The Emergence and Relevance of Cultural Difference in Mediated Health Interactions

ABSTRACT

This paper discusses cultural difference as it emerges in bilingual health communication involving health professionals, migrant patients, and intercultural mediators at community healthcare facilities in Northern Italy. Drawing on a sample of authentic mediated health encounters, we will see how cultural differences surface and are made relevant to the overall goals of the interaction by its participants. Special attention is paid to the intercultural mediator’s contributions and how these render the interlocutors’ cultural presuppositions and related expectations mutually accessible (or not), thus arguably either favoring or hampering the attainment of quality and equality of care.

Notes

1. See below for more on the interpreter’s roles.

2. Threesome here is intended as three parties in the conversation; as we will see below, parties can in fact be made by more than just one individual.

3. This is witnessed by works published in the past couple of decades, starting from issue 1 of the 1997 volume of Health Communication, which is entirely devoted to the centrality of the patient.

4. In taking on these different roles, the interpreter may act as an institutional gatekeeper (Davidson, 2000), i.e. s/he may select, adjust or withhold either primary participant’s contributions to fit the medical agenda.

5. See http://mediation-time.eu/index.php?option=com_content&view=article&id=9&Itemid=140&lang=en.

6. For ease of reference to the cited literature, no distinction has been made here between the term ‘interpreter’ and the term ‘intercultural mediator.’

7. For a detailed description of the prototypical stages of the medical interview see Byrne and Long (1976) and Ten Have (1989).

8. Regioni are first-level administrative divisions of the Italian Republic, and intercultural mediation is one of the matters that are subject to regional legislation, especially in terms of training standards and qualifications and hiring procedures, the latter drawing on separate rolls/registers at either regional or municipal level (for further info, see Amato & Garwood, 2011; on healthcare settings, see also INMP, 2015).

9. English is mainly used as a lingua franca and often interspersed with other languages, such as Igbo and Yoruba in the case of Nigerian patients and mediators.

10. See https://tla.mpi.nl/tools/tla-tools/elan/.

11. this same ICE contains a very similar one on pap, a fermented cereal pudding that is a staple food in Nigeria and other African countries.

12. The word “velo” in Italian is commonly used to refer to Muslim women’s head coverings, especially hijabs.

13. On the notion of formulation, see Heritage and Watson (1979).

14. On ethnocentrism, see Baraldi (2006).