Download Haitian Americans

Cultural
Ambassador
Workshop:
Haitian Americans
Monday, December 8th, 2014
1 p.m. to 4 p.m.
Two River Conference Center
RMC
Meridian Health Cultural Diversity Department
Ann May Center for Nursing
Cultural Ambassador Workshop Agenda
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Check-In
Welcome
Video #1
Presentation on Haitian Culture
Video #2
Panel Discussion
Wrap-up - Next Meeting Dates
A few things…
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Please turn off your cell phones
Bathrooms
Breaks
Folder:
– HRSA demographic form
– Evaluation
– Other interesting items
• Enjoy the program!
HRSA statement
• This project is supported by funds from the Division of
Nursing (DN), Bureau of Health Professions (BHPr),
Health Resources and Services Administration
(HRSA), Department of Health and Human Services
(DHHS) under D62HPO5069 Comprehensive
Geriatric Education Program $471,625. The
information or content and conclusions are those of
the author and should not be construed as the official
position or policy of, nor should any official
endorsement be inferred by the DN, BHPr, HRSA,
DHHS, or the US Government.
Disclosure statement
• All speakers have indicated that they have no
financial relationship with any pharmaceutical or
medical device company that they may mention
today in their lecture presentation.
• Speaker and planners have agreed that this
activity is free of bias.
• There is no commercial or non-commercial
support for this activity.
Objectives
1. Understand cultural background of Haitians in the
United States.
2. Discuss and describe cultural norms and possible
cultural barriers experienced by Haitian Americans
when accessing healthcare in the U.S.
3. Group dialogue with local healthcare providers of
Haitian descent to further understanding of how to
care for Haitian patients.
Meridian’s Rationale for This Overview
• Significant Haitian population in the Monmouth and
Ocean County area
• Haitian Creole is Meridian patients’ third most
preferred language after English and Spanish
7
Haitian Language Demand Increasing at Meridian
Haitian Creole Face to Face Interpreting demand saw a
significant increase across Meridian this year!
• 2012
• 2013
• 2014 (thru Nov. 30)
8
10 hours
14 hours
307 hours!
Demographics and Socio-Economics about the
area’s Haitian population
• Demographics:
– Approximately15,000 Haitian residents reside in
the Monmouth/Ocean County area.
– Median age: 30
– Asbury Park was 29 out of the top 30 US
communities with the highest percentage of
people claiming Haitian ancestry
• Socio-Economics:
– Median household income (2006-2008)
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Haitian (NJ):
African-American (Monmouth):
Latino (Monmouth):
White (Monmouth):
$54K
$48K
$50K
$85K
Sources: 2000 US Census data; 2006-2008 American Community Survey 3-Year Estimates
Ancestry Map of Haitian Communities". Epodunk.com. http://www.epodunk.com/ancestry/Haitian.html.
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Introductory Video
Haitian Americans
Documentary
Published Jan 20, 2013
23 minutes long
http://youtu.be/fUwGrZ1dYYQ
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Barriers to Healthcare for Haitians
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Language barrier:
– Unfortunately, unlike Spanish, Haitian Creole is not taught in U.S. schools,
therefore interpreters are harder to find.
•
Cultural differences:
– Due to cultural belief systems, preventive care is not always sought. However,
preventive injections and vaccines are considered acceptable.
– However, care usually sought for babies and children under 5 years old.
•
Immigration status:
– Some Haitians who are undocumented may be reluctant to seek care due to the
fear they will be deported.
•
Poverty:
– If they have to pay for health care, it may not be a priority.
– At the same time, in Haiti, patients are used to paying for their own medical
supplies, which may be confusing for some patients in the U.S. where that is not
the case.
Source http://www.salisbury.edu/nursing/haitiancultcomp/health_care_practpg1.htm
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Barriers to Healthcare for Haitians
•
Level of Education
– The educational level of Haitians may determine how they use our American health
care system, if they have the means to do so.
– Educational level can be a sore point for some.
• Important cultural value: Pride in Appearance
– Important for people to advance and better themselves.
