W6: Analyzing the Hmong Experience

In order to understand Lia Lee’s medical story, one must first understand the culture in which she came from and was a part of along with the history of the Hmong peoples. Lia was a part of the Hmong culture, which is a group of people from Laos in southeast Asia (mjcanth, 2013). The Hmong originally came to America as refugees because of the Vietnamese War. The CIA decided to recruit the Hmong to fight in a proxy war during the Vietnamese War to keep communist forces from succeeding. In the end, the consequences of the war were devastating for the Hmong. Thousands were killed and those that survived became refugees in other countries, including the United States (Thompson). This history is how the Lee family came to America. Once they arrived, many were very unsure of the new lifestyle they had to adjust to. They had to learn a new language, cultural practices, beliefs, customs, get a job, and all the other facets that come with living in American culture. However, the Hmong did not choose this for themselves and thus, were reluctant to let their traditional practices go (micanth, 2013). This is extremely important to remember in the case of Lia Lee because their traditional practices are contradictory to the western medical practices. The Hmong have many and specific rituals and cultural practices that are essential to their way of life but they do not align with healthcare in the United States. This posed a problem for the Lee family because they wanted to heal their daughter using their own remedies, but western medication and the American society forced them to use western forms of treatment. Not only this, but the Hmong were wary of trusting the doctors not only because of their unfamiliarity with western medication, but because of their traumatic history during the Vietnamese War. The Hmong were thrown into the war without warning, which completely disrupted their way of life and then eventually became helpless refugees. Coming to America was the last thing they wanted or needed and thus, there was bound to be mistrust in virtually everything they were learning.

After learning about this week’s materials, my only personal recommendation for improving the healthcare experience in America for refugees would be to have more cultural understanding. I believe more doctors should be like Dr. Fife who mostly complied with the Hmong wishes. Although many of his peers in the profession believed him to be a lesser doctor than they, Dr. Fife was most favored by Hmong patients because he did not steamroll their beliefs and ways of life with what he believed to be best. He took their input into consideration and in the end, it ended up being best for him and his patients (Gabriel, 2016). If more doctors could take a more anthropological approach when treating refugees and others of different cultural background, I believe treatment would be vastly more successful and less stressful for both doctor and patient.

Sources:

Gabriel, Cynthia, “The Spirit Catches You and You Fall Down.” Presentation for the course ANP 370: Culture, Health, and Illness, online, 2016.

mjcanth. SH Complete. Video, 58:03. February 2, 2013. https://www.youtube.com/watch?v=5LnvuMyUvfI

Thompson, Scott. “The Hmong People’s Involvement in the Vietnam War.” Synonym: The Classroom. Accessed August 7, 2016. http://classroom.synonym.com/hmong-peoples-involvement-vietnam-war-23261.html

5 thoughts on “W6: Analyzing the Hmong Experience

  1. Hi Grace,
    I really liked your post and I liked how you started off about understanding her culture. I think that is a great point to make in general. In order to medically treat and understand people their culture needs to be more understood. Most doctors rely on charts, which contain sole medical history- broken leg at 5, asthma etc. – What needs to be included is about their actual life. Having a doctor that knows the person more than the patient would make people more comfortable. Which is extremely important, especially when considering refugees and immigrants who are so much more than uncomfortable. A dilemma faced in America (and really everywhere in the world) is that those allowed to practice medicine in that country/region studied medicine in that culture. I.e. American Doctors studied western Medicine Hmong Healers studied Hmong culture. Which in just causes a biased approach towards how they will each practice. But we can not have the entire medical practice of America shift to a more ‘healer’ approach instead I agree with you, we need to have our physicians understand anthropology a little more. (which is actually why I am minoring in Anthropology). It is also why the MCAT(the admissions test for med school) now has a social science section, people are starting to understand it needs to be more about the people. Overall I really enjoyed reading what you wrote. Thank you

