CULTURAL PERCEPTIONS AND MISCONCEPTIONS – CULTURE AS AN ISSUE FOR THE PATIENT (INSTANCE)
Saeeda Nessa had lived in the UK since 1983. Five children had been born between 1975 and 1983, and any space between pregnancies had arisen because of her husband’s visits to the UK. Since living with her husband in London, she had had a baby every October, all boys. She had a past history of pulmonary tuberculosis, leaving her with partial bronchiectasis and recurrent bronchitis. Her husband, who always accompanied her to the surgery, was rather demanding and overbearing with reception staff, and frequently referred to the Race Relations Act if they did not accede to his peremptory requests. The GP’s attempt to discuss contraception during the gestations of the 1987 and 1988 babies were repudiated by him with the rules of Islam. The religious laws were never confronted directly by the GP, but longer experience of this man revealed that his bark was worse than his bite and that the family was not in such awe of him as might at first appear. The message about contraception was respectfully but relentlessly put. Saeeda finally came without her husband, but with his tacit consent, for her first discussion about contraception. It is now four years since her last child was born and her husband smiles wryly whenever the doctor checks with Saeeda about her contraception.
Conversely, a physical symptom or other problem may be presented as the reason for not getting on with a method, in order to avoid discussing cultural issues. A consciousness that one’s culture’s general opinions about coils or Pills are held to be ridiculous by a sophisticated westerner may also incline one to pull down the cultural shutter.
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