Wednesday, 15 May 2013

I wanted share a really interesting cultural clash that occurred today at the Korean Hospital. An Afghan woman was schedule for surgery with the American OBGYN that I often sit in with during consultations. The woman was to have checked in for her surgery on Tuesday night and then it was to take place at 9am today, Wednesday.

I had some responsibilities at the US Hospital this morning and as such didn't make it over to the Egyptian Hospital until after 11am. When I arrived, I didn't really have any specific plans because normally on Wednesdays I sit with the OBGYN but today she was supposed to be in surgery. However, when the Korean staff saw me they asked if I wanted to join the American OBBYN. Confused I went to the OBGYN clinic and it turns out the woman never reported for her surgery the night before and they lost the Operating Room to other surgeries after 9am.

What was so interesting however, was that the woman showed up around 11:30am without excuse or cause for concern saying she has arrived for her surgery. When the hospital staff attempted to explain to her that she had not checked in for surgery the night before and they had lost the operating room because she arrived 3 hours late, she failed to understand why she could not still have the surgery. She remained confused and frustrated, continuing to explain that she was here now for her surgery and why could we not proceed?

This story is representative of the incredibly different sense of time and communication that exist between our two cultures. Time in Afghanistan is not a construct like it is in the West. One of the most common expressions you here in Afghanistan regarding time is "Inshallah" - God willing. In other words, if God wills you to be on time, than you will be there, but if something else comes up or you are delayed, it is God's will. This is also combined with the fact that communication in the Afghan culture tends to be very indirect, it is how Afghans maintain good relationships. So, the average person finds it hard to be told "no" or "maybe" to a request and the average person finds it hard to say "no" or "maybe" to any request.

As an example, I found this blurb of advice on the Internet about how to say no in Afghan culture:

The Three Step Rule for Effective Cross Cultural Communication:
I suggest one communication strategy is to follow the three step rule when making a request.
The first step is:
1. When we make a request and get the initial reply, "Yes" then we should talk about something else for a bit
2. The second step is: After talking a bit return to the request and ask it again. But this time throw in an extra phrase like, "What do you think, can you...?"
3. The third step: Go on to talk about something and return to the request a third time. This time, however, give valid reasons why the friend might not be able to do what you want even if they are willing, so they have a good excuse why they can say no.

In returning to the story, it eventually came out that the patient had been at a wedding the night before and it can be supposed she knew when the surgery was being scheduled she would not make her check in on Tuesday night, however she did not raise this schedule conflict as an issue. It is also likely that given Afghan cultural understandings, she did not foresee her showing up late for her surgery to be a problem.

It's when these two cultures meet head on that a power struggle ensues. American bound by their adherence to schedules and appointments and Afghans subscribing to a fluid, forgiving concept of time, find themselves frustrated and confused about why the other is so inflexible and cannot adapt in order to get things done.

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