Essay type:Â | Compare and contrast |
Categories:Â | Culture Medicine Community health Social issue |
Pages: | 6 |
Wordcount: | 1626 words |
The definition is given as the study involving the comparison of the traditional medicine that is based on bioactive compounds found in both animals and plants and is practiced by several ethnic groups. This paper is an extended appeal for a way to come to an understanding and resolve the bridge between two cultures and ethnomedical systems; these are the Hmong community and the hospital that treated Lia Lee, the child from the Hmong community. For this case, I will be advocating for Lee's family and not the hospital that treated her. Before getting any further, the case needs to be understood. The case is over an intense collision between the American culture and that of Hmong culture through a case of a Hmong child, Lia Lee who apart from being too sick, is too young to speak for herself. Lia Lee's well-being is inextricably bound up in the pursuit of high standards by those surrounding her.
This paper is organized in the following ways; a description of the two ethnomedical systems; the first description is on the Hmong community, and their beliefs, and an account of Lia Lee's epilepsy condition from the community's perspective. The second account is on the hospital that treated Lia Lee. A description of Lia Lee's medical condition is given from the doctors' perspective. Afterward, the paper proposes an approach that can be used to improve health outcomes; this is with the assumption that both sides want better health outcomes. The program will be from the perspective of the side I am advocating for, Lia Lee's family. The paper then comes to an end with a conclusion paragraph.
Hmong Community Perspective
During the infancy of Lia Lee, she experienced several numbers of seizures; this prompted them to visit the accident and emergency department at Merced's county hospital, the doctors diagnosed Lia Lee with epilepsy, the doctors prescribed regular dose medicines to treat her condition (Edberg, 2013). Lia Lee's parents did not agree with the doctors; they were immigrants and their beliefs were deeply rooted in their customs; they called the disease "quag dab peg" which in English translates to the spirit catches you, and you fall down(Fadiman, 2012). The condition, according to Lee's parents was more to do with souls or rather a soul loss; this condition they believed coincided with Lia's sister slamming the door to their apartment which frightened the spirit away (Fadiman, 2012). This disease the community perceived it as a type of illness of some discrepancy; hence they were hesitant to the doctors' treatment.
This denial of treatment is understandable with the community's beliefs very different from that of the American culture. To them, the epileptic symptoms meant something very different from the biomedical understanding. Apart from taking the epilepsy condition as a soul loss, they also took the epileptic seizures as some blessing; they took it as proof that the person suffering from this condition could perceive things that other people could not or were not able to (Fadiman, 2012). That person, therefore, is seen as having some distinctive spiritual capabilities. In treating the condition, the community believed that a spiritual doctor which they called a Shaman was needed to perform a soul calling which would bring the soul back to the body (Fadiman, 2012).
The family indeed acknowledged the fact that something needed to be done and that is why they took Lee to the hospital in the first place. Nonetheless, the family and the Hmong community were deeply rooted in their misconceptions and beliefs which eventually brought misunderstanding and frustration between the two sides. The parents irregularly administered some of the prescribed medicines by the doctors but they preferred their traditional way of treating the condition; these included Shamanism, herbal remedies and animal sacrifices (Fadiman, 2012). One of the many problems that refugees are entering the United States face is a collision with the American culture and specifically the US medical system (Edberg, 2013). The family had misconceptions about the healthcare; Lee's parents' case is understandable, considering they were new to the country and did not even understand English.
Hospital's Perspective
After diagnosing Lia Lee with epilepsy, the doctors prescribed a medication for the treatment. The different opinions from her parents and the phycians led to conflicts between the healthcare providers and Lia Lee's family. The doctors maintain that much of the tension that arises between the two sides is as a result of Lee's parents failing to comply with the treatment plan set by the doctors. The family did not follow the doctors' direction, which eventually led to the child being taken from their care and placed in foster care (Edberg, 2013). In attempts to manage her symptoms, the doctors at the hospital made occasional changes to her regimen. The challenges that resulted in Lee's family failing to comply with the prescription were many; one is that numerous medications had to be taken on a particular schedule while she was in foster care (Fadiman, 2012).
