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Hospital in Maryland Offers Multicultural Program for Immigrants - 2002-07-20

As America's immigrant population continues to grow, hospitals are finding they need more than medical expertise to treat patients successfully. A hospital in suburban Washington, D.C. has established an innovative multicultural program aimed at improving understanding between patients and staff. VOA's Nancy Beardsley visited the maternity ward at Holy Cross Hospital in Silver Spring, Maryland, and prepared this report.

The cries of a baby are the same the world over. But step outside the nursery at Holy Cross Hospital and you'll hear the sounds of many different languages.

"Buenas Tardes..."

That's a bilingual nurse giving discharge instructions in Spanish to a new mother. The population near Holy Cross Hospital has grown increasingly diverse in recent years, and the patients in its maternity ward now represent a range of cultures: Asian, Arab and African as well as Hispanic.

"We have a list of staff who can provide interpretation services in over 40 languages," Larissa Guran who manages the multicultural services program explained. "If there's an unusual language or we don't have a staff person at the time, we have a telephone interpretation service as a backup. And then in addition to the linguistic access we have things that make it a culturally sensitive place as well. So if there's a tradition that a woman should be eating a certain kind of food to restore strength after having a baby, then her family is welcome to bring that food in for her in the post-partum, providing there's no contraindications from her physician," she said. "Sometimes people come with their own folk healing ideas. Is this an idea that doesn't hurt the patient and will maybe help them because they believe it? Then let them maintain that. So that we are respectful of where our patients are coming from."

And while Holy Cross is a private Roman Catholic hospital, it honors different spiritual beliefs as well.

"One of the religious proscriptions of Islam is that whenever possible women be attended by women, especially in delicate circumstances like when a woman is having a baby," Ms. Guran said. "So we've been able to accommodate that with a female physician, a female anesthesiologist, female nurses. It's been a wonderful opportunity to help people observe their religion in a respectful way."

The staff at Holy Cross also finds that medical practices differ widely from culture to culture. Debbie Osmolovsky, who's the nurse in charge in the mother and baby unit, points to an Asian belief that women should be kept warm after giving birth.

"We have to respect not to use cold water on them or give them cold things to drink. And we're all educated on that," she said. "We do have a multicultural group that meets monthly to educate everybody on the different cultures."

Debbie Osmolovsky says that ongoing education sometimes means altering hospital rules or policies, including restrictions on when patients can have visitors.

"In the Indian culture they like to have the grandmother there taking care of the mother," she said. "A lot of times they'll say, 'Can we stay?' And we'll accommodate that because it's part of their belief."

The hospital has also found a way to help African women carry on their native tradition of burying the placenta, the temporary organ that transports nourishment to a growing fetus.

"Placentas usually go in with the medical waste here at the hospital," Ms. Guran explained. "But we've managed to accommodate that by working with the health department and working with our own hospital infection control and finding a way to store the placenta in a container here in the hospital so they can take it home with them."

Staff members at Holy Cross come from many nations and cultures themselves, and provide a built in-resource for the hospital. But Larissa Guran says hospital workers also learn from their patients and sometimes broaden their medical knowledge in the process.

"I think that one that sticks in my mind was learning that many Central American women don't initially breast feed their babies," she said. "They wait until their milk comes in, which can take a couple of days. And that's contrary to what common breast feeding teaching is, that you have to have women breast feeding right away in order for it to be successful. Well, these women wait a few days, and yet they are still breast feeding 4 to 6 months down the road."

The response to multicultural programs at Holy Cross has been enthusiastic. Angela Jaime, says she was referred to the hospital by a neighborhood clinic, partly because of its Spanish speaking services.

"I was very happy here, because every one treated me very well. But the delivery was very difficult!"

And while nothing can make childbirth a completely painfree experience, Larissa Guran believes the very existence of a multicultural program creates a lot of good will.

"People are so warmed when you even try to reach out to them across differences," she said. "So whether we completely understand a culture, or completely understand the nuance of a request isn't as important to the patient as is important that we acknowledge that there's difference and that they have a request and we'll try and meet it."

Larissa Guran says other urban hospitals in the United States offer translation services, but she believes a multicultural program that meets broader patient needs is more unusual. Holy Cross Hospital continues to seek out new ways to expand that program. Upcoming plans include a Spanish language course on medical terminology.