  2. Hi Grace! I agree with your comment that the Lee family had an entirely new life, essentially a new world even, to adjust to. They were used to farming things like poppy opium and rice, however, that is not a common trade in the United States. In order to survive in our country, they needed money. However, I recall reading that in their culture, they had no money – their currency was their stock of opium seeds. In order to obtain money, they needed to find a job. But, in order to find a job they needed to at least speak English and ideally be literate. However, the Hmong people were not typically even literate in their own language! Also, they did not have a use for college degrees in their mountainous Laos farming communities. In America, however, a college degree is more often than not an essential in obtaining a substantial career. Although the United States was their refuge from their dangerous war-stricken country, these families faced many hardships when coming to America and I feel that it is important to recognize that! That strikes me as very sad because, as you pointed out, coming to the United States was not something the Hmong families were actively seeking; in fact, most would have preferred staying in their own villages. Instead, they had no choice but to move here and adjust to a totally different way of life.

  3. Great job with your response this week Grace! I had very similar thoughts/opinions as you did. I think that American doctors could be more understanding when it comes to the Hmong culture. In the example you gave where a doctor was working with his patients long term I think that is an excellent time for a doctor to go the extra mile for his patients and understand what would help them. However, in the Lee’s case, Lia was in a terrible condition upon arrival at the hospital. The ambulance brought her in; she had been having seizures for an extended period of time that were threatening her life. In this high pressure, fast passed environment it is very difficult to take the time to incorporate the special cultural beliefs of each patient that comes in. A doctor and all supporting medical staff will do all they can to help a patient to the best of their ability, but it may not be the way a patient is used to being treated.
    There is a fine balance between respecting cultural beliefs when it comes to health care and neglecting the improvements of modern medicine. I do respect the cultural views that other people have, as we discussed earlier in the course.

  4. Hi Grace,
    I completely agree with you about the need for doctors who work with patients from different cultures to be more flexible like Dr. Fife. What I find amazing about Dr. Fife is that despite all of the criticism he receives and all of the people who question how professional he is, he continues to accommodate the Hmong people without question. It would be interesting to see how Lia and especially her family would have reacted to the medicine Lia was given if she would have had Dr. Fife instead of the other doctors she had. I wonder how Dr. Fife would have handled the situation and if he would have allowed her family to practice the Hmong rituals with more flexibility than the other doctors? I find Lia’s case and all of the pain her family had to endure to be heartbreaking. I hope that this novel helps other doctors and students to better understand the need to be more understanding and patient with people of other cultures and to listen to their concerns. With that being said, I also think that there is a lesson for everyone to learn, even those outside of medical professions. We should all be more accommodating and understanding of people from different backgrounds, especially immigrants and refugees. I’m sure if we had just moved to a foreign country where everything is different than we’d ever known, we would want to be treated with respect and understanding, so we should do the same.

  5. Hi Grace,

    You did an excellent job summarizing the history of the Hmong people and their involvement in the proxy war, their interaction with the United States government (CIA) and the consequences of said actions. As you said, many of the Hmong refugees who ended up here in the States simply ended up here. They didn’t necessarily decide for themselves that they wanted to move to Merced, or wherever they happened to be placed, but instead had little to no say in the matter. They had to choose the best course of action from what limited options were available to them. Upon reaching the United States, they quickly found themselves seen and treated as outcasts and “backwards”. They could no longer perform many of their traditional practices they were so fond of due to social and legal backlash. I, too, wrote about Dr. Fife and his encounters with the Hmong refugees. While it may seem like such a simple solution (to treat each other with respect and understanding), for many people it is easier said than done. I found it strange that someone who was so universally respected by the Hmong would be looked down upon by his “peers”. As I said in my post this week, medical knowledge is only one aspect of practicing medicine. It’s too bad that many healthcare providers in our country are so narrow-minded because more could be done to help the disenfranchised peoples here in the States and around the world.

    Thanks,
    Cory

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