W6: Communication Across Cultures to Improve Refugee Health

During the Vietnam war, the CIA recruited Hmong individuals to help the United States fight the war against the people of North Vietnam (Marcum, 2012).  After the fall of Saigon in 1975, Hmong “were persecute and many were killed”, they were forced to leave their homes and continue on the move until they were able to find refugee camps that would take them (Marcum, 2012).  This persecution followed a new leader coming to power in Laos, and was the result of the Hmong involvement in the fight against communism during the war (Hmong Culture, 1999-2011).  After staying in a very over crowded refugee camp in Thailand for multiple years, countries such as the United States began to allow a certain number of refugees into the country.  Lia Lee’s parents were among the first Hmong to settle in Merced, California, and Lia was the first American born daughter to the Lee family (Marcum, 2012).

This political history greatly helps to increase understanding of the experiences that Lia Lee’s family had with the biomedical healthcare system in the United States.  As a whole, the Hmong people have endured brutal wars along with “persecution and pressures to assimilate” (Taylor, 2003 citing Fadiman, 1997).  Their response to this pressure and not being accepted was one of two things: fight or flee to a new place in order to get away from this hostility (Taylor, 2003 citing Fadiman, 1997).  Both of these responses were in an effort to preserve not only their lives but their culture.  These pressures and many instances of persecution have only made the Hmong people become more steadfast and dedicated to their beliefs and religion.  This dedication can be seen when the Lee’s did not do exactly what the western medical staff from the hospital said, but instead sought out the help of a shaman and faithfully carried out their cultural practices to help their daughter to get better (Fadiman, 1997).  The Lee’s did not flee, they stayed in their new residence and fought to use their cultural practices instead of bending to the will of western medicine.

One recommendation I think that might improve healthcare experiences for refugees who arrive in the United States after living in refugee camps would be having translators present during medical interactions.  That way both sides can be clearly understood by the other.  Breaking down the communication barrier between the refugee patients and the United States doctors would help integrate the aspects of the refugee’s culture and the culture of western medicine into a more cohesive and functioning method of improving the health of the individual, instead of these two different cultures working against each other even though they hope to achieve the same goal.  As Lia’s sister states in her review of Fadiman’s book, understanding the differences in cultures is paramount so that they can work together in a cohesive and effective manner instead of assigning blame to “each other for not cooperating with one another” (Review by “A Customer”, 1997).


Hmong People. “Hmong Culture.” Accessed August 10, 2016. http://www.hmongculture.net/hmong-people

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