Healthcare I1

Notes from an interview with Matilda Dijeng 11/10/14

Matilda is from Botswana and graduated from OU in 1990 with her degree in Physical therapy. She was

sponsored by Botswana’s government, for schooling in the US, because there is no formal schooling for

physical therapists in Botswana. When she graduated she went back to Botswana and worked for three

years then she came back to the US and worked in Chicago and Columbus. She is called a

physiotherapist in her local area, not a physical therapist.

I asked her what her thoughts were about US before she came here.

She replied that she had seen many movies about US so she pictured US being like the movies. When

she arrived in Washington at the American Education Development orientation, before she started her

schooling, she saw a homeless man. She couldn’t believe it because she didn’t think about the US

having homeless individuals, just like she had at home. She laughed and said “the food is very

different.” I laughed and replied “welcome to the country of junk food.”

She said that she noticed cultural differences in how people viewed their bodies here in the US. She

roomed with a girl from the US and commented that she noticed how embarrassed she was about

changing her clothing in the shower room. Matilda said in her country breasts are not viewed as

something to cover up but they are a part of a women’s body and are used to feed the babies. No one

thinks about it or makes a big deal when women breastfeed out in public but in the US she has noticed

that people seem offended by breast feeding. She couldn’t understand what the big deal it was to

change her clothes, in front of other women, because they were all the same. I mentioned that I felt

this was societal and that people in the US seem to make everyday life occurrences into such a drama,

we laughed.

I asked her about her time at OU and did she feel treated differently by any professors.

She mentioned that she was in a course and received an A- in a course, and the lecturer said “pretty

good for someone from Africa”. She said she turned around and sat down then got to thinking about

what he said.

I asked her if she felt her was being rude or not?

She said he didn’t appear to be but she wondered later, why he said that and what that meant exactly.

I asked her if she brought it up again. She said no she didn’t. She didn’t have time to think on his

response because she was there to get her education.

I said but you obviously remember it so it did impact you.

I asked her about some of the challenges she faced in her country after coming home with her PT

degree from OU.

She mentioned having to educate her community about what a PT does because massage therapists

were known as physiotherapists as well. She now has her own business in the city center. She spends

time going to churches, schools, and work places educating about what PT can do for a person

physically. “Many patients believe that they need medications to get better so it is important they have

other options.” She educated about prevention of work injuries, areas of women’s health that are

taboo (such as urinary incontinence), and tries to bring a sense of trust and comfort to her people.

She told me about how in Botswana women will have urinary incontinence issues and not ever address

them because they are embarrassed. They will wear dark shawls tied around their waist so that is they

have an accident then no one will know. She realized this after speaking with some women at a

conference and decided no matter where she was she was going to address this concern so that the

women would feel comfortable and get help. She noticed that women in her community would wear

these shawls but she did not know that is was for this reason, so she feels it is necessary to address this

and not allow the stigma to persist.

I asked her about some of the obstacles she has faced here in the US through her schooling and then as

a practicing PT. I inquired if she felt that she was treated differently because she is from Africa.

She said that she was told, by her people, that she was becoming too American. That because she was

speaking out and trying to make changes in people’s lifestyles, to benefit them, that people were upset.

I could tell this was hard for her by the way she told me this. I said how interesting because you came to

the US to get education to go back and help your people and then that is their response.

She then told me about working in a hospital setting in Indianapolis and having the aide go up and check

on the patient to see if they were ready, for her the PT, to come work with them. When she entered the

room she said she noticed that the patient was talking to the aide but she assumed they were because

the aide had already been in the room. When the aide introduced her as the PT the patient said

something to the effect of “oh, you’re the PT”. She said that she never realized this perception until the

aide brought it up afterwards. She realized that most of the support staff was black/African American so

the patient must have assumed that she was support staff not the PT.

She mentioned another time when she was working in a skilled nursing center in Ohio and she was

working, for a few weeks, with a gentlemen who has been a farmer all of his life. All of the sudden he

looked at her one day and said “huh, you’re black”. She laughed at this point and said “I thought that

was obvious”.

I asked her what she felt was most important about being culturally competent in the healthcare field. I

brought up my concerns about feeling like I am walking on egg shells trying not to say the wrong things

because I just want to help. We discussed times where the biases and the stereotyping goes both ways

and how that impacts your relationship with the patient. I asked her if she ever felt like patients and/or

healthcare professionals ever use their cultural backgrounds as excuses to not be accountable.

She said she feels it can definitely go both ways.

We discussed how a person interacts is so vital. Everyone makes their own choices and how people

react to those very much determines how that relationship will go. She mentioned that she could have

chosen to get offended at a lot of things but she didn’t because she had a goal. She wanted to be a PT

and no one was going to stop her. We discussed that part of people’s reactions often stem from their

own insecurities.

I asked her about gaining the patient’s trust and if there was a time where maybe she said or did

something that she has to go back and apologize for in order to get the patient’s trust.

She told me about working with a patient who had a stroke and how she meets with the whole family so

they know exactly where she stands and how she plans to progress with her treatment. She explains

how she lays it all out so they are all understanding what she will be doing so that nobody limits her

therapy. She tells them they might see her do things that they feel are disrespectful but that she is

trying to make the person more independent. For example, if a person has had a stroke and she

(Matilda) makes them feed themselves; it is because she wants them to be able to do this independently

not because she is being disrespectful. She mentioned in her country if a person in the family has a

stroke then you feed them and totally take care of them so that is why is sometimes difficult for people

to understand why she was making the patient do it.

We discussed the importance of having the patient’s and family’s trust when working in healthcare. She

mentioned that she thought that if a HC provider does accidently say or do something they find out

offended a patient that it is important to apologize and discuss it.

Matilda was gracious enough to let me interview her on this day as she observed other therapists treat

patients. She is a strong and amazing individual who has clearly made significant changes in the

healthcare field. I very much got the sense that she experienced some cultural biases, stereotyping, and

maybe even some discrimination along the way but she very consciously made the choice to not let it

deter her from her goal of becoming a PT.