Source http://www.salisbury.edu/nursing/haitiancultcomp/health_care_practpg1.htm
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Barriers to Healthcare for Haitians
• Mental illness:
– Mental illness is not well accepted in the Haitian culture
– Often may be labeled as “stress”, “being tired”, generally “feeling bad”, “needing
rest.
– May equate mental illness as something shameful and embarrassing.
– Often assumed as being “crazy” or “requiring being institutionalized”.
– Not always perceived as something chronic; usually considered more of a transient
condition.
– Could be associated with having a “bad spirit”.
– Stigmas can lead to social withdrawal and hiding from treatment.
• Fear of Surgery:
– Abdominal surgery is particularly frightening to Haitians.
– More afraid of the after effects and use of anesthesia.
Source http://www.salisbury.edu/nursing/haitiancultcomp/health_care_practpg1.htm
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Barriers to Healthcare for Haitians
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Fear of Cancer
– Many assume a cancer diagnosis to be always terminal
– Can lead to social isolation for the patient
– Patients may not want to be seen by others as sick.
•
Reason for Visit:
– Older Haitians may use vague terms to describe their illness or symptoms (“gas”) ,
making it hard for practitioners to understand the reason for the visit.
– If the practitioner asks “what do you or your family think you have?”, it may help to
get to the problem.
•
Organ Donation/Transplant:
– Organ donation & transplants are typically neither discussed nor encouraged in
Haitian culture, although receiving an organ may be considered for a child as a lifesaving measure.
Source http://www.salisbury.edu/nursing/haitiancultcomp/health_care_practpg1.htm
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Common Health Disparities
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Poor access to primary care can make newly arrived Haitian immigrants at higher risk
for the following include:
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Hypertension
Diabetes
Sexually Transmitted Diseases
Cancer (most prevalent are colon, prostate, cervical, hepatic, gastrointestinal, and Kaposi's
sarcoma)
Tuberculosis
Vector borne diseases like malaria, dengue, and lymphatic filariasis
Diarrheal diseases
Parasites
Typhoid
Many conditions may be mitigated by the patient’s social status.
U.S. screening upon arrival for legal immigrants may catch many conditions.
Disparities can exist between those who are documented versus those who are not.
Source: http://www.salisbury.edu/nursing/haitiancultcomp/biocultural_ecology.htm
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Common Health Behaviors & Practices
• Sexually transmitted diseases (STDs) are a common health
problem in Haiti.
– Many Haitians do not associate STDs with sexual intercourse.
• Exercise should be encouraged for its benefits.
– “Sexy” = “Fit”
– Being healthy helps avoid diabetes and needles
Source: http://www.salisbury.edu/nursing/haitiancultcomp/high_risk_health_behav.htm
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Common High-Risk Health Behaviors
• Traditionally, Haitians tend to seek clinical care only when all
other options are exhausted.
– One’s ability to afford care factors into this as well.
– Home remedies often sought first.
– Many weigh “Not feeling good” versus an illness that requires a
hospitalization.
– Illness is associated with not being able to work.
Source: http://www.salisbury.edu/nursing/haitiancultcomp/high_risk_health_behav.htm
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Haitian Spiritual Overview
The most prevalent religion found in
Haitian culture is Christianity.
Christianity
• Catholicism was the first Christian religion
to be introduced to the Haitians and it is
now the religion of the majority of the
population in Haiti.
• Protestantism was introduced more
recently and is growing in popularity.
• Haitians in the U.S. are very active in their
churches and for most Haitians, religion
helps to maintain their cultural identity.
Source: http://www.salisbury.edu/nursing/haitiancultcomp/spirituality1.htm
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Haitian Spiritual Overview
There are two religions that Haitians may practice and that can be
practiced simultaneously-Christianity & Voodoo.
Voodoo (also spelled Voudou, Vodoun, or Vodon)
• The word Voodoo comes from an African word meaning spirit. The
Voodoo religion was thought to have been brought with the slaves to
Haiti, and over time, it developed into a religion specific to Haiti.
• Voodoo is often considered the national religion of Haiti as many
Haitians may practice it to some degree or are affected by it in some
way.
• Voodoo does not have an organized hierarchy or a specific
theology.
