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Chapter 2 - Cultural Considerations in Consequence Management and Emergency Response

Wayne P. Bergeron, Lieutenant Colonel (Retired) US Army

Interim Chair and Instructor, Department of Criminal Justice, Security and Emergency Management

The University of North Alabama

“Your culture is a defining aspect of your humanity.” (The Culturally Proficient School, 2005, Lindsey et al)

Abstract

Because culture profoundly affects human behavior, it is important that military and

civilian officials who will be involved in consequence management situations build cultural

considerations into their planning, preparations, education and training from the very

beginning to ensure that when the crisis hits, the response efforts undertaken will at a

minimum not disregard culture or make situations worse because of a lack of cultural

understanding, and optimally will use the consideration of culture to frame the most effective

response possible to save lives and relieve suffering.

Whether it is recognizing that in some traditional societies burial practices of victims will

require certain specific practices and timeframes or the fact that female victims may be

reluctant to reveal the extent of their wounds and injuries to a male medical first responder, it

is these (and many more) small cultural considerations and an overall understanding of the

effect that culture has on behavior, that can enhance the overall effectiveness of a culturally

aware consequence management organization and emergency response operation.

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Additionally, it is within this framework of culture that consequence management

officials can also leverage cultural understanding to build resilience, preparedness and

self/community response capabilities within the communities that they serve well before an

incident or event occurs. Unlike huge equipment purchases or the warehousing of emergency

supplies, investing in cultural awareness and cultural understanding in consequence

management and emergency response organizations costs very little compared to the ultimate

return on that investment, both post terrorist or disaster incident, but also in the day to day

operations of those organizations as well.

Why is culture important? Why in Consequence Management?

“As the smoke from the burning of sage and tobacco rose into the sky,

prayers of healing were offered up by participants from the Red Lake

Nation in Minnesota. The prayer circle was being conducted to provide

spiritual comfort to a community that had just experienced the worst

school shooting in the United States since Columbine nearly six years

before. For an hour, elders prayed and shared stories. In the middle of

the ceremony, an eagle circled overhead, symbolizing that the prayers

were being carried to the spiritual Maker.” (Silva and Klotz, 2006)

As individuals, we are ultimately the result of our culture, that system of values, beliefs,

behaviors, and norms that provide us with the world view that we share with others that are

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similar to or like us within society. It is through this cultural lens that we perceive and interpret

the world around us. (US Army Cadet Command. 2008/2009) It is also this lens that we use to

determine the appropriate actions and responses, both individually and collectively as a society,

in the aftermath of a crisis or a terrorist attack. However, in the confusing immediacy of

consequence management situations rarely do we, as emergency management officials, have

the time or the ability to consider the impact that cultural considerations may ultimately have

on the effectiveness and the outcome of our response efforts.

As evidenced in the quote above concerning the actions of the elders of the Red Lake

Nation, clearly it is one’s culture that ultimately forms the context through which traumatized

individuals and communities formulate, implement, and evaluate their own responses in the

wake of a catastrophic incident. It is through this window that these responses “may help

define healthy pathways to recovery from a crisis.” (Silva and Klotz, 2006)

“Cultural Competency” within emergency management (EM) and consequence

management (CM) organizations refers to a requisite level of sophistication within the

organizations’ interactions with diverse populations. Therefore, such an organization would

recognize the significance of and if possible, help to facilitate the type of activity mentioned

above in the prayer circle example as a culturally competent action that serves to assist the

affected community and population deal with the aftermath of a crisis. For EM and CM

organizations cultural competence refers to “a set of values, behaviors, attitudes, and

practices…that allows people to work effectively across cultures.” (Seidenberg, 2005)

Within EM and CM, cultural considerations are also equally important when it comes to

ensuring the sustainability of interventions that are undertaken by response organizations as

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part of consequence management and post incident and disaster recovery and reconstruction.

“There are enough examples to show that lack of consideration given to cultural and social

concerns serve to reinforce and sometimes-even increase the vulnerability of local

communities.” (Boeni & Jigyasuii, 2005) It is within this environment of the cultural terrain that

culturally competent EM and CM organizations must deal with and consider culture because

one “cannot not have a culture” as Lindsey, et. Al. (2002) state “You are your culture, you live

your culture, and you express your culture whether you intend to or not.” (Lindsey, et. Al.,

2005) While they discuss this in the context of human interaction within the normal situational

environment, that statement holds equally (if not more so) true in the wake of terrorist

incidents and disaster situations as well. The most effective EM and CM organizations realize

and ultimately embrace this reality as they build cultural considerations into their pre-event

planning, within incident response, and post-incident response and recovery operations.

