A common theme that has been discussed regarding the adversities that immigrants experience when arriving to the America are the social and cultural clashes between immigrants and citizens. What I find interesting is the conflicts pertaining to the health care system. Based on previous lectures, immigrants tend to mistrust the American healthcare system due to difference in medical remedies and the language spoken. I know first hand that my mother would perfer to have a Ghanaian physician, as opposed to the general white American doctor. Anne Fadiman wrote a successful award-winning book called, The Spirit Catches You and You Fall Down, which highlights how the cultural differences between the Hmong culture and American medicine jeopardized the health of a little girl named Lia Lee. The story brings into light the topic of Medical anthropology, which is the study of medical systems, healing practices, and views on health from different cultures.
The book penned by Anne Fadiman, The Spirit Catches You and You Fall Down describes about cultural deviation and language barrier with respect to medical beliefs among Hmong natives who migrated to the United States. The story has exhibited the impact on conflicting cultural beliefs with reference to medical care and their interpretation towards Western medical health system (1997). This is a heartbreaking story about Hmong native couple and has a daughter named Lia who is suffering from epilepsy at an early age of 3 months old, which is regarded as a serious medical condition. Epilepsy is the fourth most common neurological disorder that affects all ages and characterized by unpredictable seizures (Epilepsy Foundation, 2014). However, in the book the disease in itself is no longer a source of urgency to Lia’s parents believe that their daughter’s soul had fled her body and become lost.
Over the progression of the book the view points and relationships between the Lees and the doctors develops slightly. The medical staff was not prepared with a translator or a cultural understanding of the Hmong and how their beliefs would not match up with their medical practices. “Not only do the Hmong fail resoundingly to improve the payer mix- more than eighty percent are on Medi-Cal- but they have proved even more costly than other indigent patients, because they generally require more time and attention, and because there are so many of them that MCMC has to hire bilingual staff members to mediate between patients and providers” (Fadiman 25). This theme in the story was immensely eye opening for all of the cultural gaps that exist throughout the United States. The solution to this problem is for both sides standing on opposite sides of the gap to take the time to bridge the gap together.
Fadiman believes Lia’s life was “ruined not by septic shock or noncompliant parents but by cross-cultural misunderstanding” (Fadiman 1997). The Lee’s were not the only ones suffering from not understanding, the doctors were struggling with it as well. A clear example is found in chapter thirteen when the doctor has her parents sign a waiver that says if they take her home she will die. In the Hmong culture this is highly offensive and they believed that telling them this would cause evil spirits to get closer to Lia’s soul. This showed readers that it was just as important that the doctors understand the Lees cultural healing so that they could’ve worked together in Lia’s illness.
It is vital for health care providers to incorporate a person’s specific cultural elements to provide patients with the same ideal care that is provided to everyone (Kodjo, 2009). For example, many cultures have gender-specific views and those in that cultural group may desire care from a health care provider that is of the same gender as they are. Thus any future appointment with the patient in the primary care setting the health care providers would need to ensure the patient’s ideals are respected and the physician of the same gender is overseeing their care (Purnell, 2008). This should never be taken personally, but rather as step in the direction of providing the patient with the paramount
The Lee’s had a difficult time trusting the doctors who were supposed to be making Lia healthier, but to the Lee’s it was as if she was only getting worse. The Lee’s were very skeptical of modern medicine and felt more comfortable with the Hmong cures. “Since Lia’s brain death, whatever scant trust Foua and Nao Kao had once had in American medicine had shrunk almost to zero … When their daughter May broker her arm, and the doctors in the MCMC emergency room told them it needed a cast, Nao Kao
For the Hmong, it is seen as deep sadness and can be healed with communal rituals and traditions, whereas in Western societies, it can involve doctors and therapy. It concerns the biomedical model because medication can be used to aid individuals in recovering from this illness, and it negatively affects one’s body as well. It is seen as a mental illness in many different places around the world, yet the Hmong never referred to it as such, and preferred to think of it without stigma instead, though they lived within Western culture. Nevertheless, the culture shock they experienced changed a lot for them, such as having their children veer off from the lives their parents had previously led before them. Becoming literate was another aspect of American life that they had to face, and they dealt with the challenge to the best of their ability.