Source: http://www.salisbury.edu/nursing/haitiancultcomp/spirituality1.htm
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Haitian Spiritual Overview
Voodoo (also spelled Voudou, Vodoun,
or Vodon) - continued
• Misconceptions about voodoo have
given Haiti a reputation for sorcery
and zombies.
• Popular images of voodoo have
ignored the religion's basis as a
domestic cult of family spirits.
http://blogs.reuters.com/photographersblog/2013/04/05/voodoo-alive-and-well/
• Adherents of voodoo may not
perceive themselves as members of a
separate religion; most consider
themselves Roman Catholics or
Christians.
Source: http://countrystudies.us/haiti/33.htm
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, U.S. Library of Congress
Nutritional Preferences
• Haitian cuisine has
both French and
African influences,
and also uses spices
commonly found in the
Caribbean.
• Food is often used to
establish reciprocal
relationships and
networks with new
immigrants or new
friends.
Source: http://www.salisbury.edu/nursing/haitiancultcomp/nutrition.htm
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Nutritional Preferences
•
Many Haitians may be reluctant
to try new foods and would
rather not eat than eat unfamiliar
foods.
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For older Haitians, the way a meal
is prepared may present problems
for them.
Haitian foods can be very spicy
and fattening.
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Traditionally, high in sodium and
very starchy.
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Common beverages include water,
homemade fruit juices, coffee in
the morning, and cold fruity soda.
Herbal teas are also popular.
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Source: http://www.salisbury.edu/nursing/haitiancultcomp/nutrition.htm
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Example: “maggi” – bouillon cube
a common recipe component
Tea is only used when sick.
Characteristics and values important
to Haitian families and communities
Education:
“Education is like religion.”
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Haitians attach a great value to
education, although affordable
access to education can be very
limited in Haiti.
•
French was traditionally the
language of instruction in Haiti, but
the majority of Haitians do not
speak French at home.
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In the late 1970s this changed, and
now Creole is used as the
language of instruction in the first
four grades.
Sources:
•http://www.salisbury.edu/nursing/haitiancultcomp/overview_cont5.htm
•Local Haitian community feedback, Meridian Health, 2010.
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http://atlantablackstar.com/2013/06/08/delta-sigma-thetasorority-opens-school-in-haiti/
Characteristics and values important
to Haitian families and communities
Education: continued
•
The literacy rate in Haiti in 2001 was estimated at 48.6%. In the U.S.,
however, literacy rates for Haitian immigrants mirrors American literacy
rates.
•
In the U.S., some Haitian parents may choose to send their children to
Catholic school, because of the emphasis on discipline and perceived
success as well as their belief that it a mark of social status.
•
Many Haitians in the U.S. seek to quickly complete their high school
education and will get their high school equivalency before they would
normally graduate from high school.
• For Haitians both in Haiti and in the U. S., a college degree is
valued and a sign of status.
Sources:
•http://www.salisbury.edu/nursing/haitiancultcomp/overview_cont5.htm
•Local Haitian community feedback, Meridian Health, 2010.
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Characteristics and values important
to Haitian families and communities
Education: continued
• For Haitians both in Haiti and in the U. S., a college degree is
valued and a sign of status.
Ralph Alexis, who arrived as
an orphan from Haiti, hugs
mentor Michael Kelly after
graduating from Haverford
College. His brother, Ruben,
graduated as well. (MICHAEL
BRYANT / Staff Photographer)
http://articles.philly.com/2013-0521/news/39395722_1_philadelphia-futuresmichael-kelly-joan-mazzotti
Sources:
•http://www.salisbury.edu/nursing/haitiancultcomp/overview_cont5.htm
•Local Haitian community feedback, Meridian Health, 2010.
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Characteristics and values important
to Haitian families and communities
Family Roles and Organization: Traditional Roles
• Haitian society is a matriarchal society, yet the man has the
ultimate control. However, typically when Haitians come to the
U.S., the relationship may become more egalitarian.
Sources:
•http://www.salisbury.edu/nursing/haitiancultcomp/family_roles_and_organ.htm
•Local community feedback, Meridian Health, 2010
•http://galleryhip.com/haitian-family.html
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Characteristics and values important
to Haitian families and communities
Family Roles and Organization: Traditional
Roles
•
The person that makes the health care
decisions may vary between mother,
father or elder family member.
