Healing Traditions: Alternative Medicine and the Health Professions

By Bonnie Blair O’Connor | Go to book overview

Chapter 3
Hmong Cultural Values, Biomedicine,
and Chronic Liver Disease

In the past decade, scholars of many disciplines concerned with health care in complex societies have paid increasing attention to the importance of matters of culture and worldview in health care delivery. The education and training of health professionals in the United States, however, does not yet incorporate much of this information or routinely teach the skills for evaluating and responding to significant differences in worldview between patients and providers. As a result, many providers remain unaware of the extent to which such differences can affect clinical interaction and outcomes, and are badly hampered in cross-cultural encounters. The case history recounted in this chapter illustrates the possible extent of the complexities of this meeting of very different views of health and illness. It highlights the great variety of values, beliefs, and cultural considerations—not merely those directly related to health and illness—which may have bearing on both patients’ and providers’ responses to illness and to care. Mr. L., the patient in the case, is a young Hmong refugee who was resettled in Philadelphia in 1979.


Historical Background

The Hmong are an ethnically distinct southeast Asian group whose origins are generally traced to central China, during the second millennium, B.C. (Chindarsi 1976; Geddes 1976).1 In the middle of the eighteenth century large numbers of Hmong were forced out of China and began a decades-long peregrination that resettled the majority in Laos and Vietnam by the early to mid-nineteenth century, with smaller numbers migrating into northern Thailand. In these adoptive homelands the Hmong were mountain dwellers, as they had been for centuries in China, inhabiting the forested ridges at altitudes several thou

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