The Medical Practices Of The Hmong

Being a Hmong-American in the United States was hard. Growing up in a community that was full of Americans, and being in a private school in my early years, (consisting mostly of Americans and little diversity) was difficult. In that kind of environment, I never saw each person differently. The characteristics that I saw were our skin color, and another distinction that I saw was our religious and cultural backgrounds. I started to lose touch of my own culture and identity as a Hmong-American girl. My family told me that in the stages of my toddler years, I used to be good at speaking my native tongue until I started school.

In Hmong’s, they have their own traditional beliefs in which they hardly ever alter due to a different atmosphere. Some of the Hmong beliefs are they prefer traditional medicine, are culturally active, host ritual ceremonies, and are spirituality influenced. In the book The Spirit Catches You and You Fall Down, refers to the Hmong culture and their beliefs on medicine while their baby Lia Lee, is suffering from epilepsy in which they have a hard decision. Traditional Hmong’s have their own medicinal beliefs which they obey prior to obtaining Western medicine. The gulf between Western medicine and Hmong health beliefs is an impossible abyss. Also, The Spirit Catches You and You Fall Down describes the life of Hmong refugees assimilating to

“She had never said it was love. Neither had he. They were shy. They had been unsure. Now, there would be no time for love. It was in the moment of parting that she knew she loved him” (21).

While the language barrier became very obvious to them as the Hmong language has very long descriptions for even the simplest words, the cultural barrier lead to a cultural bias in regards of western medicine. Hmong patients expected to be released of the ER with any kind of medicine they wouldn’t need. In addition to that the Hmong had a negative attitude towards surgery or any other invasive treatments, as it was frowned upon in their culture. One aspect that made it even harder was that pregnant Hmong women preferred to stay at home till the really last moment, so that often Hmong children were born in the parking lot or the elevator. They distrusted the western medicine so much that they preferred not getting better by gratefully accepting the medicine and diagnosis to save their pride and dignity. Just as history showed, they would rather die than give up their pride.

Though American Indians are enjoying an independent public health system with above $3 billion funds provided by Congress annually for delivering healthcare services to them, still figure and facts on health status of American Indians reveal that they are facing many difficulties and have to suffer from diverse type of illness and disease at a misappropriate level. Since long it was identified by medical communities that there are wide spread diseases diabetes, alcoholism, tuberculosis, suicide, unintentional injuries, and other health conditions among American Indian and they are dying of these diseases at shocking rates (American Heart Association [AHA], 2010). Through this essay I want to discuss the healthcare status of American Indians in the perspective of their culture as how it impacted and lead to develop mistrust between amongst the medical community and American Indians.

“Between the ages of eight months and four and a half years, Lia Lee was admitted to MCMC seventeen times and made more than a hundred outpatient visits to the emergency room and to the pediatric clinic at the Family Practice Center.” The Lee family was a regular visitor at the hospital but it did not make thing between the Lee family and the hospital any easier. There was many issues between Lia’s family and the Merced hospital staff. Many of these issues steamed from many different areas of things. Between the Lee’s a Hmong family and the American doctors at Merced Hospital there were several cultural differences on what both parties wanted. Cultural difference was not the only thing they did not see eye to eye on there was also a huge language barrier between the Lee family and the workers at Merced hospital.

Many years ago, an epileptic Hmong girl named Lia Lee entered a permanent vegetative state due to cross-cultural misunderstanding between her parents and her doctors. An author named Anne Fadiman documented this case and tried to untangle what exactly went wrong with the situation. Two key players in her narrative were Neil Ernst and Peggy Philp, the main doctors on Lia’s case. As Fadiman describes, “Neil and Peggy liked the Hmong, too, but they did not love them… [W]henever a patient crossed the compliance line, thus sabotaging their ability to be optimally effective doctors, cultural diversity ceased being a delicious spice and became a disagreeable obstacle.” (Fadiman 265) At first glance, this statement seems to implicate Neil and Peggy as morally blameworthy for a failure to be culturally sensitive enough. However, upon further inspection of the rest of the book, it becomes clear that Neil and Peggy’s failure to be more culturally sensitive to their Hmong patients was caused by structural issues in the American biomedical system. To prove this point, this paper will first present a background to Lia’s case, then discuss possibilities for assigning blame to Neil and Peggy, then show evidence for the structural issues in American biomedicine, before finally concluding.

