THE LOCKED MEDICINE CABINET: HMONG HEALTH CARE IN AMERICA (REFUGEE, INDOCHINESE)
Author(s):
Kirton, Elizabeth Stewart
Format:
Thesis
Degree granted:
Ph.D.
Publisher:
Ann Arbor : University of California, Santa Barbara, 1985.
Pages:
234
Language:
English
Abstract:
Hmong refugees, resettled in the United States following the Indochinese War, have continuing problems obtaining adequate health care. Although American health care providers controlled acute diseases in the refugee population, they fail to confront current realities in Hmong health care. Hmong patients present unique health care problems. As refugees, they arrived with particular physical and mental conditions, and they have a health care history that affects participation in the American medical system. In Laos, Hmong openly exploited all health care resources--herbal cures, shamanistic healing, and sporadic medical care. Memories of free, quick, and caring treatment led to expectations of superior care in the United States. However, experience with American medical care leaves Hmong patients critical and dissatisfied, resulting from culturally inappropriate care, lack of understanding of American medicine, and inadequate care-seeking skills. Hmong compensate by supplementing medical care with methods used in Laos. In contrast to exploitation of combined resources in Laos, however, this is not an open and clearly recognized pattern of health care: American doctors are unaware of the supplementary methods their patients use. Research methods consist of participant-observation, informal interviews, collection of community demographics, and life histories. Research included involvement as a volunteer interpreter in 90 illness episodes during routine office visits, emergencies, and births. Extensive case studies illustrate the range of available care, cost considerations, communication difficulties, Hmong opinions of medical care, care-seeking behavior, the social impact of illness, and problems specific to women. Increased services can improve refugee health care. Interpreters are essential: most effective would be the combined services of American and Hmong interpreter/liasons. Further research on traditional healing and current patterns of illness behavior would familiarize American doctors with their Hmong patients. Health care education would inform Hmong on environmental health hazards, safety hazards, and appropriate use of medication. Establishing a liaison position would enable health care providers to disseminate information. (Abstract shortened with permission of author.)