openness and acceptance and building of bonds begins at the venue where we eat the food where we can be provoked into a process of reflexivity  and begin to care for the cooks as much as we are willing to enjoy the food.

 

Celebrating African women in Aotearoa New Zealand

I was honoured to be invited by the African Community Forum Incorporated to attend and speak at an event on March 10th 2012 to celebrate International Women’s Day. I have written elsewhere about my links with East Africa. Briefly, I was born in Tabora Tanzania and lived in Nairobi, Kenya until the age of ten, when my family migrated to New Zealand. Originating from Goa, India, both sets of grandparents moved to Tanzania in the late 19th Century and both my parents were born there. Until moving to New Zealand I was fluent in both Swahili and Maragoli.  The African part of my identity rarely gets the opportunity to play, so I was thrilled to attend the event.

 

Indians in Africa

Many people might be surprised to know that the Indian connection to Africa goes back three thousand years. Indians were traders and later sojourners. The British indentured labour scheme which replaced slave labour, ushered a new era of cheap and reliable labour for plantations and the building of railways. The construction of the great railway from Mombasa to Lake Victoria in Uganda in the late nineteenth century brought fifteen thousand (of the sixteen thousand) workers or ‘coolies’ from India. Tragically one quarter of them died or returned disabled (Sowell, 1996). Indians (especially Goans) were also recruited to run the railways after they were built (as my grandparents were) and Goans came to dominate the colonial civil services.

Africans in New Zealand

The history of African migration to New Zealand is much more recent. Te Ara online encyclopedia notes that the first black African in New Zealand was travelling on James Cook’s second voyage as a servant (no name is provided) and later killed by Maori in 1773. The 1871 New Zealand census recorded 34 people who were born in ‘British African Possessions’ and another 31 from other African countries. The 1911 census recorded 92 African-born people. However, these African born people were likely to have been white given the mobility of white settlers through the then British Empire. The 1916 census recorded 95 “Negroes” referring to African Americans and six African born people, four Abyssinians (Ethiopians) and two Egyptians. The Colombo Plan saw the arrival of Black Africans as students in the 1960s, some of whom remained in New Zealand and had families. During the 1970s two groups of Africans arrived in New Zealand. White Rhodesians who were escaping from the war and two hundred Ugandans (not sure if they were all Asian Ugandans) who were ejected by Idi Amin. The number of African born residents (mainly from Commonwealth countries) increased to 3,939 Africans by 1986, but again were mainly white. It was not until the changes in migration policy of 1987 that there were significant demographic changes as a result of the development of a formal refugee quota  which saw arrivals especially from Ethiopia (1991-3), Somalia (1992-4), Rwanda (1994) and the shift to a migration points policy which saw a greater number of African people coming New Zealand as migrants. The 2006 Census 10,647 or 0.3% of the population identified as African. 4,806  Africans reside in Auckland and 5,841 outside of Auckland. In the 10 years between 1991 and 2001 the number of women from African countries increased considerably with numbers of women from South Africa, Zimbabwe and Somalia more than quadrupling in that time (Statistics New Zealand, 2005).

The growth of the African community is an exciting development and the event organised by ACOFI was a fantastic celebration of Pan-African culture and the vitality and energy of the community. I look forward to taking part in more events and improving my now very rusty Swahili! By the way, the art work is from a drawing competition run on the night. My big thanks to all the organisers especially Carlos Carl, Boubacar Coulibaly and Sharon Sandra Paulus and all the people that worked hard to make the event happen.

When activists become oppressors: Nurses and migrant mothers.

This Sunday I’ll be doing a Picnic lecture where I’ll be sharing stories from nurses and migrant mothers from my PhD to discuss how well intentioned activism can become a form of oppression. The lecture will be held in the Albert Park rotunda in Auckland on Sunday 1st April at 3pm and is linked with Te Tuhi’s What do you mean, we? exhibition which brings together an international selection of artists to examine prejudice.

