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Healthcare organizations and professionals avidly address the issue of ethnic and racial disparities as well as multicultural diversity in health . Purnell’s model is a major circle which represents an immense global society which consists of politics as well as communications, warfare and conflicts, famines and natural disasters, commerce, businesses, information technology, space exploration and the aptitude of the people to travel globally and interact. The model allows for assessment of a modern culture by focusing on 12 domains which are found in each culture. The model structure focuses on the community level to individuals ( Purnell, 2002, pp. 193-196). It generally takes into account that one must comprehend the society at large as well as their norms before they are applicable in communicating with a specific person.  The domains comprise of inhabited localities, overview, communication, topography, family organization and roles, bicultural ecology, workforce issues, nutrition, childbearing and pregnancy practices, spirituality and death rituals and finally health care providers (Purnell, 2000, pp. 40-46).   This paper hence focuses on death rituals and spirituality according to Purnell’s model.

Death rituals

Death rituals comprise of how the culture as well as the individuals view rituals, death as well as behaviors in preparation for burial practices and death (Louise & Carolyn, 2008, pp. 235). Some of the bereavement behaviors are also included in the domain. The rituals which surround death do reflect greatly on what death means to divergent societies and culture. It drives on this question. Is death a failure as far as medical science is concerned, a part of life’s circle or basically an ultimate liberation?

The Haiti people are culturally sensitive and  incase they realize the time of death is impending, the family gather together to cry, pray as well as use spiritual artifacts and religious medallions (Cosgray, 1999, pp. 482-507, Miller, 2000, pp. 204-11).  They usually prefer dying in their homes rather than in the hospital (American Geriatrics Society, 2006,  pp. 87).  Autopsy is usually allowed in some circumstances and in case death is seen to be caused by maleficence, then autopsy can be done. It can also be done to make sure that the body is dead and essentially not a zombie (Haitian information bureau, 1994). The bereavement practices comprise of dernier priye, veye as well as prise de deuil (Haitian information bureau, 1994). This process helps the soul to pass to the next world. Prise de deuii does take place on the seventh day and is similar to the funeral which hence begins on mourning period (Haitian information bureau, 1994).


It comprises of the use of prayers and religious practices. It also focuses on the meaning of life as well as where people get to gain their strength (Louise & Carolyn, 2008, pp. 235). It also involves a connectedness in search of a meaning with an immense power which is broader than religious beliefs.  The Haiti people do practice two religions namely Voodoo and Christianity (Andre,  2007, pp. 292).  Catholicism was the main religion that was introduced to the Haitians and thereafter the Protestantism. Most of them are quite active in church as religion helps in shaping their entire cultural identity. The Voodoo religion was believed to have been brought in with the slaves to Haiti and hence considered to be the national religion(Andre,  2007, pp. 292).  It has no any hierarchy or theology. In Voodoo, they believe in a god called Bon Dieu who has three spirits namely the dead, loa and twins. The loa are usually the forces of health, reproduction, evil and good (Andre,  2007). The twins are usually descendants of one god and the Haiti people believe that incase the twins are remembered during religious ceremonies, they will hence help to improve life (Andre,  2007). The dead are considered to be helpful and part of the family. The major tenet of Voodoo is to heal the people from their sickness and the priests are paid for healing and other activities like spelling casts.


Purnell model is very abstract, quite comprehensive as far as content is concerned, has some form of logical congruence as well as conceptual clarity which demonstrates a clinical perspective and utility. It helps the health professionals in offering individualized , appropriate care and culturally competent care to the patients. It can as well be used in accessing families, community and the society. It is quite easy to apply and is relevant to any cultural setting.