Yvonne's Presentation

SUDANESE CULTURE : 

SUDANESE CULTURE IMPLICATIONS IN THE DELIVERY OF HEALTH CARE

http://www.worldatlas.com/webimage/countrys/africa/sd.htm : 

http://www.worldatlas.com/webimage/countrys/africa/sd.htm

SUDANThe name means “Land of Blacks” : 

SUDANThe name means “Land of Blacks” The people of Sudan have experienced continuous civil war since 1956. Persecution, political and religious oppression, famine, floods, and warfare are common in the daily lives of the Sudanese people. Corrupt leaders have prevented aid from the United Nations, USAID, and UNICEF In 1993 there were an estimated 4,750,000 Sudanese people seeking refuge in other countries. An estimated 1,300,000 died in the attempt to seek refuge. The largest Sudanese refugee population in the United States is concentrated in the Midwest. Omaha, Nebraska and Des Moines, Iowa are currently home to most of these refugees. Kemp, C., (n.d.). Sudanese Refugees. Retrieved August 2, 2009, from http://bearspace.baylor.edu/Charles_Kemp/www/sudanese_refugees.htm

LANGUAGE AND RELIGION : 

LANGUAGE AND RELIGION Arabic is the language spoken by most Sudanese. English is spoken by the educated minority. Each tribe has its own language and often several dialects. Over 130 individual languages exist in Sudan. Sunni Muslim is the predominant religion, followed by indigenous beliefs and Christianity. Religion is an important source of strength. Widespread belief in the supernatural, spiritual realm and its manifestation on an individuals health. Illness afflicted through the “evil eye” of a malicious person, with supernatural powers, is often cited as the cause of many ailments. Kemp, C., (n.d.). Sudanese Refugees. Retrieved August 2, 2009, from http://bearspace.baylor.edu/Charles_Kemp/www/sudanese_refugees.htm

REFUGEE HEALTH RISKS AND ENDEMIC DISEASES : 

REFUGEE HEALTH RISKS AND ENDEMIC DISEASES Malnutrition Parasitic Infections Hepatitis B Tuberculosis Malaria Sexually transmitted diseases HIV infection Mental Health Disorders (PTSD) Kemp, C., (n.d.). Sudanese Refugees. Retrieved August 2, 2009, from http://bearspace.baylor.edu/Charles_Kemp/www/sudanese_refugees.htm

HEALTH CARE BELIEFS SICK CARE PRACTICES : 

HEALTH CARE BELIEFS SICK CARE PRACTICES The Sudanese have traditionally used curative methods and herbal recipes created from environmental resources (Lack of availability limits their use in the U.S.) Segregation and isolation of the sick is common. The passage of blood is looked upon as essential to the cure of many ailments. Many Sudanese refugees exhibit scarring from such practices. Cough (quhha): is considered a disease and not a symptom. In all types of chest complaints, cupping, scarring and cauterizing painful sites is common. Cutting of the patient’s heal is sometimes done to “root out” the cough. Fever: also considered a disease caused by natural or supernatural agents. Often thought to be caused by the “evil eye”. Massaging the skin with salt, water, and liquid butter is common. Also, wet cupping of the nape is practiced. Parasite Infection: treated with herbal pastes, ingestion of pumpkin seed and removal through daily pulling and winding of the worm to the outside of the body until it is fully removed.

HEALTH CARE BELIEFSSICK CARE PRACTICES : 

HEALTH CARE BELIEFSSICK CARE PRACTICES Convulsions: In children, parents are forbidden from touching the child. The sign of the cross is drawn on the forehead and prayers are cited. Pain (alam or waja): Tolerance of pain and stoicism in an important attribute of the Sudanese. It is considered shameful for a man to complain of pain. Anesthesia or analgesia are rarely used in Sudan. Sexually Transmitted Disease: The appearance of genital sores and ulcers is considered an outlet for disease and not often treated. When treatment is used, ineffective dietary restrictions, herbal concoctions, medicine baths, and cautery are used. Sudan Health, (n.d.). Retrieved August 2, 2009, from http://www.sudan-health.com/tm/tm/treatment/treatment.htm

COMMUNICATION CONSIDERATIONS : 

COMMUNICATION CONSIDERATIONS Muslim men shake hands in greeting with men only. It is not appropriate for men and women to shake hands with non-family members. Separation of men and women is common, even within the home. Respect should always be directed towards the man, the head of the house. Mothers are most knowledgeable about the health of their children. Men of common age will refer to one another as brother, sister and cousin. Elders are given more respect and referred to as father or uncle and mother or aunt, when related by blood. Kemp, C., (n.d.). Sudanese Refugees. Retrieved August 2, 2009, from http://bearspace.baylor.edu/Charles_Kemp/www/sudanese_refugees.htm

IMPLICATIONS ON WESTERN HEALTHCARE : 

IMPLICATIONS ON WESTERN HEALTHCARE Refugees are required by the United States to receive a complete physical exam within one year of establishing residency Many refugees have not previously had access to health care. Discovery of undiagnosed medical conditions such as hypertension, diabetes, depression, and parasitism are common. Sudanese often discontinue use of prescribed medicine when their symptoms improve. They also share over-the-counter medications for similar symptoms. Exact birthdates are often unknown. Lack or loss of records and uncommon use of calendars amongst tribes are frequently evident. Kemp, C., (n.d.). Sudanese Refugees. Retrieved August 2, 2009, from http://bearspace.baylor.edu/Charles_Kemp/www/sudanese_refugees.htm

