October 8th

One of the topics in class was health literacy. This topic brought me back to my cultural competency days. After I finished undergrad I worked for a community health center on a project to increase cultural competency amongst physicians and staff. A large portion of patients were Hmong or Latino immigrants and there was a huge cultural/language barrier. The Hmong population were more challenging to work with because there were not many professionals/staff that spoke the language and their cultural beliefs were so different from westernized medicine. Some of the new Hmong immigrants were diagnosed with TB and were required to take medications for treatment. However, this was difficult for them to understand because in their country there is no doctor. They believe in a Shaman, which is a well respected person from the community that has spiritual powers to cross to the spiritual world. If a family member becomes sick or depressed they are sent to a shaman for help. Animals are sacrificed and the Shaman goes into a special trance state to cross to the spiritual world to ask the ancestors for advice or direction. So taking pills at certain times for a certain amount of days or months was totally unheard of. Physicians and healthcare staff really struggled to keep this population healthy because of this cultural misunderstanding. To make a long story short, physicians and the Hmong Shaman work together to treat Hmong patients. Some gaps still exist, but this project help fill a very important space.

I recognize that health literacy is a big problem in healthcare. I've come across so many patients, friends, and family members that just don't know what is going on. I find that many people don't know how to ASK...WHAT, WHEN, WHY? For example, my little sister who is in her early twenties living by herself in LA had a minor operation. My family lives about 6 hours north, so i'm the closest family member distance wise and of coarse the health expert. My mom was really worried about her so I took a day off to help her out on the day of her discharge. When I arrived at the Kaiser Hospital (oh, by the way I HATE HMO'S and KAISER...if you have this insurance I feel for you...these companies are money making heartless...bleep, bleep...you get the point!) they hadn't told my sister when to take her meds or when she needed to follow-up with a doctor. Nothing! The nurse just said...oh if you want me to call the doctor I can. Being the assertive woman I am, I said "YES get the doctor on the phone". I had my sister ask all the questions that I could think of and told her...you need to ASK. It's soooo sad! I mean, my sister is a smart, independent woman who speaks English fluently and luckly has a HEALTH EXPERT 4 A SISTER....but it made me think....what happens to people who don't speak up....who don't know English...who don't have a health expert in the family....who are illiterate???? How many new immigrants who can not speak English well and can't read are going to say to that nurse "oh yah, get the doctor on the phone, because I have a list of questions that he or she hasn't answered yet". That doesn't happen....they fall down the cracks and don't get the healthcare they need! Gosh...I could go on with this topic! Goodnight!:-).