Cultural differences

I was on a womens health prac recently, where my responsabilities included the ward round (maternity), seeing the occasional ante-natal outpatient and running ante-natal education and post natal exercise classes.
I was not uncommon on the ward for women to have perineal tears and or haemhorroids which required ultra sound. This was one of the treatment techniques that I used on many women, most of whom did not seem too phased by the procedure. Most were happy with a quick education on what it is, it's benefits as well as the procedure. I found that most women did not seem too uncomfortable with this treatment and once they'd had the first treatment, they realised what relief it gave them and began asking for it as we came round!!
I came across on woman however, who was a bit different. She was a very young indian woman who only one year ago had come here from India to meet the man her parents had arranged for her to marry. There had been plenty of women of other cultures who i had treated with the ultrasound - most from Sudan. They needed more information and education and I had to be very mindful of making sure i maintained their decency at all times and made sure doors were closed etc. This Indian woman was different as I do not think she was used to a hospital environment like this one she was in. I know this because I lived for six years in the same town as her in India and I've seen the hospital facilities myself - not too crash hot!!
I made this connection not too long into my first meeting with her. Her mother, who had come all the way from home was with her as well as her husband. She had a large tear to her perineum which was extremely tender and required ultra sound. The aim of seeing her that day was to see if she would accept a treatment.
Even as I entered the room with her family there, she seemed uneasy. I sensed this quite quickly and asked if her husband wouldn't mind stepping out while i spoke to her. She asked if her mother could stay in the room as she was the one who was caring for her and the baby. I told her all about the ultrasound and why it would help. she blatantly refused and said she'd be fine, so I then offered her other advice.
The next day, her pain had not subsided - she was unable to sit, and had a lot of pain with walking and going to the toilet. I could sence she wanted me to do something more but she'd used the ice packs and all the advice i gave. The only thing left was the ultrasound.
I sat down and chatted to her about India and her life here. She relaxed a lot and told me how she's so homesick. That she wants to go back. She doesn't like it here and she didn't want to get married in the first place but it was good for her future as her husband was well off. I felt quite sad for this woman and her situation and tried to be as empathetic as i could. Once we'd chatted, i told her again about the ultra sound. I explained it would not hurt, that she could stop the treatment at any time and ask any questions she wanted. She agreed to the treatment - finally!
She was extremely shy I knew, so I made sure the door was shut, sign up. I also asked my supervisor to be close by incase she did not want me to treat her for some reason. I maintained her decency and dignity the whole way through the treatment. I also talked to her and explained what i was doing while the treatment was going on.
At the end of the treatment she felt a lot better. The next day, she was quite eager to have some more ultrasound as it had allowed her a better sleep etc.
Having a patient who is a bit out of the ordinary highlighted to me our cultural differences and how we have to be respectful, mindful and adapting to their beliefs, customs and cultural differences. It was a very valuable lesson for me and I think all of us as Australia is such a multicultural society and as physio's we need to be able to communicate effectively to people from all over the world.