WA News Letters Cultural Barriers to Care
Cultural Barriers to Care
Written by Dr Aesen Thambiran
Wednesday, 07 June 2017


Dear Editor,

Almost a third of WA’s population is born overseas. Migrants and refugees living in WA come from more than 190 countries and speak around 270 languages. This is also reflected in our culturally diverse medical and nursing workforce.

Breaking Down Cultural Barriers (May, 2017), highlighted the challenges women from Africa face when accessing health care in WA. Providing health care to an individual from an unfamiliar cultural background can be quite challenging for a GP.

Effective communication is the cornerstone of gaining an accurate medical history and building trust. It is essential to work with a professional interpreter if the patient has low proficiency in English. Despite being free and relatively easy to use, the Telephone Interpreter Service (TIS) is still underused in Australia.

Evidence shows that patients who don’t speak English are more satisfied with their care and are more likely to take their treatments correctly when interpreters are used. There are also medicolegal implications if an interpreter is not used. This is especially so for medical procedures where informed consent is required.

Culture is another important aspect to consider. Culture is deeply ingrained in all of us and is reflected in our norms, values and behaviour. This includes our concepts of illness and health, and our expectations of health care. Misunderstandings can arise if the practitioner and patient are from different backgrounds.

It would be impossible to learn about all cultures that exist in WA. One practical solution is to use a Cultural Awareness Tool which can be applied to any patient you consult. Simple questions such as what do you think caused your illness? can give the practitioner insight into the patient’s cultural beliefs about health.

It is also important to remember that many of our patients are coming from countries with very different health systems to ours. The Australian health care system is very complex with its mix of public, private, primary, secondary and tertiary care. It can be quite bewildering for new arrivals. Even going to the pharmacy to fill a prescription may be new experience for some migrants. Over the years, I have come across many refugees who have shown me their unfilled scripts; unsure what the pieces of green paper are for!

Dr Aesen Thambiran, GP