Cultural Diversity

Supported by DHHS/HRSA/BHPR/Division of Nursing Grant#D62HP06858

Cultural Diversity

ELDER ProjectFairfield University School of Nursing

Haitian Culture


Haitian CultureObjectives: Upon completion of this session,

the participants will be able to ….Discuss the role of religion, traditional health care

beliefs, social values, and family structure of Haitian Culture and the impact these factors have on health care.

Identify specific culturally sensitive practices that can be incorporated into your work with Haitian patients and Haitian American patients.

Identify similarities and differences between the Haitian and Jamaican cultures.


Haitian CultureIntroduction:The Haitian community in the United States

is diverse and their differences in social class and regional variations make it difficult to generalize about this population.

This group is comprised of 95% Black and 5% Mulatto.

Most Haitians indicate Black or African American as their racial category, but do not identify with that culture.

Currently, there is no category for them on surveys.


Haitian CultureIntroduction:Haiti’s history has been plagued with political violence for

most of its existence:In 1492 Columbus landed on the island of Hispaniola (Spanish

Island) which was originally inhabited by Taino and Arawak Indians. Almost immediately the Spanish set up agricultural settlements

using the natives on the island as labor.Early 1500’s – The Spaniard began to bring over slaves from

West AfricaEarly 1600’s – France became interested in the island1697 - The Spanish cede the western third of the island to

France via the Treaty of Ryswick. Formed a French colony called Saint-Dominque and became one of

the richest colonies of the time period.


Haitian CultureIntroduction:

1789 - The French Revolution started1804 - After 3 decades of slave revolts, Haiti declared

independence from France and became the first black republic in the world. The leader at the time chose an Arawak name meaning “country

of mountains”.1844 - Dominican Republic declares its independence from

Haiti1915 - The Unites States invaded Haiti as a strategic move

during World War I, and occupies the nation for almost 25 years. Although the U.S. did improve the conditions of the cities,

poverty and illiteracy still predominated. The Americans left in 1934, leaving behind a well-trained military.




Haitian CultureCommunication:Two official languages-Haitian Creole (known as

Kreyol) and French Kreyol (mixture of French and African languages that Haitian slaves spoke).Creole is spoken by the majority of Haitians.

Identifying as French is an indicator of social class.Oral forms of communication are preferred over

written forms of communication.Word of mouth is used to disseminate information. It is common for Haitians to use a lot of hand gestures

while talking.Speech may be loud, but it is not an indication of anger.


Haitian CultureCommunication:Direct eye contact is appropriate to use with

friends, along with an active tone of voice.Eye contact is avoided with those of higher

socioeconomic status or someone of authority.Touch is accepted in informal situations; however,

embracing those of the opposite sex is not typical.A stern handshake is an acceptable greeting in

formal situations.Often smile and nod head, but this does not

indicate understanding.


Haitian CultureFamily and Social Structure:Family is very important and often those Haitians living in

the US have financial responsibility to those who are still in Haiti. Haitians in the U.S. do not identify themselves solely as

residents of America or Haiti, but instead live life that bridges both countries

Home is geared towards the needs and strengths of the extended family. Households often consist of multiple generations

Traditionally a patriarchal society:Men are the bread winners and do not get involved in child

care at home. The man has ultimate control.


Haitian CultureFamily and Social Structure:Children are viewed as a gift from God.Elderly parents live with children.

It is considered an honor when a parent has chosen the child’s home to live.

Mother, father or elder family member makes the healthcare decisions.

Elders are viewed as knowledgeable and their counsel is sought.

Education is important; it can improve social status.Gender roles are strictly defined:

In healthcare, nurses are women and physician are men and expected to be an authority and trusted to do what needs to be done.


Haitian CultureView of Illness:Illness is thought to have either a natural or

supernatural cause. Natural illness occurs due to an imbalance with nature,

thus a short duration. If hot and cold equilibrium is disturbed, it results in a

natural illness.Illness can also be caused by sympathetic magic, such

as voodoo dolls and magicoreligious beliefsSupernatural illness is caused by God or the spirits and

usually appears suddenly, without warning. Sick person becomes passive and allows others to help.

Family typically comes to their assistance.


Haitian CultureView of Illness:Illnesses specific to this group:

Fright (seizisman): Result of extreme fright, surprise or shock. Believe blood is moved from the head into the body and

causes headache, visual disturbance and temporary mental problems.

Oppression: Describes asthma or a state of hyperventilation and anxiety.

Evil eye (maldyok): Result of a person’s envious glance and could be accidental. It can cause gastrointestinal problems (diarrhea) in children. It is treated by an herbalist or a voodoo practitioner.


Haitian CultureFolk Medicine:Believe they are sick if the illness interferes with their

ability to work. Home remedies are used first and include herbal

preparations, massage, and over-the-counter medications. These remedies are often passed on by the family and

Haitian Americans will even have ingredients sent from Haiti.

Often biomedical care will be simultaneously used with magico-religious care.

Strong belief that the quality of a person’s blood signifies the health of the person.


