Essay on "Hmong This Saying, Attributed to William Osler"

Essay 5 pages (1548 words) Sources: 0 Style: MLA

[EXCERPT] . . . .

Hmong

This saying, attributed to William Osler, is the preface of the book by clinical neurologist Oliver Sacks called An Anthropologist on Mars. He is also the author of the book Awakenings, and is known for becoming the translator of neurological disorders. Sacks dismisses the traditional medical/clinical way of examining disease. Instead, he enters into the lives, senses and environments of his neurological patients. Until recently, but even now, managing healthcare has been centered on financial and administrative structures to reduce costs. However, due to the growing competition in the marketplace, price alone will not make a healthcare provider successful. The new way of viewing healthcare is to recognize that disease management includes not only the ill patients, but the well ones, too. Patients are recognized as partners in their treatment, self-managers of care. This is not easy. The information that needs to be gained from the patient, the partner is not all data and measurements. It is the perceptions that the patients have about their own health.

Plus, treatment for the patient is not just pharmaceutical. It is necessary to identify and address the patients' behaviors, instruct them in self-care as an important backup to clinical efforts, as well as management lifestyle factors, such as nutrition, exercise, and cessation of cigarettes and high alcohol consumption. It is essential to obtain patient information regarding symptoms, duration, severity and treatment side effects, but just as important are the personal beliefs, behavioral and life issues that contribute to their condition. Like Sacks' view of his neurological patients, the healthcare industry is only starting to help its caregivers view their patients in new ways.

2. In recent history, the Hmong have had a very tumultuous existence. Their kingdom was first established in China with a hereditary monarchy and very structured villages and districts. Only the rulers and men could vote. When the Sun Dynasty gained control, the Hmong returned to their earlier nomadic existence in 900 AD. However, they continued to fight for their independence in different Chinese locations. In 1800, they were lured to northern Laos, because of the rich and fertile land and the hope for a free life in the secluded Loatian mountains. They established ten villages and got along with the villages in the area. Once again, however, their lives were in turmoil when France took over Laos in 1940. Some Hmong supported the French, others did not. France surrendered to the Nazis in World War II, and then in 1949, Laos become an independent country. A year later, Vang Pao, a Hmong military officer, began spying on the French. Then, a decade later, the American CIA asked Vang Pao to end Communism in Viet Nam, in return for arms, training, and food. The half million Hmong living in Laos at were organized solely by clans. Vang Pao was named a General in the Royal Lao Army in 1964, and approximately 30,000 Hmong people fought against the Vietnamese. They were paid an average of 10 cents a day, along the promise of being taken care of by the U.S. government. When the war ended and the Americans left Southeast Asia, 17,000 Hmong soldiers were killed and 5,000 Hmong civilians perished. Vang Pao was ordered by the CIA to leave Laos. The Hmong who were left were being reeducated by the communists, frequently in concentration camps. In retaliation for their support of the Americans, the communists waged chemical warfare against the Hmong, 100,000 Hmong were killed. About 100,000 Hmong fled to Thailand, and remained in refugee camps as long as a decade. When the camps were closed, a large number resettled in France, but thousands returned to Laos and were tortured. A few thousand remained in Thailand and about 170,000 came to the United States.

It is impossible to have a stable culture in circumstances such as this. When moving into other cultures, some assimilation must occur, although, at the same time, many of the traditions are continued to be held, as well. This creates a major conflict between Hmong leaders and their constituents, between family members, and within a person's own psyche. For example, in the United States the Hmong culture is torn between their traditional norms and values and those of their new country. The Hmong culture has always placed considerable importance on family and clan, with the end goal of promoting the good of the group above the needs of the individual. Families with many children were encouraged and valued. Hmong men living in Laos thus had more than one wife to increase the amount of children, and most married young. The majority of boys wed when they were 15 to 18 years old; girls between the age of 13 and 16. Sons were particularly important in this patriarchal society, since they would continue the clan name and care for their parents in old age. It was unacceptable for an individual not to marry.

Thus, issues of different sexual orientation are very new to the Southeast Asian communities, and the Hmong culture, does not accept that these differences exist. Many adult Hmong still believe other sexual behaviors than the norm is "crazy," and a complete disrespect of the culture and traditions. Some Hmong youth and adults have thus been disowned, banned from the home, and shunned in their community. This has resulted in emotional despondency and, for many, attempting or committing suicide. Gender equality is another major problem: With the Hmong patriarchal society, the women were always subservient to the men. In the U.S., this approach conflicts with the gender equality. Many women are abused by their husbands, but have no place to go for help. These are only two examples, but all of the traditions are being questioned and there is a sense of alienation and isolation.

3. Hmong mythology tells the story of how their shamans received their healing power. Shee Yee observed the arts of dragons and learned the secrets of healing the sick. He tried to venture out and heal all humans with what he had learned, but the god of sickness and death, Ndu Nyong, stopped him in battle. Shee Yee, who lost much of his strength, cast down his shamanic tools for humans to use against the dabs, Ndu Nyong's remaining army of malevolent spirits. These shaman, then, were strong enough to overcome the dabs and have the responsibility of caring for the ill in their society. It shows how the shamans today, both the official and lay, will do whatever they can to help their own. Everyone must work together to fight off the dabs, the evil spirits, as did Shee Yee. This may or may not correspond with what is desired by the American doctors.

4. Obligations and responsibilities are of major importance to the traditional Hmong culture. They help provide structure and unite the Hmong community organization and clan identity. For instance, Hmong are expected to be hospitable and helpful to fellow clan members no matter whether or not they have ever previously known this individual. Clan leaders are very important community members. They help resolve disputes and conflicts including marital disputes. The institution of the family is paramount with the Hmong, who have an old saying, "To be with a family is to be happy. To be without a family is to be lost."

The doctor's obligation is to his work and his place of employment. It is necessary for the healthcare worker to act on behalf of the most vulnerable individual in the situation, and in this case it was the child. The child's welfare was more important than the parents' beliefs. The healthcare providers were obligated to do what was best for the child, even if the parents were against it. The Hmong were committed to listening to the shaman, who would cure their daughter,… READ MORE

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