Journey to the promised land: The health consequences of refugee status for Cambodians in San Diego
Author(s):
Pickwell, Sheila Murphy
Format:
Thesis
Degree granted:
Ph.D.
Publisher:
Ann Arbor : University of California, San Diego, 1990.
Pages:
272
Language:
English
Abstract:
Nearly one million Southeast Asian refugees have resettled in America since 1975. This heterogeneous group has been subject to a wide variety of United States resettlement policies as public attitudes toward refugees have shifted. Since World War II, America has reacted to refugee asylum by enacting only temporary legislation for perceived short-term situations. As the Vietnam war drew to a close a vastly relieved and politically divided public generously assuaged the collective guilt by providing emergency economic relief and social support services to the fleeing Vietnamese. The educated Vietnamese who constituted the "first wave" fleeing the war zone came to represent the prototypical Southeast Asian. Survey data of this population supported ideological beliefs that migrants would assimilate if they learned English and found jobs. The "second wave" refugees who began entering the country in 1978 were largely Cambodian, Laotian, and Hmong. The social differences between the two "waves" were striking. The new population of peasant farmers was illiterate, in failing health from malnutrition and disease, and psychologically impaired from the total disruption of their lives. This dissertation analyzes the health consequences of refugee status on a subset of the Cambodian population in San Diego. Qualitative data collected in interviews with 50 adults and two years of intensive participant observation forms the empirical basis of this research. Additionally, an historical analysis of the history and culture of the Cambodians demonstrates the ways their heritage influences their response to America's newly constrained resettlement policies. The Cambodians manifest their distress in illness symptomatology and the relentless pursuit of healing. In the process they have constructed an elaborate multilevel healing structure consisting of self-care techniques, indigenous healers, accommodative practitioners, and Western medical care. The clash between refugee values and America's institutionalized expectations of sick role behavior based upon individualism and self-reliance precludes healing and increasingly relegates Cambodians to a permanently dependent underclass status.