– Older patients may defer to younger
children.
– Families may gravitate to the family
member who is most knowledgeable.
– Church leaders may also be consulted.
•
Gay and lesbian relationships in Haitian
culture may not be recognized.
Sources:
•http://www.salisbury.edu/nursing/haitiancultcomp/family_roles_and_organ.htm
•Local community feedback, Meridian Health, 2010
•http://galleryhip.com/haitian-family.html
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Characteristics and values important
to Haitian families and communities
Family Roles and Organization: Obligations
to family members on the island
•
Family is very important to Haitians, and
emigration does not mean that their obligation
to the family in Haiti has lessened.
•
It is not uncommon for individuals to have
extended families, one in Haiti and one in the
U.S.
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Family members that have emigrated are still
financially responsible to those in Haiti.
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They also may help to finance others'
immigration to the U.S.
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When new immigrants arrive, they often live
with a friend or relative.
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Haitians are expected to be generous and
often will take in new refugees, even if there
are no ties to these individuals.
Source: http://www.salisbury.edu/nursing/haitiancultcomp/family_roles_and_organ.htm
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Characteristics and values important
to Haitian families and communities
Family Roles and Priorities: Children
•
Children are viewed as a gift from God and they must be well cared for
to fulfill God's blessing.
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There may be a general expectation that children are an investment in
providing for the parents’ future needs.
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The lack of extended family and kin support has been noted to be one of
the most difficult aspects of raising children in the United States.
Source: http://www.salisbury.edu/nursing/haitiancultcomp/family_roles_and_organ2.htm
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Characteristics and values important
to Haitian families and communities
Family Roles and Priorities: Children continued
•
In Haitian culture, discipline of children can
be swift and physical which may be
considered abusive by American standards.
•
Haitian children are encouraged to be
independent and self-reliant from an
earlier age than American children.
•
Haitian children are socialized to know they
must be obedient, quiet, and subordinate to
their parents.
– Lack of discipline and lack of respect for authority
are taboo.
Source: http://www.salisbury.edu/nursing/haitiancultcomp/family_roles_and_organ2.htm
https://www.microlinks.org/learning-marketplace/notes/note-haiti-microcredit-education
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Characteristics and values important
to Haitian families and communities
Family Roles and Priorities: The
Elderly
• Elderly parents often live with
their children and a child usually
considers it an honor that a
parent has chosen their home
to live in.
• Elders are viewed as
knowledgeable and their counsel
is often sought.
Fred R. Conrad/The New York Times
“I don’t know if it makes me lucky or unlucky to still be here. It’s like part of me
is gone.” — Junie Sufrad, a 110-year-old survivor of the Haiti earthquake.
Source: http://www.salisbury.edu/nursing/haitiancultcomp/family_roles_and_organ2.htm
http://www.nytimes.com/2010/03/12/world/americas/12elderly.html?_r=0
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Gender Roles and Authority Expectations
in Healthcare
• Gender roles in the workplace are not as strictly defined as in the
past.
– For example, in healthcare, nurses are women.
• The physician in Haiti is expected to be an authority, and is trusted
to do what needs to be done.
Sources:
•http://www.salisbury.edu/nursing/haitiancultcomp/workforce_issues.htm
•Local community feedback, Meridian Health, 2010
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Gender Roles and Authority Expectations
in Healthcare
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Challenges with Informed Consent forms
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A Haitian physician in the U. S. may have
difficulty with understanding the rationale
behind informed consent.
– International and Haitian patients also may
not understand the need for informed
consent forms.
– Insistence on signing consent forms may
raise concerns about a physician’s motives
behind the form.
– Many want to know if they can change
their mind once the form is signed.
Sources:
•http://www.salisbury.edu/nursing/haitiancultcomp/workforce_issues.htm
•Local community feedback, Meridian Health, 2010
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Health Beliefs
•
Pain:
– Some Haitians can be very vocal about pain; moaning and complaining
are not uncommon.
– Some Haitians may have a low pain threshold, but can be very vague
about where the pain is coming from.
– Alternatively, some Haitians are not very expressive about their pain or
discomfort.
