I’ve often said to other remote area nurses that we haven’t done ourselves any favours by doing the work that we do as we often feel we don’t fit in anywhere anymore. I read something recently that reinforced that opinion. In a book called “Other People’s Country” by Maureen Helen, her account of her work in remote Western Australia in the nineties, she speaks with a nurse who’s leaving after many years working in the same community: “It was to have been my big adventure,” she said wryly. ‘I’d planned it for a couple of years and thought I was lucky to get this job. But I hate the heat. And I miss my family, ‘she confides. ‘Sometimes I can’t remember why I came. everything’s so different. It’s like a foreign country, isn’t it? I feel as if I can’t talk to people who’ve never been here because they don’t understand. And people who live up here permanently are so comfortable they’re almost smug.”

Odd Friends

When you find yourself in a remote place you welcome any overtures of friendship. loneliness, culture shock and generally figuring out how you’re going to fill in the hours after work can be quite a challenge.

A sulphur-crested cockatoo befriended Fasi and I one afternoon. It was sitting on the guttering of the clinic building just above our heads, leaning over peering at us as we talked. When we walked the hundred or so metres home along the red dirt track, it flew through the gum trees, over our heads and landed on the metal railing outside the kitchen, loudly calling “hello”. It must have once been someone’s pet, although we never found out whose, and it never ventured far from the back verandah and it’s water and sunflower seed tray, from the day it arrived till the day we left.

I loved that bird, it brought another dimension to the harsh life I was experiencing in Aurukun. Just watching it waddle about on the railing or wandering into the house made me smile.

Reverse Culture Shock

I worked in Aurukun at the top of Cape York, Queensland on a five week contract before deciding to apply for a permanent job in the clinic. After I was interviewed and got the job I was flown home to South-East Queensland for 10 days to pack my things to be shipped back for the three-bedroom house I was to move into.

En-route I stayed overnight in Cairns. There were too many people at the airport, the shops and the motel foyer. There seemed to be more cars on the roads than when I was there five weeks previously. The colours were brighter, there was too much choice in the shops and everyone seemed to be talking loudly. I felt strange just walking around Cairns Central looking at the shops. I felt out of place, like I didn’t belong.

When I arrived home and met up with family and friends their questions sounded trivial to me, or their lack of questions widened a gap I felt was opening up between me and everything I’d considered normal before I left home.

I didn’t know it then but I was feeling the effects of reverse culture shock.

When a person returns home after being in another country or social environment it takes a whole other set of adjustments to when they first encountered the new setting. People assume because their friend or family member who’s been away, looks and sounds like the person they knew, that they still  belong to all they left behind. But often things have changed in their absence and they have experienced life outside their previous norms in the time since they left home. They can, in fact, be quite disorientated on return.

Being aware of reverse culture shock, being prepared to experience boredom, isolation, disorientation and annoyance on arrival home will help a person to readjust. It’s a good idea to keep in contact with new friends made from the host culture and to talk to people with whom you can relate. It’s also often helpful to use creativity to incorporate the new cultural experiences into one’s regular life by writing articles or creating a photo exhibition, or simply by bringing art or cultural items into one’s home as a reminder of the time away.

Asking yourself what you’ve learnt and how you’ve changed help you to be more aware and to adjust and for the time away to have a positive effect.

I have to admit though that while these ideas are helpful, coping with reverse culture shock takes a much longer time than you’d think and if a person moves between cultures fairly regularly it doesn’t seem to get any easier. In fact one often feels like an in-between person not quite belonging anywhere.

More Culture Shock

100_0269When that shop assistant told me to Google culture shock, I’m sure I did, but I don’t remember a thing I read, neither have I written anything about it in my journal. Thats a puzzle to me and unlike what I normally do. I read to figure things out and record my thoughts.

I probably read that the definition of culture shock is “The feeling of disorientation experienced by someone when they are suddenly subjected to an unfamiliar culture, way of life, or set of attitudes.” It may be experienced due to immigration or a visit to a different country, a move between social environments or simply travel to another type of life.” But I don’t remember being helped by any words about it.

Culture shock is a type of transition shock. Its a predictable state of loss and disorientation caused by a change in a person’s familiar environment that requires adjustment. Completely understandable when you read back  a few years later from the comfort of the familiar place, but when, without warning you suddenly lose sense of yourself and the reality of the country you thought you knew, no written words will enlighten your rational mind.

