W6: Immigrant Healthcare

Understanding the history of a culture can be helpful when it comes to understanding their choices in medicine. The Hmong are among these that their challenging political history has impacted their medical decisions. This starts with their involvement in the Vietnam War, where they worked closely with the United States military. In “Hmong History, Culture, and Acculturation: Implications for Counseling the Hmong”, Anthony Tatman states that “the involvement of the Hmong in the Vietnam War is an event that has produced significant ramifications for their mental health and family unity” (1). After the U.S. left Vietnam, the Hmong struggled greatly become the main target from the North Vietnamese and Lao Communists. Because of this, the Hmong saw no other option but to flee their country, however during their escape many of their family members would not make the journey. The ones who did make it to refugee camps faced terrible living conditions and struggled to keep their cultural traditions due to the camp set up. It can easily be seen that the Hmong do not like to take orders and can be very uncompromising.

When it comes to the United States health system, the Hmong are very cautious and feel that it will mistreat them. This is mostly due to how the Hmong perceive illness; they believe that when a spirit leaves the body that the person becomes sick or depressed. According to the film “The Split Horn”, the Hmong believe that without a shaman, the people will become sick and die. In “The Spirit Catches You and You Fall Down”, Anne Fadiman describes how different the Hmong health system is compared to the United States. A shaman could spend as many as eight hours with a sick person to heal them where in the U.S., a patient is lucky to get twenty minutes with a doctor. Also in the United States doctors quite frequently need to take blood samples and Hmong “believe that the body contains a finite amount of blood that it is unable to replenish, so repeated blood sampling, especially from small children, may be fatal” (43). The language barrier also does not help, because the Hmong often times do not know or understand what they are agreeing to and then get frustrated when the doctors perform a procedure that goes against their beliefs. These reasons have lead to a lot of mistrust throughout the Hmong culture.

As for suggestions, to help make this less of a problem would be to try to eliminate the language barrier. I think that the biggest issue is the doctor not understanding what the patients or parents of the patient want and the patients not understanding what is going on with the patient. Many hospitals are starting to get interrupters in the areas where the Hmong population is higher. I also think that both the patients and doctors need to compromise on treatment. We saw in Lia Lee’s case that both the doctors and parents were very uncompromising and the patient’s outcome was terrible. In “The Story Catches You and You Fall Down: Tragedy, Ethnography, and ‘Cultural Competence’”, Janelle Taylor states “Their unwillingness to compromise, their constitutional inability to bend before the will of another, was, for both parties, the hamartia, the tragic weakness that is the flip side of all that is admirable about them” (165). Science dominates the medical field in the United States; this is both a blessing and a curse because while we are able to cure so many diseases, we often forget about culture. The Hmong were thrown into a country where we are far more advanced than their home and being such a self-efficient culture, they have a difficult time conforming and want to preserve their culture. Forcing the Hmong to do something is never going to work, they are a very stubborn culture and trying to compromise is going to be the most effective way to provide the best care possible for them.

Tatman, Anthony W. “Hmong History, Culture, and Acculturation: Implications for Counseling the Hmong.” Journal of Multicultural Counseling and Development 32.4 (2004): 222-33. Web.

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