The kinds of questions that my work has been concerned with are:

  • What subjectivities and beliefs and values are being reproduced when a woman has a baby in neoliberal Aotearoa New Zealand?
  • How does a maternal health care system provide services for birthing women whose subjectivities have been partially or significantly formed outside a white settler nation context and specifically outside the colonial dyad of settler and indigenous?
  • Do the policy rhetoric of biculturalism in response to Treaty of Waitangi obligations and the requirement for culturally competent practice actually improve the care migrant mothers receive?
  • Do the liberal feminist aspirations for birth as an empowering experience extend to women outside the world of white middle-class feminism?

When helping does not help: Invisible children and colonialism

In almost thirty years of being a nurse I’ve learned that what one person thinks is helpful can be coercive to another. “Help” is complex, raising questions such as: how has the helper negotiated the relationship? Does the helper understand the problem? Do the people being helped agree with the helper’s framing of the problem? There is also the issue of power in the helping relationship. How did the helper get the power to help? What access to resources and knowledge does the helper have? Does helping disempower the helped?

The film and campaign KONY 2012 by Invisible Children and directed by Jason Russell about the Lord’s Resistance Army (LRA) led by the “monster” Joseph Kony has generated passionate pleas from a range of “friends” to support the “people” of Uganda. I am excited about the democratisation of information through social media, but I’ve been frustrated that this video has made us all “experts” about Africa. There is a bigger social and political backdrop to this story which has been tracked by Blackstar news and Akena Francis Adyanga.

My concern with this video is that it valorises the story being told by Invisible children (and other white people) at the expense of African leaders, without access to the same power structures or resources. The  documentary repeats the colonial imperative for Africa to be saved by white people. This video smacks of yet another colonial “civilising” project,  where the old binaries of colonialism are revived. These frame Africa as backward, while the west is modern; “we” are positioned as free while “they” are oppressed and so on. In this binary of good and bad, Africans are represented on the not so good side of the binary. Therefore, the solution must be a good one, a white one, and in this hierarchy Africans lose out. Local efforts and voices go unacknowledged in favour of the white saviour complex, which as Teju Cole suggests “supports brutal policies in the morning, founds charities in the afternoon, and receives awards in the evening”. Even the name  “Invisible Children” as the Sojourner project points out “denies and co-opts the agency of Ugandans – many of whom have organized to protect child soldiers”.

I have a stake in this propaganda video on several fronts. One is my personal experience of being born in Tanzania to parents who were also born in Tanzania and and having two sisters who were born in Kenya. My own life has been shaped by three versions of colonialism: German, Portuguese and British, and continues to be shaped by colonialism’s continuing effects in the white settler nation of Aotearoa/New Zealand. Secondly, in my doctoral studies, I investigated the colonial legacies of health and nursing in the context of migrant maternity. My profession of nursing is not only an altruistic and caring enterprise, but is also complicit with biomedicine in the advancement of colonialism and imperialism. Medicine has used imperial claims to modernity and universalism, while the concept of “health” has in turn has lent moral credibility to the colonial enterprise. Consequently, one of my theoretical and political commitments is the resistance to imperial cultural analysis. I abhor the white saviour narrative, where vulnerable children or women of colour must be rescued from men of colour by “culturally superior” white men or women.  We need less individualising narratives, where the full social, political and historical contexts of a situation can be considered.

So what does a process such as colonialism have to do with this video? European colonialism put in place hierarchies of superiority/inferiority and structures of domination and subordination. The conquest and control of other people’s land and goods has recurred throughout human history, but European colonialism in the 19th century allowed for the growth of European capitalism and industry through the economic exploitation of raw materials, cheap, indentured or slave labour and profitable land in the colonies. Profits always returned to the imperial centres. Domination and authority were supported by defence and foreign policies and internalised so that ordinary “indeed decent men and women accepted their almost metaphysical obligation to rule subordinate, inferior, or less advanced people” (Said, 1993, p.10). These imperial ventures were justified on the basis of developmental and pedagogical notions of progress and improvement. They created the template for contemporary production under globalisation. So none of us are outside of or immune from postcolonial relations, values and belief systems whether our ancestors were colonisers or colonised. We are all influenced by colonialism.

