Dr. Mohamed Hassan greeted 11-month-old
Salman Husen after an appointment with Salman’s mother at the University
of Minnesota Medical Center.
Minneapolis Star Tribune
Tuesday, April 10, 201
Area doctors work to bridge cultural suspicion of medical care, particularly life-saving transplants.
The young Somali patient had received attentive, proper treatment and
had "a very good shot'' at surviving her case of hepatitis, according to
the doctor who saw her last year at the University of
Minnesota-Fairview Medical Center.
But when she was offered a new liver, despite the best efforts of a
Somali interpreter, her family had too many questions that couldn't be
Less than three weeks after refusing an organ transplant, the 32-year-old woman died.
Nearly 700 Minnesotans have died for want of liver transplants in the
last 15 years. But Dr. Mohamed Hassan, the physician who treated the
young woman, thinks she needn't have been one of them.
Although her medical records suggest that "noncompliance" was an
issue, Hassan said the real problem was a much broader gulf of trust and
understanding that has kept many Somali immigrants from donating and
Hassan, a native of Somalia and now a gastroenterologist at the U,
keeps the memory of the young woman with him as he works to bridge a
troubling gap between Minnesota's large East African community and a
medical community that is trying to serve it better.
In the 20 years since Somali refugees began arriving in Minnesota
from their war-torn homeland, many have adapted quickly to the U.S.
medical system, state health officials say. Having left a part of the
world where infectious diseases can still be endemic, many are familiar
with measles or polio and seek out vaccinations and other forms of
But many others remain wary.
Organ donation may be the most dramatic example. Many Somalis believe
that having a donor logo on their driver's license would make them the
subjects of medical experimentation. Some believe it keeps doctors from
trying their best to save patients so they can harvest their organs.
Others cite religious beliefs about respecting and preserving the bodies
of the deceased.
Hassan, a member of the Minority Affairs Committee at United Network
for Organ Sharing, the nation's main organ transplant organization,
analyzed organ donor data from Minnesota driver's license records. He
found that among Minnesotans identified as black, the percentage of
potential organ donors who chose to do so decreased by more than half
after Somalis started arriving.
Dr. Abdirahman Mohamed, chief of staff at Axis Medical Center in
Minneapolis, has spoken on radio shows and participated in family
consultations to try and confront the misconceptions.
"I tell them there is a verse in the Qur'an that says if you give a life, it's like giving life to all humankind," he said.
Jabarti Warsame juggled his two daughters and infant son on his lap
in an examination room at the Liver and Transplant Clinic at the U one
morning last week. His wife, a hepatitis B carrier, was there to see
Hassan for a routine check-up. He and the children were there for
"A family should always stand together," the 30-year-old college student said.
But he said that same logic is keeping some young Somalis from doing
something he wishes more of them could do. He wanted to register as an
organ and tissue donor. But the suggestion caused such a stir in his
family, he decided against it.
To bridge the cultural gap, a series of outreach efforts have been
organized in the Somali community, including a recent public meeting at
the Brian Coyle Center in the Cedar-Riverside neighborhood of
Hassan said people have sought his medical opinion to the point of
knocking on his door at home and calling his personal cellphone.
Said Mohamed: "Even if a competent American doctor tells them something, they still need to hear it from me."
Diib Yusuf heard many doctors and nurses enter and exit her room
during a five-day hospital stay at the U. She heard monitors and carts,
explanations and assessments. But no matter how hard she listened, she
didn't hear anything that could make sense of her bloody vomit and
Then she heard something familiar. Hassan entered her room and spoke
with her in her language. He explained her condition and treatment in a
way she could understand it.
Now, the mother of four drives 30 minutes each way every month for an appointment with him.
When Hassan first arrived in Minnesota in 2005, he didn't see any Somali patients in clinic. Today he sees one or two every day.
As of 2009, there were only 14 Somali-born doctors in Minnesota -- about one to every 2,800 Somali immigrants.
Despite the serious nature of his work, a deep-throated chuckle
follows Hassan everywhere he goes. On a Sunday afternoon in late March,
it followed him to the Cedar-Riverside area, home to one of the largest
communities of Somali immigrants in North America. There, Mayo Clinic
and pharmaceutical company Gilead Sciences brought together Somali and
non-Somali doctors and researchers to educate community members about
hepatitis and liver disease.
Community members flooded the small conference room with questions and concerns in both English and Somali.
That day, Hassan played many roles -- a speaker, an interpreter, an
educator. And then, when a man with a bright, henna-dyed beard and a
cane approached him, he became a counselor, too. He listened as the
elder carefully explained his condition and concerns in Somali. Then,
just before being called to return to the front of the room to speak,
Hassan tore a corner from a program, jotted down the man's name and a
phone number, and quietly slipped it into his pocket.
Amanda Bankston is a University of Minnesota student on assignment for the Star Tribune.