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Reflections

This section consists of both video and written reflections. I created four reflections per week for the time in which I was studying abroad. In each reaction, I ponder a new prompt and disucss how my new found experiences are chnaging my global health perspective. 

Culture and Health Reflection 1: Pre Departure

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Reflection 1: Ask Yourself

Culture and Health Reflection 2: Importance of Cultural Competency

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Reflection 2: Global Issues and Events

Culture and Health Reflection 3: Health Behaviors and Heritage

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Reflection 3: Common Stereotypes of U.S. Citizens 

Culture and Health Reflection 4: Health Effects of Location and Heritage

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Reflection 4: Global Injustice and Disparities 

Culture and Health Reflection 5: Diversity and Health 

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Reflection 5: Positive and Negative Viewpoints of Globalization

Going into this study abroad trip, I was not sure what to expect in terms of diversity in London. However, I have been really happily surprised. I have been raised in Miami, Florida, which is known for being a cultural melting pot, and London reminds me a lot of Miami in that sense. Walking around London, I have noticed that they have many different types of cuisine from all over the world. Since Miami has a large Hispanic population, we tend to have a lot of Hispanic food option. However, London has food from all over such as India, China, France, Mexico, etc. I have also seen a lot of inclusivity in the food options. Today at the Camden Market, I saw a food vendor that served Halal food. I have seen many restaurants with meat free options. Even McDonalds has a plant based burger that has yet to exist in the United States. I have also seen many signs regarding those with dietary restrictions. For example, when we visited St. Paul’s Cathedral, they included gluten-free wafers and wine so that anyone would be able to participate in communion if they so desired. Not only have I seen a great deal of diversity within the food options, but I have also seen a large amount of diversity in the people. I have seen a lot of Muslim women wearing the hijab and burka. I have seen a lot of gender inclusivity with many shared gendered dressing rooms in clothing stores and gender neutral restrooms. I have also seen quite a few posters advocating for the rights and equality of the LGBTQ+ community around the city, such as in Borough Market. I have also seen religious representation, as I have seen both crosses and Star of David jewelry being sold in jewelry shops. In addition, I have noticed that London makes a point to try to be accessible for disabled persons, with the underground making a distinction as to which stops are wheelchair accessible and which are not. I have never seen this sort of thing in the United States. Overall, I believe that London is an incredibly diverse city. I cannot say with certainty that the same diversity can be seen throughout the rest of the United Kingdom, just like I cannot say that the diversity that exists in Miami exists in all of the United States. However, noting the different ways that diversity plays out in my daily interactions in London has been an incredibly enriching part of this Study Abroad experience thus far. 

Culture and Health Reflection 6: Global Variances in Diversity and Health 

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Reflection 6: Global Competence

Health 

Traditionally, health has been defined as solely being a measure of physical health represented by the state of one’s own physical body. However, this definition has expanded to a more  all encompassing one as society takes on more a holistic approach towards health care. Being in a state of good health means being physically healthy, mentally and emotionally well, finically stable, and overall being able to function properly in day-to-day life. I believe that in order to be healthy also means to have a good quality of life. 

Illness 

Illness refers to the presence of some sort of disease or disorder that may negatively impact the quality of life of the individual. Illness can be something physical like a cold, or something mental like depression and anxiety. Illness may be outwardly visible, but they may also be invisible to onlookers. Some illnesses can be cured while others cannot, but most can be treated in some way to improve the quality life of the affected individual often through pharmaceuticals and some type of therapy. 

Culture and Health Reflection 7: Health and Illness

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Reflection 7: Advancement of Global Awareness and Civic Engagement 

In London, I see that people appear to be much more active on a daily basis. I have noticed that in London many people chose to walk or bike as opposed to driving cars around the city. Even if they choose to take public transport such as the underground train, they will still typically have at least a small walk to get towards their destination. 

 

I have observed a large prevalence of fried foods and meat based meals. I also notice many meals are served with chips (French fries) or veg (typically peas, which come hard or mashed). I also noticed that many people will drink a pint of beer with their meals, especially at the pub. However, there are a lot of other cultural food options such as Indian and Thai. I have noticed that alternative milk options for things like coffee are free and widely available. Typically milk options like oat and soy milk cost additional in United States. In addition, there are many fake meat alternatives presumably due to the high prevalence of meat based meals in London. For example, there are plant based burgers available at McDonalds that do not exist in the United States. There are also many gluten free options, such as the communion wafers at St Paul’s Cathedral. This allows for more people to have access to nutritional meals that fit their dietary needs. 

 

Since the healthcare system in London is based on a national healthcare system, there are much more preventative care options. People, whether tax paying citizens or those visiting on holiday, can receive free or low cost hospital treatment. This increases accessibility to healthcare, which in turn encourages more people to seek professional medical attention that otherwise may not. In the United States, many see going to the hospital as a last resort option since it can be so costly. This leads to many people not seeking the care they need. 

