This case focuses on a low-income, non-English-speaking Latino patient and famil
ID: 3526233 • Letter: T
Question
This case focuses on a low-income, non-English-speaking Latino
patient and family. As you read this story, pay special attention to issues involved in medical decision making, such as gender roles and values and interest in treatments outside of traditional Western medicine based on culturally constructed folk illness beliefs.
When Alejandro Flores was born, his parents were ecstatic and very proud. Alejandro was their first child born in the continental United States, in a world far away from their traditions and family in Puerto Rico. The Flores family had worked very hard to move to the northeast a year before Alejandro’s birth, and they felt that his arrival helped connect them with their new home.
It is 4 years after Alejandro’s birth, and the Flores family has grown even larger. There are now five children (three older than Alejandro and one 20-month-old baby) and Alejandro’s grandmother living in the same apartment. Alejandro’s mother, Señora Flores, takes care of her family as best she can, and she feels lucky to have her mother there to give her advice and a helping hand. Señor Flores works very hard as a custodian at a local school to provide his family with enough income. He has picked up a little English at work, but only Spanish is spoken at home.
Serious asthma problems run in the Flores family, and Alejandro is no exception. Although he looks healthy, Alejandro has had severe asthma for several years. When he was 2 years old, a series of awful wheezing episodes sent him to the hospital multiple times. His parents do their best to care for him, but they are both spread pretty thin and have limited time available. To help with Alejandro’s asthma problems, the Flores family recently relocated to a new apartment that has air conditioning, and Sr. Flores has limited his smoking to outside on the patio. The family has two dogs, which could be a problem, but they just couldn’t see getting rid of two loved members of their family.
Alejandro also takes a lot of medications for his asthma symptoms. His parents have been taught about asthma and have been given an asthma action plan—all in Spanish. They were told to call the clinic if at any time Alejandro’s symptoms worsened. Despite these actions, Alejandro still continues to have heavy wheezing and a tight cough, especially at night.
With Alejandro continuing to have asthma problems, Sra. Flores became skeptical that the medications were not working. Under her mother’s guidance, she took Alejandro to an espiritista (in curanderismo, the Mexican American healing system, an espiritista is a healer who serves as a medium for exorcisms and is adept at facilitating the help of benevolent spirits and removing malevolent spirits that surround the client). Sra. Flores took the espiritista’s advice and stopped giving Alejandro all of the prescribed medications. She began giving him an herbal tea that she believed, along with prayer, would take Alejandro’s asthma symptoms completely away.
Alejandro and his parents attended their regularly scheduled visit to the clinic to see if the new medications were helping to control Alejandro’s symptoms. This is the second visit since Alejandro’s last hospitalization 6 months ago. Sra. Flores has not contacted anyone at the clinic about Alejandro’s asthma getting worse, so the clinic staff assumes the best.
There are several issues to consider about this case: please answer with at least 300-500 words. thank you
Why might Sra. Flores have chosen to consult an espiritista rather than call the clinic when Alejandro was not getting better?
Do you think traditional Latino gender roles might have some effect on this child and family’s experience with the health care system?
How might it be possible to incorporate alternative folk remedies with mainstream Western medicine in developing a treatment plan for Alejandro?
Source: Cross Cultural Health Care Case Studies (n.d.).
Explanation / Answer
In medical practice, such cases come up a number of times, where, patients coming in from culturally vivid backgrounds concentrate and believe on their traditional practices with much more faith than they would or allopathy or western medicine.,,
This happens because of the difference in cultures and that these cultures have their own traditional healing systems or medications that have been profound and embedded in their cultures for a long time. It is important that the medical professionals should be respecting the difference in cultures without hurting or harming the cultural sentiments. This ability of the medical professionals to respect and recognise the cultural values of a group is referred to as cultural competence.
Sr Flores has a house in which they have a dog. Also, sr Flores has regular smoking habits, though it is outside the house. One of the main reasons why sr Flores does not see a difference in asthma like symptoms is dog hair. Since, sr Flores has been more exposed to traditional medicine than western medicine, his trust would be on traditional medicine.
Also, since his faith is unshaken, he wouldn’t want to change his mode of treatment or accept the fact that traditional medicine is not working. Also, gender roles play a decision making aspect as being the male member, he is the head of the family and the decision taker. This makes him rigid and adamant.the decisions and thoughts decided by him are the end decisions, making incorporation of western medicine even more difficult.
The problem occurs when people think that alternative medicine and western medicine cannot work together. If the condition is clearly narrated to the health care professionals, there could be incorporation of both the Medicwtions. There could be a holistic approach rather than a mutually exclusive approach