Cultural Humility as a Clinical Skill: Lessons from IPC Practice aboard a Humanitarian Surgical Hospital Ship in Sierra Leone
Background
Infection prevention and control (IPC) frameworks are predominantly developed within high-income healthcare contexts. Their translation into low-resource, culturally distinct environments demands more than technical adaptation — it requires cultural humility as an active, practised clinical competency. This presentation draws on a four-month IPC deployment aboard a humanitarian surgical hospital ship operating in Sierra Leone to examine how cultural humility shaped every dimension of IPC practice, from hand hygiene education to viral haemorrhagic fever (VHF) preparedness.
Objectives
To demonstrate that cultural humility is not a supplementary interpersonal quality but a core clinical skill that directly determines the effectiveness of IPC interventions in diverse and resource-constrained settings.
Methods
Reflective practice and observational learning informed this work, undertaken within a high-volume surgical service staffed by multinational clinical teams alongside local Sierra Leonean healthcare workers. IPC activities included surgical site infection surveillance, aseptic technique coaching, PPE training, environmental hygiene auditing, and VHF preparedness education. Local co-design was central to implementation.
Key Findings
Effective IPC practice required continuous interrogation of assumptions embedded in standard protocols. Behaviour change was achieved not through directive instruction but through relationship-building, curiosity about local context, and genuine integration of local knowledge. Protocols imposed without co-design consistently met resistance; those developed collaboratively achieved meaningful and sustained uptake.
Conclusion
Cultural humility — the ongoing commitment to self-reflection, power-sharing, and contextual responsiveness — functioned as a clinical tool as essential as any surveillance methodology. IPC specialists working across diverse populations, whether internationally or within multicultural domestic settings, must cultivate cultural humility with the same rigour applied to technical skills. This presentation offers a framework for embedding cultural humility into IPC education, policy, and practice.