The Practices of the Traditional Caring Culture and Western Nursing Culture in Cameroon Emmanuel Aoudi Chance Master in Health Sciences - Nursing Praxeology Research Group Department of Public Health and Primary Health Care Faculty of Medicine and Dentistry University of Bergen Spring 2015 i ii TABLE OF CONTENTS STATEMENT OF AUTHORSHIP .............................................................................................. ix ACKNOWLEDGEMENTS .......................................................................................................... xi ABSTRAKT ............................................................................................................................... xiii ABSTRACT ................................................................................................................................. xv SUMMARY OF CHAPTERS ................................................................................................... xvii 1. CHAPTER I: INTRODUCTION ........................................................................................... 1 1.1. Introduction ............................................................................................................................. 1 1.2. Research Background ............................................................................................................. 1 1.3. Research Access and Questions .............................................................................................. 2 1.4. Purpose of the Study .............................................................................................................. 4 1.5. Researcher Background: Capital, Habitus and Field—Auto-Socio-Analyze ......................... 5 2. CHAPTER II: THE CAMEROON SETTING .................................................................... 13 2.1. History of Cameroon ............................................................................................................. 13 2.2. Culture and Religion ............................................................................................................. 15 2.3. Education System .................................................................................................................. 18 2.4. Politics ................................................................................................................................... 19 2.5. Economic System .................................................................................................................. 20 2.6. Health-practice System .......................................................................................................... 20 2.7. The Protestant Hospital of Ngaoundéré (HPN) .................................................................... 22 2.8. Education of Nurses and Services in HPN ............................................................................ 23 2.9. Nurse Education and Nurses in Cameroon ............................................................................ 24 iii 2.10. Description of Mbé .............................................................................................................. 27 3. CHAPTER III: HEALTH-PRACTICES AND CULTURE .............................................. 31 3.1. Understanding Culture and Cultural Meanings Applied to Illness ...................................... 31 3.1.1. Understanding Culture ............................................................................................ 31 3.1.2. Cultural Meanings Applied to Illness ................................................................... 32 3.2. Health-practices Systems in Cameroon ................................................................................ 33 3.2.1.The Western Health-Practices System in Cameroon .............................................. 34 3.2.2. Traditional Health-Practices Systems in Cameroon ............................................... 35 4. CHAPTER IV: THE LOGIC OF PRACTICE .................................................................. 37 4.1. Pierre Bourdieu’s Concepts of Field, Habitus, and Capital .................................................. 37 4.2. The Praxeology Tradition ..................................................................................................... 37 4.3. The Significance of Bourdieu’s Theory of Practice .............................................................. 40 4.4. Field, Habitus, and Capital Theories ..................................................................................... 41 4.4.1. Field ........................................................................................................................ 42 4.4.2. Habitus ................................................................................................................... 43 4.4.3. Capital .................................................................................................................... 44 5. CHAPTER V: METHODOLOGY ....................................................................................... 47 5.1. Research Approach ................................................................................................................ 47 5.2. Gaining Admittance to the Field ........................................................................................... 48 5.3. Construction of Agents’ Different Habitus and Operative Capital ....................................... 50 5.4. Bourdieu’s Reflexivity, Understanding, and the Semi-Structured Interview ........................ 51 5.5. Population and Sampling ...................................................................................................... 54 5.6. Observation of the Field ........................................................................................................ 56 iv 5.7. Data Analysis ........................................................................................................................ 57 5.7.1. A Relational Analysis of Social Tastes and Practices ............................................. 58 5.7.2. Field, Habitus, and Capital ..................................................................................... 59 5.8. Ethical Considerations .......................................................................................................... 60 5.9. Limitations of the Study ........................................................................................................ 61 6. CHAPTER VI: THE ARTICULATION OF CARING PRACTICES ............................. 63 6.1. Health-Seeking Decision: Traditional, Modern, or Both ...................................................... 63 6.2. The Environment Where the Practices of Care are articulated .............................................. 66 6.3. Understanding of Agents’ Daily Activities—Habitus .......................................................... 69 6.3.1. Nurses and Nurse Assistants’ Daily Activities in HPN ......................................... 70 6.3.2. Nurses’ Practices in the Hospital ............................................................................ 72 6.3.3. Patients and Relatives’ Daily Activities in HPN .................................................... 74 6.3.4. Traditional Healers’ Daily Activities in Mbé .......................................................... 76 6.3.5. Story of One Traditional Healer .............................................................................. 79 6.3.6. Behaviors of Nurses and Traditional Practitioners that Inhibit or Stimulate Patient Participation .......................................................................................... 81 6.3.7. Practices of Care and Reputation of Agents .......................................................... 83 6.3.8. Dispositions and Competence Generating and Shaping Action ........................... 84 6.4. Capital of Agents Enabling the Practices of Caring .............................................................. 86 6.5. Power Relationships Between Agents in the Practices of Care ............................................. 91 6.6. Emic and Etic Approaches to Agents’ Dispositions ............................................................. 94 6.6.1. Physical Care and closeness .................................................................................... 94 6.6.2. Nursing Skill ......................................................................................................... 95 6.6.3. Regular Checkups .................................................................................................. 96 v 6.6.4. Attention ................................................................................................................. 97 6.6.5. Good Behavior ....................................................................................................... 98 6.7. Preferences and tastes ............................................................................................................ 99 6.8. Agents Perspectives on The Practices of Care ..................................................................... 100 6.8.1. Practice of Care with Compassion ....................................................................... 100 6.8.2. Practice of Care through Comforting ................................................................... 101 6.8.3. Practice through Respecting Patient’s Beliefs and Culture .................................. 101 6.8.4. Authenticity and Genuineness in the Practice