Is Your Website Culturally Competent?

If you have paid any attention to GHA’s newsletters and articles over the past 18 months you will have noticed one of the constant themes, if not the primary one, is highlighting strategies to enhance the patient experience across the Medical Travel Care Continuum™. A big part of enhancing is customization. Healthcare providers should seek to fine-tune or customize their policies, processes and services so that they address the unique needs of traveling patients.

Language and cultural differences often create challenges for traveling patients while they are interacting with destination healthcare providers – prior, during and after treatment. To deal with these issues, some healthcare providers offer staff language and cultural sensibility training or orientation, use interpreters, translate educational and promotional content, implement multilingual signage, and design culturally-adapted lounges so medical travelers from other regions feel at home. These are all great ways to ensure different traveling patient populations receive a care experience that is aligned with their unique needs and expectations.

But what about a hospital’s website? Should it be approached any differently? After all, this is often the first point of contact for many potential medical travelers – and first impressions matter.

Most readers would probably agree that a healthcare provider’s website content should be translated into the language or languages of its primary traveling patient populations if it is going to be truly effective. But is translating a website’s content enough or can we go further to ensure it meets the needs of patients from different countries and cultural backgrounds?

The following anecdotes will serve to clarify this question.

In 2011, a new pair of Puma trainers sneakers, released in the United Arab Emirates in celebration of the country’s upcoming 40th National Day, caused a huge uproar in the country. [1] Why the commotion? Were UAE citizens rushing into stores to buy the shoes before they went out of stock? Almost the opposite; the sneakers were red, white, black and green, the same colors as the UAE flag, and Emiratis saw the colors as a huge insult to the nation. [2] One UAE professional stated, “Puma should have borne in mind the cultural sensitivities of the people of the UAE. The flag is a very sacred symbol for the UAE. It cannot be trivialised, especially not as footwear.” [3] An Arab expatriate working in marketing and advertising summed up the general consensus, “Big brands have to realise that you cannot have one idea for the whole world. Each area you operate in has to have tailor-made solutions. Especially here in the Middle East, where cultural senstivities are key, you have to be very careful.” [4] Puma apologized and immediately removed the shoe from its stores.

Another well-known cultural gaffe occurred when Pepsi expanded to the China market using the slogan “Pepsi brings you back to life”. What they didn’t realize was that the phrase translated to “Pepsi brings your ancestors back from the grave.”[5] This certainly is not the type of first impression a company wants to make when entering a new market.  

The takeaways should be clear: just because an image or symbol is attractive in one culture does not mean it will be appropriate in another. Also, simply translating text from a source language to a target language does not ensure that a message will attain the level of cultural and technical nuance required to effectively resonate within a specific locale, and at worst, it can lead to a public relations nightmare.

Website localization

In order to project a clear and relevant message to different patient populations, consider localizing your website’s content. Website localization is the process of refining website content through culture, language and flow to provide the most useful and relevant experience for users.[6] It goes beyond simply translating the text into another language and takes into account images, symbols, color preferences and website functionality to ensure they are culturally relevant.

Take, for example, research conducted by, a company that specializes in website optimization. Comparing dentist’s websites in the United States and the Netherlands, it found that the former featured images of smiling individuals with bright white teeth while the latter had almost no such imagery. Culturally, white smiles and bleaching services do not appear to be nearly as important in the Netherlands as they are in the U.S.[7] 

The fact is our cultural background or orientation impacts the way we interpret various elements on a website such as:


Art, photographs, icons and symbols are often subjective. Designs that seem attractive to Westerners may be offensive to other cultures. Images of hands positioned using certain gestures, religious symbols and animals can be offensive in some cultures.[8]


How color is interpreted can also vary from culture to culture. In Japan, yellow traditionally signifies bravery and wealth. In Thailand, it is considered a “lucky” color and was associated with the beloved and recently deceased King Bhumibol Adulyadej. In China, on the other hand, the color yellow has negative connotations and is often associated with pornography.[9] Therefore, it is important to research colors and potential conflicts if you are not sure of cultural implications. 


