Interview – Talking health in cross-cultural spaces with Win Yee Tan

This piece is the third in be:longing‘s cross-cultural health series, which aims to explore health and health-related topics in cross-cultural contexts.  Today, we bring you an interview with Win Yee Tan in Sydney, Australia.

Win Yee was born in Malaysia to Chinese parents, and has lived in Australia for more than half of her life.  She is grateful for the opportunity to learn intimately from all the cultures she is a part of, and is always eager to have insight into the many societies around the world.

Win Yee has worked in a number of health delivery programs across Australia. Her recent roles have involved managing population health programs at a regional level, promoting hepatitis B awareness in Chinese and Korean communities in New South Wales, and producing online content for ABC Health and Wellbeing.

belonging - win yee tan - m kass
Image: © Moustafa El-Kass, 2017

Could you give us an overview of the Hepatitis B Community Education Project?
The Hepatitis B Community Education Project was a federally-funded project I was involved in that ran from 2016-2018.  The project aimed to promote awareness of hepatitis B in Sydney’s Chinese and Korean communities, because hepatitis B is especially prevalent in these populations.  The objective of the project was to increase testing, diagnosis, treatment, and vaccination in the target communities.  The project looked at achieving these objectives through a grassroots approach, which included community education campaigns and community grants.

How would this education programme reach its audience?
During the project, we decided to adopt an “arts in health” approach for one of our activities.  I worked with a local Chinese acting troupe to develop a play on hepatitis B.  Hepatitis B is a highly stigmatised condition, and a taboo topic of conversation in the Chinese community.  With this in mind, we felt that it was important for hepatitis B to be discussed in ways that were more accessible and interesting for the community.

The play “Love Your Liver”, which I co-wrote, was an educational comedy that incorporated elements from Chinese opera and poetry.  The plot concerns Liu Yun, a young Chinese woman who finds out about her hepatitis B status when she goes to the doctor for a pregnancy test.  Chaos ensues when her parents are included in the conversation, and the small family starts to navigate their way through the Australian medical system.

The play was quite successful; it was attended by a large audience, and has since been developed into a longer production.  It was also publicised by local media, and (most importantly) led to higher rates of testing in the local area!  I think the factors for success can be attributed to the following:

  • Working closely and directly with the target community (Australian-Chinese people) to develop a project that suited their needs;
  • Promoting awareness of taboo topics through entertainment; and
  • Developing a script that directly related to the lives of the target population.

Were there any barriers to delivering such a programme in a cross-cultural context?
Hepatitis B is a sexually-transmissible, blood-borne virus.  It is a highly stigmatised condition, particularly in the Chinese community, where up to 10% of the population is living with hepatitis B.

Those with hepatitis B are often viewed negatively and are regularly excluded from the Chinese community.  This is because hepatitis B is commonly misconstrued to be transmitted through saliva.  As a result, people with hepatitis B are often expected to distance themselves from friends and family.  Many people with hepatitis B dine alone, and a significant portion are expelled from school and work.

In order to promote hepatitis B awareness in the Chinese community in Sydney, it was important to fully understand the sociocultural barriers that surround this condition.  In our experience, it was helpful to advertise hepatitis B education workshops, which we delivered as part of this programme, as a “gift” to one’s family, and as a strategy to keep oneself healthy.  It was also helpful to understand and dispel myths – for example, the saliva myth was borne from a hepatitis A (not B) spike that occurred due to contaminated seafood in China in the 1980s.  By directly addressing the issue, and explaining the differences between hepatitis A and B, we were able to minimise misinformation about this in this Chinese community.

In your experience, what strategies optimise the effectiveness of communication of health and well-being topics across linguistically- and culturally-diverse communities?
We have found that grassroots approaches are the most effective for health promotion in cross-cultural contexts.  This is because the target population is usually the most experienced and knowledgeable about their own cultural values and beliefs.  Also, working with the target population provides most health communicators with the valuable relationships and connections they will require to achieve success in their programmes.

© Win Yee Tan, 2019