Culture and Health Reflection 8: Examples of Health

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Reflection 8: Global Interconnectdness and Social Responsibility 

My culture as a Cuban American has instilled in me certain health practices. One major health practice that I have been raised with is vicks vapor rub. Vicks is a petroleum jelly-based menthol eucalyptus ointment that can be used as a cough suppressant. I also drink camomile tea with honey and lime if I am sick and have a sore throat. If I don’t have tea on hand, I will just drink a spoonful of honey mixed with lime juice. Growing up, my mom would make me a homemade chicken and vegetable soup or arroz con pollo to make me feel better. I also have more niche health practices, such as my cure for the hiccups in which you must drink sitting at a table, pick up a water glass, and chug all of the water without stopping while someone tightly covers your ears from behind. It sounds weird, but I promise it works Every time. The Cuban culture also has certain beliefs regarding behavioral practices. One belief is that if you go out of the house with your hair wet, that you will get sick. If you go to bed with your hair wet, you will also get sick. Another belief is that if you walk around the house without shoes on during your period, you will get sick. 

Culture and Health Reflection 9: Health Tradtions 

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Reflection 9: Global Consequences of Local Behaviors

I have observed a lot of interesting health practices in my current location in London, England. The most distinct feature I have noticed is that London has free healthcare based on the national healthcare system. I went to the emergency room at the University College London Hospital with my friend who had food poisoning. We waited at the hospital for 6 hours, but all the care she received was completely free including blood work, and EKG, insulin, two hydration IV bags, anti nausea medication, anti nausea pills to take home. This was really impressive to me because typically healthcare in the United States is very expensive. A visit like that one would have likely costed several thousand dollars. I also thought it was really interesting how the doctor was very kind and took time to ask questions about how she was feeling. He also took time to explain to us the mechanism that causes food poisoning, how it coincides with the symptoms she experienced, what medication they gave her and how it would work, and how she may be feeling following the visit. This was a really pleasant experience and felt much more comprehensive then any hospital visit I have ever experienced in the United States. Especially in the emergency room, I typically feel like the doctors are very rushed and overwhelmed with the quantity of patients that they do not give each individual as much time. However, even though the emergency room was packed with patients the doctor still took the time to explain everything to us one on one. We also witnessed that the NHS was on strike, which was very interesting to me. This is because they did not feel they are getting paid adequately. In class Dr. O explained that overall people are paid less in London, there is a smaller wage gap. This means that crucial members of the healthcare field like doctors and NHS workers are not being payed high enough wages despite being instrumental in health practices. 

Culture and Health Reflection 10: Variances in Health Practices  

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Reflection 10: Global Warming

For this reflection, I will be discussing variances in healing practices in London versus the United States. Both London and the United States have a more individualistic based approach to healing. For example, the University College of London Emergency Room only allows one person to come in with you in the hospital. This means many people come alone and do not have the support of friends or family while receiving medical care. Community can lead to a lot of opportunities for healing. Having support from your loved ones can help mentally and create a potential for more positive health outcomes. Another practice to observe is the reliance on prescription medication versus natural remedies. As I have seen in the British Museum Cradle to Grave exhibit, people in London also have a reliance on prescription medications. Both England and London have an antibiotic resistance crisis due to previous overprescribing of antibiotics. However, in the United States we also have an opioid crisis. I find that London is a bit more strict on giving out dangerous and potentially highly addictive drugs such as pain killers. You even need a prescription to get melatonin in London, whereas the United States and especially Florida is filled with pill mills and pain clinics. Although prescription medication can have potential for dangerous outcomes, they can also be extremely helpful and an important and necessary part of healing. This being said, there is also an important spiritual and emotional aspect to healing. We see this demonstrated a lot in London, where Christianity and spirituality is all over. This creates a community of support, and explains why many peoples first line of defense when something goes wrong is life to to turn to prayer. Healing does not have to be one or the other, though. The opportunity for healing can actually be much greater when both are used in tandem. This can be said for both the U.S. and London. 

Culture and Health Reflection 11: Variances in Healing Practices  

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Reflection 11:
Women's Health in Europe 

One major healing tradition that I practiced is prayer. I have always been raised in the church, seeing as my mother is very religious. This has led to me relying heavily on Christianity and faith during times of tribulation. Prayer has always been some thing that I have been taught to turn to whether I need a mental, physical, or spiritual healing. Another major healing tradition that I have is myself is yoga. I really enjoy practicing hot yoga because it challenges but my body and mind. Yoga allows me to sweat as well as strengthen my spine, core, and balance. In addition, it allows me to strengthen myself mentally and push myself physically. It allows me to be in tune with my mind, my emotions, and my spirituality. On the other hand, I also rely on medication for healing. I suffer from anxiety and depression, and I have taken Prozac to treat these conditions since high school. I also do therapy in tandem with this pharmacological treatment to heal myself. I believe that treating both your body and mind are curricula in order to experience true healing.