People in the West usually scan a website from left to right. However, people from Arabic countries read from right to left. If this is one of you target markets, you will need to change the layout of the section that includes the Arabic translation.[10]


Instead of translating word-for-word, localization strives to ensure that the content speaks exactly the language of the target audience in tone and style. Localization also involves more than just translation. It addresses factors such as text length, local idioms, cultural references, measurement units, date formats, and page sizes.[11]

Website localization can enhance the user experience

Evidence suggests that localizing a website improves the user experience and business performance. In fact, studies have found that:

  • Website localization can have a significant impact on consumer acceptance of a website.[12]
  • Culturally customized websites are more useful and easier to browse.[13]
  • Culturally customized websites are more engaging for users ensuring they will spend more time on the website.[14]
  • Effective localization can produce a significant increase in the e-sales of a company outside its language borders.[15]

 Motionpoint, a company that specializes in online localization strategies discovered some interesting analytics after localizing a website for a hospital group. The hospital group, whose intended audience was U.S.-based, saw a surge in new visitors from international markets after localization. This traffic was larger by 50 percent compared to international visits to the English language website. Moreover, organic traffic from international visitors also increased from 25 percent to 38 percent. [16]

5 Keys to successful localization

Motionpoint goes on to list five key elements[17] for successfully localizing a website:

  1. Language and regionalisms ensure that copy, content and brand voice come through accurately and authentically—and make users feel like the site experience has been customized for them.
  2. Cultural elements of communication like date and time formats, units of measure and local holidays ensure that websites communicate an understanding of global nuances and make users feel at home on the site.
  3. Transactional elements such as currency, payment options, addresses and character sets are not only important for the local feel of the site, but for the accuracy and proper handling of transactions and on-site conversions.
  4. Local communication and trust elements such as phone numbers, local addresses, in-language customer support, legal notices and security banners may not seem mission-critical, but they’re key to engaging with local audiences. They also ensure that your in-market sales and marketing teams have the information they need to serve your customers.
  5. Navigation and discovery for your translated site is critical to helping users select the language they need, and immediately start interacting with your site in an authentic way.

Ultimately localization is a form of customization. You are adapting the elements on your website so they align with the cultural and language needs of specific patient populations, which in turn enhances the patient or prospect’s experience. But don’t stop with your website; email communications, newsletters, brochures, and social media initiatives can all be enhanced by localizing them to your specific patient populations.

[1] Colours of the UAE Flag on Puma Shoes Anger Nationals Retrieved from

[2] The United Arab Emirates Is Up In Arms Over This Pair Of Puma Sneakers. Retrieved from


[3] Colours of the UAE Flag on Puma Shoes Anger Nationals Retrieved from

[4] Ibid.

[5] 4 Cross Cultural Marketing Flops You Won’t Forget in a Hurry.

[6] What is website Localization?

[7] Cultural Differences in Websites.

[8] The Definitive Guide to Website Translation. Lionbridge. Retrieved 1/8/18

[9] What Colors Mean in Other Cultures. Huffington Post, Jan. 26, 2016. Retrieved 1/8/18

[10] How to Conduct Website Localization – Don’t Get Lost in Translation. Retrieved 1/8/18


[11] When Just Translating the Words Is Not Enough: Localization and Transcreation Explained.


[12] Cyr, D. Modeling Website Design across Cultures: Relationships to Trust, Satisfaction and E-loyalty (2005). Cited in Singh, N., Park, J., Kalliny, M. A Framework to Localize International Business to Business Web Sites (2013).


[13] Singh, N. The Definitive Guide to Website Translation. Lionbridge

[14] Ibid.

[15] Tixier, M., Globalization and localization of contents: Evolution of major internet sites across sectors of industry (2005) Cited in Singh, N., Park, J., Kalliny, M. A Framework to Localize International Business to Business Web Sites (2013).


[16] Hutchins, C. Localizing Hospital Websites for Medical Tourism (2016). Retrieved from on March 23, 2018.


[17] What is Website Localization


*Medical travel is also commonly known as medical tourism or health tourism.