The Inquiry Conference was very informational and I enjoyed learning about the methods and procedures others have used who performed projects similar to my own. Daniel Hansen and Katie McDiarmond both introduced different aspects which had not been brought to my attention earlier and which will be very beneficial to my own research and the success of what I take from this cultural experience. The following are my notes and the things I learned and will take into account from their presentations:
New Paradigms of Westernized Medicine and Traditional Healing
Daniel Hansen: Modern vs. Traditional Medicine in Tonga
- Health care is influenced by the modernization/westernization of Tonga
- Government health care is free, they can seek health care there whenever they would like.
- Traditional healers in Tonga are usually women who have been trained by their mothers.
- Their treatments and procedures have been passed down from generation to generation.
- They believe that the power to heal is Divine and comes from God.
- As such, they do not accept payment for these treatments
- Methods (limited by time. language and cultural barriers make it difficult to get a representative sample)
- Observations
- volunteer/shadow in Hospital
- observe healers
- Semi-structured Interviews
- professionally trained doctors and nurses (~10)
- traditional, natural healers (~10)
- average community members (~25)
- Results:
- in general, most people preferred western medicine (First) because the doctors "always knew the right thing: and "has qualifications" and "know about more than just one sickness"
- equipment
- they thought the healers were "simply guessing"
- A healer would be visited second to receive a supplementary treatment just to cover all their bases. (if anyone went to the healer first they would still go to the hospital second)
- doctors were rarely at the hospital from 12-6. They go in the morning and take the afternoon off and then return in the evening so traditional healers were the only thing available at that time.
- Kahi could not be treated at the hospital, you must go to a traditional healer
- Mahaki Faka Tevolo cannot be treated by western medicine. It is a spiritual sickness contracted from offending their ancestors.
- Implications:
- the people like traditional healers because it was a tradition in Tonga and preserving that culture was important
- transportation and doctor availability
- Education and Outreach programs
Katie McDiarmond: The Patient-Practitioner Relationship in Rural Communities of Ashanti, Ghana
- Seventh Day Adventist Memorial Hospital
- Expectations, Communication, Education, and What they mean for Future Outreach
- the Relationship defined: dependent of interactions between patient and practitioner
- Information-Giving
- Information-Seeking (each parties value of the others information determines success)
- Social Conversation
- Partnership Buillding (the most influential in the interactions--goal setting, allowing patient to participate in diagnosis and treatment, also patients compliance to practitioners treatment)
- Methods:
- Interview: semi-structured- patients were more comfortable in sharing stories which gave insight into their true feelings about things
- Observation: observe and participate in treatments at the hospital in Asamang. observe patient visits and physicians rounds in the morning (saw malaria, diabetes, gangreen)
- participant observation: able to act as the practitioner and perform certain exercises as well as being admitted for malaria and pneumonia
- Findings:
- Expectations and Satisfaction
- influenced by:
- culture
- gender
- occupation
- age
- education etc...
- their perceptions of the world change what they will expect from these visits.
- their unique backgrounds and experiences influence this a lot
- individual background influence what people will allow
- Barriers in Communication
- diction
- grammar
- syntax
- language
- thought
- vocabulary
- Ghanaians speak a different English which made communication so difficult
- being aware of comprehension and intent of communication is essential
- The Education Gap
- mistrust and fear
- religious interference (don't accept medical care)
- discrepancies, misunderstandings, and socioeconomic differences (journalism is not regulated so stories get out into the media that scare people and traditional healers advertise remedies that have not been tested)
- patients who are uneducated may not understand what it is that the doctors are saying and the patients did not know the words to say that would describe their syndrome which scared them thus they were scared to go to the hospital
- many of the people interviewed had never been to a hospital
- Polychronic vs. Monochronic
- P-Time
- no appointments, people just came and went as they would
- relationship-oriented
- you just see whoever is there
- M-Time
- task oriented
- structured
- appointments
- because of her ethnicity, they saw her as an authority in all things Westernized. Doctors felt like there were things she could teach them.
- Ghanaians exceeded here expectations: they are doing so much and are able to do a lot with what they have. treatment she received for malaria was just as good as anything she would have received here.
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