Principles of cultural understanding and the cultural proficiency continuum.

To begin the process of building cultural competence within an organization, it is

important for both the individual members and the collective body to begin with what Lindsey,

et. al. describe as the “five principles of cultural proficiency” which include: 1) Culture is the

predominant force in people’s lives, 2) The dominant culture serves people in various ways, 3)

People have both personal identities and group identities, 4) Diversity within cultures can be

vast and significant, and 5) Each individual and each group has unique cultural values and

needs. (Lindsey, et. Al., 2005) Consideration and understanding of these principles serve as a

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starting point for EM and CM organizations to begin to incorporate cultural considerations. For

instance, just considering the issue of a mandatory evacuation, the cultural orientation of a

particular group concerning property rights – whether land is individually owned or communally

held within the community - can make a huge difference with individual and community

compliance with such an evacuation order based on the way it is conceived and delivered.

The second important concept concerning cultural understanding is that cultural

competence/proficiency can best be illustrated by the use of what Cross (1989), Lindsey, Nuri,

Robins, & Terrell (1999) call the “Cultural Proficiency Continuum” as illustrated below. (Lindsey,

et. Al., 2005)

As can be seen above the continuum consists of six degrees or levels which progress

from left to right toward increasingly greater ability within the cultural realm to the ultimate

goal of cultural proficiency. (Lindsey, et. Al., 2005) “Cultural destructiveness” which is the level

that is furthest from the ideal is described as the tendency to try and negate, disparage, or

counteract cultures other than one’s own culture. The next level of “Cultural Incapacity” can be

seen as less sinister, with the propensity to try and elevate the superiority of one’s cultural

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values and beliefs while either knowingly or unknowingly suppressing the culture of others.

“Cultural blindness,” which is seen by many as being a reliable standard of fairness or equality,

tends to operate in an environment where cultural differences are not only not recognized, but

are actually seen as not existing or not having any effect on society. In many cases this is the

realm that governments and by extension emergency management and consequence

management organizations operate from. “Cultural Pre-competence” begins when the

differences in culture are recognized and there is a realization that a lack of cultural knowledge,

understanding, and experience can limit one’s ability. “Cultural Competence” on the other

hand is achieved when individuals and organizations begin to employ behavior and practices

that recognize cultural differences in ways that begin to enhance and optimize performance.

“Cultural Proficiency,” the final level on the continuum is seen as “honoring the differences

among cultures, seeing diversity as a benefit, and interacting knowledgeably and respectfully

among a variety of cultural groups.” (Lindsey, et. Al., 2005) Ideally, this would be the state or

condition that officials involved in consequence management and emergency response would

strive to achieve. Another analogy that is applicable to the cultural continuum is the idea of it

being a balance scale or a seesaw with a corresponding middle point or “tipping point” where

individuals and organizations begin to emerge from cultural blindness into cultural pre-

competence and begin to realize the benefits of cultural awareness.

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Culture Comparison – a necessary starting point.

In many ways, the key factor in reaching the cultural tipping point begins with a

necessary evaluation of an individual or organization’s own cultural environment in comparison

with the culture of the target group or individual. Trumbul and her associates (2000), in their

work Bridging Cultures in Our Schools: New Approaches That Work, present this concept in a

table titled “Salient Features of Individualism and Collectivism,” which describes a framework

that compares the differences between the primary culture in the United States (individualism)

as opposed to the culture of many other countries, immigrant populations, and traditional

societies being one of collectivism as outlined in the table below. (Trumbul; Rothstein-Fisch; &

Greenfield. 2000)

Individualism

Collectivism

Fostering independence and individual achievement

Fostering interdependence and group success

Promoting self-expression, individual thinking, personal choice?

Promoting adherence to norms, respect for authority/elders, group consensus

Associated with egalitarian relationships and flexibility in roles (e.g., upward mobility)

Associated with stable, hierarchical roles (dependent on gender, family background, age)?

Understanding the physical world as knowable apart from its meaning for human life

Understanding the physical world in the context of its meaning for human life

Associated with private property, individual ownership

Associated with shared property, group ownership

Additional concepts that apply to this comparison and are useful to the individual or

organization working on moving past the “cultural tipping point” are outlined in the following

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table which is adapted from training in cultural awareness given to all US Army cadets during

their last year of college prior to their graduation and appointment as commissioned officers.

