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CASE STORY – A LATINA presented by Nancy Evans. Nancy Evans (case story presenter) personal profile Born in L.A., Calif., of Mexican descent, married.

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Presentation on theme: "CASE STORY – A LATINA presented by Nancy Evans. Nancy Evans (case story presenter) personal profile Born in L.A., Calif., of Mexican descent, married."— Presentation transcript:

1 CASE STORY – A LATINA presented by Nancy Evans

2 Nancy Evans (case story presenter) personal profile Born in L.A., Calif., of Mexican descent, married Moved to MN in 1981 Mother of two adult children Since 1991, working for Recovery Plus, St. Cloud Hospital Currently doing case management for Phase II programming

3 UNIITEs Health Care and World Religions series Phase B - Talking Circles conducted Dec 06 – Feb 07 at Abbott Northwestern Sartell Outpatient Center

4 CASE STORY – A LATINA presented by Nancy Evans

5 Background of subject (40-year old female born in Mexico): Mother of 4 children--youngest born with Cerebral Palsy Currently resides in St. Cloud metro area with husband (US citizen) and 3 of her children Employed full time, has drivers license, but no medical health insurance She has no mental health diagnosis

6 Subjects language skills: She has some proficiency in English but converses mainly in Spanish Husband and children provide most interpreting services Husband usually accompanies her to medical appointments Shes aware that the medical facilities will provide translators upon request In sum: language not significant barrier to obtain medical care

7 Subjects basic health practices (1) Her first line of care: a combination of traditional Mexican herbal remedies and western over-the-counter medications Thus, for stomach ache she would take Hista Fiate tea, for headache: Tylenol, for sore throat: Hieyba Buena tea with lemon & honey, for stuffy nose: Actifed to stop bleeding: spiders web

8 Subjects basic health practices (2) Has some confidence in western medicine regarding Mental Health issues (like taking medications) but wont spend money on talk therapy [In Mexico, not much attention is given to addressing mental illness Assumptions: The person did something wrong--God is punishing them or Theyre just crazy]

9 Subjects basic health practices (3) Open to recommended medical treatments for serious medical conditions (as with her child with Cerebral Palsy) However, for major surgeries and any dental work needed she (and her family) continue to return to Mexico (where medical procedures are considerably more affordable)

10 Religious Influences on Subject (both western & non-western) A devout Roman Catholic, she continues to hold onto her native cultural beliefs: For serious illness and disease, she follows western medical treatment while praying for God willing a Milagro or miracle In addition, praying to the Virgin of Guadalupe and making a promise of an offering or pilgrimage to her cathedral Also belief in the Evil Eye, La Llorona (the Weeping Women) and the magic of a Brujas (witchs) spell.

11 Barriers to Medical Care (1): appointments In most US clinics, one needs to call for an appointment and there may be no openings In Mexico, no appointment is needed; one just walks in and waits (as in local Emergency Room)

12 Barriers to Medical Care (2): clinic hours In USA, most clinics arent open on weekends or evenings so the only option is the ER In Mexico, doctors and dentists work into the evenings and on weekends

13 Barriers to Medical Care (3): expense In US, uninsured routine doctor visits are expensive (the office visit charge). --The doctor always wants to see you even though you know whats wrong --Without insurance, clinics want the bill in full and are unwilling to take payments In Mexico, cost of medical procedures may be half of cost in the US. [Hence, strong incentive for Mexicans to just wait for next trip to Mexico for elective procedures even with travel expense]

14 Barriers to Medical Care (4): time constraints; compartmentalism vs. holism In USA, the practice of addressing one condition per visit, hence, need to make another office visit for a second condition; approach seems morecompartmentalised In Mexico, physician listens to all complaints of client; seems moreholistic in approach

15 Barriers to Medical Care (5): medication accessibilty In USA, many medications require a prescription, such as Codeine or an antibiotic In Mexico, many common medications such as these are purchased over-the-counter and require no prescription.

16 Observations/Recommendations (1): postponement of diagnosis/treatments Theres a perception that Mexican or foreign doctors and dentists are as competent as US doctors and dentists This perception, right or wrong, and the tendency to put off medical treatment until the next trip to Mexico, could have significant negative medical consequences for a person / community

17 Observations/Recommendations (2): language While language didnt appear to be an issue for this woman, for many Latinos/as, it continues to be an issue because many health care facilities dont want to incur the expense for translators

18 Observations/Recommendations (3): culturally competent/compatible care (a) --More cultural competency training for medical staff including alternative medicine- and-medical-practice education --Hospitals and clinics need to recruit more Latino health care professionals

19 Observations/Recommendations (3): culturally competent/compatible care (b) --Health care systems must continue to fund and staff more satellite clinics in Latino communities --Health education forms and literature need to be written in Spanish

20 Observations/Recommendations (3): culturally competent/compatible care (c) --Clinics need to have more consumer friendly hours --Doctors must be more holistic in their approach and in their medical practice

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