Folk Medicine and Healthcare Access

“In 1993, scientists found that there is a general increase in hospital admissions on Friday 13th,” (The Telegraph). No surprise, as people around the world believe in a wide range of superstitions that shape how they deal with their health. Logic says that the most superstitious day of them all would be when people visit the hospital.

WebMD describes the driving force of superstitions as, “Wanting more control or certainty,” often over something which we don’t have control, such as health.  Stuart Vyse, PhD, the author of Believing in Magic: The Psychology of Superstition says, “Sometimes the creation of a false certainty is better than no certainty at all, and that is what much of the research suggests.”

folk medicine drawingSuperstition can become so ingrained in a culture that it brings communities together, and traditional, folk, or ethnomedicine is one way in which it is most evident.

From my experience in hospitals around the world, folk medicine is much more accepted in developing nations. I have found this to be especially so in countries where health and the body are viewed differently than the Western world. In fact, according to the World Health Organization (WHO), it has been estimated that “about 80% of the population in developing countries depend on traditional medicine for their primary health care needs.”

Folk medicine practices have a huge impact on the healthcare that immigrants get in the United States. They tend to trust the healthcare with which they are familiar, and, therefore, it is important to understand the role superstitions and folk medicine play.

Health Superstitions Around the World

In Indian, Tibetan, and Mongolian traditional medicine is very simple and related to every part of their lives. The treatment includes medicinal herbs, the limbs of animals, and minerals. Mongolians believe in a whole body treatment, so in addition to physical medicines, they use sayings, such as mantras, shamanic charms, and prophecy (Asian Medicine Zone).

In some places of Mexico, all the women sing “Aye Yie Yie” during birth as a way of comforting the birthing mother. Additionally, some Mexican women typically wait until they are home to breastfeed since they believe that they need to give their breasts time to fill with milk. Often, they are unaware that breastfeeding causes milk to be produced (Ann Hinnen Sparks).

African medicine is very different from Western medicine in that it is entirely holistic and believes every pain is interconnected with every part of the body. “According to traditional African belief, human beings are made up of various aspects – physical, spiritual, moral, and social” (Ancient Origins). If any of these areas of the body are ill, then the entire body is ill and must be treated entirely. A pain in the abdomen could be treated spiritually or could even be a moral issue.

Folk Medicine & Healthcare Access

"Many people do not understand the role of the interpreter, don't really value the importance. We're talking about somebody's life. If the interpretation is not done correctly, big mistakes can be made." - Guillermo ArenasWith so many folk medicine traditions influencing how immigrants approach medicine, it is vital to understand these health beliefs. There are so many stories, including some hospital lawsuits, of immigrants and limited English proficiency individuals having their lives put at risk as a result of their local traditions being ignored. One story from the report, Overcoming Barriers says:

“…. a caseworker recommended the removal of a Mexican-American boy from his family because of potential physical danger. The child in question was ill and in need of medical care, but the mother had kept saying, in broken English, that she could not allow any evil spirits to come near her child and hung from the ceiling a pair of sharp scissors just above his head, and would not allow anyone, including the caseworker and the doctor, to enter the child’s room. A Mexican-American worker familiar with folk-healing practices was asked to intervene.  She told the mother that she had heard her grandmother talk about [the cure]. To protect the patient and his or her entire surroundings, however, the grandmother usually nailed the scissors on the room’s entrance door. The worker explained that, should the spirits attach themselves to anyone who wished to enter the room, the scissors on the door would immediately prevent them from doing so and thus provide stronger protection to the patient. She asked the mother if she thought this would be more beneficial since it would allow her child to be seen by the caseworker and the doctor. The mother agreed, and they changed the location of the scissors and welcomed the caseworker and the doctor to examine the child.”

It can be frustrating and even time-consuming to try to understand folk medicine traditions and use that knowledge to gain trust, but it is important to provide good healthcare.

I personally was on the patient side while serving in Peace Corps Ukraine, and it was incredibly frustrating. After going to the hospital for an issue, I relayed my health story to a doctor (in poor Russian!), then I sat and waited. Twenty minutes later, another doctor came in, and I told them my health story again, and then I sat and waited some more. This happened again and again. I spoke to 15 different doctors about the same problem. Then they all gathered in the corner of my room, drank a cup of coffee, and spent over two hours discussing my health issues with me barely understanding. They additionally spoke with my friends and co-workers to gather my health history.

To me, this felt incredibly invasive as if my health information wasn’t private and it was unnecessary to have so many doctors. I later learned that this was normal, as aggregate opinion is the primary form of deciding a diagnosis and treatment. However, at no point did my poor Russian protests and questions result in a doctor taking time to sit with me and explain what was going on, what the process would be like, or why were they speaking to my coworkers. In the end, I felt humiliated and belittled, and I remember feeling like the experience was a reflection of the entire Ukrainian health system (which I now see isn’t fair either).

It is incredibly important to include patients in their healthcare, and it can radically change their health outcomes. The lack of communication with patients and understanding of folk medicine can result in misdiagnoses, inappropriate or even dangerous treatment plans, miscommunications, and a mutual distrust of both patient and doctor. In fact, data shows that providing culturally competent interpreters or having knowledge of relevant folk medicine practices can even have a huge impact on healthcare costs and available resources (NCBI). Interpreters can prevent the cost of unnecessary tests and procedures and can ensure the patients understand the importance of preventative care in a culturally competent way.

When working with an immigrant or a limited English proficiency (LEP) patient, take the time to understand their culture and make sure you have a qualified interpreter who is familiar with their cultural beliefs. There are literally lives on the line, and you will be a better medical professional for it.

For more information, check out the free resources we have compiled for working with immigrant patients.

Qualified medical interpreter meme

Have you ever worked with an LEP patient or received medical care overseas? Tell us your stories in the comments section.

Leave a Reply