– It is often believed that the pain affects the whole body system; therefore
the origination of the pain source is not important.
– Haitians tend to prefer injections for pain relief, then liquids, tablets,
and lastly capsules. Injections are thought to lead to a faster result.
Source http://www.salisbury.edu/nursing/haitiancultcomp/health_care_practpg1.htm
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Health Beliefs: Pregnancy and Childbearing Practices
•
In Haiti, contraceptive use is not common and Haitian men are generally not
willing to use contraceptives.
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The fertility rate in Haiti, as of 2002, is 4.3 infants per woman.
In Haiti, pregnancy does not relieve a woman from work nor does it require medical visits,
thus prenatal care is not traditionally sought.
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However in one study subjects revealed that they thought prenatal care was important.
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In the U.S., Haitian women are at risk for accessing prenatal care later than other cultural groups.
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Fathers are usually not involved as labor is considered woman's work, and best
handled by female friends and family members.
Source: http://www.salisbury.edu/nursing/haitiancultcomp/preg_and_childbear_prac.htm
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Health Beliefs: Pregnancy and Childbearing Practices
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Breastfeeding is the norm in Haiti and in the U.S.
•
However, health care practitioners have been alarmed at the lower rates
of breast feeding practiced by Haitians in America.
– The increase in formula feeding has been related to socioeconomic factors
including mother's need to work outside the household.
– In America, there may be a lesser priority to continue breastfeeding among Haitian
women.
Source: http://www.salisbury.edu/nursing/haitiancultcomp/preg_and_childbear_prac.htm
36
Death Rituals
• When death is impending, the entire
family will gather, pray, cry, and use
religious medallions or other
spiritual artifacts, dependent on the
family’s religious practice.
• Organ donation is not viewed as an
option.
• Haitians prefer to die at home,
although the hospital is acceptable.
•
Autopsy is allowed in certain
circumstances.
– If it is thought that the death was a result of
malfeasance, an autopsy may be requested.
Source: http://www.salisbury.edu/nursing/haitiancultcomp/death_rituals.htm
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Death Rituals
• When death is close, family members may make a more fervent
effort to take care of the patient.
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Hair brushing
Teeth brushing
Changing bed linens
Bathing the patient
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Family members may want to take on “nursing” duties.
•
Nurses should ask the family about their role in taking care of the patient.
Source: Local community feedback, Meridian Health 2010.
http://graphics8.nytimes.com/images/2010/03/31/us/31family-span-337-395/31family_CA0-articleLarge.jpg
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Haitian Language/Dialects
Identifying the correct language is essential for
proper communication
•
The official languages of Haiti are French and
Creole.
•
French has always been the language of
business, and Creole, the language of the
people.
•
Creole was only accepted as an official language
in 1987.
•
The origin of Haitian Creole is not certain. One
theory asserts that Creole was created by slaves
combining their African dialects with the French
spoken by their white owners. Others site its
influences as Spanish, African, English, and
Portuguese.
Source: http://www.salisbury.edu/nursing/haitiancultcomp/communication.htm
http://270c81.medialib.glogster.com/devonconstant/media/d3/d368d1330bc45ab556c25e1f36a31d43b607387c/creole.jpg
http://images.betterworldbooks.com/073/The-Haitian-Creole-Language-Berotte-Carole-9780739112366.jpg
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Haitian Language/Dialects
•
Creole is spoken by the majority
of Haitians, while only about 10%
of the population can
communicate in French. However,
many are not fluent in French.
•
French is still valued by all
Haitians and is an indicator of
social class and higher education.
•
Creole is seldom written.
– Not until 1979 was there a
Creole spelling system
recognized by the government.
Source: http://www.salisbury.edu/nursing/haitiancultcomp/communication.htm
40
In this Jan. 24, 2013 photo, Carline cameau Fils-Aime teaches
Creole at the Louverture Cleary School, which also teaches
French, English and Spanish, in Croix-des-Bouquets, Haiti. Haitian
Creole, which grew out of a mix of 18th-century French and West
African languages, is the nation’s lingua franca, but it wasn’t until
1961 that it joined French as one of the country’s two official
tongues. (AP Photo/Dieu Nalio Chery) (The Associated Press)
Haitian Language/Dialects
•
According to 2002 statistics, in Haiti,
the literacy rate of Haitians is 45%.
