Combining Culture and Care: South Asian Women’s Health Talk’s approach to advocacy

Uday Chhina

Two BC family physicians are using community dialogue and multilingual resources to uplift South Asian women’s health.

Cultural stigmas surrounding health often perpetuate harmful ideas and limit individuals from seeking out the care they need, creating unnecessary gaps in our healthcare system. The South Asian Women’s Health Talk (SAWHT) initiative, led by co-founders Dr. Navjit Kaur Phulka and Dr. Japneet Gill, is bridging the gap for South Asian communities in British Columbia and Alberta, through educational programs offered both in-person and online. As family physicians, Phulka and Gill are motivated to advocate for South Asian women and normalize the health issues they experience. 

In an interview with the CMSP, Phulka and Gill discussed the origin of their initiative, with the seeds for SAWHT being planted during their clinical experiences as medical students. Gill noted the uncertainty of providers when approaching certain topics with South Asian women in addition to cultural and language barriers, as significant factors leading to impaired communication. Phulka recalled a specific patient encounter that spurred her to push for change.

“We had a female patient come in, and the provider was a South Asian male. She had never received a pap test, mainly because she was misinformed. She thought there would be a lot of pain and bleeding, and she didn’t realize why we were doing it… I felt there was a lack of knowledge since nobody sat down with her to have this conversation… We discussed the importance of getting your pap tests completed every three years, and that the South Asian physician in the clinic doesn’t have to be the one to perform it.”

Established in January 2023, SAWHT operates information booths at Sikh religious temples known as Gurdwaras, which are an excellent hub for connecting with the South Asian community. Both Sikh and non-Sikh individuals are welcome to attend, partake in worship, and access free meals at the Langar hall, the community kitchen. SAWHT provides brochures from local organizations, like BC Cancer and HealthLink BC, while clarifying any questions or misconceptions individuals may have. Many South Asian women are often juggling multiple jobs, caring for their children, and managing their household. Due to the fast–paced nature of their lives, Gill claims that having a physical information source that individuals can refer to at any moment is practical. 

“When they are coming to the Gurdwara, they are on the go and don’t necessarily have time to sit and listen to a full presentation. Having these handouts is a great way to provide them with important information, so that they can go to their family doctor and have further conversations.”

SAWHT members attend the health fair at Guru Nanak Sikh Gurdwara in Surrey-Delta.

Language was identified as a key barrier by Gill, and SAWHT addresses it in multiple ways. Both Phulka and Gill are bilingual, allowing them to communicate with individuals in Punjabi and Hindi at in-person events. Online, they post short blurbs about common diseases such as polycystic ovarian syndrome (PCOS) and perinatal anxiety disorders in Punjabi, Hindi and Farsi, significantly improving accessibility for individuals who are more comfortable with their native languages. 

Gill acknowledged the nuance of the language barrier, highlighting that it is not just the availability of translations, but also the style of language used for educational materials that poses a challenge for community members. 

“Even when I showed a few family members the translations that were available, they had a hard time understanding them because the language was very formal. We try to raise awareness by using language that’s not as formal as what some organizations have posted online.” 

Gill discussed how discomfort when approaching sensitive conversations about menstrual periods and pregnancy also forces women to use discrete terms and not directly address their concerns. 

“Women’s health topics are not really talked about in our community… No one is comfortable saying ‘Oh, I got my period.”

Despite their initial uncertainty about discussing these topics in settings like the Gurdwara, Gill and Phulka were both pleasantly surprised by the overwhelmingly positive community response. 

Often, women would visit the booths and inquire about conditions like anemia or depression, prompting the SAWHT team to craft new resources on these topics. Engaging in these two-way exchanges with visitors was crucial for building trust and meeting the exact needs of their community members.

A misconception that Phulka noted to be common within the community was the belief that screening tests like pap smears and mammograms are painful, making women reluctant to complete these procedures. SAWHT dissolved this notion effectively by partnering with Papapalooza BC, which provides cervical cancer screening free of charge to any patient without a family doctor. By translating the advertisement for these free testing opportunities to Punjabi, Hindi, and Farsi, the importance of screening and its harmless nature was conveyed to the South Asian patient population.

The SAWHT and Papapalooza teams at the City Centre Obstetrics & Gynecology clinic in Surrey BC.

Phulka also recalls the productive conversations they had with men at the Gurdwara, even if they were not the target audience for the conditions discussed. 

“We would have our Punjabi sign that says ‘This is women’s health information’, but [the men] were so curious as to what we were doing, and then they would go home to share that info with their wives and daughters.”

SAWHT’s charitable work has not gone unnoticed, earning them both local and national recognition, with the “Doctors of BC – Excellence in Health Promotion” and “CFMS-CPAMD Humanitarian” awards, respectively. The CFMS award included a grant worth a minimum of $5,000, which will be used to fund healthcare workshops with allied health professionals and help the team access more printed resources for distribution. Additionally, youth in Alberta took note of the initiative, which led to the development of both Calgary and Edmonton SAWHT chapters.

Phulka (left) and Gill (right) receive the CFMS-CPAMD Humanitarian Award at the Canadian Medical Student Conference in Halifax, Nova Scotia.

In the foreseeable future, Gill and Phulka are focused on supporting expansion into Alberta. Phulka also expressed interest in educating the South Asian community around common brain diseases like Alzheimer’s disease and strokes, and destigmatizing mental health.

“I find that the brain is often overlooked because we’re so focused on the heart, the bones, or the joints. So it is an area we also hope to tap into”. 

Gill and Phulka hold their Sikh roots close, with the tradition of Sevā, or selfless service, informing their approach to both SAWHT and their family medicine practice. 

“For me personally, Sevā comes in all forms. Growing up, it was going to the Gurdwara and doing Sevā.” Reflecting on her medical career, Gill continued. “My dad always told me, ‘You’re becoming a doctor in your community, and your duty is to take the education you have and pay it forward.’ That is what Sevā is: being able to use what I have the privilege of learning and repaying the community that I grew up in.”

Phulka described how spending her youth at the Gurdwara and working in the community helped her derive satisfaction from volunteering. 

“It’s right in the name—selfless service… If you go into it with the mindset that you are trying to help the community, even if it’s just one individual, the satisfaction you feel is much greater than any monetary prize you could receive… It’s very refreshing, and nothing beats that.”

To learn more about SAWHT, visit their website.