These concepts have also been incorporated into various training programs targeted at all

military members as part of their preparation for overseas deployment in which they will be

dealing with and working in other cultures. (US Army Cadet Command. 2008/2009)

US Culture

Traditional Cultures

Mono-chronic – very focused on time, punctuality, and efficiency of effort - “Time is money”

Poly-chronic – focused more on consensus, inclusion, and harmony of effort – “we’ll get around to it – in time”

Task Oriented – Get down to business – get the job done

Process Oriented – Get to know each other first – build trust and confidence

Rule of Law – No one is above legal authority Rule by Law – the authorities make the law – can change the rules as necessary

Highly mobile – go where the opportunity is as able based on socio-economic status

Tend to be tied to specific areas – multi generational family ties

Value and respect accomplishment and achievement - ask the question “What do you do?”

Value status, wisdom, and cultural ties – ask the question – “Who are you? – Who is your family?”

It is within this context, that EM and CM officials can begin to evaluate their progress in

reference to the cultural proficiency continuum. By beginning the process of evaluating their

own culture, bias, and stereo typical tendencies these officials can then begin to understand

and build cultural considerations into their planning and operations. Such awareness and

understanding serves as a cultural lens through which these officials can then evaluate their

policy and procedures for effectiveness.

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The reality of dealing with culture in consequence management situations.

“Traumatic events do not exist in a vacuum. Like other social phenomena,

they should be understood within the social and cultural context in which they occur.” (Silva

and Klotz, 2006) Whether it is a natural disaster, a catastrophic failure of manmade structures

or technology, or the deliberate devastation of a terrorist incident, the ability of EM and CM

officials and organizations to deal with events from a culturally aware perspective can greatly

enhance the ability of those organizations to quickly and effectively deal with problems and

challenges.

When it comes to consequence management operations, one of the most important

areas that must be addressed before all others is effective communication with the population

impacted by the incident or situation. In many cases this may mean that emergency

responders and other CM officials must be prepared to use multiple communication methods

and mediums. While mass media is largely seen as the method of choice for emergency

communication in developed societies, before, during, and after an incident, in many cases in

the developing world and in traditional societies and cultures without reliable access to a

robust mass media environment this method will quickly prove ineffective. In some cases, EM

and CM officials may find that more traditional methods such as face to face communication,

word of mouth notifications, and use of existing community networks prove more efficient,

effective, and responsive to their needs. In many cases, “To reach all members of the

community, information should be conveyed in languages other than English, including sign

language as needed.” (Silva and Klotz, 2006) This may mean that EM and CM officials will need

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to quickly identify key leaders and communicators who are able to deliver cultural appropriate

messages (in the correct language and cultural context) that will inform the affected population

and prompt desired actions and results. In some cases (particularly in post incident recovery

operations), emergency responders themselves may be forced to take on this communication

role, particularly in the unenviable task of casualty notification. It is in this context that “on an

interpersonal level, responders should remain aware of culturally specific communication

techniques such as the use of eye and physical contact and physical proximity, the expectation

of eating or drinking during discussions, the pace of conversation, and body language.” (Silva

and Klotz, 2006)

Cultures and societies have specific funeral rituals that are developed and refined over

many generations. These rites and ceremonies serve to help people cope with the death and

loss of their family members. In many cases there is a strong psychological need to quickly

identify lost loved ones and to grieve for them in culturally customary ways. While these

religious and cultural beliefs and death practices will be important to survivors, there will

inevitably be conflicts concerning “autopsies, timeframe and handling of the body, including

ceremonial washing of the deceased and religious ceremonies and/or items to be left with the

dead.” (NACCHO,2012)

In many cases, dealing with casualties and death can be one of the most critical areas

where cultural proficiency can have the biggest impact. For instance, in the aftermath of a

terrorist attack, active shooter situation, or other emergency incident where the site is

considered a crime scene, “cultural and religious beliefs and death practices may lead to

requests (that are) irreconcilable with the demands” of consequence management officials and

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law enforcement authorities. (NACCHO, 2012) Dealing with these types of issues can be

particularly challenging in a mass fatality incident. EM and CM officials should ultimately “strive

to be culturally competent and sensitive—responding to requests when possible and

demonstrating awareness and sensitivity when explaining why requests cannot be met. The

nature and scale of the mass fatality will be the primary determinant of what can and cannot be

done.” (NACCHO, 2012)

In some cases CM officials may not even be in a position to be able to release the

remains of victims due to a lack of casualty identification in mass casualty incidents. In such

cases it may take months or even years before reliable identifications can be made. “The

process needs to be communicated to families so that they understand it and know how long it

will take until personal effects are returned. If the incident is the result of a crime, some or all

personal effects may be evidence and cannot be returned until after the trial”, if at all in some

cases. Communicating this in a culturally sensitive manner can pose particular challenges.

