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Part 1 of the 6 webinar series: Essential Clinical Issues in Migration Health

DATE RECORDED: March 19, 2014
PRESENTED BY:  Deliana Garcia, MA, International Research and Development, Migrant Clinicians Network

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**Note: Due to technical difficulities the first 7 minutes of the presentation are not recorded. Please refer to the pdf of the slides for the content that was covered in those 7 minutes.

Over the last 30 years, considerable attention has been paid in the clinical setting to cultural competency- the ability to mitigate against the effects of the sociocultural differences between clinicians and patients and to take into account how culture affects the symptoms presented or the patients’ attitude about health care.  More recently, scholars and clinicians have encouraged those in practice or health professions training to focus not only on the behaviors and beliefs of cultural groups but more importantly to consider the structural determinants, prejudices, injustices and blind spots, the “pathologies of social systems” that affect health outcomes and the stigma experienced by patients. The session will introduce participants to the broad framework of structural competency and the five core structural competencies.

Learning Objectives:

  1. Identify the structures that shape clinical interactions;
  2. Discuss the means of developing an extra-clinical language of structure;
  3. Rearticulate “cultural” formulations in structural terms;
  4. Explain the process of observing and imagining structural interventions; and
  5. Describe the concept of structural humility.



Farmer, Paul, Bruce Nizeye, Sara Stulac, Salmaan Keshavjee. 2006. Structural Violence and Clinical Medicine. PLoS Medicine 2006 (3): 1686-1691.

Holmes, Seth, Fresh Fruit Broken Bodies, 2013

Messac, Luke, Dan Ciccarone, Jeffrey Draine, Philippe Bourgois. 2013. The good-enough science-and-politics of anthropological collaboration with evidence-based clinical research: Four ethnographic case studies. Social Science & Medicine 99 (2013): 176-186

Quesada, James, Laurie Kain Hart, & Philippe Bourgois. 2011. Structural Vulnerability and Health: Latino Migrant Laborers in the United States. Medical Anthropology, Vol. 30, No. 4: 339- 362

Srivastava, Ranjana. Complicated Lives—Taking the Social History. New England Journal of Medicine 2011 (365): 587-589.

Willen, Sarah. 2012. How is Health-Related “Deservingness” Reckoned? Perspectives from Unauthorized Im/migrants in Tel Aviv. Social Science & Medicine 74 (2012): 812-821.

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Families Talking Together (FTT) is an evidence based program designed to help Latino parents better communicate with their children and teens about healthy relationships, sex, contraceptive use, and preventing pregnancy.  Dr. Vincent Guilamo-Ramos, the creator of the program and co-director of the Center for Latino Adolescent and Family Health at New York University’s Silver School of Social work, along with Planned Parenthood Los Angeles and Visión y Compromiso, recently enlisted 25 promotores (community health workers) from three communities in California with high rates of teen pregnancy and high percentages of Latinos in an effort to help Latino parents address teen pregnancy. Over a four-day period, the 25 promotores were trained to deliver the FTT intervention.  In the next two months, the promotores will deliver the intervention to 250 families in California.  The National Campaign wishes to recognize and thank Dr. Guilamo-Ramos, PPLA, and Visión y Compromiso for their work on this innovative and important project. 

The FTT intervention—both the community health worker curriculum and parent materials---are available online, free of charge.  

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This webinar is the sixth in a series of seven in our Clinician Orienatation to Migration Health.

DATE RECORDED: Wednesday, July 17, 2013
PRESENTED BY: Candace Kugel, FNP, CNM, Specialist in Clinical Systems & Women's Health and Melissa Bailey, Executive Director of North Carolina Field, Inc.

To view the recorded version of this webinar, click here.

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This webinar is the third in a series of seven in our Clinician Orienatation to Migration Health.

DATE RECORDED: Wednesday, April 17, 2013
PRESENTED BY: Edward Zuroweste, MD, Chief Medical Officer, Migrant Clinicians Network

To view the recorded version of this webinar, click here.

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This webinar is the second in a series of seven in our Clinician Orientation to Migration Health.

DATE RECORDED: Wednesday, March 13, 2013
PRESENTED BY: Jennie McLaurin, MD, MPH, Specialist in Child and Migrant Health, Migrant Clinicians Network

To view the recorded version of this webinar, click here.

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Good article on cultural humility--basically the groundbreaking one used to propose the term

Journal of Health Care for the Poor and Underserved; May 1998; 9, 2; Research Library
Melanie Tervalon; Jann Murray-Garcia 

This site holds many medical Spanish material, including a comprehensive medical Spanish dictionary, complete with audio.

This website offers some free online lessons which teach basic Spanish concepts. More detailed and advanced lessons can be purchased on CDs from the website.
The goal of this project is to create awareness about less common languages. This website offers a database of less commonly taught language classes, instructional materials, and other resources for teaching these languages. There are some resources for Zapoteco, Nahuatl, and Mayan indigenous languages.
The town of Greenfield, CA has a high population of indigenous immigrants from Oaxaca, Mexico, many of whom speak little Spanish and/or English. This website is a compilation of work done by students from the UC,Berkeley Graduate School of Journalism and reports on what the town of Greenfield is doing to improve communications and relations with these indigenous peoples

FIOB has a good presentation that they use to teach the general community about indigenous cultures. This PowerPoint could be used to teach staff about indigenous languages.

M E J Personal Business Services, Inc. is an interpreting, translation, and financial service based in New York City.  They provide Foreign Language Interpreting, Telephone interpreting, video remote Interpreting, and Financial and Translation Services.  Their website specifies that they provide document translations in Mixteco.  

