Medicine In A Multi-Cultural State;

Front 1

What was the story the Dr told at her blint meeting?

Back 1

An Ethiopian new immigrant woman of 25 complained of weakness, was diagnosed as general fatigue syndrome, the Dr noticed bruises and involved a social worker. she advised her to lodge a police complaint and told her about a shelter for battered women. She fainted, was hospitalized and went home. she then entered what the dr called a major depression and sent her to a psychiatric hospital. She was sent to her parents and her husband went to his brother and the woman deteriorated. finally an advisor who understood her culture stepped in and talked with her, had a group meeting and explained the marital problem on the basis of difference of desire regarding when to have another child and sexual habits and they expressed desire to consult a traditional shamgeleh. The Dr stayed in touch and helped the husband stay strong during the winter. A warm relationship ensued and other Ethiopian women came to her clinic with similiar complaints.

Front 2

What are the lessons from this first story?

Back 2

The correct professional western behavior is not always appropriate for those coming from a different cultural group and our medical routine is not automatically correct.

Front 3

What was the second story?

Back 3

A moroccan man of north african descent in traditional galabiya asked for medical help and was seen in attacks similar to epileptic grand mals. The entire family was afraid and the Drs who did not understand his language or culture prescribed him psychotic drugs until a Professor of anthropology of Moroccan Jews got involved. She came in the evening when the spirits are about, found out he is frustrated sexually and feels guilty about his desire for his daughter. His feelings legitimized and his fears about being alone and who will care for them in their old age, his children were supportive and his attacks stopped.

Front 4

What are the lessons from this second story?

Back 4

1. Cultural behavior including faith and beliefs is like a "dress". When the right expert comes who knows how to penetrate the dress and find the naked seed, it is usually a human, universal problem understood well by the therapist and for which he has effective tools. A translator is on a lower level than someone with a deep understanding of mentality and culture.
It is vital to respect and be sensitive to a culture we have limited knowledge of. Our expert rules and methods which arise from a modern Western cuture are not automatically for persons of another culture. Each staff ought to include an expert of the ethnic background of the patients. It is essential to respect the treatment methods of folk, religious, alternative wisdom and see in them complementary care and not a competitive threat.