Tewa children who have epilepsy: a health care dilemma

This paper explores the part ethnicity may play in utilization of available western health care methods by Tewa families who have a child with epilepsy. Suggestions are made for appropriate responses by non-Indian health care providers to Tewa patients with epilepsy and their families. Findings indicate that, on the surface, Tewa families behave much like other Americans generally in utilization of western health care services. However, the Tewa are extremely reluctant to discuss with non-Indian health care providers traditional healing practices that may be used simultaneously. Such reluctance is well-documented in literature on the Tewa Pueblos and is substantiated in the present research. Suggestions are made for health care providers who wish to be "culturally aware" about the appropriateness of routinely asking a patient about his or her perception of the traditional etiology of the disease. The roles of the family and the western health care system are challenged. The response of Tewa extended families to children who have epilepsy is complex and not necessarily supportive. Often considered the primary health care provider for Native Americans, the Indian Health Service is based on an acute care model and lacks the ability to serve chronically disabled American Indian children. Finally, the paper argues that epilepsy is varied enough to complicate the development of a single model of chronic illness that is appropriate for those who suffer from the disability.