The Many Uses of Olive Oil

There were 6 of us in a small examining room designed for two people — the doctor and the patient. In this case there were two women from the Sudan, two nurses, one patient navigator, one interpreter, and one baby.

It was crowded.

To say I was invited  to come to this community health center was something of a delusion, it was more as if I had been challenged to come – challenged with strong words: “This program isn’t working! You try to use this life-style education tool with culturally diverse patients”

To give context the “challenger” was referring to a health assessment that my office had developed to gauge whether a person is ready to make changes to their lifestyle. It included questions on weight, healthy fats, exercise, fresh fruits, vegetable consumption and more.

I was not a fan of the questionnaire – I had worked with people from different cultural backgrounds my entire professional career and knew that this tool had been developed from a bias of western biomedicine. As such, it had limited use.

But I accepted the invitation knowing that at least they would see I was on their side.

So there we were: health professionals, patients, and a culturally biased assessment. Speaking through an interpreter I began talking. I introduced myself and asked if I could ask them a few questions. They nodded in assent – no problem.

And so I began:

“Are you a healthy weight?” Blank looks.

The interpreter tried again, and then looked at me. “This is not relevant,” she said. “They do not weigh themselves.” Of course, they didn’t. What was I thinking? They were women who had escaped the Sudan, made their way through the arduous process of refugee camps and resettlement and I was asking them about healthy weight. Wow. But determined to continue I pressed on.

“Do you eat healthy fats?” More blank looks. My problem-solving mode switched on and I thought – ok, I’ll ask if they use olive oil – that’s a healthy fat.

New olive oil, just pressed. It has a dense co...

“Do you use olive oil?”

Their eyes lit up. They smiled. “Oh yes! We use olive oil all the time”. Good, I thought!  We’re making some progress…..

“Yes olive oil. We love olive oil! It is wonderful. We use it every day…..on our hair”

I began to laugh, and they with me. The whole encounter was so absurd. I would have gotten more information on their health and eating habits by having a normal conversation and inserting the right questions at the right time instead of following this biased and culturally illiterate tool.

The story is a great example of some of the challenges presented in working with patients from different countries and cultures. The healthcare professional (whether nurse, doctor, social worker or any other) comes into the clinical encounter with his or her own predetermined biases, values, and beliefs. Added to that is the often inflexible culture of western biomedicine under the umbrella of the institution. All of this mixes into a potentially difficult interaction with the patient.  We then wonder why patients won’t come back…or get offended…or don’t do as we want them to.

Culturally responsive care is critical to healthy outcomes.

But changing this dynamic is not easy. It’s a journey and as such takes time, preparation, and mile markers.

One of the first mile markers in learning to communicate across cultural boundaries is to understand one’s own cultural beliefs and values. Only then can we better interact with those from different backgrounds. If we don’t know what we believe and value, what is unique to our cultural backgrounds, we are ill-equipped to forge into relationships with those vastly different from us, even less ready to offer them good health care.

And after that it’s about listening to the stories and constantly being willing to learn and adapt.

It’s interactions like the one I’ve described that help me on this journey of communicating across cultural boundaries. They remind me that I have to be ever flexible and willing to see from the other person’s perspective; recognizing both literally and metaphorically the many uses of olive oil.

10 thoughts on “The Many Uses of Olive Oil

  1. This piece reminds me of another question I find interesting: are all healthy choices appropriate for everybody? I live down the road from supported accommodation for people with schizophrenia, and I often find myself thinking about their smoking. In our western model, smoking is Bad, Bad, Bad – but for some of my neighbours suffering from mental illness, smoking is very calming, and provides them with an activity through long and quiet days. So, should they give up the cigarettes? Similarly, your piece raises the question, do people who may have spent many years hungry need to grapple with the western ideal of a healthy weight? Difficult questions, to which perhaps there are no straightforward answers.

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    1. Such a good comment! This is something I think about all the time and yes, the story is just one small illustration of that. The idea of worrying about healthy weight when most of your life you have fought to not be hungry; the idea of worrying about breast cancer screening when you have survived all of your peers who have died in war or childbirth. And you’re right about smoking – it’s a non prescription anti anxiety and anti depressant. A couple of years ago I heard a physician speak and one of the things he said completely transformed my care for patients – he said “What we consider the problem, many of our patients consider the solution” Smoking and obesity are two of those things. Interesting as I’ve been meaning to write a post about this and you’ve inspired me. Thanks for your good thoughts!

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  2. I just love your stories Marilyn. When I saw the title the first thing that came to my mind was a Pakistani lady telling me once that she got rid of her kidney stones by drinking some olive oil everyday.

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  3. Great reminder of the importance of culturally competent care – knowing your clients and targeting your outreach, your care, your interactions to them! Made me laugh though, for sure. I could just imagine the wonderful, well intentioned folks coming up with said questionnaire.

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    1. Exactly Sarah! It’s that “well intentioned” run a muck! And I know you know what it’s like to try and bring the community in, learning instead of telling. It was a funny time! Awkward for sure. Thankfully the laughter helped.

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