Campos Navarro centered his talk on the concept of interculturality, which means the attitudes and relations of one group of people in respect to people of a different culture than themselves. Experiences around interculturality can be negative or positive. For healthcare professionals, interculturality is relevant when we are taking care of patients who may have a different culture than ourselves. This could include patients who have cultural needs that we are unaware of or do not understand. To create a positive experience of interculturality, we must create processes to achieve a reciprocal understanding of each other’s cultures so that everyone involved is treated with respect. 

We must realize that patients and their families may hold different beliefs and conceptions of disease, life and death. We need to appreciate their beliefs and create space for them within our healthcare facilities.  

After 30 years of research in Latin America, Dr. Campos Navarro has created the recommendations below for practicing interculturality within hospitals, no matter where they are in the world. 

1. Community involvement in hospital design 

When creating a new facility, we need to respect the worldview of the people of the region, including their sacred sites and their beliefs about architectural design. For instance,
Dr. Campos Navarro shared that when designing a hospital in Argentina, the architects worked with the indigenous Mapuches people, not a health ministry or government. They designed the hospital in a half moon and oriented it straight east, toward the sun, which represents life in their culture.  

To guide U West Valley, we now have two main groups that serve complementary purposes. The U West Valley Steering Committee guides overall planning and convenes both organizations, community groups, and residents. This group is co-led by University Neighborhood Partners and University of Utah Health. It meets monthly and includes western side residents, West Valley City government, Granite School District, Salt Lake Community College, as well as non-profit organizations like Comunidad Materna en Utah and Comunidades Unidas. 

The U West Valley Resident Committee is facilitated by University Neighborhood Partners. The resident committee drives their own agenda, sets individual and community goals, and is where we delve deeply into topics.

2. Recruitment of community members for staffing  

In addition to helping with the design of the hospital, people in the region who are part of racially and ethnically diverse communities should be employed by the hospital so they understand both the language and the culture of the patients they will serve. This could also mean ensuring that the healthcare professionals working in the hospital or clinic are representative of the patients who live in the community in terms of race, ethnicity, language preference, cultural background, etc.  

3. Patient language preferences 

Dr. Campos Navarro argued that staff should also be speaking the language of the region regularly. Going to a hospital can be a scary or intimidating experience. Patients feel far more comfortable when they are greeted in their own language and are able to converse in their language during their visit, whether it is Spanish, Arabic, or Mandarin. This means recruiting and hiring staff that speak the languages spoken in the community. 

4. Mandatory intercultural training for health care workers 

All staff members should receive training about the local communities’ culture and their views on life, death and health. Health personnel should understand how people refer to certain ailments and the various holistic remedies that are often used. 

5. Welcoming patients 

Healthcare facilities should have information or a welcome desk using the language spoken by the community that uses the facility. This may mean having an understanding of the language preferences of patients at a certain clinic or hospital and hiring staff or volunteers who speak these languages to welcome patients.  

6. Signs for directions and services 

In addition to guides who speak the language, signage should also be in any and all of the languages spoken locally. These signs can help people feel less lost and more comfortable within the hospital.  

7. Lodging near the hospital for family members 

Dr. Campos Navarro stressed that it is important for the health of patients to have family and loved ones nearby. It is more welcoming when the lodging, such as a hotel or guest house, is near the hospital, so that family and loved ones have a comfortable and convenient place to stay while their loved one is in the hospital. Dr. Campos Navarro stated this is especially important for patients from rural communities. 

8. Culturally appropriate furniture and decor 

Dr. Campos Navarro advocated that in both the hospital and in the family lodging, we should consider the different types of furniture and space that patients can use and gather with their family. For example, Dr. Campos Navarro shared a story of a hospital in Yucatan that used hammocks for patients to sleep in since this is what patients were most comfortable with at home. Having an understanding of the furniture, art and decor, and other environmental factors that make patients feel comfortable is an important part of making a welcoming hospital environment 

9. Flexible visiting schedules

Visits from loved ones—families, partners, and friends—are necessary for good health. To make it easier for loved ones to visit, visiting hours must be flexible to accommodate different working hours.  

