Rev. Fr. Anselm Amandikwa on enabling Nigerians to perform their expected duties

What Chaplains Should Know about Nigerians

I am a Nigerian who is presently residing in America. My experience as a chaplain this year has highlighted how connected effective chaplaincy is to people's cultural, religious and ethnic world views. According to research, there are three major areas where differences are particularly manifested: "Communication of 'bad news'; locus of decision making; and attitudes towards advanced directives and end of life care."[1] With this in mind, I want to offer a few basic ideas related to these aspects from a Nigerian cultural perspective.

To begin, communicating critical diagnoses directly to a Nigerian sick person is culturally inappropriate. Medical professionals should communicate “bad” news to family members who then decide the best way of conveying it to their sick relative.

Who makes decisions in these critical moments? Americans emphasize the autonomy of the sick person – but, Nigeria is a family-oriented cultural community. While the autonomy of the individual is recognized, family relationships usually determine personal behavior and decisions in sadness – and in joy. Nigerian families prefer to take care of their unwell loved ones at home. The following assertion by Harley, et al, is true of the Nigerian situation: “Family members often make sacrifices to care for relatives. Families provide care, pain management, and protect the patient. Although they may lack knowledge, caregivers gain satisfaction and pride from providing care ….” [2]

Nigerian families hope for recovery and divine intervention until the last moment. We expect a medical team to continue treatment until all interventions and/or financial resources are exhausted. Chaplains should not be surprised when relatives – often the eldest in the family – make all of the decisions. This makes family – or Nigerian community – support essential.

Nigerians rarely rely upon a durable power of attorney or complete advanced directives. Traditional norms of most Nigerian communities are organized in ways that specific family roles are culturally designated. Depending upon their position in the family, children know their responsibility to their relatives; the same applies to relatives and their children. The local community holds its members accountable in the performance of these roles. One invokes community anger when not performing one’s expected duty.

Moments of sickness or danger of death are inappropriate times to talk about wills. Discussions about “who gets what” while the owner is alive – whether sick or elderly – is considered disrespectful and selfish. Further, it is equated to a death wish and as such, is highly offensive. Traditional laws of inheritance are embedded in the cultural norms of the community. Often this is based on how each loved one either cared for the deceased while alive or contributed towards the burial.

Last but not least, it is a dignifying honor for Nigerians to die in their homes amid their loved ones. Nigerians strongly believe in the relationship between the living and the dead and so, would prefer to be buried in their hometown among their own people. Nigerians living far away from home are worried about what will become of their corpse after death.

One extremely important pastoral intervention that a chaplain can provide to an unwell Nigerian – or one who is suffering the ravages of ageing – is to connect that person to other Nigerians within the community at-large.

Footnotes

[1] H. Russell Searight, et al. “Cultural Diversity at the End of Life: issues and Guidelines for Family Physicians.” AAFP, 2005. http://www.aafp.org/2005/515.html. Accessed 4/3/2007.

[2] Haley, W.E., & Bailey, S., (1999). "Research on family care giving in Alzheimer’s disease: Implications for practice and policy." In B. Vellas & JL Fitten (Eds.), Research and Practice in Alzheimer’s Disease Volume 2. (pp.321-332). Paris, France: Serdi Publisher.

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