Global health isconcerned with the improvement of health worldwide. It aims toachieve equity in health services for people from all nations, races,and languages. Global health also deals with health issues thattranscend international boundaries. In this manner, global healthendeavors to control the economic, political, and global impact ofhealth problems (Beach, Price, Gary, Robinson, Gozu, Palacio, Smarth,Jenckes, Feuerstein, Bass, Powe, & Cooper, 2005). “Thespirit catches you and you fall down,” by Anne Fadimanhighlights the plight of a sickly 3-month old girl from the Hmongcommunity. Lia Lee, daughter to Foua and Nao Kao, is diagnosed withepilepsy by her American doctors, Neil Ernst and Peggy Philip(Fadiman, 1997). In the context of global health, Lia can be used asa perfect example.
First, Lia comesfrom an immigrant community in the United States. Her community viewssickness and healing as spiritual experiences. According to the Hmongculture, everything in the universe is linked, and the body and soulcannot be separated. On the other hand, western medicine separatesphysical and spiritual aspects by solely focusing on treating thebody. While American doctors attribute her seizures to herdysfunctional cerebral neurons, her parents blame the “qaug dabpeg” (the spirit catches you and you fall down). Nao and his wifeclaim that their daughter’s soul is wandering. Subsequently, theybeg the spirit to release her soul back into her body in exchange foranimal sacrifices (Fadiman, 1997). Contrariwise, her pediatriciansprescribe anticonvulsants.
Therefore, therearises a cultural conflict that inevitably leads to Lia sufferingbrain death (Fadiman, 1997). Entrenched differences between culturaland behavioral influences permeate Lia’s case. The Hmong communityhas little to no knowledge concerning modern science. Lia may havelived longer, if not survived, had her parents ensured she receivedearly dosages of appropriate medication. The disparities in healthcare services between the Hmong community and modern Americancommunities cost her proper treatment.
“The spiritcatches you and you fall down," by Anne Fadiman discussesfundamental issues related to global health. In particular, itisolates the effects of cultural differences in medicine. Westernmedicine categorizes health problems into different aspects of ahuman. Such elements include emotional, physical, spiritual, andmental problems. Furthermore, western medicine also uses differentphysicians to diagnose and treat various organs. Consequently, itensures segmentation and specialization. For example, 3-month old Liais treated by pediatricians, physicians specially trained to treatinfants and children under five years of age.
On the otherhand, the Hmong community typifies a traditional tribe with adifferent worldview on health. According to the Hmong, the body andspirit are intrinsically linked and inseparable. Hence, theyexclusively view all health problems as spiritual matters. The Hmongchampion a holistic approach to medicine since they do not imaginethat a human body is made up of linking organs. This explains whyFoua and Nao Kao seek spiritual solutions to their daughter’sepilepsy (Fadiman, 1997). Their aversion to classification is alsoreflected in their classless social structure.
Culturaldifferences have fuelled ingrained disparities in health careservices. The Hmong community lacks adequate information concerningmodern scientific methods. They lack appreciation towards advancedmedical procedures since they would rather cling to their traditionalviews. Fadiman portrays a situation where both the doctors and theparents seem to conflict. The parents are suspicious, evendismissive, of American doctors and their methods. They loathe thehubris of assuming physicians. On the other hand, the doctors areperturbed by the stubborn, unreasonable behavior of the parents(Fadiman, 1997). Granted, both parties love Lia unconditionally andwould go to any lengths to ensure she recovers. Nevertheless, theirdifferent perspectives on health care lead to the unfortunatebrain-death of Lia.
Global healthseeks to ensure improved access to the technological advances inmedical practice. Additionally, information concerning new methods oftreatment should be made available to persons from all backgrounds(Kai, Beavan, Faull, Dodson, Gill, & Beighton, 2007). If theHmong community had been aware of the causes and treatment ofepilepsy, Lia would have received medical care earlier and possiblysaved her life. Global health is concerned with reducing suchunfortunate occurrences.
Professional uncertainty and disempowerment responding to ethnicdiversity in health care: a qualitative study.