Culture and Health Reflection 12: Healing Traditions  

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Reflection 12: Nutrition in Europe 

Healthcare is an inalienable human right. We as humans have the right to live a happy and healthy life. If there is a treatment for a certain condition, one should we able to have affordable and attainable access to a treatment. Healthcare should be free and equal to all. The United States is actually the only nation that does not have universal healthcare, despite spending the greatest GBP in the world. In the United States, healthcare is incredibly expensive. This leads to a phenomenon in which the more money you have, the more healthy you are. This to me is extremely unethical because your health should not be tied to income level. No one should have to do without healthcare simply because they are unable to afford it. Millions of Americans are one medical emergency away from the poverty line. I was shocked to find out that  ambulance rides in London and Paris are free. In the United States, the average cost of an ambulance ride is around $1200 for an individual without insurance. I have known people that have stated they do not want to call an ambulance because they rather go in a car or Uber simply because they cannot afford the medical debt riding in an ambulance would cause. In addition to this, the United States healthcare system has a lot of systematic discriminatory behavior is embedded within the system. This leads to a lot of healthcare disparities, such as increased maternal mortality rates for black women. This is in part due to lack of accessibility, but also due to medical mistrust. You would think that a universal healthcare system would eliminate these disparities, but yet they still persist in other developed countries as well. 

Culture and Health Reflection 13: Healthcare

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Reflection 13: Differing Ways of Living & Being in the World

The United States has a privatized healthcare system, whereas London has a system called the NHS. Historically, the NHS has been run strictly by the government. However, recently the NHS has began to become privately owned as well. This is a big issue in London and has led to the NHS going on a strike. During my time in London, I was able to experience a hospital at the University College of London Emergency Room. Although we did wait 6 hours to be seen by a doctor, I did notice that the doctors were extremely kind. They took ample time to thoroughly explain everything regarding symptoms, medication, and what to expect in the following days, as well as taking the time to ask the patient a lot of questions. In the United States, I feel that the healthcare system is so overwhelmed. The doctors often only spend a minimal amount of time with patients and are primarily used to prescribe medication, whereas the primary patient interaction is with nurses. Although I have not had an experience in the hospital in Paris, I do have a peer who did go to the hospital in Paris. She said that her experience was pretty negative and was very stressful and overwhelming. She stated that she was being yelled at in French by a lot of the medical staff there and overall it was not a pleasant experience. This may be due in part to a language barrier, but I also think it is partially cultural. Paris also has a universal healthcare system. However, I have not noticed the same emphasis on health in Paris that I witnessed in London. In terms of education, the process to become to doctor in Paris and London is similar to that of in the United States. In order to become a doctor in France, one must complete 10 years of medical school and 3 years of specialty training. Similarly, the training to become a doctor in the UK can take anywhere between seven and fifteen years. In the United States, it takes can take anywhere from 10-14 years to become a doctor.

Culture and Health Reflection 14: Global Differences in Healthcare

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Reflection 14: Children's Help in Europe

Admittedly, my current knowledge of Native American, Alaskan Native, and Asian populations is somewhat limited. However, I have learned a lot more information about these cultures through my studies in this module. There are some cultural differences from American versus Native American  persons that may impact the way a provider should approach a health situation. For example, although a doctor or nurse taking notes during an appointment is relatively normally in the United States, is it seen as being very rude to take notes while someone is talking in Native American culture. Therefore, doing so would likely make the patient uncomfortable and overall give them a negative healthcare experience. In addition, there are certain health issues that are more prevalent in the Native American population. For example, the use of inhalants have a low prevalence in the general  population, but has a very high prevalence by Native American youth living on reservations. 

 

The largest native tribe in Alaska are known as the Eskimos. However, the Inuit Circumpolar Council prefers the term "Inuit" as Eskimo is slowly fading from popularity and is instead often perceived as being a derogatory term. Similarly to Native Americans, Alaskan natives share believe that living in total harmony with nature leads to good health and that illness can be caused by a disharmony with nature and evil spirits. 

 

Asian populations include many different types of cultures and populations, such as Japanese, Chinese, and Indian persons. Asian teachings often surround philosophies such as Buddhism, Confucianism, and Taoism. However, there are different teachings and philosophies in each Asian culture. Chinese Americans, for example, often use holistic healing practices for ailments such as moxibustion, cupping, acupuncture, and herbal teas. In the United States, Asian persons 

often form close knit communities to avoid discrimination such as China Town. This is especially true during times such as Covid in which discrimination against Asian Americans was rampant. 

