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Stop the spread of Ebola fear with cultural competency

November 3, 2014
by H. Steven Moffic, MD
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As scary as Ebola has been in a physical and psychological sense, over the Halloween weekend it became more frightening in a sociocultural sense. The relevance of the complete bio-psycho-social model of medicine and psychiatry comes to the fore.

Over a century ago, Joseph Conrad wrote the famous short novel, "Heart of Darkness." Overtly, it is about the travels of one man into the depths of Central Africa in search of Mr. Kurtz, a journalist who has become worshipped by a tribe of "savages." Along the way, it exposes the racism of European imperialism. As Kurtz dies after he is found in somewhat of a psychotic state, he whispers: "The horror! The horror!" Critics claimed the book dehumanized Africans.

Could modern remnants of this portrayal be beginning to emerge with Ebola? The first suggestion may be in the first person diagnosed with Ebola in the United States, Thomas Duncan. After his death, suspicions of discrimination emerged after he, a Liberian immigrant without health insurance, was turned away from the emergency room in a Dallas hospital. Of course, the opposing explanation is that the hospital was just too unfamiliar with what the early presentation of Ebola might be. So far he is the only patient to die in the United States from Ebola.

Of possible related concern are some social reactions. Angelique Kidjo, a popular singer known as "Mother Africa," has been called "Mama Ebola" ahead of her upcoming concert at Carnegie Hall in New York. Those returning to the United Sates from Africa are being stigmatized, even if they had no health or healthcare connection with Ebola.

Those in behavioral healthcare in the United States have fought long and hard to eliminate the discrimination and racism against poor minorities, most especially African Americans. Some progress has been made, but now is the time to use our knowledge and skills of cultural competency to help counter anyone's heart of darkness regarding Africa and Ebola. There is more than enough fear of Ebola itself; let's work to stop the spread of that fear to the Black community.



Dr. Moffic,

The concept of cultural competency is the foundation in providing positive and effective patient care. The delivery of cultural competent healthcare enables healthcare providers to deliver services that are respectful of and responsive to the health beliefs, practices and cultural and linguistic needs of diverse patients.
The Ebola crisis has shocked the healthcare system into forgetting we have a responsibility to provide care to all who enter our doors to reduce healthcare disparities by improving access to high-quality healthcare. Ebola can only shake us, but not destroy years of improving healthcare for all, despite the color of their skin or their culture. We cannot afford to forget our healthcare obligations and reverse the steps we have made, nor become unresponsive to the care of African Americans, despite their ability to pay. This healthcare issue is nothing we cannot handle with accuracy, and the adherence to precautionary healthcare standards.
The NIH illuminates this response and suggests:
Cultural competency is critical to reducing health disparities and improving access to high-quality health care, health care that is respectful of and responsive to the needs of diverse patients. When developed and implemented as a framework, cultural competence enables systems, agencies, and groups of professionals to function effectively to understand the needs of groups accessing health information and health careā€”or participating in research-in an inclusive partnership where the provider and the user of the information meet on common ground (, 2014).
National Institute of Health (2014)

H. Steven Moffic

H. Steven Moffic

H. Steven Moffic, M.D. retired from the clinical practice of psychiatry and his tenured...

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