Multiculturalism in
Action 2015-16
Pakistani Culture
Workshop: Making a Change for the Better
Session 4: Health and
the Pakistani Community
Speakers: Dr. Nazia
Shahid and Ms. Asma Batool
The Multiculturalism
in Action Project organized a public seminar entitled Health and the Pakistani Community on 7 November, 2015 at The
Chinese University of Hong Kong.
Prof. Siumi
Maria Tam, Director of the Project, gave an introduction to issues related to healthcare
among the Pakistanis in Hong Kong. Cultural and social factors, such as
language barrier and lack of information, affected the quality and frequency of
healthcare seeking. Many Pakistani patients found it difficult to communicate with
Cantonese-speaking clinic staff, including the doctors and nurses. Some did not
know there were free interpretation services provided in government hospitals
and clinics. On the other hand, the lifestyle and occupations of Pakistanis in
Hong Kong triggered specific health problems. Obesity, for example, was common
among Pakistanis because their diet contained high fat and sugar content.
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Prof. Tam giving an introduction |
The
Hospital Authority and some non-government organizations have started special
service programs to meet these needs. For example, ethnic minority languages
were used in response cue cards, disease information sheets, and patient
consent forms in public hospitals and clinics. The United Christian Nethersole
Community Health Service and HKSKH Lady MacLehose Centre have been providing
outreach and public education for the general public. Prof. Tam encouraged the
audience to think whether these services were accessible to those in need, and
to what extent these services were effective and helpful.
Our guest
speaker, Dr. Nazia Shahid delivered an informative presentation on the general
medical issues among the Pakistanis. She highlighted the fact that 37.6% of
Pakistanis were born in Hong Kong, which was a relatively high ratio when
compared with other ethnic minority groups in Hong Kong. First, Dr. Nazia explained
some basic concepts on how Islam understood “health” and “disease”. Islam perceived
health and illness as balance and imbalance of a body respectively. The Quran
has provided guidelines to Muslims to stay healthy, such as one should maintain
good personal hygiene, avoid drinking alcohol, and eating halal food. She also
explained the concept of “life” in Islam, and the belief in afterlife - death
was a transition for the soul to depart the body and enter another realm. Islam
helped to comfort Muslim patients and their families who perceived illness as a
test or punishment from God, and provided a spiritual healing power through
prayers and meditation to ask forgiveness from God.
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Dr. Nazia giving a presentation |
Dr. Nazia
explained that it was mainly non-communicable diseases such as obesity, heart
attack, and high blood pressure that affected Pakistanis in Hong Kong. Females
were more vulnerable to these diseases because they were not encouraged to go
outside so they rarely had physical activities. Limited information on healthcare,
and an oily diet, led to heart attacks, high blood pressure, and obesity. Compared
to their counterparts in Pakistan, those in Hong Kong had better health in
general, as they had adjusted to a steamed cuisine and more attention on their
body shape. Pregnancy was another factor affecting the health of women. As each
pregnancy made it harder to get back to pre-pregnant physical conditions, when
Pakistani women needed to bear more children according to the cultural concept
that children were a symbol of fortune, Pakistani women were more at risk due
to childbearing. Dr. Nazia believed it was essential to educate fellow
Pakistanis on dietary hazards and raise awareness on leading an active and
healthy life, especially among the women.
According
to Dr. Nazia, Pakistani men suffered more from occupation-related accidents,
such as in construction sites, as little attention had been paid to safety in
the workplace. Moreover, Pakistani children in Hong Kong were often obese
because they consumed lots of junk food and frequented fast food shops.
Dr. Nazia
continued her presentation by discussing the socio-economic factors affecting
the Pakistanis’ healthcare seeking behavior. Language was a big problem, as not
all Pakistanis in Hong Kong could speak and understand Cantonese and English.
Even if they know these languages, it may not be good enough to communicate in
medical terms. Dr. Nazia mentioned that the interpretation services for ethnic
minorities were not always satisfactory as some interpreters were not well
trained. This topic was further discussed during the panel session, which will
be mentioned below.
Gender was
another factor especially affecting the healthcare seeking behavior of
Pakistani women in Hong Kong. Muslim women preferred to have female doctors or
nurses in order to follow modesty requirements in regard to opposite sex.
However, in Hong Kong, doctors and nurses were often males. Muslim women would
feel very uncomfortable if a male doctor conducted prenatal
checkup on them. Dr. Nazia advised the government should pay more efforts in
training female doctors and to create a user-friendly environment to help all patients with
their needs. On the other hand, it was a tradition for Muslim baby boys to be
circumcised at the earliest. However, most doctors in Hong Kong had little awareness
of this and were not trained about circumcision. It usually took a long time to
wait for circumcision in public hospitals, while the fee in private hospitals
was high. Compared to the United States, where circumcision was routinely done
to meet the religious need of the Jewish faith, Dr. Nazia suggested that the
Hong Kong government could pay more attention to the special needs of ethnic
minorities.
Following
a short break, a panel discussion was carried out. Dr. Nazia was joined by Ms.
Asma Batool, a Community Health Officer in South Asian Health Support Program United
Christian Nethersole Community Health Service, who gave us some ideas on the
limitations of clinics in Hong Kong, for example, the lack of prayer rooms, and
lack of nursing facilities. Ms. Batool believed that there should be more
cultural sensitivity training for frontline doctors and nurses.
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Panel discussion |
The focus
of discussion then turned to interpretation services for ethnic minorities, and
everyone actively expressed their opinions. Some in the audience questioned the
effectiveness of interpretation services as these were seen to be passive
action as patients needed to get approval from the hospitals in advance. Clinic
staff often asked out-patients to bring family members or friends who know Cantonese
to translate for them. Moreover, interpretation in the emergency room was not
available. Some patients even did not know how to apply for the service.
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Pakistani guests expressing their opinions during the panel discussion |
Representatives
from Hong Kong TransLingual Services (HKTS), Mr. Ryan Choi and Ms. Candy Hui,
opined that the culture in public hospitals, which emphasized time and cost
efficiency, has restricted the effectiveness of interpretation services. Some
of the reasons why hospitals discouraged the use of interpreters were cost
minimization, and limited consultation time. Mr. Choi said that as service
provider, they were trying hard to monitor and improve the quality of staff. The
latest statistics showed that there were 800-900 interpretation cases per month
last year, and the number was increasing as more patients knew about the
services. HKTS also organized talks and sharing sessions in public hospitals to
promote their services and to heighten the cultural awareness of hospital
staff. Lastly, Mr. Choi reminded service users to be punctual to make sure the
services were properly used.
After
the fruitful discussion, Prof. Tam concluded that although there were
structural and other factors affecting the healthcare seeking experiences of
ethnic minorities in Hong Kong, many efforts had been done to improve the
situation. Both healthcare service users and providers needed to know their
rights and responsibilities to make the healthcare system in Hong Kong a more
user-friendly and effective one.
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(First Row, from left) Dr. Nazia, Ms. Batool and Prof. Tam, together with guests and participants of the Workshop |