SUDANESE WOMEN : 

SUDANESE WOMEN Nearly 80% of refugees are women The role of the Sudanese wife is subservient to the husband. Muslim women are often distrustful and reluctant to be examined by male physicians. Initial care should be provided by a female physician. Many women have been subjected to insanitary conditions, malnutrition, dehydration, loss of husband and family, violence, and rape. 89% of Sudanese women have been subjected to female circumcision. A practice widely performed as the female genitalia is believed to be unclean as well as to keep the female chaste. Kemp, C., (n.d.). Sudanese Refugees. Retrieved August 2, 2009, from http://bearspace.baylor.edu/Charles_Kemp/www/sudanese_refugees.htm

CHILDBEARING AND INFANCY : 

CHILDBEARING AND INFANCY Refugee women often have higher parity, lower birth weight babies and poor prenatal care. During pregnancy, a salty clay is often chewed to stimulate appetite and reduce nausea. Due to female circumcision special consideration should be made in vaginal deliveries for the lack of stretch to the perineum. The risks of maternal and infant mortality are also doubled. Breast feeding is commonly practiced for two years or until the child is walking. Kemp, C., (n.d.). Sudanese Refugees. Retrieved August 2, 2009, from http://bearspace.baylor.edu/Charles_Kemp/www/sudanese_refugees.htm

ADOLESCENCE : 

ADOLESCENCE Puberty for both boys and girls is seen as passage to adulthood. Male rituals involve cutting of lines across the forehead, tribal scarring across the body and occasionally the removal of lower teeth. Girls may marry as early as 14 to 16 years old. Married adolescent refugees may have difficulty coping socially. Kemp, C., (n.d.). Sudanese Refugees. Retrieved August 2, 2009, from http://bearspace.baylor.edu/Charles_Kemp/www/sudanese_refugees.htm

MARRIAGE : 

MARRIAGE Marriage is a contract between two families. The grooms family provides a dowry to the bride’s family with the exchange of cattle. The wife does not take the husbands name. The wife's ability to produce children is very important. Birth control is frowned upon. Divorce is discouraged. Polygamy is common and signifies wealth. Kemp, C., (n.d.). Sudanese Refugees. Retrieved August 2, 2009, from http://bearspace.baylor.edu/Charles_Kemp/www/sudanese_refugees.htm

SPECIAL CONSIDERATIONS : 

SPECIAL CONSIDERATIONS Mental health problems exist in the refugee population due to the experiences of war, imprisonment, torture, rape, and witnessing of torture and execution of loved ones, and displacement.

CONSEQUENCES OF THE REFUGEE EXPERIENCE : 

CONSEQUENCES OF THE REFUGEE EXPERIENCE Post traumatic stress disorder Problems with trust, support groups and social environment Problems with illiteracy, employment, legal system and finances Problems with adequate housing Problems with acts of violence Problems with grief and depression Problems with access to health care

DEATH : 

DEATH Death is seen as the will of GOD. Burial ceremonies are conducted to appease the God’s. Several months of mourning is common. In the Muslim religion, burial happens as soon as possible following a ritual of cleansing and blessing. Widowed women are the deceased brother’s responsibility. They may remarry. Kemp, C., (n.d.). Sudanese Refugees. Retrieved August 2, 2009, from http://bearspace.baylor.edu/Charles_Kemp/www/sudanese_refugees.htm

SUDANESE FOOD : 

SUDANESE FOOD The Sudanese diet is a blend of Arab and African cuisine. Four dishes are usually served during a meal, the soup, salad, Shata (hot spice) and a dessert. A low table surrounded by pillows is used for meals. Meats include lamb and chicken Rice is a staple with every meal Kisra, a omelet style pancake or Arabian Khubz, a bread are commonly served. Okra, tomatoes, fruits, and sweet deserts compliment the main dish Guhwah (Sudanese coffee) or tea is served. Sudan Menus and Recipes. (n.d.). Retrieved August 1, 2009, from http://www.sudan.net/society/recipe.html

SUDANESE RECIPECRÈME CARAMELA : 

SUDANESE RECIPECRÈME CARAMELA Beat 8 eggs with 1 quart milk and ½ cup sugar until frothy. Add 1 oz. butter, melted and 1Tbs. Vanilla, in a 1 ½ quart star shaped aluminum cake pan Melt ½ cup sugar and burn to caramel stage Rotate the pan to spread caramel on all sides Beat the egg mixture again and pour quickly into the cake pan, cover with well buttered foil Place the pain in a larger pan half filled with water Bake at 350 degrees for 30 minutes Chill until thoroughly cold, then turn out onto platter. Garnish with Maraschino or candied cherries on top and sides

REFERENCES : 

REFERENCES Kemp, C., (n.d.). Sudanese Refugees. Retrieved August 2, 2009, from http://bearspace.baylor.edu/Charles_Kemp/www/sudanese_refugees.htm Sudan Menus and Recipes. (n.d.). Retrieved August 1, 2009, from http://www.sudan.net/society/recipe.html Sudan Health, (n.d.). Retrieved August 2, 2009, from http://www.sudan-health.com/tm/tm/treatment/treatment.htm http://www.worldatlas.com/webimage/countrys/africa/sd.htm