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July 22, 2004
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Accommodating diversity in healthcare

Some of the members of the committee studying cultural diversity for the Health Care Corporation of St. John’s
Some of the members of the committee studying cultural diversity for the Health Care Corporation of St. John’s: (L-R) Mona Wall, social worker, Faye Gear, Native Friendship Centre, Janet MacKey, social worker with the Association for New Canadians, Dr. Fern Brunger, medical ethics, MUN, and Dr. Rick Singleton, director of Pastoral Care, HCCSJ. Other committee members are: Sharon Dominic, co-ordinator of services for people from St. Pierre and Miquelon, Dr. Ajit Bedi, Faculty of Education, MUN, Myrtle Blandford, Native Friendship Centre and Sister Madonna Gatherall, co-ordinator of Mission Effectiveness at St. Clare’s Hospital. Graduate student Jill Bonnell is the research assistant.

By Sharon Gray
Ethnic background, gender, life experience and sexual orientation are just some aspects of cultural diversity, and sometimes a person’s experience with the healthcare system can be negatively affected if these differences are not acknowledged and accommodated. The Health Care Corporation of St. John’s is taking a proactive approach to dealing with diversity through a study headed by Dr. Rick Singleton, director of pastoral care.

“Right now we don’t have much in place to help individuals and staff other than language translation and accommodating dietary needs,” said Dr. Singleton. “In the past our response has always been contingent on someone identifying and being an advocate for an issue, but we see a need to go deeper and to respond not only to issues as they are identified but to have principles in place and be positioned to respond.”

Since the cultural diversity study began, one major improvement has been introducing services for the deaf. Dr. Singleton said it is a matter of going beyond multiculturalism to cultural sensitivity. “Even aging is a factor. One of the things I find interesting is that people can come into the health care system and end up with significant disabilities. They then have to face moving into a different culture if they need to be cared for other than being independent. There are cultural aspects to that shift that we really don’t think about very much.”

Dr. Fern Brunger is a medical anthropologist with the Faculty of Medicine who joined the cultural diversity study committee when she came on faculty last year. “We’re talking not so much about cultural sensitivity as about inclusion of diversity. One of the things that has dismayed me since 1987, when the government passed the Multiculturalism Act, is that programs have been set up that focus only on things like appropriate foods and language translation. I find the study here quite exciting in that Dr. Singleton’s group is clearly not making the mistakes others have made – for example, the questionnaire does not ask for ethnic background.”

Dr. Brunger said what needs to be changed is not accommodating people who are different, but changing the health care setting so caregivers are aware of what they are doing. “In other words, it is the culture of medicine, not just the cultures of patients, that has to be understood and managed.”

She said that a lot of time people are intuitively doing things that are right. “Much of our task is to identify what people are doing well and emphasize that. It strikes me that there is an openness to diversity here that you might not see in other provinces where there are more ethnic minorities. A lot is already being done properly because of the way Newfoundlanders are.”

The plan is to complete the cultural diversity study by the end of this summer and post the report and its recommendations on the HCCSJ Web site. If you are interested in participating in the survey, it is available at or you can contact Dr. Rick Singleton at 709 777-6959, by fax at 709 777-7612 or by email at


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