For tribal families on the Navajo Nation, as in most tribes, respect for persons is relational--k'e. Rather than teach cultural diversity through listing some customs and practices, a perspective of recognition may be the best way to understand the principal ethical implications of cultural diversity for health care--recognition of the relations between self and culture, shaping and being shaped, that each and every family struggles with due to the internal partitions of boarding schools, loss of language, and generational assaults on traditional family functions. Yet rarely are the sorrows vocalized in language.
Tribal families base communications on wellness principles that are forward looking and mutually affirming rather than any focus on complaints or negativity. The language of tribal family wellness relies less on English language explanations and description than on affirming humanity. English language-based engagements especially in Q&A formats rarely lead to straightforward answers with mutually understood meanings. E.g. the use of English words even for “family” or “wellness” fails to express what is meant. Understanding the communications aspect of k’é and hózhó is fundamental in involving tribal families, especially of CYSHCN, in any shared healthcare-centered decisions. This fundamental communication aspect needs to be developed.
In July 2023, Navajo Family Voices coordinated a conference in the Navajo Nation Museum in Window Rock, AZ, partnering and sharing costs with the NM Title V MCHB, NM state department of health, the AZ F2FHIC, and the tribal college land grant office. The conference, called "Envisioning Diné Bikeyah for our Families in 102 Years, used films, essays, photos and art submitted by the families themselves that envisioned a future of wellmess. Other families responded to and interpreted the submission, then provided their own wellness visions over 2 days, almost always including gently described sorrows, trauma and complaints so profound there were frequent tears. The event was indoors, outdoors, and with ceremonial instruction components. There were 250 registrants, with 189 actually attending and as many walk-ins. Within 19 days of announcement, registrations had well exceeded capacity.
102 years in Diné means a lifetime of a matriarch who can see 3 generations behind and 3 generations in front. The many providers who attended left the conference with valuable insights and feeling as if they had been immersed in a sacred gathering that affirmed their mutual humanity.