Module 4 – Part 2 – The role of culture in health care

Culture, among many other factors, coins the way people express their health related needs and their distress, also in communication and interaction with you as a health care provider. Helman (1995) uses a very comprehensive definition of culture. He defines it as “a set of guidelines (both explicit and implicit) which individuals inherit as members of a particular society, and which tells them how to view the world, how to experience it emotionally, and how to behave in it in relation to other people, to supernatural forces or gods, and to the natural environment. It also provides them with a way of transmitting these guidelines to the next generation – by the use of symbols, language, art and ritual” (Helman 1995, 2-3). Culture not only determines how patients express and understand their illness, it also coins our own medical practice and the way we as individuals interact with our patients.

The refugees, who only recently arrived here in Europe, take their first steps in an environment that is often new and strange to them. They very likely experience a culture shock, a period of personal and cultural alienation and, therefore, may have difficulties to communicate their health related needs. To find one’s way in a completely new environment makes a person vulnerable but at the same time a person also may gain strength and resilience due to the challenging situation.  In this regard, it is important to be generally aware of cultural diversity and the fact that our own culture, that is so familiar to ourselves, might appear strange and challenging to others. Therefore, the willingness to reflect on your own cultural background and the willingness to help others, the refugees, in orienting themselves in a new environment, is one important aspect in providing culturally sensitive health care – for the new refugee population as well as for other migrants who have been living here already for a longer period of time.