Executive Health Administration

Cultural Context Imperative for Global Health Solutions

[fa icon="calendar'] Sep 22, 2015 7:30:00 AM / by Susan Bell

                                                                                                                                                                   (Illustration by Richard Mia)

After a catastrophic 7.0 magnitude earthquake ripped through Haiti in 2010, crews posted signs warning against drinking contaminated river water. But since most of the population could not read, the caution went largely unheeded. The well-intended crews lacked cultural understanding — a mistake that resulted in a devastating outbreak of cholera.

By August 2013, more than 8,000 people had died in the ongoing epidemic — the worst cholera outbreak in recent history. “In the realm of global health, the importance of understanding cultural contexts cannot be overstated,” said Erin Quinn, associate dean for science and health at the USC Dornsife College of Letters, Arts and Sciences. This is equally true within the United States, where language and cultural barriers account for 37 percent of health care access issues, outstripping the 18 percent of access problems caused by affordability. As the largest minority group in the United States, Latinos are among those most often affected.

A cultural understanding of Latinos

When Joe Herrold ’06, MD ’12 arrived at USC Dornsife in 2002, the then-undergraduate realized he needed to gain a better cultural understanding of Los Angeles’ Latino population if he wanted to realize his dream of becoming a doctor. He came to Los Angeles from rural Indiana. “I didn’t speak Spanish, but soon realized I needed to learn the language if I wanted to join the USC health care community,” he said. After earning a bachelor’s degree in biological sciences with a minor in international relations from USC Dornsife and his medical degree from the Keck School of Medicine of USC, Herrold is now training as a surgeon at the Keck School.

In addition to learning Spanish, he familiarized himself with Latino culture, then sought to help others do the same. In 2006, Herrold and fellow USC Dornsife graduate Elise Wach ’06, who earned her B.S. in environmental studies, created the nonprofit educational program Somos Hermanos (loosely translated as “We Are Family”). The group teaches the language skills and cultural competency required to provide quality health care to Latino patients. “As a health care provider, the first and most important step is communicating with your patients,” Herrold said. Somos Hermanos has trained more than 200 health care providers nationwide, combining one-on-one Spanish-language instruction and family homestays with cultural activities in Guatemala, El Salvador and Mexico. “The patient-provider relationship is built on trust,” he said. “Without empathy and cultural humility, it’s unlikely you can establish that connection with those you are trying to serve.”

A holistic view of global health

Global health involves a holistic view, so dental care is also an important component. Some use their Spanish in that effort. One is Erin Walker, now a pre-dental student. She was a senior majoring in neuroscience and human biology when she founded USC Global Dental Brigades in 2012. Her mission: to provide free dental care to those in developing countries. Poor dental health is implicated in increased risk of heart disease, diabetes, lung disease and premature birth. Walker collaborated with students from the Virginia Tech Global Medical Brigades chapter to organize a trip to Honduras to establish a medical and dental clinic. In Honduras, Walker and her team rose before dawn each day and drove for two hours on dirt roads to schools or churches, transforming them into makeshift pharmacies, and consultation and operating rooms. (Illustration by Richard Mia)                                                  They used a reclining lawn chair as a dentist’s chair and a flashlight to provide illumination. Walker, who speaks fluent Spanish, taught children how to brush and floss properly and provided fluoride treatments. The team served 1,111 patients in three days. “Beyond the dental work, patients were touched and grateful that our volunteers had taken time to make them a priority,” Walker said.

Taking a fresh approach

Alternative remedies, which focus on a healthy lifestyle, may have increasingly significant preventive value during worldwide increases in noncommunicable diseases, including cancer, diabetes and heart disease — what Quinn terms “the new game-changers” in global health. “Traditionally, global health has focused on communicable diseases such as malaria and cholera. The new challenges we now face involving global chronic disease and cancer require a fresh approach and a fundamental change in thinking about how we ‘manage’ health across the globe,” Quinn said. USC Dornsife is ideally positioned to help the medical field of the future find innovative solutions. “Now, diabetes is becoming a global issue. Our role is to use our advanced knowledge to help, while remaining respectful of culturally accepted health practices so that we can integrate them into the solution. “Together, we can forge good decisions to successfully improve health for as many people as possible on our planet.”

This article first appeared in USC News under the title, Culture sensitivity is needed in the global battle against serious health issues.

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Topics: Health Policy, Population Health

Susan Bell

Written by Susan Bell

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