The Purnells model for cultural competence is a circular model that comprises of the following four rings: global society, community, family and person (Purnell, 2000). Global society is the outer ring that represents such aspects as world politics and communications, global exchange in fields of commerce, health and technology, war, famine as well as the increasing ability of people to travel around the world and interact with individuals from diverse cultures. The second ring, which is called community, represents people who share a common interest or have a common identity and live in a specific locality. The third ring is family and it represents two or more people who are emotionally involved. The fourth one is called person and it represents the human being who is constantly adapting (Purnell, 2000). The interior of the four rings is divided into twelve wedges that show cultural domains and their concepts. The core of the circle is left empty to depict the unknown aspects of a cultural group. The twelve domains include heritage, communication, family organization, workforce issues, bio cultural ecology, high risk behavior, nutrition, child bearing practices, death rituals, religious practices and health care practices. Nurses can use the model to become consciously competent of a groups culture (Purnell, 2000).
Place New Order
Ethiopia is a multiethnic and multicultural country. The religious practices have a major influence on everyday life. About 50% of population are the members of Ethiopian Orthodox Church. In addition, there is a large Muslim population while others still uphold traditional Judaism (Milkas, 2011). Muslims lead in the business community and they occupy the lowlands. However, there is a significant number of Muslims dwelling in the capital, Addis Ababa. The English language is widely spoken and used as a medium of instruction in high schools and universities (Milkas, 2011). People use local languages, such as Amharic and Tigrinya, for instructions in primary schools.
The Ethiopian culture is diverse as it contains more than eighty ethnic groups. However, the majority consists of Somali, Amhara, Oromo and Tigreans making up more than 75 % of the population. English is the most frequently used foreign language (Ethiopia - language, culture, customs and etiquette, 2014). The Oromo people who are the largest Cushitic speaking ethnic group in the horn of Africa are believed to have occupied Ethiopia for a few millennia now. Their precise origin has not been established but they are believed to have been nomadic pastoralists. It is believed that the Amhara people lived in central Ethiopia (Milkias, 2011). The emperors ruled their region. The Somalis early life can be traced to the northern part of Ethiopia due to the ancient rock paintings found in this region. Based on linguistic evidence the Tigreans are considered to be the ancestors of some early Semitic speaking people found in central Eritrea and north of Ethiopia (Ethiopia - language, culture, customs and etiquette, 2014).
Sharing Thoughts, Feelings and Ideas
The Ethiopian people value politeness .Therefore sometimes they are unable to communicate their true feelings. They tend to speak indirectly to people whom they do not want to offend especially foreigners. For instance, they can say it is possible to a request that they do not want to comply. It helps to avoid disappointing somebody. However, they are willing to communicate and share thoughts on topics such as religion, marital status and business (Ethiopia - language, culture, customs and etiquette, 2014). It is advisable to refrain from talking about sex and politics during the initial stage of acquaintance with someone from this culture. They also do not appreciate questions on what tribe or area one is from. That is why it is recommended to avoid such questions. Moreover, Ethiopians are not open to discuss the topic of homosexuality since the practice is outlawed and considered to be a taboo in their culture (Ethiopia - language, culture, customs and etiquette, 2014). Raising ones voice, showing anger and public confrontations are considered rude. However, comments and conversations about physical appearance are very common and acceptable in this culture.
When people of the same sex are having a conversation, touch is acceptable. In addition, people of the same sex can be seen in public holding hands or arm in arm. It is common to see men holding shoulders or with hands around the waist, they can also hug each other (Ethiopia - language, culture, customs and etiquette, 2014). Men touching and hugging is just a sign of closeness and friendship in this culture and does not indicate their sexual preferences. On the other hand, women rarely practice similar closeness (Ethiopia - language, culture, customs and etiquette, 2014). Normally there is no touching when people of opposite sex are having a conversation. However, this tradition is changing especially among the young generation and the urban population. The majority of Ethiopian Muslims consider touching among people of different sexes a taboo, thus a stern handshake or a nod will suffice as a way of saluting one another (Ethiopia - language, culture, customs and etiquette, 2014).
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Personal Space and Distancing Strategies
In Ethiopian culture personal space and distancing strategies vary from one place to another depending on tribal influences and religious beliefs. An arms length distance or less is considered appropriate during conversations. This distance can be shorter when people of the same gender are involved in the conversation.
In Ethiopian culture eye contact is acceptable during the conversation between people of the same gender. It is also considered appropriate during conversations between people of different genders (Milkias, 2011). When people of the same age group communicate, it is appropriate to maintain direct eye contact. On the other hand, eye contact should be avoided when communicating with respectable people. For instance, eye contact will be avoided when talking to someone who has a higher socioeconomic status. In order to show a sign of respect young people avoid direct eye contact when communicating with their elders.
Gestures and Facial Expressions
Ethiopians also use gestures and facial expressions when communicating. For instance, clapping is used as a gesture to summon someone. However, foreigners find this gesture hard to adopt because in many countries it is considered rude. When signaling someone to come over they gesture by facing the palm towards them and making an inward scratching motion (Ethiopia - language, culture, customs and etiquette, 2014). Sometimes, Ethiopians show emotions with the help of their voice tone. For instance when someones speech becomes loud it may mean that they are excited or angry (Ethiopia - language, culture, customs and etiquette, 2014). In this culture, public display of affection, such as kissing, is not common. Sex is considered private and a couple is usually shy of expressing themselves even among their family members. Hand gestures are used to express approval, satisfaction or dissatisfaction.
Greetings are an important part of the Ethiopian culture. They can be lengthy lasting from one to ten minutes. It is considered important to ask about ones day, health and family. When a man is greeting another man, a handshake using the right hand is appropriate. For friends and family the handshake is accompanied by leaning forward and slightly bumping the right shoulder of the person who takes part in the conversation (Ethiopia - language, culture, customs and etiquette, 2014). In this culture men also hug and exchange kisses in the cheeks as a sign of closeness. However, it does not imply anything on their sexual preferences (Ethiopia - language, culture, customs and etiquette, 2014). When a woman is greeting another woman a handshake is also considered appropriate. When women are friends or members of one family, they greet one another by several kisses in a cheek. When a man is greeting a woman, the appropriate type of greeting depends on their relationship. Before a man and a woman establish a relationship a handshake is usually the appropriate form of greeting (Ethiopia - language, culture, customs and etiquette, 2014). Family and friends exchange a few kisses on alternating cheeks. However, most Ethiopian Muslims consider touching to be a taboo, thus they use a simple nod. Children are expected to bow as a sign of respect when introduced to elder or senior people (Milkias, 2011).
The Ethiopian people tend to be present-oriented. It means that they focus more on relationships than on schedules and appointments. In this culture, few people keep track of time and it is not considered rude. If someone arrives late for an appointment or meeting, he/she offers an apology and it is customary to accept the apology without emphasizing the lateness. Any actions are rarely planned in advance, thus people often start working late (Ethiopia - language, culture, customs and etiquette, 2014). Punctuality is not as valued in this culture as it is valued in the Western society. People are rarely in a hurry as they do not attach much importance to their time. Usually punctuality is more appreciated in business encounters than in social ones (Ethiopia - language, culture, customs and etiquette, 2014).
The Impact of My Culture
The culture has impacted the way I provide services to patients. My greetings to a patient are always courteous and formal. I always show respect to my patients while addressing them by adding Mr. or Ms./Mrs. to their names. In addition, I maintain eye contact with my patients because in our culture avoiding eye contact could be a sign that you are hiding something. I also use a calm audible voice while communicating with the patients because using a high voice may be recognized as a sign of disappointment or anger.