Breaching Barriers of Culture and Understanding

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Every culture has its own way of interacting with health-care professionals, said internist Elise Riley, director of the Holy Cross Hospital Health Center at Montgomery College.

The humble plantain, she said, is a great example of cultural confusion. To nutritionists advising their West Indies clients to eat more vegetables and fewer carbohydrates, the starchy, banana-like food is mostly a taboo. But in the Caribbean, many consider the plantain a vegetable, so "eat more vegetables" means "eat more plantains."

And for non-English speakers relying on friends and family members, some of them children, translation may miss important information from doctors and pharmacists.

"Being able to communicate directly with patients is so important. We must be able to communicate in the appropriate language but use the appropriate terminology, too," Riley said. Immigrant patients often wait until things are unbearable, she said. Many emergencies are advanced illnesses, such as diabetes, that could have been well controlled in office visits. Sometimes her patients don't know their illness is treatable here, because it would not have been at home.

This is where a health educator like Nora is so valuable, Riley said: He translates, he understands medical jargon and people trust him. He finds the right word when a direct translation doesn't exist. He makes life easier for doctors.

And for patients like Belyayeva, what she learned from Nora about health care in the United States will help her stay strong as she explores her new home. ¿

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