– This low rate is a result of poor
access to schools as well as the
late acceptance of Creole as a
written language.
•
In the U.S., 85% or more of
Haitian residents are literate.
–
Many older Haitians may not be
able to read or write in French
and/or Creole.
Source: http://www.salisbury.edu/nursing/haitiancultcomp/communication.htm
http://d1d7ektpm2nljo.cloudfront.net/QoGaVIvK9xd6JMEpzRHHCg/thumb-Haitian-Creole-Translation.jpg
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Haitian Language/Dialects
•
Because Creole is viewed as the language
of the poor, many Haitians will claim to be
able to speak French.
•
Newly arrived immigrants may initiate
conversations in French with persons
unfamiliar to them.
•
To suggest that someone only speaks
Creole, even if they do only speak
Creole, can be construed as an insult.
•
However, there is cultural pride in
the generation of younger Haitians
in their ability to speak Creole.
•
Providers may initiate a conversation in
French.
•
Many in the U.S. think that only
French is spoken in Haiti.
Source: http://www.salisbury.edu/nursing/haitiancultcomp/communication.htm
http://cache.boston.com/bonzai-fba/Third_Party_Photo/2011/07/22/thepowerofcreole__1311364025_8668.jpg
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Language/Dialects
To access any Meridian language assistance services, please consult
the Meridian’s Language Assistance Policy and Procedures
which are available online via Meridian’s Intranet.
43
Haitian Communication Style
• When speaking with friends, Haitians will
use direct eye contact, and an active tone
of voice.
– However, eye contact is usually
avoided with people of a higher
socioeconomic status or position of
authority.
• Tone reflects emotion.
– Speech may get loud, but this does
not necessarily mean there is anger
or that a patient is combative.
• Haitians may smile and nod their heads
rather than reveal their lack of
understanding.
– Uneducated Haitians may be
unwilling to expose their lack of
knowledge to Americans, so many
will keep to themselves and may
seem timid.
– Speech is usually accompanied by hand
gestures.
Source: http://www.salisbury.edu/nursing/haitiancultcomp/communication.htm
http://vegueroviajero.blogspot.com/2013/04/gloria-rolando-in-miami.html
44
Haitian Communication Style
•
When in informal situations,
touch is accepted, like
embracing, kissing, or hugging.
•
In formal situations, a firm
handshake is the accepted
greeting.
–
•
However, woman may give a
limp hand shake as a sign of
good etiquette and
femininity.
Haitians require much less
personal space than
Americans, so they may
position themselves close to
another in communication.
Source: http://www.salisbury.edu/nursing/haitiancultcomp/communication.htm
http://findingpaola.files.wordpress.com/2012/09/dsc_1914.jpg
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Haitian Time Orientation & Naming Conventions
•
•
Many Haitians tend to be oriented in the present. It
is not considered rude to be late to appointments.
•
For example, a wedding invitation will show a starting time
of 6 pm, when the actual starting time is in fact 7 or 7:30.
–
However, most Haitians will make the effort to be on
time if punctuality is stressed or if being on time is a
priority for them.
Name formats are similar to that of traditional U.S.
name formats.
–
–
Women are given a first, middle and last name.
When she marries, she loses the last name of her father
and is always called by her husband's last name.
Sourcehttp://www.salisbury.edu/nursing/haitiancultcomp/communication.htm
46
Culture-Specific Customer Service
Recommendations: Health Care Practices
•
Home remedies may be used first before seeking help, and may include
herbal preparations, massage, or over the counter medications.
•
The use of herbal medicine is passed on by the family and sometimes Haitians in
the U.S. will even have ingredients sent from Haiti to make herbal preparations.
Source http://www.salisbury.edu/nursing/haitiancultcomp/health_care_practpg1.htm
47
Culture-Specific Customer Service
Recommendations: Health Care Practices
Medicinal Spices
• Haitian spices are grown for medicinal purposes as well. Those who live there
and treat people with herbs and Haitian spices are known as leaf healers. The
following are just a few of the plants grown for medicinal purposes:
–
–
–
–
–
–
–
–
–
–
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Aloe Vera: Use the leaves of the plant to treat cuts, burns and sunburn.