(NACCHO, 2012)

In cases such as this, giving families the ability to visit the actual incident site can be a

way to allow for cultural accommodations for grieving and closure. “For many families, being

able to go to the incident site is extremely beneficial. It allows them to feel close to their

deceased loved ones, imagine their last moments, honor them and say good-bye.” (NACCHO,

2012) Obviously, these visits must be carefully coordinated with all authorities involved and

should be conducted in as culturally considerate manner as possible. The National Association

of County and City Health Officials (NACCHO) recommend the following guidelines be followed:

- If the visit takes place during recovery, work should stop to show respect.

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- Visiting families should not be exposed to bodies, body parts, or personal effects.

- Spiritual care and mental health personnel should be present during visits and

available to family members if desired.

- Separate visits should be arranged for families of surviving victims and for families of

deceased.

- Prepare families for what they will see—describe conditions, the

destruction/wreckage, and the odors.” (NACCHO,2012)

Another area where culture can be significant in consequence management is regarding

family roles, responsibilities, and support structures. For instance, in more traditional cultures

and societies it may be the matriarch or patriarch who is the decision maker of the extended

family or clan in an evacuation or relocation scenario, which means that officials may need to

ensure that they specifically engage these individuals if they expect these type of operations to

ultimately be successful. Additionally, in such traditional societies during a mandatory

evacuation or emergency shelter situation, providing the capability to keep all members of

extended families together may prove to be the critical component in families’ compliance with

CM official’s instructions. Cultural considerations are also manifest in the differences in how

individuals and groups implement their own evacuation decisions, for instance research

indicates that within the United States, “African American and Latino populations tend to rely

on family members for shelter and support whereas white families may rely on friends and on

co-workers to a greater degree.” (Seidenberg, 2005) Consideration of this cultural distinction

can significantly impact the planning assumptions of CM officials in regards to the distances and

locations that the various groups will have the willingness and the ability to travel.

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Another area that deserves consideration within consequence management can be the

very definition and manifestation of what exactly is considered a “household” in terms of the

distribution of relief supplies in the immediate aftermath of the incident and also the

disbursement of longer term recovery funds. For instance, in many traditional societies the

“household” may be strictly defined by family ties related to the eldest male member. Of

course, such a definition can prove to be particularly problematic when one begins to consider

single mothers with children or even women newly widowed as a result of the incident with no

remaining male family ties. The status of gender roles may also cause additional complications

in many traditional cultures as female victims of disaster and terrorist incidents may not feel

comfortable with, or even be allowed in some cases (by male family members) to seek out

treatment for their injuries from male medical first responders. Operating in such cultural

environments can greatly complicate the efforts of CM officials as they strive to provide

immediate relief for all victims in the most expedient manner.

These types of issues are also not just unique in traditional societies as can be seen with

the example of post Hurricane Katrina recovery aid in the United States where, “under the

single-household rule, Katrina victims were required to file for FEMA benefits as members of a

household rather than as individuals. Numerous disaster victims were denied FEMA assistance

because they shared the same address or phone number as another applicant” (Seidenberg,

2005) Even a cursory study of the culture of African Americans and Hispanics within the lower

socio-economic groups within the US would reveal that in many cases, you may have more than

one family group living in a single household and unmarried couples and partners who have no

legal way to define their relationships in terms of government bureaucracy.

