Our dilemma: the self-marginal people

Cultural diversity is nowadays a common phenomenon in most developed countries. Its impact is felt in daily life, as well as in health care settings. Hospital del Mar, due to its geographical location, receives some of the 34.7% of immigrants from a varied cultural background. Endeavours are made to promote cultural awareness among staff and to facilitate communication. However, a Spanish Gypsy group, albeit not immigrants, are by large the problematic cultural group. A questionnaire study was conducted to validate the difficulty in treating these Gypsies versus migrant patients. The questionnaire was distributed to different health care professionals in the hospital. The result is not surprising. The problems encountered with the migrant patients are mainly due to language barrier. Concerning these Gypsies who speak fluent Spanish, the problems are by far more extensive. These are often generated by their abiding cultural values, distinctive lifestyle, low educational level and rejection of the shared norms of the majority. Any attempt to encourage adherence to hospital rules are often futile as a result of the gypsies' negative attitudes. Staff have expressed occasional feelings of weariness when dealing with such situations.