Hey everyone.  So here's my cultural issue for posting.  They other day I was giving an annual physical to a middle-aged Japanese woman.  She had emmigrated from Japan to the US about 10 years ago, and married an American born man.  She spoke limited English, and came alone.  I was able to get through most of the physical without too much problem, but I noticed a big problem during the personal questions and domestic violence screening.  Not only was this woman reluctant to talk about her sexual life, but also did not give clear answers to domestic violence questions.  It got me thinking about this woman, and about all the cultural barriers facing her if she were being abused and wanted help.

I found this article here, which talks of some of the barriers faced by Asian and Pacific Islander communities.  Basically, women who emigrate here from these communities face man problems if they try and seek help.  The number one problem is of course language.  But that problem is deeper than one would expect.  Sure, the fact that many do not speak English, and that there are few interpreters is a barrier, but so is prejudice.  There are many people in this world prejudiced against those who do not speak their language.  And perhaps this woman's experience with that type of prejudice translated into her timidness and unwillingness to share about her life with me.

Customs too also play a role, with the rights a woman had back in her native country influencing the rights she may perceive she has here.  While all women in the USA have equal rights as men, not all women who emmigrate to this country have that same viewpoint.  Many countries are more or less patriarchal than here.  This could play a role with the patient I saw as well.

Money and family is also a factor.  This woman married an American, and moved to America for him.  Her family is all back in Japan, and her money is all tied up in her husband.  He is literally her support financially and emotionally here.  And both distance and pride serve as barriers to her reaching out to her family back home if there was a problem.

Basically, what I learned from this woman is that cultural differences between the patient and the caregiver affect the information a provider can gather, and subsequently, the care they can provide.  And we as future providers must keep our eyes open to these cultural differences, and be sensitive to them so that we may truely get to konw our patients so that we may help them.  Incidentally, I got the chance to see this woman again, and the second time she was more open with me, and I was able to find out she was indeed safe at home, and get some of the info I was unsure of before.  But had I just passed her off as being shy, and not thought of the cultural differences between us, I would never have gotten the answers I needed.