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The level of education and literacy as well as socio-economic status within a particular

culture may also play a role in effective consequence management, particularly in the mid to

long term recovery phases. As was discovered in the United States as a result of “the

Hurricane Andrew experience in 1992 (which) taught federal agencies and charities alike that

maneuvering the aid process requires education, time, and skill that poor families simply do not

possess.” (Seidenberg, 2005) This lesson was again relearned during the aftermath of

Hurricane Katrina as both the Federal Emergency Management Agency and the American Red

Cross and their large bureaucratic process marginalized and alienated many victims and

potential recipients of disaster recovery aid. It was not until US Catholic Charities, which works

through local community based church parishes and organizations, and is arguably closer to the

culture of the people they are serving, began to provide services designed “to meet

marginalized communities where they are in their unique cultural needs.” (Seidenberg, 2005)

They quickly recognized “the importance of empowering individuals with the ability to navigate

difficult bureaucratic systems, the group offered trainings to church parishes on how to assist

victims with post traumatic stress and on FEMA assistance.” (Seidenberg, 2005)

Conclusion

As discussed previously, “culture acts as a strong force upon a group and its members.

It is a way of seeing, thinking about and relating to the world around us, including other

humans. It concerns the behavior of humans, their values and beliefs and how they arrive at

them.” (Reinke, 2009) While this is true in normal everyday life, it is even more critical in times

of crisis, strife, and disaster. For those involved in consequence management situations there is

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no escaping culture; it will manifest itself in a variety of ways and has the potential to

complicate the efforts of CM organizations that are not equipped and prepared to deal with it.

Interestingly, “the Chinese word for crisis comprises two symbols: wei, which means danger,

and ji, which means opportunity.” (Silva and Klotz, 2006) Consequence management in the

wake of a terrorist incident or natural or manmade disaster presents both; how individuals,

organizations and communities “respond to a crisis dictates in great measure the degree to

which risk is transformed into opportunity.” (Silva and Klotz, 2006)

The first step for CM organizations is to understand the risk presented by not

considering cultural considerations in their planning, training, and operations for consequence

management. Once this risk is realized, they can then to begin to mitigate and eliminate it by

building programs and incorporating cultural considerations into their everyday efforts and

interactions as well as their crisis response operations. In many cases, this takes very little

commitment of physical resources, unlike stockpiling massive amounts of supplies or

purchasing rescue equipment, it instead really just requires an awareness and a change of

thinking of CM personnel when it comes to culture.

“One way to do so is to include crisis responders and cultural brokers (e.g., community

leaders) from the affected minority (and cultural) groups before, during, and in the aftermath

of any crisis situation. In addition, community based groups can (also) provide an important

communication link with the cultural groups they represent.” (Silva and Klotz, 2006) Once this

linkage is established EM and CM officials may also find that they have the ability to greatly

enhance the readiness and resilience of the populations they protect and serve through a

culturally appropriate dialogue. This is especially true in regards to long term planning and

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preparation before an incident occurs. When cultural considerations are taken into account, it

is much more likely that individuals and groups will respond in the ways that CM officials have

anticipated, planned for, resourced, and communicated. Ultimately, that is when the risk is

transformed into opportunity.

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Reconstruction Post-Tsunami Challenges. Retrieved from: http://www.adpc.net/irc06/2005/4-6/TBindo1.pdf

Lindsey, Randall B., Roberts, Laraine M, and Campbelljones, Franklin. (2005). The Culturally

Proficient School: An Implementation Guide for School Leaders. California: Corwin Press.

National Association of County and City Health Officials (NACCHO). (2012) “Family Concerns and

Religious/ Cultural Considerations in Mass Casualty Events.” Managing Mass Fatalities: A Toolkit for Planning. Retrieved from: http://www.sccgov.org/sites/sccphd/en-us/HealthProviders/BePrepared/Documents/ManagingMassFatalities/SECA.pdf.

Reinke de Buitrago, Sybille. (2009). “The Impact of Psychological-Cultural factors on Concepts of Fighting Terrorism”. Journal of Strategic Security, Volume II, Num. 1. Retrieved from: http://scholarcommons.usf.edu/jss/vol2/iss1/4/.

Seidenberg, Jennifer. (2005). Cultural Competency in Disaster Recovery: Lessons Learned from the Hurricane Katrina Experience for Better Serving Marginalized Communities. University of California, Berkeley School of Law; Berkeley: CA. Retrieved from: http://wwwlawberkeleyedulibrarydisastersSeidenbergpdf.

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101. NASP: MD. Retrieved from: http://www. n a s p o n l i n e . o r g/culturalcompetence/cc_crisis.html.

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Schools: New Approaches That Work. West Ed Knowledge Brief. WestED: CA. Retrieved from: http://www.wested.org/cs/we/view/rs/81.

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