1. Ethnicity, Culture & Diversity
Ourselves
Ourselves and other people
How it affects us at work
Bradford’s Asian community

2. Who are you?

3. Dimensions of diversity, some more visible than others
Class (wealth? education? family?
Occupation
Sexual orientation
Political orientation
Disability
Culture
Gender
Age
Ethnicity
Nationality
Language
Skin colour
Religion

4. Understanding different cultures
… or stereotyping?

5. General issues when language and culture differ between doctor and patient
Non-verbal communication
Use of interpreters
Health beliefs
Differing agendas of doctor and patient
Need more time
Practice organisation
Need special health promotion materials and methods

6. Working as a GP with Patients from Bradford’s Asian community
Useful things to know

7. Bradford’s Asian community
Mostly from Mirpur in Kashmir
Mostly Muslim
Mostly from an unsophisticated rural community, low educational level
Languages: Urdu, Punjabi, Mirpuri
Dam built on houses and land in Mirpur - and Bradford mills needed labour

8. Most Bradford Asian families originate from Mirpur

9. A reminder - don’t generalise, don’t stereotype, don’t forget importance of
Class
Education
Religion
Age/generation

10. Asian families Respect for elders
Families more important than individuals
Distinct roles for men and women
Importance of mother in law
Big families, desire for sons
Taboo subjects - termination of pregnancy, STDs, domestic abuse
Cultural conflict for those born in Britain

11. Muslim patients Don’t drink alcohol - in theory
Don’t take tablets or medicines during fasting hours in Ramadan
Women aren’t allowed to pray when bleeding

12. Some medical issues
Commoner in Asian patients: TB, rickets/osteomalacia, thalassaemia
Hugely increased incidence of diabetes and IHD
Not tuned into psychiatric diagnoses (use the word ‘stress’)
Consanguineous marriages: recessive syndromes
Seem to be a high degree of medically unexplained symptoms/somatisation - BUT high morbidity
Patients may be consulting other healers

13. Some common health beliefs of people from Mirpur
‘hot’ and ‘cold’ food
Gas in the stomach is bad and can migrate to the head
Important to be buried with all your organs inside so you can rise after death
Eating oily food is good - not only tasty but makes you fat (being skinny is a sign of disease)

14. A reminder - don’t generalise, don’t stereotype, don’t forget importance of
Class
Education
Religion
Age/generation

15. Want to do more? Your group presentation?
Videos on cross cultural consultations
Video of BBC4 programme about South Asian doctors who came to the UK