In 2014, Juan Pablo Pimentel, a PhD candidate in the Department of Family Medicine at McGill, created a pilot exercise that has since become the basis for his PhD thesis. Working with Family Medicine professors Dr. Neil Andersson and Dr. Anne Cockcroft, Pimentel devised a way for medical students in Colombia to engage in training and activities to help close the medical gap between practitioners of traditional medicine and physicians trained in Western medicine. Together with traditional medicine users from the Sabana Centro region of Colombia, cultural safety experts, and senior medical students, Pimentel and his team now have an ongoing trial that will assess the impact of students’ participation in the trainings compared with standard lessons on cultural safety.
“[We came up with] a system in which players engage in competition under pre-defined rules with a common goal in mind,” Pimentel said in an interview with The McGill Tribune.
Specifically, the system educated students on the cultural significance of traditional medicine and how to blend it with modern medical practices. In Colombia, where 40 per cent of the population uses traditional medicine methods, this is especially important. Blending traditional and Western medicine has increased awareness of cultural safety in medicine, a term that was developed by Irihapeti Ramsden, a Māori nurse in New Zealand.
“She developed the concept as a result of the increasing discontent of Māori people with the type of healthcare they were receiving,” Pimentel said. “[It was] totally disconnected from their cultural background.”
As part of her PhD dissertation, Ramsden wanted to adapt Western medicine to the cultural needs of Māori people, an indigenous people of New Zealand. At its core, cultural safety training dismantles the ethnocentric frame of mind—the tendency of people to view other customs and cultures through the lens of their own—to produce culturally competent health systems. Ramsden believes that by introducing future physicians to different cultures, Western and traditional medicine can exist in harmony with one another.
Pimentel stressed that traditional medicine is much more comprehensive than many think.
“We must avoid reducing traditional medicine to medicinal plants,” Pimentel said. “Traditional medicine encompasses many other aspects of life. For example, maintaining a healthy relationship with ourselves, our families and friends, the environment, and the spiritual world.”
Spirituality and religion play an especially large role in some traditional medicine practices. For example, Catholicism is a major religion in Colombia, and concepts from the faith often blend with cultural health practices; communication with the spiritual world is regarded as an important way to keep a healthy mind.
Pimentel also highlighted the importance of environmental health in Colombian traditional medicine.
“It is true that, in some cases, traditional medicine can harm the environment, especially when animal products from an endangered species are used,” Pimentel said. “However, traditional health systems […] include environmental health as a prerequisite for human health [.…] Actions such as recovery of native plants and protection of rivers are common health promotion activities.”
Though initially more popular in New Zealand and Australia, many universities in Canada—including McGill—have been developing ways to integrate the training into their medical programs. Since 2018, McGill has offered a course called Indigenous Perspectives: Decolonizing Health Approaches (FMED 506). Furthermore, the Royal College of Physicians plan to make cultural safety training mandatory in the near future.
Latin American countries have been more hesitant to incorporate cultural safety into their medical programs. Pimentel hopes, however, that his thesis will be a step in the right direction. His end goal is to preserve cultural history while creating a happier and healthier world.