Case Study

Case Study: Mrs. Mehmet

Mrs. Mehmet, from Kulu in Turkey, has recently come to Sweden where her husband has

secured a well-paid job. After several visits to her house by a health visitor Mrs. Mehmet has

been persuaded to take her children to a 'well child clinic'. The doctor, dressed in jeans and a T-

shirt, wel-comes Mrs. Mehmet by shaking her hand and asking, 'How are you?' Because the

translator feels that it is unnecessary to translate this common greeting, the doctor gets no reply

from Mrs. Mehmet and proceeds to examine her 6-year-old son, Yusuf. The young boy, cautious

of the doctor, is encouraged by his mother to comply with the translated requests. While Yusuf is

being examined Mrs. Mehmet tends to her 9-month-old baby girl, Gulay, wrapped tightly in a

large blanket, and resting on her lap.

The doctor asks Mrs. Mehmet various questions about her son's health and she replies to them by

addressing her answers to the translator. The doctor asks, 'How is his health?' and Mrs. Mehmet

replies 'Good?' 'Does he eat well?' asks the doctor, and Mrs. Mehmet replies, 'Not so well; it

would be good to get some medicine so that he can eat better.' 'Does he sleep well?' 'Yes, fine.'

The doctor shines a small torch into Yusuf's ears and nose. He then examines his throat, using a

spatula to hold down his tongue. He looks at his back and runs his hands down the boy's legs,

grimacing to himself. Finally, he lowers Yusuf's underpants to inspect his genitals.

The doctor sits down behind his desk and starts to write out a referral slip. As he writes, he

appears to speak to his pen, and says ‘Basically your son is in good health, but I would like to

refer him to a specialist in Stockholm for a second opinion about his legs which appear a little

bent to me.’

'OK let's have a look at your baby then,' says the doctor as he gets up from behind his desk and

moves towards Mrs. Mehmet and Gulay. However, Mrs. Mehmet hesitates, appears anxious and

tells the transla-tor that she is just here for Yusuf. The translator tells Mrs. Mehmet that since she

has brought both children to the clinic she must let the doctor examine both. Uncomfortably,

Mrs. Mehmet allows the doctor slowly to unwrap her baby, revealing a tiny skeletal motionless

body. The doctor cups Gulay's fragile head in his big hands, examines Gulay's neck and ears, and

tests various reflexes, while rapidly firing off questions to the translator. The mother says that

her Gulay has always been that way and that she nurses the baby herself. The doctor, beginning

to appear frus-trated, asks 'Why haven't you taken her to a doctor before now?'

Mrs. Mehmet starts to wrap the blankets around Gulay again, explain-ing to the translator that

there is little point in taking her daughter to doctors because they would not understand what is

wrong with her. Meanwhile the doctor, suspecting chronic diarrhea and fluid loss as well as an

upper respiratory infection, and fearing meningitis, announces, 'This baby needs immediate

hospitalization!' He explains to Mrs. Mehmet that she must take her baby to the hospital today

and that he will tele-phone the hospital so that they know to expect her. He draws out a rough

map of how she can get to the hospital from the clinic and recommends that she goes right away.

Mrs. Mehmet smiles gratefully and thanks the doctor as she gets up and leaves his office with

Yusuf close by her side. They go straight home. They do not go to the hospital as instructed by

the doctor.

QUESTIONS

1. What type of teams would be helpful in this scenario?

2. How do you address this as hospital administrator?

3. Present your solutions.