ON Chiropractic
atrophied musculature only after moving
to the village’s central courtyard in full view
of the community.
In an Egyptian desert outpatient
clinic, he was allowed to perform an
unrestricted motion palpation examination
on a female nurse with severe lower back
pain so long as she was sitting or standing.
Dr. Bourassa said that “the moment side
posture manipulation and mobilization
was attempted, this proved too intimate
and the treatment session was aborted,
regardless of the fact that the room was
filled with 8-10 other observant female
nurses. There would be no question of
a non-related male, regardless of marital
status, to be alone behind a closed door
with a lone female.”
Awareness of Local Healing
Traditions
D
r. Kanga has encountered many
diverse cultural and religious
beliefs governing the medical
decisions of her patients. “In Botswana,”
she shares, “individuals would often
present with a thread around their waist
that was given to them by their traditional
healer for back pain. In Mumbai, patients
have come in with scars from bloodletting.” Not unlike practitioners in
Canada, she has seen patients who use
Reiki, reflexology, acupressure, ayurvedic
remedies and homeopathy for conditions
from lower back pain to ankylosing
spondylitis. She notes the importance of
practitioner awareness of other healing
methods used by their patients.
Dr. Wilson also emphasizes the
importance of inquiring about other types
of healers. In order to provide holistic
health care, “we need to know what natural
remedies and medications people are
taking as well as what other practitioners
they are working with.” In Tanzania, he
saw patients with progressing conditions
including untreated fractures and bacterial
wound infections. Since the hospitals
were far away, less understood and more
costly, “patients gave themselves a trial of
care with their traditional healers for a few
months first. This led to some patients
developing irreparable damage in the worst
of cases and developing progressive or
chronic conditions in others.”
Despite a lack of evidence for certain
“
doctor-patient communication, trust and
improved health outcomes.
Communicating Without a Common
Language
I
n Botswana, Dr. Carpenter worked
with the aid of a dedicated translator.
She quickly realised how important
it was to address patients directly, rather
than directing questions to the translator.
“By speaking directly to patients,” she said,
“it helped build trust and they were more
If you accept your patients for what they
are, non-judgementally, you will do just
fine. Everyone has a reason for being the
way they are. Allow the patient to tell
you who they are and what they need.”
Dr. Stefan Eberspaecher
remedies, Dr. Kanga urges practitioners
not to try to influence their patients
against them. Rather, she describes cultural
competency in patient care as being
“mindful of the differences in culture, not
being disrespectful or voicing opinions
regarding certain practices or beliefs, and
treating all patients as equal regardless of
their race, religion or ideals.”
Dr. Eberspaecher agrees. “If you
accept your patients for what they are,
non-judgmentally, you will do just fine.
Everyone has a reason for being the
way they are. Allow the patient to tell
you who they are and what they need.”
Focusing on mutual respect leads to better
willing to open up and answer questions
more thoroughly.”
“Regardless of the country,” Dr.
Bourassa writes, “we always made an effort
to learn the basics of the language.” A smile
and a simple ‘hello’ and ‘thank you’ served
as an effective ice breaker and helped Dr.
Bourassa to build trust and gain invitations
to remote rural communities.
Using a translator can be a slow and
sometimes frustrating process particularly
when inquiring about complex medical
issues. Dr. Carpenter suggests “being
patient with the process and asking the
question in different ways or using hand
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