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photo Worlds Apart
A Four-Part Series on
Cross-Cultural Healthcare

By Maren Grainger-Monsen, MD, and Julia Haslett
Stanford Center for Biomedical Ethics

These unique trigger films follow patients and families faced with critical medical decisions, as they navigate their way through the health care system. Filmed in patients' homes, neighborhoods and places of worship, as well as hospital wards and community clinics, Worlds Apart provides a balanced yet penetrating look at both the patients' cultures and the culture of medicine. This series is an invaluable tool for raising awareness about the role sociocultural barriers play in patient-provider communication and in the provision of healthcare services for culturally and ethnically diverse patients.

Mohammad Kochi, a devout Muslim from Afghanistan, had surgery for stomach cancer, but is now refusing the chemotherapy recommended by his physician. His daughter thinks he may fear that the kind of chemotherapy offered will prevent him from observing daily prayer, and wonders if a professional translator might have avoided misunderstandings. 14 Minutes

Justine Chitsena needs surgery for a congenital heart defect, but her mother and grandmother, refugees from Laos, worry that the scar left by the operation will damage her in her next reincarnation. They want to seek advice from the local Buddhist temple. 11 Minutes

Robert Phillips, a health policy analyst who is African-American, believes he's likely to wait twice as long as a white patient for the kidney transplant he needs. He's looking for a new nephrologist — someone who will be more sensitive to his concerns. 10 Minutes

Alicia Mercado, a Puerto Rican immigrant, has strong beliefs about using natural home remedies rather than prescription medications. Her diabetes, hypertension, asthma and depression have been aggravated by her recent eviction from her apartment of eighteen years, which has also disrupted the continuity of her care. Her son worries about the "assembly line" care he feels she is receiving. 13 Minutes

The interactions between these patients and their healthcare providers reveal a great deal about both problems and opportunities in cross-cultural healthcare. The study guide for this documentary series was designed by cross-cultural medicine educators Drs. Alexander Green, Joseph Betancourt, and Emilio Carrillo. The series consists of four programs, ranging from 10 to 14 minutes each; total combined running time is 47 minutes.

47 minutes
© 2003
Purchase $398 DVD
Order No. QA-912
ISBN (DVD) 1-57295-805-7
close captioned

Reviews
"An excellent production. Very different in feel from stagy, after-the-fact training videos. We plan to use it repeatedly in our training." Patricia J Ohmans, MPH, Health Advocates

"One of the best examples of introducing cultural competency I have seen. Very realistic scenarios." Carol Spector, MS, MHPE, Department of Family Medicine, Midwestern University

"An excellent addition. Worlds Apart will be an integral part of our cultural competency training program and future professional development workshops. Doctors have given only exceptionally positive reviews of these videos." Juanita Dimas, PhD, Alameda Alliance for Health

"A wonderful tool that we can use in communities and speaking with health systems leaders and policy makers. Can be used in many contexts to raise awareness about disparities, the importance of providing culturally sensitive health care, and addressing the needs of increasingly diverse communities." Romana Hasnain Wynia, PhD, American Hospital Association

"Our Fellows rated the films very highly, saying that they 'can see many uses in training health care professionals' and would recommend them to health systems leadership." Johanna Infantine, Health Forum, American Hospital Association

"Worlds Apart moves beyond data to put a human face on disparities in health care, and allows us to create solutions to facilitate cultural competency among health care workers, policy makers and educators." Elizabeth A. Williams, National Conference for Community and Justice

"Worlds Apart offers compelling insights into the lives of patients as they navigate the medical system, making sense of their problems and decisions about their care. It will give our medical students a unique opportunity to appreciate the complexity of patients' experiences, understand the significance of those experiences for patient-doctor relationships, and explore the impact of these experiences on the medical system as a whole. The modules will contribute considerably to our students' efforts to become the deeply knowledgeable and effective medical practitioners our diverse society needs." Dorothy Porter, PhD, UCSF School of Medicine

"Aims to improve cross-cultural healthcare practice through deepening students' understanding of culture's influence on healthcare beliefs and behaviors. The four films focus not only on different ethnicities, but also on different gender and developmental stages, allowing the audience to realize the importance of taking multiple variables into consideration in comprehending patients' behaviors in healthcare. An excellent resource for cross-cultural healthcare education."International Journal of Intercultural Relations

Awards & Conference Screenings
Silver Award and Creative Design Award nominee
Health and Science Communications Assn.
Silver Hugo, INTERCOM Chicago
Quality Health Care for Diverse Populations Conference

Related Films
Donka: X-Ray of an African Hospital: Daily life in the largest public hospital in the Republic of Guinea

Hold Your Breath: Mohammad Kochi, a devout Muslim immigrant, faces possible death from stomach cancer. His American doctors try to comprehend his faith and respect his viewpoints, but cultural and linguistic confusions complicate his treatment. His story, first summarized in the acclaimed Worlds Apart series, is a powerful argument for the necessity of cultural competence and diversity training.

Ten Commandments of Communicating With People With Disabilities: This top selling video is used to train staff and community about disability etiquette.

The Culture of Emotions: Designed to introduce cultural competence and diversity skills to mental/behavioral health professionals and students who deal with multi-cultural client populations.

Community Voices: A multi-cultural array of patients, clinicians, and other healthcare workers explore the many ways that differences in culture, race and ethnicity affect health and the delivery of healthcare services.

A Culture Undiscovered: Explores the needs and experiences of college students, from diverse racial and/or ethnic backgrounds, who have learning disabilities.

That Spirit, That Thing Inside: Invaluable for nursing recruitment and retention: Hispanic/Latino and American Indian nurses describe how they came to their careers, and have used their nursing expertise to serve their families, their tribes, and their communities.

The Angry Heart: Spotlights the epidemic of heart disease among African Americans through the story of 45-year-old Keith Hartgrove, who has already experienced two heart attacks and quadruple bypass surgery.


Reviews

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