When Ruthie Gomez recently made a home visit to see a young asthma patient, she was puzzled to see that the 5-year-old was not responding to the prescribed medication to relieve severe lung inflammation. Gomez was not surprised, however, to find that the little girl's mother instead was treating her daughter with a home remedy from her native El Salvador consisting of honey, lemon and onion. The concerned mother felt that her native custom made a better treatment than the prescribed medication.

Gomez and other caregivers of the MGH·Chelsea HealthCare Center often encounter such customs and traditions in the culturally diverse community of Chelsea. To address issues that can arise when treating patients of different backgrounds, the health center staff conducted a year-long training program to help incorporate cultural sensitivity into patient care. The training was funded by a grant from the Kenneth B. Schwartz Center, a nonprofit organization dedicated to strengthening the relationship between caregivers and patients.

The population of Chelsea is largely made up of Latinos, Asians and African Americans. Over the last few years, many refugees and immigrants from places such as Bosnia, Somalia, Cambodia and Vietnam also have poured into the community.

Recognizing and understanding the specific differences in how patients from foreign countries view medical help can be a constant challenge to health care providers.

"Our goal is to always recognize, acknowledge and respect patient differences and to provide the best, most appropriate care possible," says Thomas Sterne, MD, medical director of MGH·Chelsea.

The training program featured seminars to help health center staff better understand various cultures and ethnic groups.

Three presenters from the Department of Public Health visited the health center to talk about recent Somali immigrants. Fadumo Hirsi, a Somali translator, shared some of the cultural and religious differences in her culture and gave examples of the language barrier that can complicate care. "When a Somali says, 'This leg is not mine,' which is the literal translation, what is meant is, 'There is a pain in my leg,' " says Hirsi.

Representatives from the International Institute of Boston shared with the health center staff some of the history of war-torn Bosnia and included details of the country's current conflict. Recent Bosnian immigrants have an increased risk of post-traumatic stress syndrome, to which health center clinicians now are particularly attuned to treating.

Probably the most popular of the presentations was one featuring some familiar faces. Focusing on the Latino culture, seven of the health center's support staff, who hail from such countries as Costa Rica, El Salvador, Puerto Rico and Columbia, shared some of the home remedies and folklore of their native lands.

The presenters described such Latino home remedies as boiling water, honey, lemon and onion to cure a cough; tomato slices and coffee grounds to treat burns; and a drop of breast milk in a child's ear to cure an ear infection.

"Some of our cures, potions, oils and and lotions may sound weird, but people from our countries hold them dear," says Gomez, who adds that sometimes the best solution in interacting with patients such as the El Salvadoran mother is to allow them to continue using their traditional cures as long as they are supplemented with modern medicine.

According to Jeannette McWilliams, administrative director of MGH·Chelsea, these training sessions sent an important message to health center staff. "Understanding a community goes beyond just understanding its language," she says. "It is about culture, beliefs, customs and traditions. Learning how other cultures are different helps us to be sensitive to those differences and relate to patients more compassion."

From left, Janette Benitez, Ruthie Gomez and
Zaida Adams display Latino cures and remedies.