Narratives produced about the colonies have historically defined the West in contrast with the “Orient”. The Orient was represented in a denigrating and negative way, in order to represent a civilised and positive Britain. Generalisations were made about groups of people who were treated as a homogenous mass (rather than communities of individuals) about whom knowledge could be obtained or stereotypes created – for example ‘the inscrutable Chinese’. The video plays into this oppositional dichotomy of “us” and “them”, constructing two social groups as distinct and internally homogenous. It begins with a sense of connection, it targets our desire to belong and connect by talking about social media, emphasising what we have in common. However, the “we” that it refers to is white. The video then moves to the “other” and the mobilisation of social movements that social media allows in the form of the Arab Spring. The director Russell then shares a very personal experience of the birth of his son and how his son takes part in his father’s film work and activism. The son embodies Russell’s desire for a better world than the one he came into “because he [my son] is here, he matters”. Russell then takes us to Uganda and the experience of another young man who has had a different life from that of his son. A young man who has experienced loss and unimaginable suffering, who has no future because of Joseph Kony. Russell says something like “you mean this has been happening for years? If this happened in America for one day it would be on the cover of Newsweek”. How can we fail not to be moved? Rusell takes us through the journey he makes with his friends of trying to raise the attention of the United States government of the plight of this young man and eventually through the advocacy and donations of lots of young people who donate small amounts of money every month, the government takes action. Of course this might have nothing to do with the fact that oil was found in Uganda in 2009. Russell in his voice over says they did not wait for governments, they’ve built schools, created jobs, created warning systems to keep people safe. All funded by young people.  Russell invokes liberal humanist arguments (the very ones that were central to colonial capitalism) about the right of the individual to have a good life. As Teju Cole righly points out “the White Savior Industrial Complex is not about justice. It is about having a big emotional experience that validates privilege”.

The video enacts the binary colonial script of the civilised and liberated white person who rescues Ugandan children, thereby affirming the superiority of the former. Russell reproduces the narrow representations of people of colour as a mass of oppressed people who live in a world without freedom, ruled by oppressive vain tyrants (oops that sounds like the West!). He reproduces a flattened and familiar “single story” of Africa. As Chimamanda Ngozi Adichie says “the single story creates stereotypes, and the problem with stereotypes is not that they are untrue, but that they are incomplete. They make one story become the only story.”  In the process, the complexity and diversity of people’s lives are lost and local activism is hidden from view in favour of camera crews with resources and magnanimity. Think about Binyavanga Wainana’s essay, How to Write about Africa:

Never have a picture of a well-adjusted African on the cover of your book, or in it, unless that African has won the Nobel Prize. An AK-47, prominent ribs, naked breasts: use these. If you must include an African, make sure you get one in Masai or Zulu or Dogon dress

The effect is that we focus on the other, instead of looking at the monsters in our own communities. Rather than offering our support to the efforts of indigenous people who are quietly attempting to right wrongs without a television camera present, we get carried away in a tide of righteous indignation about “stopping the monster”.The video provides a depository for our own feelings of powerlessness and frustration. It demands very little of us. We don’t need to be accountable to a faceless mass, because we can trust Russell, we’ve seen the birth of his boy child, we’ve seen him in his kitchen, we’ve seen him in the family bed with both his children. He is trustworthy. Never mind facts such as Kony is no longer in northern Uganda, that the Ugandan army have also contributed to the violence meted out to civilians, that General Museveni used child soldiers way back in 1986 or that only 31% of funds that Invisible children receive go into this charity work.