The parents could not speak English, and they also did not have a better understanding of western medicine. Also, professional language translation was not present, making it hard for the physicians to communicate complex instructions to the parents (Fadiman, 2012). Nonetheless, the language was not the most defining compliance barrier; Lee's parents understood the doctors' instructions but remained non-compliant. The hospital that treated Lee saw her family as resistant; the family did not want to comply with doctors' instructions because of their beliefs.
Proposed Program
The cross-cultural conflicts like the one involving Lia Lee can be resolved by formulating a program that puts into consideration the feelings, beliefs and ways of treating diseases that both cultures are accustomed. In that case, in this section, I propose an approach that if implemented, will better the health outcomes; this is assuming that both the sides want better health outcomes. The program, I propose integrates the beliefs of these two cultures. In navigating cultural differences, it is vital that the difference between disease and illness is understood. Kleinman (1978) defines both diseases and illness as explanatory models of sickness.
Bringing Hmong Translators to the Hospital
Kleinman et al. (1978) may have unknowingly been explaining the c between the hospital that treated Lia and her family when he stated that the medications prescribed by healthcare providers may not cure an illness notwithstanding great action from the pharmacologics when the clients do not abide with the medical regimen as a result of them not understanding the doctors stated basis. From the case, there was a language barrier between the parents of the epileptic child and the hospital; this is partial to be blamed for the collision between the two sides. How patients perceive sickness plays an essential role in making them come to a decision. Hmong translators should be brought to the hospital, which will facilitate communication between the hospital and the Hmong community.
Therapies Combination
In the program, there will also be a combination of therapies from the two cultures, which can easily be used depending on the desires of the client. This type of partnership should be encouraged in hospitals and should not be used in just exceptional cases (Scott, 2016). An example of attempts being made in this direction is the creation of the field of transcultural medicine and nursing; the model stresses compromise on the client's culture without insisting that the patient fits into the hospital's own culture (Scott, 2016). In the case of the Hmong community and the American culture, the hospital should integrate the culture of the Hmong community with theirs. This integration can be done via a variety of ways; one of them is allowing Shaman visits to the hospitals. The community has a strong belief in the ability of the Shamans, allowing them will do the hospital a lot of good as it will strengthen the community's trust in mainstream medicine, they can then be allowed to perform their ceremonies at the hospital. To facilitate more Shaman hospital visits, training should be put in place.
Promoting Awareness
Another element of the program will be promoting awareness. Most of the Hmong community have misconceptions about the United States healthcare system. Some of the misconceptions are that drawing blood from the body, and other invasive medical procedures lead to good spirits escaping, therefore, causing death (Fadiman, 2012). They are also mindful of surgery; they believe that the soul could escape the body as a result of any surgical incision leading to death (Fadiman, 2012). These are some of the misconceptions that the Hmong community has, promoting education and awareness among the community members will make the community be more conceitful to the medical procedures of the american health system.
Conclusion
A minority group among the lowland Lao, the community of Hmong, has for decades struggled with keeping their identity and maintaining their culture. The Vietnam war forced some of them to move to the United States as refugees; this is the case with Lee and her family. Moving to a new culture, it is obvious one is going to struggle to adapt to the new culture. Lia Lee's family resistance to prescription is understandable. Nonetheless, a way of integrating the two cultures is needed hence in the paper; I proposed a new approach that facilitates the health outcomes for both sides.
References
Edberg, M. C. (2013). Essentials of health, culture, and diversity: Understanding people, reducing disparities. Jones & Bartlett Publishers.
Fadiman, A. (2012). The spirit catches you, and you fall down: A Hmong Child, her American doctors, and the collision of two cultures. Macmillan.
Kleinman, A., Eisenberg, L., & Good, B. (1978). Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. Annals of internal medicine, 88(2), 251-258. https://doi.org/10.7326/0003-4819-88-2-251
Scott, K. (2016). Cross-culture management: Global healthcare workers. Journal of Continuing Education Topics & Issues, 18(3), 68.
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