|
Pediatrics
“Intercultural pediatrics” at
Sainte-Justine
According to a study conducted in 2002 by Annie Gauthier,
an anthropology student at Université de Montréal,
more than 40% of patients who present at the emergency room
of Sainte-Justine Hospital are first generation immigrants. “In
order to get a better handle on things, the hospital has
put forward the concept of “Intercultural Pediatrics.” “During
our medical training, not much attention was paid to the
differences between the people to whom we were providing
health care,” explains Dr. Fernando Alvarez, Director
of the Pediatrics Department at the university’s hospital
for children. Given the cultural diversity we have to face
nowadays, our diagnostics, our therapeutic methods, and how
we talk to people are no longer appropriate.”
To help develop new skills, the physicians asked medical
anthropologists to come to the hospital and look into the
matter, given the new context. A dozen anthropology students
were paired with pediatricians in order to examine the relationships
between physicians and foreign-born patients. And according
to the partners in this “therapeutic alliance,” as
they call it, the language barrier is not the main obstacle. “When
a Haitian mother tells you that her 45 day old baby has bad
blood, you have to know how to interpret what she is saying,” the
physician explains. She could mean that she herself is distressed
and that breast-feeding is causing problems.”
Dr. Alvarez, who was born in Argentina , knows something
of the immigrant experience, because he lived in France and
the United States before coming to Québec in 1992.
He is therefore very sensitive to these questions. “When
a mother entrusts her child to us, we can’t act the
same if she came from Latin America , Africa or the Beauce
in Québec. We have to learn to adapt our approach
to each case.” When anthropologist Gilles Bibeau suggested
that they collaborate, two years ago, he leapt at the invitation. “The
therapeutic alliance,” he explains, “seeks to
put the parent, child and physician on the same wavelength.
We practice a profoundly humanistic medicine. That’s
why the viewpoint the anthropologist can bring is so precious
for us.” The 150 specialists in the Pediatrics Department
at Université de Montréal have been invited
to learn about Intercultural Pediatrics, and 10 of them are
taking part in the research into medical anthropology as
co-directors. Dr. Alvarez, for example, who is a specialist
in liver transplants, is supervising a study of children
who undergo this kind of operation. A good example of what
Intercultural Pediatrics can accomplish is the collaboration
set up with the Cree community. Three times, when parents
were not cooperating well with caregivers, they had to ask
to meet the band chief. He came from Northern Québec
to talk to the physician and his staff. “We told him
how important it was for the success of the treatment to
follow the drug instructions. By becoming responsible for
the child, he took his work very seriously and talked to
the parents. The results were positive every time.”
|
