Poor Maria was ill and probably needed medical attention. But her mother's deeply ingrained cultural beliefs and notions prevented anybody from coming hear her. No amount of persuasion could get her to cooperate until one caseworker drew upon her knowledge of cultural differences and finally convinced the woman to allow her daughter to receive medical treatment. The following account is based on true story and illustrates the need for intercultural understanding. A child protective service worker had been asked by local school authorities to find out why Maria Ramirez had been out of school. The school principal had received alarming news from the school nurse sent on several occasions to look into the girl's absence that Maria's mother refused to cooperate and allow her daughter to receive the medical attention she probably needed urgently. The worker left for the Ramirez's home in the predominantly Hispanic suburb of the sprawling American city. Upon her arrival she found Maria's mother was very glad to have somebody with whom she could speak Spanish. Visibly upset about Maria's illness, she told the worker that she had resorted to several remedies well known back home to bring her daughter's fever down. But she was convinced that it was too late because evil spirits had already taken possession of Maria and were causing her to suffer. This is why she had locked her daughter in her bedroom and had put a pair of large sharp scissors, suspended at the end of a string, directly above Maria's bed (and her head). The scissors would "cut" any spirit that tried to enter the young girl's body. The alarmed worker immediately asked whether she could see the child. The reply was, No. Nobody could enter the room. They might possibly bring spirits into the bedroom. The mother calmly explained in a very matter-of-fact way that evil spirits could cling to any person. Under no circumstances would she let anybody, including the Spanish-speaking woman, into her daughter's room. The worker knew that she had to remove those dangerous scissors. But how could she persuade her mother to let her see the child, let alone remove the scissors in which the woman had so much faith? Knowing that such beliefs run deep in people's cultural patterning, the worker was facing a dilemma: how to gain access to the child's bedroom, remove the dangerous scissors, and get the mother to agree to allow a doctor to examine her daughter. The worker, although familiar with many Southern and Central American folk practices, had never heard of this remedy before, but had heard from her own grandmother of a similar practice whereby scissors were placed over the door to a sick person's room. The worker started by gaining the mother's confidence in recognizing the cultural validity of such folk healing practices. She then explained that the mother should remove the scissors from above her daughter's bed and place them over the door to her bedroom. This would prevent any evil spirit that clung to a person from entering the room. This would allow a doctor to enter the child's room with no risk of evil spirits' also entering the room. The mother agreed, saying that all she wanted was to see her daughter well again. The caseworker and a doctor were able to examine Maria and treat her and within days the child was well again.

• The text discusses the differences between the Magico-Religious, Holistic, and Biomedical approaches to medicine. Relate that info to this case.