Books: Migration, Illness & Healthcare

Migrant health has never been more relevant. In 2016 an unprecedented 65.6 million people were forcibly displaced worldwide.¹ Providing equitable care presents enormous challenges, from the politics of healthcare policy to the nuances of cross-cultural consultations in daily practice.

Altschuler’s new book is a timely and fascinating exploration of these issues and much more. She does not shy away from writing about the diversity of migrant experiences: from professional economic migrants choosing to work for the NHS, to how survivors of torture may struggle to trust clinicians in positions of power.

Working as an inner-city GP I recognise many of the patients and the situations. In one chapter Altschuler describes cultural dissonance between first-and second-generation migrants, and how this impacts on health and wellbeing. In another chapter the differences in the cultural constructions of illness and death are examined. She reminds us that Western concepts often fail to understand the ‘spiritual’ dimension of wellbeing. An example given is a study showing that Hindu women undergoing treatment for cervical cancer had a better psychological recovery if they believed the cancer was caused by God’s will rather than linking it to their own bodily weakness or mental stress.

As healthcare professionals we are challenged to reflect on our own cultural beliefs and values, and on how these influence our ability to communicate with patients and provide sensitive care. Altschuler tackles politically thorny issues including restrictive healthcare policy and the barriers faced by vulnerable patient groups trying to access care.

The real appeal of this book lies in the narrative, into which Altschuler artfully weaves case studies, contemporary research, and her own personal experiences of migration. She is an adept storyteller and writer, and her expertise as a family psychotherapist is evident throughout, providing a compelling and accessible analysis of the topic.

This book is an invaluable resource for GPs, healthcare professionals, and readers interested in healthcare policy or the wider issues related to migration and health. It not only gives practical recommendations, but also raises questions about how as individuals and as a society we can provide more equitable health care.

• © British Journal of General Practice 2017