Cultural Competency and Haitian Immigrants

 

Health Care Practices ... page2

Purnell's Model

Overview/Heritage:
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Communication
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Family roles & organization
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Workforce issues

Biocultural ecology

High-risk behaviors

Nutrition
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Pregnancy

Death rituals

Spirituality
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Health care practices
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Health care practitioners

References

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  • The quality of the person’s blood often signifies the health of a person.31, 32, 51  "The amount (too much or too little), color, viscosity (thick or thin), turbulence (quiet or rushing) of flow, degree of impurities (good/bad or clean/dirty), and rise and fall of blood in the body are diagnostic of health or illness in traditional Haitian ethnomedicine" (p. 12).51

  • Gas or gaz also is notable to Haitians. It can cause pain, anemia, colic, headaches, rheumatism, back pain, shoulder pain, and problems for women who have just given birth and their infants. It can enter the body in a variety of ways and can usually be relieved by the administration of certain foods and teas.28, 31, 32, 38

  • Illnesses specific to Haitians

    • Séizisman (fright). This illness is the result of extreme surprise, shock, fear, or indignation. When this occurs,  blood is thought to  move from the head into the body, and can cause headaches, visual disturbances, and temporary mental problems. Nursing women are considered particularly prone to séizisman and believe that it can ruin their breast milk.31, 32, 36 

    • Oppression is used to describe asthma, but also is used to describe a state of hyperventilation and anxiety.31, 32 

    • Maldyok (evil eye). This condition is the result of a person’s envious glance and could be accidentally caused. Maldyok affects infants and children and results in gastrointestinal problems like diarrhea and ultimately death. It can be treated by an herbalist or a voodoo practitioner.26, 36, 56, 58 

  • Often biomedical care is used simultaneously with ethnomedical or magicoreligious care.26 

  • Although the Haitian belief system is fatalistic, there are treatments that can be sought to cure the sick of their diseases. For example, by consulting with a voodoo priest or priestess, you may be able to change the predetermined illness.26, 60, 63

  • Family structure dictates that women usually make healthcare decisions for themselves and their children.29

  • In Haiti, there is no health insurance. 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.37, 57, 59, 64, 65, 33 

  • Some Haitians may feel that services offered at clinics or through Medicaid are inferior, because they are free.31, 32 

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  • When consulting a biomedical physician, a Haitian expects a quick diagnosis, politeness, the use of the stethoscope (evidence of a physical exam), and a prescription.31, 32 
  • Compliance with a  physician's course of treatment depends on the perceived severity of the illness. Some illnesses are in themselves severe (cancer, diabetes), while others are perceived to be severe because someone else has died from the disease. The physician can also tell the patient the condition is serious. The higher the perceived severity, the higher the degree of compliance.32

Health Care Practices:

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