Abstract
There are considerable cultural, social and religious differences between human beings, and some superficial physical differences (skin colour, hair, etc.), although humans are remarkably genetically similar. It is plausible that these differences are not a permanent feature of human society but are a by-product of the invention of agriculture. The early Cro-Magnon hunter-gatherers that drifted out of Africa would have been relatively homogeneous. When isolated groups settled down with flocks, crops and lands that were worth defending from others, their differences would have had the opportunity to grow and develop. It can be argued that we are reaching the end of the agricultural revolution, with the majority of people no longer tied to flocks, crops and land; mass transportation making physical contact between human groups easy; and, above all, the internet creating a worldwide common culture, so these differences might disappear in the future (Guha, 2009). An interesting analogy can be found in the fire ants living in much of the southern USA. When first introduced to America they lived, as ants do, in isolated nest colonies. They have very recently evolved so that they now form one interconnected community – local populations now coalesce into a single sheet of intercompatible ants spread across the inhabited landscape of Alabama, Texas, Mississippi, Arkansas and parts of adjoining states (Holldobler & Wilson, 2008). This is a community bigger than Google.
The prospect of a monocultural homogeneous human race is disconcerting for those of us who grew up at the peak of general awareness of human diversity. If I may lapse into autobiography for a moment, I was born a mixed-race child at the height of a war against a regime based on the idea of racial superiority, grew up, unbelievably, as the only non-white child in the whole of a large grammar school, and have lived on into an age where my foster son can sit up at night playing and chatting with his contemporaries in China. My father came to England from India, spending days at sea, and never saw his parents again. They had one photograph of me. My father’s great-nephew dropped in to England for a weekend’s shopping, sending home online photos of what he was buying from Oxford Street. Racial, cultural and especially religious differences still have some nasty kicks to give us, as well as human characteristics that will be sorely missed, but seem to me to be on their way out.
The interim stage in which we live, where people from different groups and cultures come into frequent contact with each other but are not fully integrated, creates considerable problems for people of all ages. Shakespeare gave us seven stages of life (http://quotations.about.com/cs/poemlyrics/a/Seven_Ages_Of_M.htm), all of which are worth considering in this context, but we only have space to consider four here.
The infant, ‘mewling and puking in his nurse’s arms’, can be ignored for the moment – there is some slight evidence that neonates are acculturalized to the language spoken around them before birth but infant awareness of diversity is really minimal. Parental expectations show enormous cultural variations however, so there is a need for anyone working with very young children to have some awareness of diversity. Extending Professional Practice in the Early Years is an edited collection of pieces, most of them previously published in the same or similar form, brought together to support the final module of an Open University (OU) foundation degree course aimed at anyone working with very young children in a variety of settings. Of particular interest to us is the second of four sections, entitled ‘Diversity & Transitions’, containing an assortment of papers – ‘Questioning Diversity’, ‘Inclusive Practices for Children with Special Educational Needs’, ‘Family-Centred Practices: Parents’ Perspectives’, an oddment on ‘Children Experiencing Rural Poverty in Wales’ and the usual ‘posts’ – post-modern and post-structural approaches. I must confess to being slightly disappointed with this rather disconnected collection: taken in isolation it seemed not to touch on some of the more important issues in diversity. However, examination of the OU course outline (http://www3.open.ac.uk/study/undergraduate/qualification/g01.htm) suggests that health staff taking the whole course and working their way through this book and the other suggested readings will end up with a reasonably good grounding in the diversity of the human problems that they are likely to face.
The child, ‘creeping like snail, unwillingly to school’ will creep even more unwillingly if he knows that bullying, social exclusion or other forms of prejudice are awaiting there. Introducing Confronting Obstacles to Inclusion, Richard Rose speaks of the problems faced by children who are ‘considered different and are said to challenge existing systems… if this is true of schools where we would expect tolerance and understanding to be the norm, how much more likely is it that difficulties will be encountered in other aspects of life’. I do not agree that we can automatically expect tolerance to be the norm among adolescents. Adolescence is the period of socialization in life, so I would expect schoolchildren to be the least tolerant of differences. I am more impressed with his opening sentence: ‘Understanding demands effort.’ Schools have to learn to cope with differences, and adolescents have to be taught to be tolerant. This book makes a valiant attempt at the task, although again I found it rather disconnected. For example, the first section, ‘Causes of Exclusion & Obstacles to Inclusion’, consists of just three chapters: one on the US mass media, one on gypsies and travellers, and one on children with special needs in India, rather than a reasoned discussion of the whole field. There are 20 chapters by about 40 contributors – mainly British or American academics. I would note the significant topic of ‘beyond tokenism’ in the section on ‘Pupils as Partners’, and chapters on supporting students with disabilities in inclusive classrooms, and on classroom support for including students with challenging behaviour, in the section on ‘Support in the Classroom’. Socializing adolescents into their local culture while at the same time encouraging them to tolerate diversity is an enormous task. No one book can do very much towards it, but this one can help in providing background reading.
