Ethnicity, Culture & DiversityEthnicity, Culture & Diversity

OurselvesOurselves and other peopleHow it affects us at workBradford’s Asian community

Who are you?Who are you?

Dimensions of diversity, some Dimensions of diversity, some more visible than othersmore visible than others

Gender Age Ethnicity Nationality Language Skin colour Religion

Class (wealth? education? family?

Occupation Sexual orientation Political orientation Disability Culture

Understanding different culturesUnderstanding different cultures

… or stereotyping?

General issues when General issues when language and culture language and culture differ between doctor differ between doctor and patientand 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

Working as a GP with Patients Working as a GP with Patients from Bradford’s Asian from Bradford’s Asian communitycommunity

Useful things to know

Bradford’s Asian communityBradford’s Asian community

Mostly from Mirpur in KashmirMostly MuslimMostly from an unsophisticated rural

community, low educational levelLanguages: Urdu, Punjabi, MirpuriDam built on houses and land in Mirpur -

and Bradford mills needed labour

Most Bradford Asian families Most Bradford Asian families originate from Mirpuroriginate from Mirpur

From World Book © 2001 World Book, Inc., 233 N. Michigan Avenue, Suite 2000, Chicago, IL 60601. All rights reserved. Three new states were created in November 2000 but are not shown on this map. World Book map; map data © MapQuest.com, Inc.

From World Book © 2001 World Book, Inc., 233 N. Michigan Avenue, Suite 2000, Chicago, IL 60601. All rights reserved. World Book map

A reminder - A reminder - don’t generalise, don’t generalise, don’t stereotype,don’t stereotype,don’t forget importance ofdon’t forget importance of

ClassEducationReligionAge/generation

Asian familiesAsian families

Respect for eldersFamilies more important than individualsDistinct roles for men and womenImportance of mother in lawBig families, desire for sonsTaboo subjects - termination of pregnancy,

STDs, domestic abuseCultural conflict for those born in Britain

Muslim patientsMuslim patients

Don’t drink alcohol - in theoryDon’t take tablets or medicines during

fasting hours in RamadanWomen aren’t allowed to pray when

bleeding

Some medical issuesSome 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

Some common health beliefs of Some common health beliefs of people from Mirpurpeople from Mirpur‘hot’ and ‘cold’ foodGas in the stomach is bad and can migrate

to the headImportant to be buried with all your organs

inside so you can rise after deathEating oily food is good - not only tasty

but makes you fat (being skinny is a sign of disease)

A reminder - A reminder - don’t generalise, don’t generalise, don’t stereotype,don’t stereotype,don’t forget importance ofdon’t forget importance of

ClassEducationReligionAge/generation

Want to do more?Want to do more?

Your group presentation?Videos on cross cultural consultationsVideo of BBC4 programme about South

Asian doctors who came to the UK