Strategies to surmount the potential barriers to providing anti-discriminatory care in Irish healthcare settings
Kathleen Markey
Lecturer, Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
Mary Tilki
School of Health and Social Sciences, Middlesex University, London, United Kingdom
Gina Taylor
Principal Lecturer, School of Health and Social Sciences, Middlesex University, London, UK
PP: 269 - 276
Abstract
Aim: This article aims to explore some of the potential Irish specific barriers to providing anti-discriminatory care to non-Irish nationals in health and social care settings and considers strategies to overcome them.
Background: There has been a rapid and unprecedented increase in the ethnic and cultural diversity of the population in Ireland over the past 10 years. This brings with it both opportunities and challenges. The challenges that are particularly poignant include Irish nationals adapting to a multicultural society and integrating migrants into mainstream society. Historically, Ireland's relative homogeneity as a nation has been reflected in their health services, suggesting the need for an approach that addresses the more diverse needs of their growing multicultural population.
Conclusion: Increasing awareness in the Irish health care setting of the complexity of working transculturally is important to interrogate the concept of privilege and the presence of racist practices. Unless practitioners are consciously aware of the personal, social and professional values that inform their attitudes and practices, their ability to be culturally competent will be at best superficial. The need to challenge attitudes, deep rooted social behaviour and misinformation which underline racial hostility is essential. Attention should focus on creating an environment of trust where critical reflection occurs, blame is avoided, risk managed and new ideas developed, tested and evaluated.
Keywords
anti-discriminatory care; ethnocentricity; racism; transcultural competence; xenophobia
Article Text
Global migration is a phenomenon that affects every country (United Nations, 2009) and it brings with it both challenges and a wide range of benefits for sending and receiving countries. Some of the challenges for host countries include adapting to the impact of new cultures and developing collective ways of promoting the integration of people from diverse cultures and ethnic groups into mainstream society. Over the past 10 years, Ireland has both benefited from and struggled to adapt to the effects of such global migration, as there has been a rapid and unprecedented increase in the ethnic and cultural diversity of its population (Central Statistics Office, 2006). Despite a recent downturn in the Irish economy following the economic boom of recent years, Ireland's history of mass emigration to which it was traditionally accustomed, was replaced with a net inward immigration (Central Statistics Office, 2006). Ireland is now far more diverse in terms of culture, race and ethnicity than during the greater part of the twentieth century. This cultural and ethnic diversity has significantly enriched the fabric of social, economic and cultural life in Ireland. However, it also presents many challenges for Irish society to adapt to an increasing multicultural population and integrate migrants into mainstream society. Such challenges are not exclusive to Ireland, however, the rapid and unprecedented changes to its demographic profile and its political and socio-economic history suggest that the challenges faced by Irish society are multifaceted and constitute possible barriers to integration. Indeed, Irish society as a whole has struggled with ethnic and cultural diversity issues of the existing and new migrant communities (Fanning, 2002).
The challenges faced by Irish people adapting to cultural diversity is also reflected in Irish health and social care settings. Although Ireland has been host to diverse cultural groups, such as Irish travellers and Jewish communities for generations, health services and the training of health and social care professionals were predominantly geared towards a relatively homogenous nation until recently. Ireland is now host to 188 different nationalities (Central Statistics Office, 2008); however the health services and professionals working within these services have not been adequately equipped to respond to the needs of such a rapidly increasing diverse patient base. Increasingly reports highlight that the health care provided to ethnic minorities in Ireland is not meeting their needs (Cairde, 2005; Equality Authority, 2008). Such reports are not unique to Ireland and evidence worldwide suggests there are many challenges associated with providing quality care to cultural groups (Alexander, 1999; Gerrish, 2001). However, lessons can be learnt from our neighbouring and other countries about initiating and implementing multi-tiered local and national strategies and practices to address such issues promptly and effectively. This article reports some of the challenges faced by health and social care professionals caring for individuals from different cultural and ethnic backgrounds in Irish healthcare settings and considers how some of these challenges may be addressed.
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