The perceived ethnocentrism on the part of the healthcare provider creates a stigma for patients who may have a different worldview. Sociologist Erving Goffman (1963,) defined stigma as “the process by which the reaction of others spoils normal identity” (p. 3). The potential negative reaction of the healthcare provider towards a patient in relation to the causes of and cures for disease, or the providers’ questioning of the rationality of alternative treatments can “spoil the normal identity” of the patient. In other words, this cultural disconnect can make them feel that something they value is seen as wrong, silly or irrational by others. This stigma produces a (sub-)conscious fear on the part of the patient regarding their relationship with their provider, negatively influencing the care they receive. Yet, the consequences of cultural disconnect can be more dire than fear of social stigma. One participant reported an instance when a healthcare provider notified Child Protective Services because of marks on a child’s arms. As a result, the child was removed from the home. Although temporary, this experience was traumatic for the child, the parents, and the community. A cursory knowledge of the community could have prevented an event like this from occurring; the marks on the child’s arm were from the application of a traditional remedy to treat the child’s sickness rather than the child abuse that was alleged. Seen in this light, there may be good reason to hide the use of alternatives to biomedical treatment. Cultural competency is a well-documented issue in the literature on health disparities (Betancourt, Green, Carrillo, and Ananeh-Firempong, 2003; Betancourt, Green, Carrillo, and Park, 2005; Farmer, 1999; Hirsch, 2003; Ikemoto, 2003; Kleinman and Benson, 2006).
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