So what does helping really mean in a different social context? How does sharing a link to a video to an organisation that is barely transparent about its funding, that uses the bodies of children to make a point, that carries us away with the injustice of it all, help? How does the fact that the focus now in Northern Uganda is about repatriating child soldiers who are being held in DRC, Sudan and the Central African Republic, on postconflict rehabilitation and the reintegration of child soldiers? What impact will this film have on former child soldiers who have now reintegrated into  their communities? Can something with good intentions lead to misconceived interventions? Hell yes! The history of modern Africa is replete with aid failures and poorly allocated resources.

I am not against standing up and fighting for what is right, but only when we really understand what we are standing up for, not on “zero knowledge and maximum hysteria” as Elliot Ross argues. So we must make the most of this technology that is available to us and to critically interrogate the sources of this new media, their motivations and their operations . We need to do the research, to ask questions about our own complicity in contemporary geopolitics and to support the people who understand the problem.

New mothers in a new land: Indian migrant mothers talk

Originally published in: DeSouza, R. (2010). New mothers in a new land: Indian migrant mothers talk. In S. Bandyopadhyay (Ed.), India in New Zealand: Local identities, global relations (pp. 207-217). Dunedin: Otago University Press.

Ethnic identity and acculturation become important issues in the transition to parenthood. The birth of a child presents parents with the opportunity to consider what values are important to them and whether they will look to the future or the past (or both) to determine what will sustain them in their role as parents and nurture their newborn to adulthood. This sifting process involves parents interpreting and accepting or rejecting the values, beliefs, and practices from both their heritage culture and their current community.

Migrant Indian mothers play a pivotal role in such negotiations. This chapter presents research findings from a study on the maternity experiences of Indian migrant women living in Auckland, New Zealand in late 20062. It begins with a brief discussion of the literature around the process of acculturation and its influence on Indian health and maternal health in particular. It then looks at the inherited beliefs and practices that shape the maternity experiences of Indian mothers, especially the centrality of motherhood to identity, and the idealisation and rewards of self-denial and good behaviour. Finally, the chapter discusses the study’s findings. These exemplify how motherhood is idealised and viewed as a socially powerful role among immigrant Indian mothers, and that these mothers have also taken on the messages of New Zealand models of motherhood (and parenting in general) where self-monitoring is required in order to be ‘a good mother’.

Power relations

Hot off the press! I’ve just had this chapter on power relations published in S. Shaw, A. Haxell & T. Weblemoe (Eds.), Communication and lifespan development. Melbourne: Oxford University Press

Many practitioners see themselves as apolitical and powerless, particularly with regard to their relationships with the structures of medicine and management. However, in reality practitioners are powerful both as individuals and as members of the groups with which they identify. The structures and cultures within which most health and disability practitioners exist and work are based on beliefs and practices that constrain autonomy. These constraints are at work through a number of mechanisms, such as the market, the infusion of targets and performance measures and quality programmes (Newman & Vidler, 2006). In addition, the changing role of consumers or service users from passive recipients of care in the past to people who may be informed, empowered, articulate and ‘demanding’ poses a threat to the ‘knowledge–power knot’ on which professional power rests.

When practitioners view themselves as people who are doing good, they tend to lack awareness of their complicity and embeddedness in relations of power that structure inequality. Yet, power is embedded in everyday practices and interactions (Bradbury Jones, Sambrook & Irvine, 2008). Practitioners within the wider health and disability sectors contribute to social regulation through their roles as employees of the state. They enact government policies for the benefit of the health of the citizens of the state; so they are both governed and governing. Members of recognised professional groups are provided with a moral authority by their capacity to define problems and pose solutions, and their role in defining and evaluating good or normal behaviour and health practices through surveillance of the population and the criteria for interventions on behalf of the state (Gilbert, 2001, p. 201).

These ambivalent relationships with power that are evident among health professionals require exploration. This can be done by considering the various ways in which power is conceptualised and the micro and macro definitions of empowerment. Some shifts in power have occurred in the last few decades, largely influenced by various social movements. Maternity and mental health are two particular examples of professional practice and service delivery in which power can be recognised and ideas of empowerment can be translated meaningful engagement between service delivery and those who engage with the service.

