Cultural Mediation Service

Why at the Hospital del Mar?

The percentages of recent immigration (over the last 6-7 years) in the community of the Hospital del Mar's catchment area (some 280,000 inhabitants) are of over 38% in the Ciutat Vella district and nearly 15% in the Sant Martí district. Currently, nearly 25% of emergencies attended concern immigrants, and, little by little these people are becoming integrated into the care work circuits. Over the last few years this has led to some changes in the healthcare needs and in the outlook of the hospital itself, and has required the incorporation of new indicators in population studies. With this continuous change and change in the process of adaptation -immigration-new figures have come into play, the Intercultural Mediators. In this field the Hospital del Mar, with the help of the "Health and Family" Association is a leading body, and it is no surprise that a number of professionals from this centre have become consultants in questions concerning immigration and healthcare policy.

General context

The most important political and social debate in Catalonia in recent years has, without doubt, been that of immigration. Catalonia, like most countries in the south of Europe, has had to establish a clear institutional and social discussion regarding the progressive increase in the immigrant population in our society, and especially the circumstances that they bring with them. At the start of the 1980s, new immigrant groups began to appear in our country, such as the Moroccans, Senegalese, Colombians, Pakistanis and Guineans. These groups constitute a new reality: “transcontinental immigration” (Fernández, 1998). Unlike the immigration into Catalonia in the 1960s, these immigrants of very diverse origins (Africa, Asia, South America) are highly culturally heterogeneous, and their migratory processes are very different (for economic reasons, political asylum, refugees, family regroupings and so on).

In Barcelona city, the increase in certain groups of foreigners has been quite spectacular. The percentage of the foreign population out of the total population of Barcelona City in January 2004 was 12.8%, though in the district of Ciutat Vella it reached 36.1%. These figures increase notably if we include foreigners who are not registered as residents, but who are nevertheless attended to, both in the Primary Healthcare Centres and in the hospitals.

The Intercultural Mediator in Healthcare

The Intercultural Mediator is a new figure, who has been gradually emerging in many and varied areas around the world with varying orientations. The arrival of immigrants has generated new areas for intercultural mediation in general and specifically for the intercultural mediation in healthcare.

The participation of the professional mediator in the healthcare sector is fundamental in order to offer a comprehensive quality care service. It allows the exchange of knowledge between the newly arrived and the healthcare professionals, overcoming linguistic and cultural barriers.

The Intercultural Mediator is a person who acts as a bridge between the people concerned to explain the different cultural and social concepts of health, illness, and the health-illness-care process. They advise the healthcare professionals on cultural characteristics, as well as informing the communities about the host society's health system in order to facilitate and, if possible, guarantee, their access to healthcare services under the same conditions as the rest of the population. For this reason, it is proposed that the Mediator should have knowledge of both environments, both from a cultural and social viewpoint. The double role that he or she carries out, of advisor and information provider, means that the mediator's task is not just one of a linguistic translator but also involves accompanying and, at a given moment, conciliating between, the persons concerned, and also promoting dialogue and relations with the host community.

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