Meeting Chamorro women's health care needs: examining the cultural impact of mamahlao on gynaecological screening.

Peoples of Micronesia customarily seek western medical care only when needed and not typically as a preventive care. There is a subtle reluctance to resorting to available modern biomedical practices. This article discusses cultural aspects of Chamorro women's preventive health-seeking behavior. It specifically examines the effect that the Chamorro cultural value of mamahlao, or a sense of shame, has on women getting Papanicolaou (Pap) tests and other ways mamahlao dissuades modern-day Chamorro women from seeking preventive gynecological care. A purposive sample of fifteen Chamorro women living on Guam participated in this exploratory study. A semi-structured interview was administered and included questions on what mamahlao means to them, appropriate versus inappropriate reasons why women should get annual Pap tests, and the relationship between mamahlao and modesty in women. The interviews revealed women's concerns with shame, religion, and morality in their health-seeking behavior. The study suggests that for a Chamorro woman, seeking gynecological care can have negative symbolic connotations thereby for creating a sense of shame or mamahlao, in the woman.