10. Supporting parents and guardians 

Dr. Campos Navarro stated that parents and guardians should also be able to stay with any children who need to stay in the hospital. Hospitals should make accommodations for this to be easy for parents and guardians to stay in the hospital with their child to reduce the stress of these visits. 

11. Use of regional food and diets  

Dr. Campos Navarro also recommends hospital food options that include regional diets instead of forcing individuals to eat typical hospital meals that tend not to include foods eaten by many diverse ethnic groups. Dr. Campos Navarro shared that many patients feel that hospitals are “killing them of hunger” because they are not receiving food that aligns with what they would eat in their day-to-day life. In the example he gave, patients were offered bread instead of tortillas, even though tortillas were a staple of patients’ diets. Patients ended up bringing tortillas from home because that was the food they were most accustomed to. This can sometimes be in tension with hospital practices. For instance, in the example about tortillas, Dr. Campos Navarro shared that the hospital nutritionist was resistant to feeding patients 3 tortillas at a meal because they felt it was too many carbohydrates. However, patients were used to eating 10 to 12 tortillas with their meals at home, and eating them with things like chilies and other food items not offered by the hospital. Patients may be less likely to eat and to feel like they are not eating healing meals if the food they are being served does not align with their normal diet. Hospitals should consider offering foods that reflect the traditional diets of the communities that they serve.  

12. Use of medicinal plants & traditional medicine 

Many patients in Latin America are also used to using plant-based medicines, such as mint or chamomile. Dr. Campos Navarro argued that patients should have access to medicinal plants in the hospital, as well as other traditional healing practices that have been used for generations in their communities. Dr. Campos Navarro stated that such practices are learned for many patients in Latin America “from the hands of their mothers and grandmothers” and that these practices are “passed down from generation to generation and will continue to do so… Because there is that efficacy. If it wasn’t something that was [effective for good health] then it would have disappeared a long time [ago].”  
 
This would mean healthcare providers understanding the full scope of care patients may be receiving in their communities, including traditional and spiritual healers. Rather than being dismissive, healthcare providers should understand these parts of a patient’s culture as relevant to their health and healing. 

13. Intercultural childbirth care 

In every culture, childbirth comes with specific traditions. Dr. Campos Navarro explained the ways that hospitals in Latin America are responding to the needs of indigenous patients in the following ways: 

• Welcoming doulas into the delivery room 

• Letting a patient decide what position they want to deliver in, such as squatting 

• Allowing a partner or other family into the room 

• Allowing a patient to keep the placenta if requested  

• Respect for the worldview and traditions of indigenous people regarding birth 

Putting these considerations into practice in our organization would mean understanding the traditions around birth for the communities we serve and allowing space for those traditions in our processes. 

14. Spiritual support for patients 

Dr. Campos Navarro argues that facilities should provide spiritual support for a diversity of faith communities. This may include providing spiritual support for Catholics, Protestants, Mormons, etc., depending on the needs of the specific community. Chaplains, priests and other religious leaders should be available for people of a diversity of faiths, and all faiths, including those patients who are atheists or agnostic, should be respected.  

15. Community representation in hospital administration  

Dr. Campos Navarro argued that when creating the governing body of a hospital, there should be people involved from the entire community, including indigenous peoples. This ensures that hospital practices respect the regional culture. This may mean hiring hospital administrators who reflect members of local communities, and having advisory boards or ethics committees for a hospital that includes local community leaders.  

Similarly, a hospital bioethical committee with local leaders will help ensure that everything is being done within regional beliefs and that each patient is having their rights respected. 

16. Satisfaction of the hospitalized patient and also of the health personnel  

Finally, there should be a system in place to ensure patients and hospital personnel are satisfied with the care provided.  

It may be challenging to envision how we would implement some of these practices in our hospitals and clinics. These practices are rooted in the cultural context of Latin America and many of these examples come from indigenous communities in Latin America specifically. However, these recommendations reflect a broader point: we need to work to understand and connect with the communities we serve and shape our practices and facilities to better meet their needs. Mutual respect through interculturality improves health outcomes for our patients and our region.