Catnip or catmint: Make a tea from the leaves of the plant, which has several uses including treating arthritis,
digestive upsets and colic.
Cinnamon: Use the ground up bark to treat diarrhea and vomiting.
Eucalyptus: Make an extract from the leaves to treat coughs, the flu and joint pain.
Peppermint, spearmint, lemonmint and horsemint: Healers use these herbs to calm a queasy stomach and to
aid in digestion.
Quassia or bitterroot: Use the bark of this tree to create a tonic that has several health properties, being an antifungal and anti-bacterial agent.
Red sage: Use this herb to thin the blood and also increase menstrual flow.
Sarsaparilla: Use the tea made from the sarsaparilla root to treat several skin ailments and arthritis.
Senna: Make a tea of the plant and to use as a laxative.
Thyme: Use this Haitian spice is in a tea to treat skin disorders or as a diuretic.
Verbena: Use this herb as a pain killer during child birth.
Source: http://herbs.lovetoknow.com/Hatian_Spices
48
Culture-Specific Customer Service
Recommendations: Health Care Practices
•
When a Haitian decides the
illness warrants a doctor's
visit, the doctor is usually
someone he/she knows or
has heard about from a
friend, someone that is
considered trustworthy.
– Trust is extended more to
the individual physician than
to an entity or organization
like Meridian.
– Haitian patients may be
more interested in the
cultural and personal
connection they have with
their nurse, doctor, or
clinician.
•
Haitians are very private
and modest.
Source http://www.salisbury.edu/nursing/haitiancultcomp/health_care_practpg1.htm
49
Culture-Specific Customer Service
Recommendations: Health Care Practices
•
Although in Haiti, there is health insurance available, many Haitians are
used to paying out of pocket for their health care.
•
According to interviews with Haitian immigrants, in Haiti the concept of no
money = no health care has predominated, even in emergency situations.
Source http://www.salisbury.edu/nursing/haitiancultcomp/health_care_practpg1.htm
50
Culture-Specific Customer Service
Recommendations: Health Care Practices
•
When consulting a physician, a
Haitian expects a quick
diagnosis, politeness, the use of
the stethoscope (evidence of a
physical exam), and a
prescription.
•
Compliance with a physician's
course of treatment depends on
the perceived severity of the
illness.
... a doctor assigned from the Haitian Ministry of health to work for his first year out of
medical school. He's displaying his new stethoscope, ...
Source http://www.salisbury.edu/nursing/haitiancultcomp/health_care_practpg1.htm
http://healingartmissions.org/images/Apr2014Mission/IMG_4833427x640.jpg
51
Summary
• Strong family values
Source: http://www.medicalmobilizers.org/The_OliviersFamilyValery__Micka_008.jpg
• Be mindful of possible cultural barriers that may influence Haitians
approach to the U.S. healthcare system
• High concern and regard for children and elders
• Importance of strong community relationships with trusted leaders
and using word-of-mouth as key approaches for informing and
educating Haitian community members.
52
Video #2
Kay Lasante: Quality
Health Care Services For
Haitians By Haitians
Published Aug 26, 2013
12 minutes long
http://youtu.be/OKSJaKZz6vw
53
Bibliography
• 2003. Cultural Competency, Haitian Immigrants, and Rural Sussex
County, Delaware, Lisl Doscher Phelps, RN, BSN, MSN, Salisbury
University, Department of Nursing, Salisbury, Maryland,
http://www.salisbury.edu/nursing/haitiancultcomp/default.htm
• U.S Census
• U.S. Library of Congress
54
Break
55
Panel Discussion
Panelists:
Rose St. Fleur, MD, FAAP, IBCLC
Clinical Assistant Professor
Rutgers Robert Wood Johnson Medical School
Pediatric Hospitalist
Medical Director, Center for Breastfeeding
Jersey Shore University Medical Center
Florence Germain, RN
Registered Nurse
3 South Complex Care
Riverview Medical Center
56
Final Questions?
Please complete
evaluation and
demographic form
57
Thank you for your participation!
See you in
the New Year
and have a happy and safe holiday!
58