By Lisa M. Belisle, MD, MPH, Medical Advisor, Raising Readers  
Originally published December 2004, Raising Readers Issue Brief

The holidays are a time to reflect on our place on this earth. They are a time to give thanks for our blessings, and show others our love. While Thanksgiving and Christmas are a perfect medium for this type of reflection, so are Diwali, ’Eid-ul-Fitr and O-misoka. These are holidays from India, the nation of Islam and Japan. This season is celebrated by people of virtually every culture. As a pediatric provider, you have the unique opportunity to interact with children of diverse backgrounds. Use this opportunity wisely and you may learn more about places beyond your dooryard. You may also improve your ability to care for your patients. 

Children are products of the home in which they are raised. They are also the product of their culture. As you may remember: 

Culture includes all of the rules for appropriate behavior which are learned by people as a result of being members of the same group or community, and also the values and beliefs which underlie overt behaviors and are themselves shared products of group membership.¹ 

A child’s background impacts her ability to enjoy good health. The U.S. Department of Health and Human Services and the U.S. Surgeon General have identified race and ethnicity as being a potential barrier to medical care.² 

Differences in language and understanding can make it difficult for some to engage in health maintenance or chronic disease management. This can be especially troubling for children, who have little control over their situations, or how their families access the medical system. 

One way to explore differences of understanding is to ask about culture during the medical interview. Celebrations can be a non-threatening ice-breaker. Some potential questions for parents and children include: 

• What holidays or traditions do you celebrate in your home? 
• What do they mean to your family? Are they from your religion or culture? 
• Which holidays are especially important for children, and why? 
• What cultural beliefs do these holidays emphasize?³ 

While these questions are by no means all-inclusive, they may lead to further discussions of culture, and its importance in your patient’s family. They may also serve to introduce you to celebrations with which you were not previously familiar. (See below, Selected Seasonal Holidays). 

Learning about other cultures is important for providers and patients alike. Children need to realize that their world is rich and diverse—filled with people who have similar needs (food, shelter, love) despite having different backgrounds. You can foster this realization by putting interesting and educational materials in your waiting room. These may include holiday decorations from different traditions, or information on local cul tural resour ces, such as museums, restaurants or performances. They may also include children’s books. 

Children’s books can provide young readers with insights and knowledge they might not otherwise have access to. Children learn through stories. They gain empathy and understanding by listening to the experiences of others. They are also fascinated by traditions. They can relate to the joy of celebrations and family togetherness. 

Not all children’s books on holidays are created equal. Some may contain antiquated views or stereotypes. Others reflect traditions that are not widely practiced within a culture.⁴ You should always preview books that you plan to place in your waiting area. It can be helpful to seek the advice of your local librarian for book suggestions. (See below, Waiting Room Books for the Holidays). 

Exploring the traditions of your patients can be a rewarding experience. You may find yourself benefiting both professionally and personally. Educating the children in your practice about different cultures can have even farther reaching implications. It can create a foundation of empathy that will allow them to understand their connectedness to other people. It also promotes love for fellow dwellers of the earth, which is the essence of the holiday season. 

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SELECTED SEASONAL HOLIDAYS  (Excerpted From Holiday Celebrations Around the World by the National Network for Child Care, February 1996.) 

Diwali (November 1): Also known as the Festival of Lights, this celebration is popular in India. It symbolizes the return of Ram—an Indian god who long ago returned from the forest after 14 years and was crowned king of Ayodhya. Some people celebrate Diwali by lighting their homes with oil lamps or electricity to welcome Lakshmi, the goddess of prosperity. Celebrants also wear colorful new clothes and eat special foods and sweets. 

’Eid-ul-Fitr (November 13): Also known as the Festival of Fast Breaking, this three-day Muslim celebration takes place at the end of a fasting period called Ramadan. Celebrants dress in holiday attire, attend special community prayers in the morning, and visit family and friends. Greeting of “Eid mubarak” or “a blessed ’Eid” are exchanged, and children are sometimes given gifts or money by their family members. 

Hanukkah (December 8): Known as the Festival of Lights, Hanukkah is a Jewish celebration that lasts eight days and symbolizes the Rededication of the Temple of Jerusalem more than 2,000 years ago. When it was time to light the Temple lamp, there was only enough oil for the lamp to burn one day, but miraculously, the oil burned for eight days. The significance of the eight days is celebrated by lighting one candle for each day of the celebration in a figure called a menorah. 

Kwanzaa (December 26-January 1): This African- American celebration is based on seven principles symbolized by candles which are placed in a candleholder called a kinara. Each night, a candle is lit and families talk about the meaning of one of the following principles: 1) umoja/unity; 2) kujichagulia/self-determination; 3) ujima/collective work and responsibility; 4) ujamaa/cooperative economics; 5) nia/purpose; 6) kuumba/creativity; and 7) imani/faith. 

O-misoka (December 31): This Japanese tradition celebrates the end of the year and longevity. Celebrants usually eat a special kind of soba (noodles) called toshikoshi- soba, reflect on the good year, and wish for long lives.

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WAITING ROOM BOOKS FOR THE HOLIDAYS

Ramadan. Written by Suhaib Hamid Ghazi. Illustrated by Omar Rayyan. Holiday House, 1996. A beautifully illustrated introduction to this Islamic holiday. 

Seven Spools of Thread: A Kwanzaa Story. Written by Angela Shelf Medearis. Illustrated by Daniel Minter.* Albert Whitman & Company, 2000. Brothers learn to cooperate and care for others. *Maine illustrator. 

Silver Packages: An Appalachian Christmas Story. Written by Cynthia Rylant. Illustrated by Chris K. Soentpiet. Orchard Books, 1997. A rural tradition impacts a young boy’s life. 

The Stone Lamp: Eight Stories of Hanukkah Through History. Written by Karen Hesse. Illustrated by Brian Pinkney. Hyperion Books, 2003. Background history and touching personal accounts. 

The Thanksgiving Door. Written and illustrated by Debby Atwell. Houghton Mifflin/Walter Lorraine Books, 2003. A delightful look at the holiday through the eyes of people who are new to the country. 

... And enjoy some holiday music:

Jewish Holiday Stories (CD) performed by Jim Weiss. Greathall Productions. An delightful alternative way of learning about Chanukah, Purim and Passover.

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REFERENCES:

¹ Saville-Troike, Muriel, A Guide to Culture in the Classroom, National Clearinghouse for Bilingual Education, 1978. http://www.ncela.gwu.edu/pubs/classics/culture/index.htm 

² U.S. Preventive Task Services Task Force, Healthy People 2010. www.healthypeople.gov 

³ Saville-Troike, A Guide to Culture in the Classroom. 

⁴ Mendoza, Jean and Reese, Debbie, Examining Multicultural Picture Books for the Early Childhood Classroom: Possibilities and Pitfalls, University of Illinois at Urbana-Champaign. http://ecrp.uiuc.edu/v3n2/mendoza.html 

Research assistance provided by Kate Bartley.