The Native American culture is the original culture of the United States. Members of Native American tribes live throughout the country. “There are an estimated 4.9 million persons, in 565 federally recognized tribes who are classified as American Indian or Alaska Native (AI/AI), alone or in combination with one or more other designated racial classifications. This demographic group compromises 1.6% of the U.S. population” (Horowitz, 2012). Wisconsin is home to the Ho-Chunk (Winnebago), Ojibwa (Chippewa), and the Potawatomi tribes (“American”, 2014). It is important for nurses within this state, as well as any other state, to understand the Native American belief system in order to provide a quality healthcare experience. Nurses are the primary point of contact in the healthcare setting. Client advocacy is one of the nurse’s major roles. Therefore, the nurse should have the highest level of diversity understanding for the cultures within the local region.

In this essay the writer will discuss the colonisation of Australia, and the effects that dispossession had on indigenous communities. It will define health, comparing the difference between indigenous and non- indigenous health. It will point out the benefits and criticism of the Biomedical and sociological models of health, and state why it is important in healthcare to be culturally competent with Transcultural theory. The case study of Rodney will be analyzed to distinguish which models of health were applied to Rodney’s care, and if transcultural theory was present when health care workers were dealing with Rodney’s treatment plan.

At birth, the Hmong view their newborns as a gift and extremely special. At birth, it is called “Mus Thawj thiab, “go become again” or more simple, “reincarnation,” is a traditional Hmong belief (Bankston 2000). When a child is born, they are automatically seen as a gift and reborn as a reincarnated soul. Though, if a child dies after three days of living there are “no funeral ceremonies…since the child did not have a soul yet” (Bankston 2000). The Hmong believe if the child lives past three days, their soul is present though if they die, the infant never had a soul to begin with. If the child lives past day three, then a shaman is brought in and he “evokes a soul to be be reincarnated in the baby’s body” (Bankston 2000). This is considered

“In the Spirit Catches You and You Fall Down”, Anne Fadiman explores the subject of cross cultural misunderstanding. This she effectively portrays using Lia, a Hmong, her medical history, the misunderstandings created by obstacles of communication, the religious background, the battle with modernized medical science and cultural anachronisms. Handling an epileptic child, in a strange land in a manner very unlike the shamanistic animism they were accustomed to, generated many problems for her parents. The author dwells on the radically different cultures to highlight the necessity for medical communities to have an understanding of the immigrants when treating them.

Health promotion can be looked out differently within each ethnic group and can most definitely influence how one manages his/her own health. Within the AI/AN population, a lot of home remedies passed down from generation to generation exist, so seeking out traditional medicine isn’t really a main source of healing. The American Indian/Alaska Native resident may have a holistic view in which people community, nature and spirituality are interconnected and interrelated. This perspective views physical, spiritual, mental and emotional health in unity, instead of indiscrete categories. Sickness may be viewed as a result of disharmony between the

The Hmong are a group of people who originally lived in the mountains overlooking Laos, China, Vietnam, and Thailand-- though most have since emigrated to other countries and areas due to political conflict. They have valued self-sufficiency and resisted authority throughout history, as they have constantly been the minority and often seen as the Other and persecuted for being such. Still, many have managed to survive and preserve much of their culture, such as religious beliefs and shamanic healing practices.

"Native American medicine is based on widely held beliefs about healthy living, the repercussions of disease-producing behavior, and the spiritual principles that restore balance." -Ken "Bear Hawk" Cohen (Chrisman 1).

YANG, Kao Kalia. The latehomecomer : a Hmong family memoir. 1st eds. Minneapolis: Coffee House Press, Coffee House Press, 2008, 277pp. (ISBN