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Amanda Robinson is a frequent patient on HCMC's fifth floor, where she gets treated for a lifelong illness. That means she is quite familiar with the daily routines and the nurses who feel like family.

So she was surprised recently when a nurse offered her new hair-care products, including shampoo, conditioner, leave-in conditioner and detangler that were appropriate for her textured hair, which she wears in locks.

"I've been going to this hospital most of my life, and I've never seen these products here," she said. "It just shows that someone's talking, and someone might be listening."

Patients across Minnesota have been sharing similar experiences recently, as a handful of hospitals have begun to offer culturally appropriate hair- and skin-care products, including head caps and hijabs.

And though it's not known how widespread the practice has become, Minnesota hospitals seem to be at the forefront of such efforts. As recently as 2019, an attempt by researchers from the University of Iowa to study the availability of culturally appropriate products in hospitals found that they weren't available on a wide-scale basis anywhere in the country.

"They love the products," said Tshilanda Nyembwe, a nurse in HCMC's internal medicine department. "They are begging us not to stop because we are giving them what they use at home, and they're happy. … We were taking care of their diagnosis with medication and physical therapy and occupational therapy, but we just missed the little thing that made the difference."

As hospitals increasingly recognize the need for culturally competent health care to improve outcomes and reduce racial disparities, many have adopted Diversity, Equity and Inclusion initiatives to address obvious shortcomings such as language barriers and the lack of diverse staffing.

Now, some hospitals are discovering that seemingly smaller practices can also have a big impact. "Hospitals are uncomfortable places," said Dr. Nneka Sederstrom, chief health equity officer at Hennepin Healthcare, which runs HCMC. "You don't feel like yourself; you feel scared and nervous and vulnerable. And it's the little things that make you feel safe and whole. We have not been allowing that sense of normalcy to be part of the experience for Black and brown patients."

Several Minnesota hospitals decided to change their practices after a patient asked for a product that the hospital didn't provide, and someone — often a nurse — decided to do something about it.

At HCMC, for example, a nurse who works on the hospital's fifth floor was lunching with her colleagues when she mentioned a patient's request for certain hair products. The nurse brought some of her own products from home, and soon the floor had a basket of products to offer patients.

Separately, Sederstrom's team started providing gift baskets to Black and brown birthing moms. Sederstrom met Tianna Thompson, owner and founder of Twin Cities-based The Human Of Color Haircare, and Alicia Thomas of Butter Luv Aromatics, at a craft fair and asked if they could make smaller sizes of their products for maternity patients.

Meanwhile, Susan Walters, a supply chain manager at Hennepin Healthcare, had been looking into a hospital-wide switch of products.

"It got me thinking, what do we have for personal care products for people of color?" she said. "I explored our catalog of supplies that we use and I found a wide-tooth comb. That's it. For people of color, we had a wide-tooth comb."

The hospital now offers 14 different, culturally appropriate products, from olive oil shampoo and conditioner to satin sleep caps.

Hennepin Healthcare's move has had ripple effects. When it made the switch, Allina followed suit, she said, since the buyers often collaborate and use the same distributor.

The Mayo Clinic's efforts to offer culturally appropriate products also started with patients. Dr. Saranya Wyles, a dermatologist, said that when a nurse noticed that many patients didn't have suitable products, the nurse alerted the Mayo Employee Resource Groups, which advocates for advancing diversity and inclusion efforts. When the group interviewed patients, they found that some in long-term care had cut their hair because they didn't have access to the right products.

Last year, Mayo revamped its lineup of skin- and hair-care products and added education outreach for providers.

Similarly, Children's Minnesota responded after a family expressed concern that their child's hair hadn't been cared for properly. The hospital also wanted to find a way to accommodate those who wear hijabs and headscarves. (To prevent self-harm, staff take away scarves from patients who check in for emergency mental health care.)

Children's now offers various personal care products, plus hijabs and head caps that meet the hospital's requirements.

Feedback so far has been resoundingly positive, the hospitals say.

At HCMC, shortly after the hospital began offering the products to new moms, the company that conducts Hennepin Healthcare's patient satisfaction surveys contacted the hospital: There had been a notable leap in patient satisfaction among Black maternal patients. What had they done differently?

"We were like, wait, what?" Sederstrom said. "The only thing we did was give them a chance to know that we see you, and give them things to help them feel normal."

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This story comes to you from Sahan Journal, a nonprofit newsroom dedicated to covering Minnesota's immigrants and communities of color. Sign up for a free newsletter to receive Sahan's stories in your inbox.