Haitian CultureFolk Medicine:Health care practitioners include:

Voodoo practitioners – They help with supernatural illnesses. They are well respected in the community. They diagnosis using cards, shells or trances. They treat with dancing, incantations, herbal

preparations, prayer and the calling on of spirits. They utilize a holistic perspective. It is not uncommon for American Haitians to seek help

of these practitioners even if it means going back to Haiti.


Haitian CultureFolk Medicine:Health care practitioners continued:

Herbalists- Are the most common traditional healers Lay trained; have no formal training. Are sought out for common illnesses such as colds,

fever, and diarrhea. They treat evil eye (maldyok) as well. They utilize a holistic perspective.

Midwives- They deliver babies and provide prenatal care. Lay trained; have no formal training.


Haitian CultureFolk Medicine:Health care practioners continued:

Bone setters- They treat musculoskeletal problems. Their treatment includes casts, massage,

manipulation, poultices (soft, herbal treated, warm covering) and prayer.

Injectionists- They travel from area to area giving injections of

whatever is needed. They use medication and herbal preparations.


Haitian CultureTime Orientation:Present orientation.Sense of time management does not emphasize

punctuality as this is not seen as an issue.Do not consider being late for appointments rude.

Dietary Habits:Haitian cuisine has both French and African

influences.Grains are a staple of the Haitian diet.

Rice is eaten at almost every meal and is often cooked with beans and served with sauce.


Haitian CultureDietary Habits:Typically the largest meal is eaten in the middle of the day.

Heavy foods are eaten during this time and include: potatoes, cornmeal mush, and broiled plantains

These foods provide energy for work.A good amount of spices are used in cooking.A common Haitian dish is griot:

fried pork cubes marinated in sour orange juice and garlic.Food is often used to establish relationships and networks

with new friends.Foods have a light or heavy characteristic.

Light foods are eaten at night because they are easily digested.They include bread and soup.


Haitian CultureDietary Habits:Haitians believe there are certain times when a person

should not eat hot foods and certain times when a person should not eat cold foods. For example, if a person was hot from exercise, cold

foods will not be eaten. The belief is that this can throw off a person’s equilibrium.

Some may be reluctant to try new foods.They believe a healthy baby is a fat baby.

This perspective carries over into adulthood. Weight is associated with health. Good nutrition means eating a lot.


Haitian CultureReligious Beliefs:Religious beliefs affect almost every aspect of

Haitian society.80% are Catholic

Catholicism is very ritualistic and has adapted itself to local ritual.

16% Protestant This culture is most famous for Voodoo and exists

side by side with the Christian faiths.Roughly half of the population practices Voodoo


Haitian CultureReligious Beliefs:Voodoo is a fatalistic religion; it is believed that your

destiny is controlled by spirits and only by contacting them can you control your destiny.Voodoo is a mixture of African and Haitian beliefs. It is made of a large number of spirits who have great

influence on people and must be respected. Daily life is conducted according to what would make these

spirits happy.Voodoo is the national religion of Haiti.No organized hierarchy or specific theology exists. To some degree, most Haitians practice or are affected by

Voodoo in some way. Its most important tenant is healing people from sickness.


Haitian CultureReligious Beliefs:Ministers of Voodoo include priests or houngan and

priestess or the mambo. Their major duties include:

healing presiding over rituals foretelling the future dream reading spell casting creating protections making potions animal sacrifice


Haitian CultureReligious Beliefs:There are two types of Voodoo:

White magic (Rada) – which deals with peaceful worship of happy spirits.

Black magic (Petro) – which deals with angry spirits, death curses and orgies. This practice only represents 5% of all Voodoo

practiced. Black magic is related to Voodoo like Satanism is

related to Christianity.Many are sensitive to being seen as voodoo

worshipers, yet it continues in the U.S.


Haitian CultureConclusion:Trust is a key issue with the Haitian culture. One way to establish trust is to sympathize with the

patient and their family and acknowledge specific stressors, which can help calm fears. Just listening without saying anything can bring positive

benefits. Sensitivity must be given to the specifics of Haitian

identity. Health care providers must recognize Haitians as

distinct from other Caribbean people and African Americans.


ReferenceCultural Competency and Haitian Immigrants. Retrieved January

23, 2011 from http://www.salisbury.edu/nursing/haitiancultcomp. Haiti: A Historical Time Line. Retrieved on March 23rd, 2010

from http://www.theroot.com/views/haiti-historical-timeline?page=0,0

Jacobson, E. (2003). An Introduction to Haitian Culture for

Rehabilitation Services Providers. Retieved January 11, 2011 from http://cirrie.buffalo.edu/monographs/haiti.php.

The World Factbook: Haiti. Retrieved on March 23rd, 2010 from https://www.cia.gov/library/publications/the-world-factbook/geos/ha.html

http://www.salisbury.edu/nursing/haitiancultcomp

http://www.theroot.com/views/haiti-historical-timeline?page=0,0

http://cirrie.buffalo.edu/monographs/haiti.php

https://www.cia.gov/library/publications/the-world-factbook/geos/ha.html

https://www.cia.gov/library/publications/the-world-factbook/geos/ha.html


Power Point Presentation Created by:Joyce Cunneen, MSN, RNFairfield University School of NursingELDER Project Education Coordinator

Monica Starr, BSN, RNFairfield University School of NursingELDER Project Program Coordinator

Cultural Diversity

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