Culture and Health Reflection 15: Population

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Reflection 15: Social Responsibility

During my study abroad experience, I have made a few observations regarding Native American, Alaskan Native, and Asian populations. It is difficult to identify who belongs to native populations without stereotyping and making assumptions regarding the nationalities of other people. However, I have more easily been able to take notice of the differences in Asian populations. Asian populations include many different types of cultures and populations, such as Japanese, Chinese, and Indian persons. In London, I visited China Town. I thought it was pretty interesting how essentially every major city contains a China Town, not just the one in New York City that we typically think of. This demonstrates how Chinese persons 

often form close knit communities where they are able to be surrounded by likeminded people from their same culture and maintain their cultural traditions. These little pockets of a cultural community exist for many different nationalities, such as Little Hati and Little Havana in south Florida. 

 

In the United States, I feel as though Asian persons are more likely to face discrimination especially during times such as Covid in which discrimination against Asian Americans was rampant. In Europe, I see a larger sense of cultural appreciation and integration. Particularly in London, I saw a lot of Chinese, Vietnamese, Thai, and Indian restaurants. There were actually two Chinese restaurants right next to our hotel with amazing authentic Chinese food. Even at pubs in London. you are often able to order a wok dish or bao buns. I have seen some similar restaurants in Paris and I have actually been to an Indian restaurant as well as a sushi restaurant. However, I think Parisians are generally a little bit more cognizant of those who are “outsiders” especially if they do not speak French. Indian people living in Paris in particular may face discrimination from tourists since they are the often trying to sell gifts and wine/beer to tourists in the Eiffel Tower area. This may lead to some having a negative perception towards them, but ultimately this is their livelihood and tourists should not bring along their own negative cultural perceptions when coming into a new country and instead be open minded to new people and new experiences. 

Culture and Health Reflection 16: Population Similarties and Differcnes 

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Reflection 16: Thinking Globally, Acting Locally

I would say that I have a plethora of knowledge regarding black, Hispanic, and white populations, since these are the demographics that largely make up the United States.  Black persons are the second largest minority in the United States, second only to Hispanic persons. I myself am Cuban American, so I feel as though I offer a moral nuanced perspective on the Hispanic population. 63% of the Hispanic population living in the United States are Mexican. However, throughout the years, Mexican people have faced a great deal of discrimination within the United States, at times being accused by certain political figures of bringing drugs and violence into United States. This has led to a border wall between United States and Mexico being built, although many determined people are still able to find their way over to seek a better life in America. Hispanic people are often very religious, with many being Catholic. This leads to many Hispanic people relying heavily on their religion and spiritual wellness for health practices. Many Hispanic people when facing some type of ailment will rely on church and prayer, with the underlying assumption that God will help to cure your ailments. In addition, Hispanic people may be less likely to go to the doctor, or take additional medication in favor of more natural home remedies. Some Hispanic people that do not speak English may rely on their children to help translate for them at the doctors office, if the physician does not speak Spanish. In a somewhat similar vein, many Black people may have a type of distrust in the traditional healthcare system. Black people unfortunately face a lot of discrimination in the United States and there is often a type of systematic racism that creates barriers to healthcare for Black people. This may be why Black people in America have the highest rate of mortality from lung cancer and maternal mortality. White people make up the majority of the United States population. Many drug trials are based on white men as he standard subjects for a clinical trial. This means that many healthcare practices and medication dosages are more specifically tailored to this population and may not be as accurate for others. White persons in the United States often have German, Irish, English, Italian, Polish, French, or Scottish ancestry. 

Culture and Health Reflection 17: Populations

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Reflection 17: Global Issues and Events

Where I call home is Miami, Florida. I believe that Paris is very similar to Miami in that it is a hub for cultural diversity. Although I would venture to say that the majority of people in Paris belong to the white population, I have also seen many Hispanic and Black people during my time abroad in Paris. Today, approximately five percent of the French population is non-European and non-white. For example, while in Paris I went to a Cuban restaurant in the Latin Quarter. I have been to multiple dance clubs in Paris that play both Spanish and English music, depending on what section you sit in. This demonstrates that there must be a large Spanish speaking population living within Paris. Several people that have spoken to me may not speak English, but they do speak Spanish. Often times, people speak both English and Spanish in addition to French. Because Parisians can ethnically be from all over, I have also seen plenty of Black people while staying in Paris. These people may be born in France, or may have ancestry originating from Africa. Because Paris is being a cultural melting pot, there are many different people from all different races and ethnicities all coexisting together in the society.

Culture and Health Reflection 18: Population Similarities and Differences

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Reflection 18: Goodbye, Europe

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