All of me meets here, an alchemy of parts – Negotiating my identities in New Zealand

Originally published in:  DeSouza, R. (2011). ‘All of me meets here, an alchemy of parts’ – Negotiating my identities in New Zealand. In P. Voci & J. Leckie (Eds.), Localizing Asia in Aotearoa (pp. 231-245). Wellington: Dunmore Publishing.

He could not see that i could be both … The body in front of him was already inscribed within the gendered social relations of the colonial sandwich. i could not just ‘be’. I had to name an identity, no matter that this naming rendered invisible all the other identities of gender, caste, religion, linguistic group, generation (Brah, 1996, p. 3).

Introduction

The title of this chapter comes from a poem by Chris Abani (2000) whom I met many years ago at the Poetics of exile conference. This line from the poem captures the intention of this chapter, to bring parts of myself together. I am often asked the question ‘where are you from?’ Depending on the person asking, it can imply that I have come from somewhere else, not here; that I am visibly and noticeably different; and sometimes reflects a desire on the part of the person asking to either connect, name or categorize. For the sake of economy, choosing one identity and keeping things simple inevitably backfires. answering Tanzania, the country of my birth, and that of my parents, or Goa, India, the place of my ancestors, results in more questions. The question has different nuances in the place of my ancestors and in the place where I choose to live: Aotearoa/New Zealand. Being asked where one is from more easily translates to ‘whom do you belong to?’ and the reference points are intimate, connecting me to a village and to a family. In Māori contexts, similar notions of belonging to place and people are invoked, where intimacy and connection rather than categorization are emphasized. such a question highlights issues of identity, difference and belonging. The process of active negotiation of identities in relation to oneself is the focus of my chapter. I centre on a little-known minority group within a larger indian umbrella identity – the Goan diaspora living in New Zealand. My aim is to provide a complex answer to the question of where I am from and, in doing so, provide a platform for further scholarship about the Goan diaspora in New Zealand.

 

People of colour decolonisation hui

The Decolonise Your Minds! Hui on February 5th in Tamaki Makaurau, Aotearoa provided a great opportunity to present my PhD work to awesome folks with similar theoretical and political commitments. Outside a professional or academic context and supported by fabulous vegan food and great korero and creativity, the radical space provided a great opportunity to not have to explain everything!

In my presentation, I talked about the ways in which the people who are supposed to care in institutions can engage in subtle coercions and “do” violence. This violence works through the reproduction of taken for granted norms and values, such that pressure is exerted on those whose personhood sits outside the accepted norms and values and reshapes their personhood. Reflecting an assimilatory process similar to the colonial process of moral improvement. Hardly a surprise considering that institutions like health and education are colonial, having been transplanted from the metropole to the colony and super-imposed over indigenous ways of learning and maintaining health.

Using the example of maternity I talked about the ways in which heath professionals draw on culturally and socially available repertoires of care that can be less than helpful when imposed on women of colour. This is because so often these repertoires are drawn on the basis of an implicit ideal user who tends to be cis-woman, heterosexual, white, middle class and one who takes up the ‘imperative of health’. That is the ideal neoliberal consumer who makes herself an expert through her consumption of self-help books and its acceptable accoutrements, who takes responsibility by attending ante-natal classes and who labours naturally with her loving and supportive partner present. She obeys the edicts of the health professional and makes reasonable requests that align with the dominant discourse of maternity as an empowering experience (if you are “informed” and “take responsibility”).

You can listen to the audio which is hosted by the Pride New Zealand website. I take the audience through the idea of discourses and how they shape subjectivity and practice.

Please note I have a tendency to swear when I am speaking passionately about something!

Adapting to New Zealand’s super-diversity

Originally published in  Contact: Newsletter for members of the Pharmacy Guild of New Zealand, December 2011-January 2012  (Issue 11), Pages 8-9.