Racial disparities in health care have increased in various parts ofthe world. However, little evidence has been obtained concerning howto improve the quality of medical attention. Moreover, scant researchhas been conducted in evaluating methods of reducing inequalities inhealth care. Granted, cultural competence has experienced enhancedgrowth in the capacity and application of guidelines. Nevertheless,stakeholders lack any insight into the perspective of health careprofessionals concerning their interaction with culturally diversepatients. The journal used 106 medical professionals in cancer careto assess efficient methods of providing quality care. The findingsbetrayed the uncertainty and apprehension manifested by physicianswhen dealing with patients from other cultural backgrounds. The fearof acting inappropriately and appearing racist disempowered thephysicians to the detriment of the patient (Kai et al., 2007).Therefore, health care professionals should be trained to respond tothe needs of the individual patient rather than endeavor to abide bythe cultural expectations of a particular patient.
As discussed, global health is concerned with reducing thedetrimental effects of ethnic disparities in medical care.Individuals from all cultures should be able to have equal access tohealth care. The Journal bemoans the use of a knowledge-basedcultural evaluation used by physicians to treat patients (Kai et al.,2007). Such an approach hindered the professionalism of medical care.However, viewing each patient as an individual contributes to equityin health care.
The book typifies a scenario where American doctors had to treat agirl from the Hmong community. The parents stubbornly insisted onpursuing traditional methods of treatment (Fadiman, 1997). Faced withsuch opposition, the doctors were limited in the quality of medicalcare that they could provide for the girl. The delay and conflictarising from cultural differences hindered the girl`s chances ofsurvival. However, if the doctors had been allowed to treat her as anindividual and not as a tribal member, she may have survived theordeal. Such forms the argument expressed in the journal.
Culturalcompetence: a systematic review of health care provider educationalinterventions.Thejournal synthesized findings from various studies evaluating methodsof enhancing the cultural competence of physicians. In particular,the journal examined the cost and effectiveness of training healthcare professionals to acquire cultural competence. The reviewincluded 34 studies conducted within a 23-year period. The findingshighlighted various benefits associated with cultural competencetraining. First, it enhanced the knowledge of health careprofessionals regarding medical practice. It also improved theirskills and attitude towards health care. Besides, patients attainedsatisfaction with the services offered by professionals who haddeveloped cultural competence. Nevertheless, cultural competence didnot necessarily improve the adherence of patients to establishedtherapy (Beach et al., 2005). The equity of health care servicesacross ethnic groups was also unaffected by cultural competencetraining. Globalhealth is concerned with ensuring equity in health care provisionworldwide. Nevertheless, it is quite impossible to attain equalitysince medical professionals stem from various backgrounds. Suchprofessionals are trained solely with the local perspective.Therefore, it is critical to educate all health care professionals asregards cultural competence. Consequently, they would be able totreat patients from other cultural backgrounds without unduehesitation or self-doubt. Cultural competence training would enhancethe knowledge, attitudes, and skills of health care professionals(Beach et al., 2005). Hence, global health would thrive in suchconditions.NeilErnst and Peggy Philip lacked information about the Hmong communityand its traditionalist practices. The pediatricians struggled to dealwith the concerns highlighted by Foua and Nao Kao regarding thetreatment of their daughter (Fadiman, 1997). Undergoing culturalcompetence training would have made the doctors adept at handlingsuch cases. Additionally, the parents manifested distrust and disdaintowards the attitude of the doctors. Rather than showing theirfrustration, adopting a calm approach would have soothed the parentsinstead.
Beach, M. C., Price, E. G., Gary, T. L., Robinson, K. A., Gozu, A.,Palacio, A., Smarth, C., Jenckes, M. W., Feuerstein, C., Bass, E. G.,Powe, N. R., & Cooper, L. A. (2005, April). Cultural competence:A systematic review of health care provider educationalinterventions. Medical care, 43 (4), 356-373.
Fadiman, A. (1997). The spirit catches you and you fall down: A Hmongchild, her American doctors, and the collision of two cultures. NewYork, NY: Farrar, Straus, and Giroux.
Kai, J., Beavan, J., Faull, C., Dodson, L., Gill, P., & Beighton,A. (2007, November 13). Professional uncertainty and disempowermentresponding to ethnic diversity in health care: A qualitative study.PLOS MEDICINE, 4 (11), 1766-1775.