General information or a free quote:  866-557-5336

The MICOP is an organization of English,Spanish,and indigenous language speakers who are working to aid Oaxacan immigrants in Ventura County California.They mostly provide direct services.The“Necessities of Life” program distributes clothing, diapers, blankets, and other items to those in need.The organization also has programs which provide food, resources for medical care,education and literacy classes for adults, and weekly community meetings.Contact info:325 W. ChannelIslands Blvd. Oxnard, California 93033805) 385-8662

The CDI is an organization that was created in 2003 to ensure that indigenous communities and people in Mexico have the rights guaranteed to them by the Mexican Constitution. It collaborates with state governments and federal dependencies to evaluate current strategies and works to form new programs that will ensure equality and fight against indigenous discrimination. It also works to help indigenous peoples to improve their quality of life. Their website includes a number of resources on indigenous areas of Mexico including news stories (some of which are written in an indigenous language), music, and research information on the indigenous populations. There is also a section of basic information on the indigenous languages of Mexico.

Radio Bilingüe is a Spanish language network on public radio.  Although it is mostly California based, there are affiliate stations in Carrboro, Asheville, and Greenville, North Carolina.  There is also a radio program broadcast in Mixteco called La Hora Mixteca.


Contact: Filemón López, Coordinator of La Hora Mixteca

(559) 455-5784

The Oaxacan Indigenous Binational Front (FIOB) is a non-profit organization based in California. It is a coalition of indigenous organizations, communities, and individuals from Oaxaca, Baja California and in the State of California. This organization works to empower the indigenous peoples of Oaxaca and make sure that human rights are upheld for these communities in both Mexico and the United States.

The Language Materials Project works to provide a variety of materials, such as dictionaries, phrasebooks,grammars, and cultural materials.Currently, thewebsite only provides materials in one indigenous language (Nahuatl), but the project continually updates the language profiles, so additional languages may be added at a later date.
Rosetta Stone is a software company which markets a variety of language learning software.This company also has an Endangered Languages Division, which creates software to preserve less prevalent languages. The company currently does not have any software available in theIndigenous Languages of Latin America but is possibly interested in developing software with ECMHSP and its parents who speak indigenous languages.Contact Marion

This faith-based organization works to document and study lesser-known languages.  It has developed a number of materials, ranging from dictionaries to literature sources, in a wide variety of languages. 

The Native Literacy Center in Oaxaca, Mexico was founded by a group of professionals and native educators from Oaxaca to support literacy projects for indigenous peoples.  This center is involved with preservation, helping indigenous peoples to write their languages, print and publish individual works, write their histories, and record their knowledge for future generations.  People come from Central and South America to this Center, where they learn how to produce their own works.  The center also works with education, teaching indigenous peoples how to write their languages so that they are able to produce their own works. 

This digital archive features a number of recordings and texts in the indigenous languages of Latin America. Materials are available in Mixteco, Mam, Nahuatl, Otomi, Triqui, Zapoteco, and many other indigenous languages. These materials give information about the cultures of these indigenous groups. Original works of literature in indigenous languages are also published on this site. AILLA works to preserve written forms of these languages, but it also collects grammars, dictionaries, ethnographies, and research notes that can be used as teaching materials. Most of the archive is free and available to the public.

  1.  Online dicitionary in a variety of languages available under the "Foreign Language Aides for Latin America and Iberia" section, including Mixteco, Nahuatl, and Zapoteco.
  2.  Mixtec-Spanish Online Dictionary                 
  3.  Mixtec dictionary created by the SIL:
  4.  Mam-Spanish Dictionary


This website, owned by SIL International, provides detailed background information about less common languages.  Many of the indigenous languages have profiles. 

Note: Wikipedia also contains a variety of sites describing the basic characteristics of each of the indigenous languages. 

Western NC Workers Center:  Located in Morganton, North Carolina, the Western NC Workers Center is a non-profit group of community organizers.  This organization currently has a number of outreach and education projects which work to uphold the rights of immigrant and low wage employees in Western North Carolina.  They also work with high levels of Guatemalan immigrants who speak indigenous languages.  One of their projects designed to reach indigenous language speakers is their Promotora Education project, which uses scenario picture books without words to educate low literacy populations about health and work safety. 


Francisco Risso                                                                                                                (828) 432-5080                                                                                                   

Mayan Ministries:  Organized through the Diocese of Palm Beach in Florida, Maya Ministries works to address the needs of Mayan immigrants to the area.  These Mayan workers speak up to 25 different dialects of Mayan indigenous languages, but most can speak Spanish as well.  The organization’s main services are literacy programs for families, adult education programs, and early childhood education programs for children who have English as a second language.  They also offer a variety of social services referrals and translating specifically for Mayan immigrants.  They have a Literacy Program funded by the Department of Education that was written in the Mayan indigenous language Canjobal. 


Contact Information:

1615 Lake Ave.
P.O. Box 209 
Lake Worth, Fl 33460-0209

General information:

This site, sponsored by the Office of Minority Health (OMH), offers the latest resources and tools to promote cultural competency in health care. You may access free online courses accredited for continuing education credit as well as supplementary tools to help you and your organization promote respectful, understandable, and effective care to your increasingly diverse patients.
Barnga is a staff simulation activity that emphasizes the power of subtle differences in culture as they effect communication.
Module Two of MCN's educational offering "Adolescent Farmworkers at Risk" focuses on cultural competency in practice. Earn continuing education creditswhile learning more about this important topic.