It has degrees of severity, different effects and time spans but the most commonly experienced symptoms are as follows:-

  1. Sadness and loneliness
  2. Over concern about your health
  3. Headache, pains, allergies
  4. Anger, depression, vulnerability
  5. Idealizing your own culture
  6. Trying too hard to adapt by becoming obsessed with the new culture
  7. Feeling insecure and shy
  8. Homesickness
  9. Feeling lost and confused
  10. Clinging to everything familiar by the need to email/phone home
  11. Compulsive eating/drinking
  12. Irritability

In the first few months and beyond of arriving in Aurukun I experienced all of the above and it was only a stranger behind a shop counter who thought to tell me about it. There’s a lot of helpful information on the internet but being aware of, and prepared for, culture shock would be the most help. The problem is that it’s an overwhelming reaction that once you’re experiencing it is difficult to get perspective. I’ve just found an on-line cultural competency course from “Unite For Sight” a US charity organisation. It gives the following helpful advice to dealing with cultural shock:-

  1. Pursue information gathering
  2. Look for logic in your new surroundings
  3. Make sense of the environment
  4. Use wisdom and patience
  5. Use humour (A big help!)
  6. Have faith in yourself (what you’re feeling is normal!)
  7. Don’t pity yourself
  8. Stay mentally, physically and socially active
  9. Get enough rest
  10. Eat a balance diet
  11. Take reasonable risks (go exploring safely)
  12. Ask for help
  13. Use friends and family as emotional supports

Thinking about all this five years later I look back over my life and recognise a few times of transition when I’ve experienced a sense of dislocation, moving interstate with my family as a teenager, staying at home with small babies after I married in my early 20s and returning to a hospital to do my nursing training in my 30s are the main times that come to mind. But beginning life as a remote area nurse was by far the most overwhelming and has taken the longest to come to terms with. In lots of ways I’m still dealing with culture shock.

Culture Shock

100_0013I was collected from the airstrip by an Aboriginal health worker from the clinic in a white rodeo ute, he tossed my luggage in the back and drove without speaking to the flat I was to stay in. It was about a kilometre up the main bitumen road, Kang Kang road. The block of three flats was across a red dirt track from the clinic.

Six foot high barbed wire fencing surrounded the flats, the sturdy metal gate was padlocked with a chain around it. I wondered if the stories I’d read of violence in Aurukun were really true. Perhaps I had good cause to feel mounting fear, the pounding in my chest was maybe an accurate warning.

A few days later when I took photos of my surroundings and emailed them to friends and family everyone was surprised at the need for such security. One person commented that the photo of the flats looked more like South Africa than Australia. Fasi told me later that I looked scared of everything when I first arrived.

There were skinny, mangy dogs lying listlessly in the heat, everywhere. The Australia I knew wouldn’t have allowed the cruelty of ribs showing and bald patches. Local people yelled at each other up and down the main street until late into the night. There were limited places to walk before you met the sea or the thick bush of pandanus and gum trees. Small children were fluent in another language with harsh staccato sounds. I felt trapped in strangeness and didn’t have a clue what to expect, none of the behavioural rules I was used to seemed to be important there. Anything could happen.

I was driven to the store soon after landing by an agency nurse. It was a large square plain building, dark and musty smelling inside. Sweaty bodies milled around, lined up at check outs or stood around the entrance mostly speaking words I’d never heard. There was little fresh fruit and vegetables, I chose a few cans and bread and wanted to get out. As I was being served by a white woman she asked if I was new and if I’d worked in an Indigenous community before. I told her I was a new nurse there for 5 weeks. She advised me to google culture shock, her kindness made me want to stay near her, but there was a queue behind me so I had to move on. I must have looked as scared as I was beginning to feel.

In her book called “Other People’s Country” Maureen Helen wrote of her arrival in a remote desert community in Western Australia in the nineties…”Life’s experiences had not prepared me for the sudden loss of personal congruency. Disorientated and sick from culture shock, I couldn’t fathom what ailed me. It made no sense that I could experience such disorientation in the country where I was born and raised.”

It’s an oddly dislocating feeling to suddenly realize you’re a stranger in your own country. No-one had prepared me for that and that shop assistant has been the only person to even mention culture shock to me in the five years since arriving in Aurukun.