The lover and the soldier will have to be omitted this time round, although they are important topics to which this journal should return again and again. Other people’s sexual preferences and domestic expectations form probably the largest single issue in the study of human diversity. A considerable literature has grown up on the topic, which needs reviewing. The soldier, full of strange oaths if no longer ‘bearded like the pard’, forms a smaller but interesting topic. The military, more or less by definition, are there to enforce uniformity and yet are having to accept diversity, from Sikhs wearing turbans instead of helmets to the ludicrousities of the former US ‘Don’t Ask Don’t Tell’ policy toward homosexuality. Any deviation from the dominant culture places an enormous stress on the already stressed soldier. Such literature as there is needs examining some day. We do need to consider diversity among adults however.
There is a strong intolerant strain in US culture, along with the strong tradition of absorbing immigrants. I am convinced that the Pilgrim Fathers embarked not so much because they were persecuted for their beliefs, as because they were not allowed to persecute others in the way that they wished; the near-genocide of Native Americans, and the institution of slavery and the violent opposition to integration that followed it, still cast a stain. As the black minority has started to be absorbed into the dominant culture however, a different group of ‘others’ has emerged. America has produced religions that are at least as different from the Church of England as Islam is – Mormons, snake-worshippers etc. Incorporating Muslims has proved to be a challenge however. Islam is, in itself, a very intolerant religion: the core teaching of Islam is that there is only one single way to God, as compared, for example, to Hinduism, where the core philosophical idea is that there are as many paths to the same goal as there are living creatures. Counseling Muslims by a couple of associate professors, one at the American University in Egypt and one from Michigan, includes a useful mix of case studies illustrating potential interventions, some awareness of the mental stresses and expectations of the emerging second generation (native-born children of immigrant parents), and some consideration of American converts to Islam – inevitably people who already feel alienated and unbalanced by their native culture. All of these groups are likely to face above-average levels of mental stress and yet at the same time are likely to have an above-average distrust of mental health services. There is a large literature on the mental health of immigrants and an enormous range of publications on ethnic diversity, but comparatively little on the specific problems of Muslims in predominantly non-Muslim countries. This book has a very American focus, which might make it less useful in other countries, but is still worth considering by any mental health practitioner who is likely to have to deal with members of minority groups. The USA led the way in educating professionals in cultural diversity – the American Psychological Association published its Guidelines in 2002: an example gradually being followed elsewhere.
And so, to ‘the lean and slipper’d pantaloon’. Aging and Diversity is the second, substantially expanded, edition of a book first published in 1998. Quite a lot has happened in the past dozen years, both in the general awareness of human diversity and in the general awareness of the problems of ageing. As a book with just two authors, this is rather more coherent than some of the others we have been looking at. Both authors are American academics. The focus is entirely on ageing and diversity in America, which may limit its use in other countries slightly: the sections on health and social services form an obvious example, but the book would still be of interest in most developed countries. The target readership is clearly students and trainees, so each chapter starts with a handful of semi-fictitious vignettes and ends with a brief examination paper of true/false questions with explanatory answers; there is a final ‘note for instructors’ and each chapter has a brief well-annotated list of suggested further readings and useful audio-visual resources rather than just a list of references. This book represents an astonishing advance: until surprisingly recently most books on geriatrics were written on the assumption that the ‘normal’ old person was a white male – very odd when you consider that in most human societies the majority of old people are female. Students are invited to consider diversity of gender; of race or ethnicity; of religion; of social class (defined in the USA mainly on economic lines); rural/urban location; and sexual orientation. The main thing that I missed was anything on the prejudices of old people themselves. This is an important topic. Americans in their 80s today grew up in a country where blacks were segregated, homosexuality was illegal and, apart from Jews, there were hardly any people from non-Christian backgrounds. There have been real problems in racially integrated care homes and in the acceptance of same-sex couples who would obviously prefer each other’s care to that of birth families that may have rejected them years before, and so on. I would have expected to see a chapter on this. I would also have liked to see something on diversity among care staff. I gather that things are better in the USA, but I worked for years in a college where the only course that was 100% white, in all three years, was the clinical psychology doctorate (in spite of the best efforts of the tutors); a disproportionate number of the doctors in the less well-regarded areas of British geriatric medicine have been immigrants from India; and nearly all of the cleaning/catering staff in care homes have been black, or more recently East European – an unhealthy situation.
Apart from minor omissions of this sort, this book can be warmly recommended. Any American nurse, social worker, psychologist or other caring professional who has worked through it properly will be very much better educated on this important topic than a predecessor who trained only a few years ago.
And so to the final stage ‘sans everything’, where, as with the infant, no awareness of diversity can be expected. Cultural differences among carers, relations and so on count for less here however. Different cultures have strong expectations around childbirth, but it is only my generation in a few economically developed countries, that has grown into the expectation that many of us will end up demented. The literature on diversity in dementia remains to be written.
Human society is changing. We have recently moved from substantially rural communities with unique dominant cultures towards predominantly urban multicultural societies, with at least a hint of the emergence of a worldwide monoculture to come. Each of these brings its own mental stresses and strains. Mental health staff currently need to learn to work with human diversity at all stages of the life cycle. These four books form a modest contribution to this process.