Cultural issues in first aid

should consider that some victims may have very different expectations about how they should treated

and be at least somewhat familar with some of the cultural differences they may encounter.

In some cultures it is a sign of disrespect to touch someone's head without their express permission, in others you would be disrespecting anyone you helped if you did not touch their head, in others it is disrespectful to touch the feet before touching the head.

But how can a first aider or first responder know what each person from each culture expects? How can you be sure that the person you are helping, who looks and dresses a lot like people from your own culture, actually believes the same as you do?

The answer is that you can't expect, even with years of experience, to know all the details. BUT you can still help people in a culturally sensitive way if you follow the basic rules taught in Red Cross classes of getting consent from each conscious, sane, sober, not drowning adult victim or the parent or guardian of a child who is present with the child.

When you obtain consent (get permission) before providing care, you need to

identify yourself

state your level of training

explain what you observe

explain why you think help is needed

and explain what you plan to do.

You need to keep explaining what you are doing and keep getting consent as you go along, especially when you need to touch the victim to give care.

Always remember that if a victim seriously needs help and refuses care, you do not need permission to call 911 or the local emergency number.

Here are some cultural diversity issues that you can expect and should respect:

You have a personal space you are used to. When someone from another culture gets too close to you, you might feel uncomfortable. When someone backs off you might feel they are reacting the wrong way to you, or trying to tell you something, but it might just be a reflection of their personal space.

Some conversation styles can be quite different than you are used to. A loud, abrupt or blunt voice that might seem to you to be anger, might actually be a normal way of speaking. Some cultures get very quiet when discussing serious issues. Your loudness might be interpreted as disrespect or even violence.

The American sign for okay of making an O with thumb and fingers is obscene in some cultures.

An elder or the family or spouse, not the adult individual, might make decisions about health care and/or first aid. Women might express opinions, but men make the decisions.

Touching within genders might be okay, but not across genders. Example: You might need to have a friend or family member who is with the victim stop bleeding by using direct pressure instead of doing it yourself.

Direct eye contact might be what you expect from people but avoiding eye contact is a sign of respect in some cultures. In others, looking away is a huge sign of dishonesty or disrespect. Some may consider your prolonged, direct eye contact rude.

You rarely need to touch near genitals when giving proper first aid care. But even talking about genitals, much less touching near them, can be acutely embarrassing to a victim, or just plain taboo.

Removing clothing from victims is not always needed for effective first aid. Some adult victims will not allow it. If it is allowed at all, some clothing and amulets provide powers of healing and should not be removed, but might be moved aside. Consult with the victim, victim's parents.

A victim may be embarrassed to ask questions.

When some people say 'yes' it can mean yes, or it can mean 'I hear you."

Some will not understand the question of how do you rate your pain on a scale of one to ten.

Losing even a little blood can be seen as seriously weakening the body.

Vomiting, constipation or diarrhea might be too embarrassing to mention to you, even if you specifically ask.

Even a small amount of vomiting might be very alarming to the victim.

Diarrhea in a child might be interpreted as caused by a hex on that child.

Shortness of breath is considered a sign of death in some cultures and may cause acute anxiety and hyperventilation.

Fatigue is in some cultures believed to be a symptom of problems it has nothing to do with. In some fatigue is thought to be primarily a sign of anemia or a displaced life force.

Gastrointestinal disturbances might be refered to as a 'liver problem'.

Some may assume that their condition is much more serious if they are given oxygen.

Some believe that every ailment is caused by the supernatural, by bad luck, by bad morals, or is a test of faith in God.

In some cases women are taught to not touch their own bodies.

It might be taboo for the spouse to be present during labor, even an unexpected emergency delivery away from a hospital.

Translating:

Remember that if a family member or friend is translating for a victim, they might not exactly translate what you are saying. An example could be that they feel the victim would be embarrassed to hear what you are saying so they don't tell them.

Another example could be that the translator does not have a direct translation of medical vocabulary you use. If you speak using simple terms instead of techical jargon you will be more easily understood.

Look at and speak to the victim, not the translator. Watch for facial expressions to tell you things, but in some cultures facial expressions are controlled.

In some cases, if the interpreter is of the opposite sex, the victim may deny that some problems exist.

If you doubt the translation you can somewhat check the translation by asking the victim to repeat back to you what they expect will be done.

Always remember that if a victim seriously needs help and refuses care, you do not need permission to call 911 or the local emergency number.