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Paths to Healing:

U-M's multicultural health initiatives foster understanding to help patients get the care they need, con't.

What people care about most, no matter what their race or culture, is that their doctor is validating them.
--Aisha Langford, director of Community Outreach


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Hiam Hamade coordinates the ACCESS Community Health Center's Breast and Cervical Cancer Control Program in Dearborn, Mich.

Her goal is to educate Arab-American women about their cancer risk and encourage prevention, screening and treatment.

Recently, a woman with a very large -- and almost certainly cancerous -- lump in her breast came to the ACCESS clinic. The woman told Hamade that she had put off going to the doctor because she didn't want her sons to know about it. And, when her sons found out their mother was undergoing a biopsy, they asked Hamade not to tell their mother if it was, indeed, cancer.

"They don't want me to tell her, but she has the right to know," Hamade said. "If she has to go for treatment, she needs to know. This is a challenge."

It's one of many challenges Hamade has faced during her 14 years at ACCESS. Women facing cancer diagnoses often won't go for follow-up treatment if there's a chance they may have to see a male doctor, she said.

Although it's not always possible to schedule all female patients with female physicians at U-M, Edwards said, the staff works with families to make accommodations. For example, if a patient needs to stay in the hospital, Edwards's team has worked out systems where all male health-care providers need to check in at the nurse's station before entering a patient's room where modesty is a concern.

Hamade said there's also a stigma attached to a cancer diagnosis within some parts of the community because people may fear that their disease will be passed on to their daughters. Some Arab- Americans also fear that doctors will experiment on them, rather than provide treatment.

"We have to change attitudes and beliefs," Hamade said. "Even if members of the community have been here for a long time, this is something rooted in the culture. The new generation may be different, but the new generation also won't know their own medical history because their mothers don't talk about it."

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This article first appeared in the Spring, 2010 issue of Thrive.

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