Cultural Assessment Assignment

Amran, aged 17, is a refugee from Somalia who arrived in the US 2 weeks ago. She is a Sunni Muslim and speaks both Arabic and Somali, but no English. Amran comes to the student health clinic accompanied by another female student who is acting as an interpreter. Amran is crying and holding her abdomen. Her classmates states that Amran is currently experiencing severe dysmenorrhea, menorrhagia, and some dysuria with prolonged urination. All vital signs are within normal limits. On physical examination,, Amran has mild to moderate suprapubic tenderness with no guarding or rebound. No masses are palpable. Inspection of Amran\’s external genitalia reveals significant keloid formation and a midline fusion of the labia minor, indicating infibulation, thus prohibiting a speculum or bimanual examination.

1. What other historical data should be obtained from Amran?
2. What part of Amran\’s social history is it important to know?
3. How should the rest of the genitourinary/gynecologic examination proceed? What should be assessed?
4. What, if any, laboratory tests should be obtained?
5. Why is it essential for health care providers to have an awareness and understanding of female genital cutting?
6. How does cultural relativism apply in this scenario? Does the cultural significance of the practice of female genital cutting outweigh Amran\’s rights? Why or why not?
7. Should Amran be provided with any follow-up care?

SAMPLE SOLUTION