The tragedy that is the conflict of two cultures, American medicine and Hmong culture, two goods that lead to inevitable outcomes coupled with a distinct language barrier. This book crucially recounts a poignant and touching tragedy of an immigrant child whose origin is the war torn traditional life of Laos’ mountains and now her home is the Merced town in California. Two disparate cultures essentially collide resulting from language barriers, social customs, and religious beliefs. The recount by Anne Fadiman, an editor at the American scholar, sequentially recounts the clash between the American physicians and the Hmong family and thereby revealing how such differences can have an effect on the attitude towards healing and medicine. Review
After reading Dr. Galanti 's articles about culturally competent healthcare please answer the following questions: What did you gain from reading Dr. Galanti 's article? Dr. Galanti provides insight into the relationship between cultural diversity and heath care providers. Dr. Galanti’s briefly states the difference between “stereotype and generalization”. The author recognizes that generalization may be a key factor used by workers in the health care community to bring awareness and a better understanding of cultural differences among patients. The article explains that although cultures differ in values, traditions, and beliefs, there are questions (the 4’C’s of culture) that may open up the line of communication, between provider and
Hmong see a world where everything is connected. They believe that nothing occurs in isolation. Their body, mind and spirit are all interconnected. They also view illness in this holistic approach. Hmong culture saw Lia as a type of “anointed one” and her epilepsy as a blessing rather than a weakness.
Cultural competence is very important in providing patient care. Culturally competent providers should understand and respect the patient’s beliefs, values, and behaviors, and develop a treatment or care based on the patient’s specific needs. Being a healthcare professional requires you not only to assess, diagnose, and make a treatment plan, but also take into account patient’s beliefs and perception of their health-related issues. Nowadays, there is more emphasis on educating healthcare providers to not only focus on disease and diagnosis, but also incorporate assessment of patient’s experiences, feelings and perceptions of his or her disease into a patient care. I feel that most of the younger generation healthcare providers try to explain the disease and treatment to the patient and hear what is the patient’s perspective on it to ensure that a patient is part of the healthcare team.
As I listened to the Riverbend scenario I thought of my own cultural competence and how at one time I knew very little of the Hmong culture. Working in a city where Asians make up only 3% of the population, this is a population I knew little about. I have learned that most Hmong are from the mountainous region of Laos, and are granted preferred refugee status by the U.S. (Cobb, 2010). From 2000 to 2010 the number of Hmong grew 40%, there are currently 260,073 Hmong people living primarily in California, Minnesota, and Wisconsin. Even though the Hmong people seem to be prospering after thirty years in the U.S., there are still challenges with communication, understanding of cultural beliefs, and use of traditional medical practices (United States Census Bureau, 2013)
The topic of birth is an interesting one and is explicitly found in the book, The Spirit Catches You and You Fall Down. There was a vivid difference between the Hmong traditional practices and the way Lia was born. It is to each and every ones own opinion to think and have a take on the differing birth practices. I find them to be odd, and extremely unorthodox especially in modern times however going back less than a hundred years, talking to my great grandmother, that is the way people gave birth. At home, wherever they were, they would work until the day they gave birth and the had to take the baby out themselves, wash it and cut the cord. I personally just think the times have changed. We are accustomed to sterility, to cleanliness, to all these wonderful things but don’t realize that people back then lived just as healthy if not healthier then now. It is normal, to give birth like that, and I will not deny that it is much safer and that some cases would not be
In the book “When the Spirit Catches You and You Fall Down” the Hmong trusted the shaman and other community members to heal Lia of epilepsy before they trust western doctors Epilepsy is a common neurological treatment that involved a general doctor and psychiatrist. In the novel there was a cultural clash between that of Hmong beliefs and western medicine, so much that the Hmong (Lia’s family) believed the medicine Lia was consuming was harming her soul. If Lia's doctors had took to the time to better understand why her parents wanted to limit the medication she took, they could have supported her parents efforts to seek spiritual and medical treatment while assuring the Lee's the medicine would do no harm to Lia’s soul. This is a classic example of the lack of cultural competency in psychiatric medicine that has led to the distrust of its treatments around the globe. Physicians are often so caught up in their course of treatment they forget to consider the