New Zealand has earned the right to call itself super-diverse. this term refers to an unprecedented level and kind of complexity that surpasses anything previously experienced in a particular society. This super-diversity leads to new conjunctions and interactions, and outcomes that extend beyond the usual ways of understanding diversity.

Super-diversity is a relatively new phenomenon given the relative homogeneity of the New Zealand population. The arrival of super-diversity, its impacts and the relevance of super-diversity to pharmacy are the focus of this article.

Why is ethnic diversity and super-diversity relevant to pharmacy? And why is a nurse with a PhD writing about it? Perhaps it is because nurses and pharmacists have a lot in common. We see a lot of people and we tend to have very regular, intimate and long- term relationships with people (if we are doing something right). If we are not, people vote with their feet. Given this ubiquity, how can we ensure that we make a difference in the context of super-diversity?

New Zealand’s super-diversity kicked in with Asian migration in the 1990s. Prior to that, New Zealand had preferred particular “source countries” to select migrants from (Great Britain and Ireland). This homogeneity of migrants was altered by Polynesian Pacific migration from the 1960s, but it was the migration policy changes of 1987 that paved the way for skilled migrants from a range of countries to arrive, notably Asia.

These demographic changes led to a philosophical shift from assimilation to multiculturalism in the context of biculturalism. The expectation of newcomers to assimilate (give up their ways to fit into a new culture) was changed to reflect the notion of New Zealand as an inclusive society where the integration of newcomers was supported by “responsive services, a welcoming environment and a shared respect for diversity”.

But the effects of assimilation can be seen on the health of Maori and Pacific people who experience health inequalities and a lower life expectancy than Pakeha. We are beginning to see these same trends in Asian and MELAA (Middle-Eastern, Latin American and African) communities. It is easy to write-off the poor health of particular groups to their individual behaviour or their culture. But there is growing evidence that health professional behaviour contributes to creating and reproducing disparities as seen by the differential quality of healthcare different racial and ethnic groups receive.

Cultural competence is a strategy for reducing health disparities and activating health gain. The American Society of Health-System pharmacists (ASHP) suggests that medication therapy management is central to many health disparities including diabetes or end-stage renal disease which disproportionately affects particular groups (for example, Maori) that pharmacists are in a position to directly address these disparities or to change the language away from deficit to health benefit or gain.

The Health Practitioners Competence Assurance Act 2003 requires that all health professionals are competent and fit to practice. There are seven standards for New Zealand pharmacists that articulate the knowledge, skills, attitudes and behaviours necessary for competence. The standard that is most relevant to cultural competence is Standard One which requires that pharmacists practice pharmacy in a professional and culturally competent manner.

Cultural competence approaches require the health professional and the institutional system of health to adapt the ways in which they deliver services in order to accommodate difference. these require the health professional to focus on three main areas.

  • The first is to be aware of how the patient or client’s health beliefs, values and behaviours are shaped by their culture or religion.
  • The second is a focus on learning about what shapes health behaviours, disease epidemiology, ethno-pharmacology and complementary health practices located in different groups.
  • The final area is that of communication where the role of the health professional is to elicit the client’s health beliefs, develop a therapeutic alliance and utilise strategies that enhance communication such as working with professional interpreters (funded in some areas) or using the pharmacy translation Kit developed by the guild, for example.

New Zealand also has an indigenous strategy called cultural safety. The emphasis, here, is on the beliefs and attitudes of the health professional rather than that of the client. Careful reflection on the assumptions that underpin the culture of the profession or the service is required because these very assumptions can be assimilatory and disempowering for people who are not invested in them. Such assumptions as the belief that the individual is solely responsible for their own health, that Western medicine is the only valid mechanism for dealing with ill-health require conforming to the system, rather than the system adapting to the needs of the patient or client. These assumptions might pose a barrier to caring for someone who does not hold those beliefs.

Instead of doing what we’ve always done, we might be inspired to develop new ways of thinking and practicing that could benefit all people and communities in this super- diverse New Zealand.