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Two successful examples of intercultural mediation in the health sector

Migration can no longer be regarded as a passing phenomenon, but is a structural trend that needs to be managed in a knowledgeable manner. Migrants might face several difficulties in accessing and using public health-care services. This article discusses two example projects that have improved health care access of migrants, and disseminates solutions and good practices.

Description ‘Tree of Health’

The first project was carried out in Italy in an area with a high number of migrants, and was called the ‘Tree of Health’. After a successful project period, it has become a structural inter-institutional organisation, linking health-care authorities, the public, doctors, social and health-care staff, teachers and students for discussion of and training in health care matters.

An important notion is that a person’s perception on his or her health status is culturally determined, as is the range of treatment options that person is acquainted with. This can lead to misunderstandings with grave consequences, which makes a cultural and linguistic mediation service indispensable.

Lessons learned

It was concluded that staff members should in this light be trained in several aspects:

  • One or more foreign language(s);
  • Legislation in relation to heath care rights of migrants;
  • Management of multicultural relations;
  • Transparency in public communication.

Description ‘Mediation in Belgian Hospitals’

In Belgium, it was not the existing staff that received training, but through the Intercultural Mediation Programme an intermediary was put at the disposal of ethnic minority patients. The aims of the ICM programme are to improve access and the quality of health care delivered to ethnic minority patients at the hospital, and also to improve communication and responsiveness to the socio-cultural and health-care needs of ethnic minority patients.

An Intercultural Mediator usually shares the cultural background of the patient, and works from a relationship of trust. He or she commonly takes on the tasks of interpretation, cultural decoding, accompanying patients to a doctor, listening and advising, conflict resolution, and defending the right of a patient. Especially newcomers benefit from the services of an ICM, as they tend to lack connections in the new society. The deployment of ICMs in Belgian hospitals has lead to an increase in the quality of care, improved communication, and contributed to the provision of culturally sensitive care.

Lessons learned

However, the pressure ICMs might experience as a result of difficult patient-doctor relations, though problems with time management and the burden of administrative work needs to be paid attention to.

Publication Date

December 2009

Type of Document

Practice document


18 Nov 2010

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