Important Facts

• Location: Central America, between Columbia and Costa Rica.
• Capital: Panama City
• Population: Approximately 3,360,000
• President since 2009: Ricardo Martinelli
• Nationalities/ Ethnicities: 70% of the population in Panama includes Spanish- speaking mestizos, or individuals of mixed European and Indian descent.  Individuals of West- Indian and colonial slave descent (13%), White (10%), and Indian (8%) descent make up the rest of the population.  

• Official Language: Spanish
• Panamanian Dialect of Spanish
• English is a common second language, mostly spoken by businessmen or professionals.
• First generation immigrants to America continue to speak Spanish; in subsequent generations, English has become the main language for Panamanian Americans.
• Climate: Tropical with a dry season from January-April and wet season from April-December.
• Currency: U.S. currency, referred to as dolares.  Panama mints its own centavo coins which are the same size, shape and value as U.S. coins; these are used interchangeably.  The balboa, although an official currency of Panama, is no longer used.  
• Main Religion: Roman Catholicism; Other Religions: Protestantism, Judaism, Santeria (Roman Catholicism with West African beliefs) and Islam. 
• Panama’s constitution allows for freedom of religion.
• Largest Population of Panamanians in the U.S.: Brooklyn, NY. 
• Population of Panamanians in the NYC area: Approximately 28,600

Panama City, Panama

 Common Misconceptions

• Lack of knowledge about Panamanian culture tends to lead to misconceptions, such as a belief that Panamanians are simply part of South American culture.
• In the U.S., separate statistics for South Americans and Central Americans were not determined until the 1960s. 
• Belief that Panamanians are lazy
• This belief may have evolved from the fact that many Panamanian Americans have suffered from high levels of poverty, leading Panamanian teenagers to drop out of schools to assist their families.
• Second and subsequent generation Panamanians have begun to place more emphasis on college and vocational programs; Panamanians have therefore seen significant occupational growth.
• Belief that Panama is a third- world country
• This belief most likely evolved due to the extremely low costs of living.
• Panama is, however, the most technologically advanced of all of Latin America.

Cultural Pride

• Panamanians show pride in their homeland and in fellow Panamanians, often greeting each other as “paisanos”, meaning friend or pal. 
• The Panama Canal is a large source of Panamanian pride
• Attracts many tourists to Panama
• Allows many Panamanians and to earn revenue from the Canal rather than as subsistence farmers.
• Due to the Panama Canal, Panama City is considered the “hub of the Americas” acting as a conduit between the east, west, north and south.
• Panamanians have made significant contributions in music through the advent of Spanish Reggae.  Panamanians are also proud of noteworthy contributions made in sports and film industries. 

Panamanian Pride in Panama City

Traditional Beliefs about Health, Illness and Disability

• Rather than using physicians, some Panamanians go to priests or folk practitioners including “curanderos”, or healers who treat illnesses that are not caused by witchcraft. 
• “Curanderos” prescribe over the counter medications.
• Panamanians often use herbal teas to maintain health and treat illnesses.
• When ill, many Panamanians stay away from spicy and high fat foods.
• Panamanians tend to believe in the theory that keeping dry and warm can prevent health problems. 
• In the event of illness or disability, strong family units act as a support system. 

Health System, Illness and Disability in Panama

• To help deal with a large number of disabled individuals, The Center for the Rehabilitation of Handicapped Persons and the Panamanian Institute for Special Training were established in 1990. 
• However, Panama is not “wheelchair friendly” and accommodations for people with physical disabilities are not found in Panama.
• In Panama, one can get public care, which allows free hospitalization for working Panamanians through the “Caja de Seguro Social”, or Social Security System.  One can also opt for private care, which is of higher quality but still costly.
• Private insurance is available in Panama, and at a lower cost than health insurance in the U.S. Many Panamanian doctors have been trained in the U.S.; many Panamanian hospitals are therefore comparable to those found in the U.S., Canada and Europe.
• Johns Hopkins-affiliated Punta Pacifica Hospital is the most advanced hospital in Latin America.
• Lower costs are due to the lower cost of malpractice insurance

Cays Zapatillas: two islands located off the coast of Bocas del Toros, Panama

Cultural Practices that Health Professionals Should Understand

                Please note that the following information applies to many Panamanians, but may not be seen in every            

                individual.

• When treating Spanish speaking Panamanians, a Spanish- speaking therapist or interpreter is required.
• Health professionals should understand that while Panamanians are quite friendly, especially with family members or friends, they are often formal or distant with strangers. 
• Panamanians generally place less importance on their value of time and therefore may have a tendency to arrive late. Late arrival to appointments should be understood as a cultural difference and dealt with as such.
• Panamanians have a belief in “personalismo”, or in interpersonal trust.
• Panamanians show high levels of trust to their extended families and tend to most value their roles as family members.  When individualizing treatment plans for Panamanians, therapists should recognize the importance of this role.
• Healthcare professionals should be aware that due to this belief, Panamanians often distrust organizations. 
• Health professionals should take care to note that Panamanians show high sensitivity to praise and insult. 
• Panamanians are most comfortable communicating with others when at a distance of a full arm’s length.
• When greeting others, Panamanian men and women shake hands, often touching on the arms or elbows.  Healthcare professionals should therefore greet Panamanian clients with a handshake.
• Professionals should be aware that a handshake’s firmness does not have significance to Panamanians. 
• Often, friends and acquaintances will kiss as a gesture of greeting.
• Belief in “machismo”, where men are expected to be dominant and in control, while women are expected to be dutiful and submissive.
• Panamanian men may therefore show less desire to show up to therapy or for healthcare, as they believe they are in control.  They may also show less desire to listen to a female professional than to a male professional.
• Some Panamanians do not believe in nursing homes for the elderly, as they feel the elderly should be treated with respect and kept at home up until the day they die.  If a nursing home is the only option, explain when visiting can be done and provide other specifications.  
• Be aware that some Panamanians may not be accustomed to follow- up care, including any kind of therapy.  Take extra care to explain the purpose of therapy before proceeding so as not to make them feel as though you are violating their privacy.  
• As many Panamanians are used to free healthcare when they need it, Panamanians may find it rude to be discharged from a hospital simply due to insurance policies.  Explanations regarding insurance would therefore be appropriate.
• Healthcare professionals should take caution to be non- judgmental regarding Panamanian theories, folk practitioners, priests and use of herbal teas as a method to prevent and cure illnesses.   
• Health professionals should take care to recognize Panamanians as their own culture, be wary of misconceptions, understand Panamanian beliefs and recognize that Panamanians are under- represented in healthcare.

The sun sets at the end of another beautiful Panamanian day.

Cultural Foods
CARIMAÑOLA

A fried roll made from ground and boiled Yucca

and filled with chopped meat and boiled eggs.

EMPANADAS

A pastry made from flour or corn that is 

filled with meat, chicken or cheese.

PATACONES

A fried plantain. 

TAJADAS

A plantain baked with cinnamon.

TAMALES

Spiced boiled ground corn stuffed with

pork or chicken and wrapped in a

banana leaf.

TORTILLAS

Made from ground corn and fried.