Ethnicity, Culture

1
Ethnicity, Culture Diversity

• Ourselves
• Ourselves and other people
• How it affects us at work
• Bradfords Asian community

2
Who are you?
3
Dimensions of diversity, some more visible than
others

• Class (wealth? education? family?
• Occupation
• Sexual orientation
• Political orientation
• Disability
• Culture

• Gender
• Age
• Ethnicity
• Nationality
• Language
• Skin colour
• Religion

4
Understanding different cultures

• or stereotyping?

5
General issues when language and culture differ
between doctor and patient

• Non-verbal communication
• Use of interpreters
• Health beliefs
• Differing agendas of doctor and patient
• Need more time
• Practice organisation
• Need special health promotion materials and
  methods

6
Working as a GP with Patients from Bradfords
Asian community

• Useful things to know

7
Bradfords Asian community

• Mostly from Mirpur in Kashmir
• Mostly Muslim
• Mostly from an unsophisticated rural community,
  low educational level
• Languages Urdu, Punjabi, Mirpuri
• Dam built on houses and land in Mirpur - and
  Bradford mills needed labour

8
Most Bradford Asian families originate from Mirpur
9
A reminder - dont generalise, dont
stereotype,dont forget importance of

• Class
• Education
• Religion
• Age/generation

10
Asian families

• Respect for elders
• Families more important than individuals
• Distinct roles for men and women
• Importance of mother in law
• Big families, desire for sons
• Taboo subjects - termination of pregnancy, STDs,
  domestic abuse
• Cultural conflict for those born in Britain

11
Muslim patients

• Dont drink alcohol - in theory
• Dont take tablets or medicines during fasting
  hours in Ramadan
• Women arent allowed to pray when bleeding

12
Some medical issues

• Commoner in Asian patients TB,
  rickets/osteomalacia, thalassaemia
• Hugely increased incidence of diabetes and IHD
• Not tuned into psychiatric diagnoses (use the
  word stress)
• Consanguineous marriages recessive syndromes
• Seem to be a high degree of medically unexplained
  symptoms/somatisation - BUT high morbidity
• Patients may be consulting other healers

13
Some common health beliefs of people from Mirpur

• hot and cold food
• Gas in the stomach is bad and can migrate to the
  head
• Important to be buried with all your organs
  inside so you can rise after death
• Eating oily food is good - not only tasty but
  makes you fat (being skinny is a sign of disease)

14
A reminder - dont generalise, dont
stereotype,dont forget importance of

• Class
• Education
• Religion
• Age/generation

15
Want to do more?

• Your group presentation?
• Videos on cross cultural consultations
• Video of BBC4 programme about South Asian doctors
  who came to the UK